Sun Xiayu, Gao Dekun, Shen Jiali, Zhu Qi, Wang Lu, Ma Xiaobao, Wang Wei, Chen Xiangping, Zhang Qing, Jin Yulian, Chen Jianyong, Yang Jun
Department of Otorhinolaryngology-Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
Shanghai Jiaotong University School of Medicine Ear Institute, Shanghai, China.
Front Neurol. 2022 Oct 10;13:997205. doi: 10.3389/fneur.2022.997205. eCollection 2022.
This study aims to investigate the potential vestibular pathway impairment through vestibular evoked myogenic potentials (VEMPs) and to explore the pathophysiological significance of these instrument-based findings in children with recurrent vertigo.
The clinical data of 21 children (mean age 4.67 ± 1.39 years) diagnosed as RVC who met the inclusion criteria of the Bárány Society and 29 healthy children (mean age 4.83 ± 1.34 years) enrolled as the control group from February 2021 to December 2021 were collected and analyzed retrospectively. All the subjects underwent both cervical VEMP (cVEMP) and ocular VEMP (oVEMP) triggered by air-conducted sound (ACS) and galvanic vestibular stimulation (GVS), respectively. The elicit rate, latency, and amplitude asymmetry ratio (AAR) of ACS-cVEMP, ACS-oVEMP, GVS-cVEMP, and GVS-oVEMP were analyzed.
(1) The elicit rates of ACS-cVEMP and ACS-oVEMP were similar in the two groups ( > 0.05), as well as GVS-cVEMP and GVS-oVEMP ( > 0.05). (2) P1 and N1 latencies of ACS-cVEMP and GVS-cVEMP in the RVC group were longer than those in the control group ( < 0.05). (3) The N1 latency of ACS-oVEMP in the RVC group was shorter than that in the control group ( < 0.05), while there was no significant difference in the P1 latency of ACS-oVEMP ( > 0.05). The N1 and P1 latencies of GVS-oVEMP were not significantly different ( > 0.05). (4) There was no statistical difference in the AAR of ACS-cVEMP and GVS-cVEMP. Although there was an increased AAR of ACS-oVEMP in the RVC group ( < 0.05), the AAR was within the normal range. However, no statistical difference was found in the AAR of GVS-oVEMP in the two groups ( > 0.05).
The latencies of ACS-cVEMP and GVS-cVEMP in children with recurrent vertigo were significantly prolonged compared with those in healthy children, and there was no difference in elicit rates of ACS-cVEMP and GVS-cVEMP, suggesting that there might be potential impairment in the inferior vestibular nerve and the subsequent nerve conduction pathway in RVC.
本研究旨在通过前庭诱发肌源性电位(VEMPs)探讨复发性眩晕儿童潜在的前庭通路损害,并探究这些基于仪器检查结果的病理生理意义。
回顾性收集并分析2021年2月至2021年12月期间21例符合巴拉尼协会纳入标准、诊断为复发性眩晕(RVC)的儿童(平均年龄4.67±1.39岁)及29例作为对照组的健康儿童(平均年龄4.83±1.34岁)的临床资料。所有受试者分别接受气导声(ACS)诱发的颈肌前庭诱发肌源性电位(cVEMP)和眼肌前庭诱发肌源性电位(oVEMP)以及直流电前庭刺激(GVS)诱发的cVEMP和oVEMP。分析ACS-cVEMP、ACS-oVEMP、GVS-cVEMP和GVS-oVEMP的引出率、潜伏期及幅度不对称率(AAR)。
(1)两组中ACS-cVEMP和ACS-oVEMP的引出率相似(>0.05),GVS-cVEMP和GVS-oVEMP的引出率也相似(>0.05)。(2)RVC组中ACS-cVEMP和GVS-cVEMP的P1和N1潜伏期长于对照组(<0.05)。(3)RVC组中ACS-oVEMP的N1潜伏期短于对照组(<0.05),而ACS-oVEMP的P1潜伏期无显著差异(>0.05)。GVS-oVEMP的N1和P1潜伏期无显著差异(>0.05)。(4)ACS-cVEMP和GVS-cVEMP的AAR无统计学差异。虽然RVC组中ACS-oVEMP的AAR增加(<0.05),但AAR仍在正常范围内。然而,两组中GVS-oVEMP的AAR无统计学差异(>0.05)。
与健康儿童相比,复发性眩晕儿童的ACS-cVEMP和GVS-cVEMP潜伏期显著延长,且ACS-cVEMP和GVS-cVEMP的引出率无差异,提示RVC患儿可能存在前庭下神经及其后续神经传导通路的潜在损害。