[前庭功能检查在急性前庭神经炎患者损伤部位分析中的应用]
[Application of vestibular function examination in the analysis of damaged site in patients with acute vestibular neuritis].
作者信息
He Feng, Han Junliang, Bai Ya, Wang Yuanyuan, Wei Dong, Shi Ying, An Xingyue, Fu Wei
机构信息
Department of Neurology，Xijing Hospital，Fourth Military Medical University，Xi'an，710032，China.
Department of Geriatrics，Xijing Hospital，Fourth Military Medical University.
出版信息
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2023 Apr;37(4):263-267. doi: 10.13201/j.issn.2096-7993.2023.04.005.
To analyze the site of vestibular nerve damaged in patients with acute vestibular neuritis. Fifty-seven patients with acute vestibular neuritis were recruited, and each patient underwent caloric irrigation test, video head impulse test（vHIT） and vestibular evoked myogenic potentials（VEMPs）. The results were further analyzed. Analysis of abnormal rates of different vestibular function tests: the abnormal rate of caloric irrigation test, horizontal semicircular canal vHIT, anterior semicircular canal vHIT, and posterior semicircular canal vHIT were 92.98%, 92.98%, 92.98%, and 52.63%, respectively. The abnormal rate of cervical vestibular evoked myogenic potentials（cVEMP） and ocular vestibular evoked myogenic potentials（oVEMP） were 52.63% and 89.47%. The abnormal rate of caloric irrigation test, horizontal semicircular canal vHIT, anterior semicircular canal vHIT, and oVEMP were significantly higher than posterior semicircular canal vHIT and cVEMP（<0.01）. Combination analysis of different vestibular function tests: there are twenty-six patients（45.61%, superior and inferior vestibular nerve） with abnormal caloric irrigation test, video head impulse test, and VEMPs. There are twenty-five patients（43.86%, superior vestibular nerve） with abnormal caloric irrigation test, horizontal semicircular canal vHIT, anterior semicircular canal vHIT, and oVEMP. There are 4 patients（7.02%, inferior vestibular nerve） with abnormal posterior semicircular canal vHIT and cVEMP. There are two patients（3.51%, ampullary vestibular nerve） with abnormal caloric irrigation test, horizontal semicircular canal vHIT, and anterior semicircular canal vHIT. The rate of superior and inferior vestibular neuritis and superior vestibular neuritis were significantly higher than inferior vestibular neuritis and ampullary vestibular neuritis（<0.01）. Acute vestibular neuritis subtypes can be divided into four categories: superior and inferior vestibular neuritis, superior vestibular neuritis, inferior vestibular neuritis, and ampullary vestibular neuritis. Video head impulse test can accurately assess the site of vestibular nerve damage in patients with acute vestibular neuritis. In addition, vHIT combined with VEMPs can provide objective evidence for the diagnosis of ampullary vestibular neuritis.
分析急性前庭神经炎患者前庭神经损伤的部位。招募了57例急性前庭神经炎患者，每位患者均接受冷热试验、视频头脉冲试验（vHIT）和前庭诱发肌源性电位（VEMPs）检查，并对结果进行进一步分析。不同前庭功能检查异常率分析：冷热试验、水平半规管vHIT、前半规管vHIT和后半规管vHIT的异常率分别为92.98%、92.98%、92.98%和52.63%。颈前庭诱发肌源性电位（cVEMP）和眼前庭诱发肌源性电位（oVEMP）的异常率分别为52.63%和89.47%。冷热试验、水平半规管vHIT、前半规管vHIT和oVEMP的异常率显著高于后半规管vHIT和cVEMP（P<0.01）。不同前庭功能检查联合分析：冷热试验、视频头脉冲试验和VEMPs均异常的患者有26例（45.61%，上、下前庭神经）。冷热试验、水平半规管vHIT、前半规管vHIT和oVEMP均异常的患者有25例（43.86%，上前庭神经）。后半规管vHIT和cVEMP异常的患者有4例（7.02%，下前庭神经）。冷热试验、水平半规管vHIT和前半规管vHIT异常的患者有2例（3.51%，壶腹前庭神经）。上、下前庭神经炎和上前庭神经炎的发生率显著高于下前庭神经炎和壶腹前庭神经炎（P<0.01）。急性前庭神经炎亚型可分为四类：上、下前庭神经炎、上前庭神经炎、下前庭神经炎和壶腹前庭神经炎。视频头脉冲试验可准确评估急性前庭神经炎患者前庭神经损伤的部位。此外，vHIT联合VEMPs可为壶腹前庭神经炎的诊断提供客观依据。
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