Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Department of Health and Nutrition, Faculty of Health and Sciences, Nagoya Women's University, Nagoya, Japan.
Nagoya J Med Sci. 2023 May;85(2):375-379. doi: 10.18999/nagjms.85.2.375.
The potential mechanism of augmented response on cervical vestibular evoked myogenic potential (cVEMP) testing and its decrease following treatment in a patient with Meniere's disease (MD) are discussed. Changes of static posturography and cVEMP testing before and after a glycerol drip in a 69-year-old man with unilateral MD, in which significant endolymphatic hydrops (EH) was confirmed on magnetic resonance imaging (MRI) on the diseased side, were evaluated. Values of total locus lengths, areas of postural sway, and their Romberg ratios were decreased after the glycerol drip. On cVEMP testing, the diseased ear demonstrated a 375% larger amplitude than the contralateral ear before treatment, but both ears showed almost the same responses after treatment. An augmented response on cVEMP testing and a decrease following treatment for MD reflect the diversity of clinical findings in MD. Responses on cVEMP testing may relate not only to the degree of EH, but also be due to abnormal acoustic energy absorbance transmitted into the saccule.
讨论了梅尼埃病（MD）患者颈部前庭诱发肌源性电位（cVEMP）测试中增强反应的潜在机制及其治疗后的降低情况。评估了一名 69 岁单侧 MD 男性患者在甘油滴注前后静态姿势描记术和 cVEMP 测试的变化，该患者在患病侧的磁共振成像（MRI）上证实有明显的内淋巴积水（EH）。甘油滴注后，总轨迹长度、姿势摆动面积及其 Romberg 比值均降低。在 cVEMP 测试中，患病耳在治疗前的振幅比对侧耳大 375%，但治疗后双耳的反应几乎相同。cVEMP 测试中的增强反应及其 MD 治疗后的降低反映了 MD 临床表现的多样性。cVEMP 测试的反应不仅与 EH 的程度有关，还可能与传入囊的异常声能吸收有关。
