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评估颈源性前庭肌源性诱发电位和耳蜗电图在前庭性偏头痛诊断中的应用。

Evaluation of cervical vestibular miogenic evoked potential and electrococleography in the diagnosis of vestibular migraine.

机构信息

Universidade de Fortaleza (UNIFOR), Fortaleza, CE, Brazil; Hospital Universitário Walter Cantídio, Fortaleza, CE, Brazil.

Faculdade de Medicina da Universidade Federal do Ceará (UFC), Fortaleza, Ceará, Brazil; Departamento de Otorrinolaringologia, Hospital Universitário Walter Cantídio, Fortaleza, CE, Brazil.

出版信息

Braz J Otorhinolaryngol. 2024 Nov-Dec;90(6):101489. doi: 10.1016/j.bjorl.2024.101489. Epub 2024 Sep 3.

Abstract

OBJECTIVES

Vestibular migraine is a neurological disorder characterized by the association of vertigo and headache, affecting up to 1% of the population. Among its differential diagnoses is endolymphatic hydrops. The aim of this study was to investigate the role of cervical vestibular-evoked myogenic potential and electrocochleography in the diagnosis of vestibular migraine.

METHOD

Thirteen women with clinical diagnosis of vestibular migraine (mean age 44 years) and 13 healthy volunteers without auditory and/or vestibular complaints matched for sex and age were evaluated by performing hydrops examinations of cervical vestibular-evoked myogenic potential and electrocochleography.

RESULTS

The presence of vertigo and headache was reported by all members of the group with vestibular migraine, associated with symptoms such as nausea, photophobia, and phonophobia. Tinnitus was the most frequent auditory complaint. A significant increase in P1 and N1 latencies was observed in the test group. There was no significant difference in the occurrence of asymmetry and decreased amplitude of the cervical vestibular-evoked myogenic potential. Electrocochleography showed an increase in amplitude of the summation potential. The altered SP/AP ratio was double in the group with vestibular migration, without statistical significance.

CONCLUSIONS

Changes in latency increase of cervical vestibular-evoked myogenic potential suggests a central lesion. Patients with vestibular migraine may present electrocochleography compatible with endolymphatic hydrops.

LEVEL OF EVIDENCE

Level 4.

摘要

目的

前庭性偏头痛是一种以眩晕和头痛为特征的神经系统疾病,影响人群可达 1%。其鉴别诊断包括内淋巴积水。本研究旨在探讨颈性前庭诱发肌源性电位和电耳蜗图在诊断前庭性偏头痛中的作用。

方法

对 13 名经临床诊断为前庭性偏头痛的女性(平均年龄 44 岁)和 13 名性别和年龄匹配、无听觉和/或前庭主诉的健康志愿者进行颈性前庭诱发肌源性电位和电耳蜗图的积水检查。

结果

所有前庭性偏头痛组患者均报告有眩晕和头痛,伴有恶心、畏光和恐声等症状。耳鸣是最常见的听觉主诉。试验组 P1 和 N1 潜伏期显著延长。颈性前庭诱发肌源性电位的不对称性和振幅降低无显著差异。电耳蜗图显示总和电位幅度增加。前庭性偏头痛组的 SP/AP 比值增加了一倍,但无统计学意义。

结论

颈性前庭诱发肌源性电位潜伏期的变化提示中枢病变。前庭性偏头痛患者可能表现出与内淋巴积水相符的电耳蜗图改变。

证据水平

4 级。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6ee0/11417573/f757baeaf3f2/gr1.jpg

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