Detection of utricular dysfunction using ocular vestibular evoked myogenic potential in patients with benign paroxysmal positional vertigo
Detection of utricular dysfunction using ocular vestibular evoked myogenic potential in patients with benign paroxysmal positional vertigo
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DOI：
10.1016/j.neulet.2013.06.041
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发表时间：
2013-08-29
影响因子：
2.5
通讯作者：
Sakagami, Masafumi
中科院分区：
文献类型：
--
作者：
Seo, Toru;Saka, Naoki;Sakagami, Masafumi
背景：眼前庭诱发肌源性电位(OVEMP)被认为起源于对侧椭圆器。然而，oVEMP的临床应用尚未确定。本研究旨在探讨oVEMP能否用于检测良性阵发性位置性眩晕(BPPV)患者的椭圆形功能障碍。材料与方法：对16例BPPV患者进行oVEMP检测。分别在两个不同的情况下进行记录：典型眼球震颤确诊时(治疗前oVEMP)和实施Epley‘s动作后1周(治疗后oVEMP)。结果以N1-p1波峰峰值不对称比(AR)来评价，当AR为31.6%时定义为oVEMP降低，当AR为0.05时定义为oVEMP增大(Fisher‘s精确检验)。4例持续性失稳患者中有3例(75.0%)治疗后oVEMP出现异常(反应减退)。OVEMP的减少被认为是由于椭圆形毛细胞的部分退化所致。相反，受影响的耳朵中增强的oVEMP被认为是由于椭圆体内耳锥脱离导致的立毛过度活动所致。上述椭圆体功能障碍应独立于半规管内有无耳锥存在，因此oVEMP的结果与症状的恢复无关。结论：oVEMP可可靠地检测BPPV患者的椭圆体病变。(C)2013爱思唯尔爱尔兰有限公司。保留所有权利。
Background: The ocular vestibular evoked myogenic potential (oVEMP) is thought to originate from the contralateral utricular organ. However, the clinical use of oVEMP has not yet been established. This study aimed to clarify whether oVEMP could be used to detect utricular dysfunction in patients with benign paroxysmal positional vertigo (BPPV).Materials and methods: Sixteen patients with BPPV underwent oVEMP measurements. Recordings were made on 2 separate occasions: when typical nystagmus was confirmed (pretreatment oVEMP) and 1 week after performing Epley's maneuver (posttreatment oVEMP). Results were evaluated using the asymmetry ratio (AR) of n1-p1 wave peak-to-peak amplitude and defined as reduced oVEMP when AR was >31.6%, or augmented oVEMP when AR was 0.05, Fisher's exact test). Three out of 4 patients (75.0%) with continuing unsteadiness had abnormal results (reduced response) on the posttreatment oVEMP.Discussion: The oVEMP measurements indicated abnormal function of the utricle in patients with BPPV. Reduced oVEMP is thought to originate from the partial degeneration of utricular hair cells. Conversely, augmented oVEMP in the affected ear is thought to originate from a hypermobility of the stereocilia due to the detachment of otoconia within the utricle. The above-mentioned utricular dysfunction should be independent of the existence of otoconia in the semicircular canal; thus, the results of oVEMP were not related to the recovery of symptoms.Conclusion: oVEMP can be reliably used to detect utricular lesions in patients with BPPV. (C) 2013 Elsevier Ireland Ltd. All rights reserved.