Clinical Characteristics of Patients With Abnormal Ocular/Cervical Vestibular Evoked Myogenic Potentials in the Presence of Normal Caloric Responses
Clinical Characteristics of Patients With Abnormal Ocular/Cervical Vestibular Evoked Myogenic Potentials in the Presence of Normal Caloric Responses
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DOI：
10.1177/0003489414564997
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发表时间：
2015-06-01
影响因子：
1.4
通讯作者：
Yamasoba, Tatsuya
中科院分区：
文献类型：
--
作者：
Iwasaki, Shinichi;Fujimoto, Chisato;Yamasoba, Tatsuya
目的：探讨热量反应正常的眼前庭诱发肌源性电位(OVEMP)和/或颈部VEMP异常患者的临床特征和前庭症状。研究设计：回顾图表。设置：第三转诊中心。方法：连续1,521例接受热量、cVEMP和oVEMP检查的平衡障碍患者，选择热量反应正常但oVEMPs和/或cVEMPs异常的患者。结果：在1521例患者中，227例(15%)oVEMP和/或cVEMP反应异常，冷热反应正常。良性阵发性位置性眩晕(BBPV)、梅尼埃病和前庭偏头痛是这些患者的常见诊断。81名患者(36%)无法被诊断为可识别的疾病。结论：BPPV、梅尼埃病和前庭偏头痛是最常见的前庭症状。结论：BPPV、梅尼埃病和前庭偏头痛是最常见的诊断，表现为oVEMP和/或cVEMP异常而无神经管麻痹。除了这些临床实体外，部分有多次眩晕发作的未确诊患者可能患有仅涉及耳石器官的疾病。
Objective: To investigate the clinical features and vestibular symptoms of patients with abnormal ocular vestibular evoked myogenic potentials (oVEMPs) and/or cervical VEMPs (cVEMPs) in the presence of normal caloric responses.Study Design: Retrospective chart review.Setting: Tertiary referral center.Methods: One thousand five hundred twenty-one consecutive patients with balance problems who underwent the caloric, cVEMP, and oVEMP tests were included, and patients who showed abnormal oVEMPs and/or cVEMPs in the presence of normal caloric responses were selected. Clinical characteristics, diagnoses, and vestibular symptoms of the patients were analyzed.Results: Of the 1521 patients, 227 (15%) were found to have abnormal oVEMPs and/or cVEMP responses with normal caloric responses. Benign paroxysmal positional vertigo (BBPV), Meniere's disease, and vestibular migraine were the common diagnoses of these patients. Eighty-one patients (36%) could not be diagnosed with a recognizable disease. Multiple episodes of spinning vertigo with a duration of seconds to hours were their most common vestibular symptoms.Conclusion: BPPV, Meniere's disease, and vestibular migraine are the most frequent diagnoses showing abnormal oVEMP and/or cVEMPs without canal paresis. Apart from these clinical entities, a portion of undiagnosed patients with multiple episodes of vertigo might have a disease that involves the otolith organs only.