[Skull vibratory test in partial vestibular lesions--influence of the stimulus frequency on the nystagmus direction].
[Skull vibratory test in partial vestibular lesions--influence of the stimulus frequency on the nystagmus direction].
复制标题
部分前庭病变的颅骨振动试验——刺激频率对眼球震颤方向的影响
DOI：
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发表时间：
2005
期刊：
影响因子：
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通讯作者：
S. Schmerber
中科院分区：
文献类型：
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作者：
G. Dumas;P. Perrin;N. Morel;D. N'Guyen;S. Schmerber
引言
部分单侧前庭周围性病变(PUVL)的颅骨振动试验(SVT)结果与完全前庭病变(TUVL)的结果不同。
目标
目的：揭示颅骨振动性眼震(SVN)水平分量分析结果与病变侧之间的相关性，并将这些结果与刺激频率相关联。目的：找出SVN水平和垂直分量与前庭病变的地形图之间的预测相关性。目的了解庆大霉素迷路切除术引起的前庭去传入程度(扩大到高频)及其对梅尼埃病的疗效。
患者和方法
入选53例SVN和PUVL患者，并与10例TUVL和10例正常人进行比较。方案包括HST(2赫兹)、30、60和100赫兹的SVT和一次冷热试验。使用2D和3D VNG设备进行记录。
结果
PUVL组30、60和100赫兹SVN的出现率分别为80%、90%和90%。在65%、63%、80%的病例中，SVN与病变侧30、60、100赫兹的频率相关。在20%的梅尼埃病、8%的前庭神经炎和6%的前庭神经鞘瘤中，SVN与病变的一侧无关。在PUVL中，69%的病例HSN与病变一侧相关。当眼球震颤同时出现时，HSN和SVN的方向有23%的不同。在PUVL中，SVN在100赫兹和30赫兹同时存在时，有16%的病例SVN方向不同。庆大霉素迷路切除后，冷热试验、HSN和SVN(屈曲性和病理性眼球震颤向安全侧搏动)结果的一致性与治疗效果相关。10%的PUVL患者存在SVN垂直成分(主要位于前管裂开，少数为部分迷路炎)。PUVL患者的水平SVN SPV明显慢于TUVL患者(p=0.0004)。
结论
SVT是一种前庭全局性快速测试，探索高频。在PUVL中，SVN的方向并不总是预示病变的一侧，有时取决于刺激频率、前庭病变的状态、相关的前庭结构(1/2环形管或耳石器)和病变所涉及的感觉细胞的类型。在TUVL中，SVN的方向总是与病变的一侧一致(这对预测庆大霉素迷路切除术的效率很有用)。SVN垂直成分可指PUVL中垂直管的病变。
INTRODUCTION
Results of the skull vibratory test (SVT) in partial unilateral vestibular peripheral lesions (PUVL) are different from the results in total vestibular lesions (TUVL).
AIM
To reveal a correlation between the results of the analysis of the skull vibratory nystagmus (SVN) horizontal component and the side of the lesion; to correlate these results with the stimulus frequency. To find out a predictive correlation between the SVN horizontal and vertical components and the topography of a vestibular lesion. To appreciate the degree of vestibular deafferentation (extended to high frequencies) provoked by gentamicin labyrinthectomy and its efficiency in Meniere's disease.
PATIENTS AND METHODS
53 patients with a SVN and a PUVL were included and compared with 10 TUVL and 10 normal subjects. Protocol included a HST (2 Hz), a SVT at 30, 60 and 100 Hz and a caloric test. Recordings were performed with a 2D and 3D VNG device.
RESULTS
In PUVL, SVN at 30, 60 and 100 Hz was obtained in 80, 90 and 90% of cases respectively. SVN is correlated with the side of the lesion at 30, 60 and 100 Hz respectively in 65%, 63%, 80% of cases. SVN is not correlated with the side of the lesion in 20% of Meniere's disease, in 8% of vestibular neuritis and in 6% of vestibular schwannoma. In PUVL HSN is correlated with the side of the lesion in 69% of cases. The direction of the HSN and of the SVN was different in 23% when the nystagmus attended at the same time for both tests. In PUVL the direction of the SVN is different at 100 Hz and 30 Hz in 16% of cases when they are concomittant on the same patient. After Gentamicine labyrinthectomy, the coherence of the results in caloric test, HSN and SVN (areflexy and lesional nystagmus beating toward the safe side) was correlated with the efficiency of the therapy. A SVN vertical component was met in 10% of PUVL (essentially in anterior canal dehiscence and few cases of partial labyrinthitis). The horizontal SVN SPV is significantly slower in PUVL than in TUVL patients (p=0.0004).
CONCLUSIONS
The SVT is a vestibular global and rapid test which explores high frequencies. In PUVL the direction of SVN is not always predictive of the side of the lesion and is sometimes depending on the stimulus frequency, the state of the vestibular lesion, the vestibular structure concerned (1/2 circular canals or otolithic organs) and the kind of sensory cells implicated in the lesion. In TUVL The direction of the SVN is always coherent with the side of the lesion (this is useful to predict the efficiency of a Gentamicine Labyrinthectomy). A SVN vertical component can mean a lesion of the vertical canal in PUVL.