Presbyvestibulopathy: Diagnostic criteria Consensus document of the classification committee of the Bárány Society.
Presbyvestibulopathy: Diagnostic criteria Consensus document of the classification committee of the Bárány Society.
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DOI：
10.3233/ves-190672
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发表时间：
2019
期刊：
影响因子：
--
通讯作者：
Strupp M
中科院分区：
文献类型：
--
作者：
Agrawal Y;Van de Berg R;Wuyts F;Walther L;Magnusson M;Oh E;Sharpe M;Strupp M
本文介绍了Bárány学会分类委员会对老年性前庭病变（PVP）的诊断标准。PVP被定义为一种慢性前庭综合征，其特征是不稳定、步态障碍和/或伴有轻度双侧前庭功能障碍的反复跌倒，实验室检查结果介于正常值和双侧前庭病变的阈值之间。PVP的诊断是基于患者病史、床边检查和实验室评价。PVP的诊断需要双侧前庭-眼反射（VOR）功能降低。这可以通过视频hit （vHIT）对VOR的高频范围进行诊断；用于中频范围用转椅测试；对于低频范围的热量测试。对于PVP的诊断，两侧水平角VOR增益应< 0.8,>.6，和/或每侧温水和冷水刺激慢相热致眼球震颤的最大峰值速度之和应< 25°/s和> 6°/s，和/或旋转椅正弦刺激水平角VOR增益应< > 0.1和< 0.3。PVP通常与其他与年龄相关的视力、本体感觉和/或皮质、小脑和锥体外系功能缺陷一起发生，这些缺陷也有助于甚至可能是不稳定、步态障碍和跌倒等症状的表现。这些标准仅仅考虑这些症状的存在，以及在老年人中记录的前庭功能损害。
This paper describes the diagnostic criteria for presbyvestibulopathy (PVP) by the Classification Committee of the Bárány Society. PVP is defined as a chronic vestibular syndrome characterized by unsteadiness, gait disturbance, and/or recurrent falls in the presence of mild bilateral vestibular deficits, with findings on laboratory tests that are between normal values and thresholds established for bilateral vestibulopathy. The diagnosis of PVP is based on the patient history, bedside examination and laboratory evaluation. The diagnosis of PVP requires bilaterally reduced function of the vestibulo-ocular reflex (VOR). This can be diagnosed for the high frequency range of the VOR with the video-HIT (vHIT); for the middle frequency range with rotary chair testing; and for the low frequency range with caloric testing. For the diagnosis of PVP, the horizontal angular VOR gain on both sides should be < 0.8 and > 0.6, and/or the sum of the maximal peak velocities of the slow phase caloric-induced nystagmus for stimulation with warm and cold water on each side should be < 25°/s and > 6°/s, and/or the horizontal angular VOR gain should be > 0.1 and < 0.3 upon sinusoidal stimulation on a rotatory chair. PVP typically occurs along with other age-related deficits of vision, proprioception, and/or cortical, cerebellar and extrapyramidal function which also contribute and might even be required for the manifestation of the symptoms of unsteadiness, gait disturbance, and falls. These criteria simply consider the presence of these symptoms, along with documented impairment of vestibular function, in older adults.