Differential diagnosis of vertigo--combined galvanic test and MRI.
Differential diagnosis of vertigo--combined galvanic test and MRI.
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眩晕的鉴别诊断——联合电流试验和MRI。
DOI：
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发表时间：
1988
期刊：
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通讯作者：
T. Sekitani
中科院分区：
文献类型：
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作者：
T. Sekitani
眩晕疾病实体的鉴别诊断在临床研究中很重要。已经针对可用的诊断测试提出了许多概念和程序。最近的基础和临床研究证明了电试验的有效性和可靠性，包括电眼震试验（GNT）和电体摇摆试验（GBST），强调电镀锌的影响是：1）对前庭神经动作电位的影响；2）对前庭神经静息放电的影响。这些进一步表明，电眼震反应（GNT）主要是半规管系统的表现反应，而电体晃动如脊髓反射（包括GBST）主要是耳石系统的反应。本文的目的是对本实验室以往GBST的研究成果进行简要回顾；并引入新设计的组合电流测试，同时记录 GBST 和 GNT；并介绍了大脑的磁共振成像（MRI），包括大脑、小脑和与中枢前庭系统相关的脑干，这两者都有助于我们对中枢性眩晕做出更明确的诊断。在正常受试者的 CGT 上，不断诱发电眼运动，显示双眼的初始眼偏差和电镀锌过程中的后续主偏差，这几乎相似且同步发生。正如之前的论文中所述，单个组件也能很好地引起电体摇摆。眩晕病例的 CGT 显示每种疾病的异常反应模式。
Differential diagnosis of the disease entities of vertigo are important in clinical investigations. Many concepts and procedures have been proposed for available diagnostic tests. Recent basic and clinical studies proved the efficacy and reliability of galvanic tests, including galvanic nystagmus test (GNT) and galvanic body sway test (GBST), emphasizing that the effects of galvanization are: 1) on the action potential in vestibular nerve and 2) on the resting discharge of the vestibular nerve. These suggest further that galvanic nystagmus reaction (GNT) is mainly a manifested reaction of the semicircular canal system, while galvanic body sway such as spinal reflexes (includ. GBST) are mainly a reaction of the otolithic system. The purpose of this paper is to review briefly the previous results of GBST in our laboratory; and to introduce a newly devised combined galvanic test, simultaneous recording of both GBST and GNT; and also introduce magnetic resonance imaging (MRI) of the brain including the cerebrum, cerebellum with brainstem relating the central vestibular system, both of which help us to make a more defined diagnosis of the central origin vertigo. On CGT of a normal subject, galvanic eye movements are constantly induced showing the initial eye deviation and the following main deviation during galvanization, on both eyes, which are almost similar and occur synchronously. Galvanic body sway is also induced well with individual components, as described in the previous papers. CGT of the cases with vertigo revealed abnormal response patterns in each disease.