Towards Providing an Automated Approach to Differentiating the Nystagmus of Ménière's Disease, Vestibular Migraine, and Benign Paroxysmal Positional Vertigo
Towards Providing an Automated Approach to Differentiating the Nystagmus of Ménière's Disease, Vestibular Migraine, and Benign Paroxysmal Positional Vertigo
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致力于提供一种自动化方法来区分梅尼埃病、前庭性偏头痛和良性阵发性位置性眩晕的眼球震颤
DOI：
10.1097/mao.0000000000003083
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发表时间：
2021
影响因子：
2.1
通讯作者：
Stephen J. Cox
中科院分区：
文献类型：
--
作者：
J. Phillips;Jacob L. Newman;Stephen J. Cox
目的：眩晕的诊断具有挑战性，尤其是患者通常无症状时出现眩晕。我们已经开发了一种可移动的医疗设备，允许前庭遥测记录30天内的眼睛运动，以帮助诊断眩晕。我们开展了概念验证工作，以确定眼球震颤的独特特性，这些特性可用于区分导致眩晕的三种最常见原因：梅尼埃病、前庭偏头痛和良性阵发性位置性眩晕。患者：我们分析了诊断为梅尼埃病、前庭偏头痛和良性阵发性位置性眩晕的患者的眼球震颤。干预(S)：我们的前庭遥测系统包括一个可穿戴的可移动监测器，它可以连续记录眼球的水平和垂直运动，以及头部的三轴运动。主要观察指标(S)：水平和垂直眼动数据，三轴头位数据。结果：16名参与者参加了这项研究，其中3人报告在他们30天的试验中经历了旋转性眩晕，证实了他们的眼球运动轨迹中存在眼球震颤。前庭遥测显示，在急性梅尼埃病发作期间出现的眼球震颤与前庭偏头痛和良性阵发性位置性眩晕发作之间存在明显差异。发作频率、眼震持续时间、眼球震颤发作是否由运动引起、眼球震颤方向、慢相速度和慢相持续时间被发现是可以用来进行自动诊断的区别性特征。结论：前庭遥测提供的数据可用于区分不同内耳引起头晕的原因。
Objective: The diagnosis of vertigo is challenging, particularly as patients usually present while asymptomatic. We have developed an ambulatory medical device that allows vestibular telemetry to record eye movements over a 30-day period to aid the diagnosis of vertigo. We have undertaken proof-of-concept work to identify unique properties of nystagmus that could be used to differentiate between three of the most common causes of vertigo: Ménière's disease, vestibular migraine, and Benign Paroxysmal Positional Vertigo. Patients: We analyze the nystagmus from patients with a diagnosis of Ménière's disease, vestibular migraine, and Benign Paroxysmal Positional Vertigo. Intervention(s): Our vestibular telemetry system includes a wearable, ambulatory monitor which continuously records horizontal and vertical eye-movements, as well as three-axis movements of the head. Main Outcome Measure(s): Horizontal and vertical eye-movement data, and three-axis head positioning data. Results: Sixteen participants were enrolled onto the study and three reported experiencing rotatory vertigo during their 30-day trial, confirmed by the presence of nystagmus in their eye-movement traces. Vestibular telemetry revealed distinct differences between the nystagmus produced during an acute Ménière's attack, and attacks of vestibular migraine and Benign Paroxysmal Positional Vertigo. Attack frequency, nystagmus duration, whether the nystagmus onset was motion provoked, nystagmus direction, slow phase velocity, and slow phase duration were found to be discriminatory features that could be exploited to allow an automated diagnosis to be made. Conclusions: The data provided by vestibular telemetry can be used to differentiate between different inner-ear causes of dizziness.