摘要
目的通过实验室检查来评估前庭性偏头痛(vestibular migrain,VM)患者的前庭功能,探寻该疾病的前庭功能特点。方法对37例确诊为前庭性偏头痛的患者及30例健康志愿者分别行冷热试验(caloric test)、摇头试验(head-shaking nystagmus,HNS)、速度阶梯试验及颈肌性前庭诱发电位(cervical Vestibular-Evoked Myogenic Potentials,cVEMP)检查,对两组冷热试验、摇头试验及速度阶梯试验的异常结果进行分析,对100dB的短音刺激情况下cVEMP不对称性进行分析。结果前庭性偏头痛患者水平半规管功能的异常率显著高于对照组,差异有统计学意义(P<0.05)。37例VM患者中,有11例(29.7%)出现冷热试验异常,14例(37.8%)出现摇头试验异常,7例(18.9%)出现速度阶梯试验异常。30例健康志愿者中,有2例(6.7%)出现冷热试验异常,1例(3.3%)出现摇头试验异常,无患者出现速度阶梯试验异常。总体而言,28例(76%)VM患者至少在一个水平半规管功能试验中出现异常,异常率最高的是摇头试验,其次是冷热试验和速度阶梯试验。前庭性偏头痛患者的cVEMP异常率(21.6%)要显著高于对照组(3.3%),差异有统计学意义(P<0.05)。结论 76%的前庭性偏头痛患者被发现存在前庭功能异常,在冷热试验的基础上加用摇头试验和旋转试验,可以提高VM患者前庭功能异常的检出率。前庭性偏头痛患者显示的cVEMP结果,反映了球囊功能的异常及VM患者在球囊-颈反射通路上有所损害。前庭性偏头痛患者存在不同程度的前庭功能异常。
Objective To evaluate vestibular function in patients with vestibular migraine by laboratory tests. Meth-ods Thirty-seven patients with vestibular migraine （VM） and 31 healthy volunteers completed caloric test, HNS, rotational test and VEMP, and the results were compared between the two groups. The asymmetry of cVEMP induced by 100 dB tone-pip stimuli was also compared between the two groups. Results The rate of abnormal horizontal semicircular canal function in the VM group was significantly higher than that in control subjects （P〈0.05）. Of the 37 VM patients, 11 （29.7%）, 14 （37.8%） and 7 （18.9%） exhibited abnormal caloric, HSN, and rotational test results, respectively, in contrast to 2 （6.7%）, 1 （3.3%） and 0 of the 30 healthy volunteers exhibiting corresponding abnormal results. Overall, 76% of patients with VM had abnormalities in at least one of the horizontal semicircular canal function tests, with the highest. abnormality rates seen in HSN, followed by rota-tional and the caloric tests. The rates of abnormal cVEMP in VM patients （21.6%） were significantly higher than those （3.3%） in the control group （P〈0.05）. Conclusions Most （76%） vestibular migraine patients have vestibular dysfunction. Detection of vestibular abnormality in patients with VM can be enhanced by adding HSN and rotational tests to caloric test. Patients with vestibular migraine may have abnormal function of the saccule and sacculocollic pathway damage as indicated by cVEMP. Ves-tibular dysfunction may be common among vestibular migraine patients to varying degrees.
出处
《中华耳科学杂志》
CSCD
北大核心
2014年第2期257-261,共5页
Chinese Journal of Otology
关键词
前庭性偏头痛
眩晕
前庭功能
Vestibular migraine
Vertigo
Vestibular function
