[Video head impulse test for evaluation of vestibular function in patients with vestibular neuritis and benign paroxysmal positional vertigo]
- PMID: 28436631
- PMCID: PMC10396883
- DOI: 10.3785/j.issn.1008-9292.2017.02.08
[Video head impulse test for evaluation of vestibular function in patients with vestibular neuritis and benign paroxysmal positional vertigo]
Abstract
Objective: To assess the clinical application of video head impulse test (vHIT) for vestibular function in vestibular neuritis (VN) and benign paroxysmal positional vertigo (BPPV) patients. Methods: Thirty-three patients with VN and 43 patients with BPPV were enrolled from Sir Run Run Shaw Hospital and Ningbo Second Hospital from March 15 to September 10, 2015; and 50 healthy controls were also enrolled in the study. vHIT was used to quantitatively test the vestibulo-ocular reflex (VOR) gains of a pair of horizontal semicircular canals. VOR gains two pairs of vertical semicircular canals, and the corresponding asymmetrical value of three VOR gains. The saccades information was also recorded. Results: Compared with the healthy control group and BPPV patients, the affected horizontal and vertical VOR gains were declined and the corresponding asymmetries were increased in VN patients (all P<0.01). BPPV group also showed higher vertical VOR gain asymmetries compared with the healthy control group (all P<0.01), but no significant difference was observed in VOR gains and horizontal VOR gain asymmetry (all P>0.05). The sensibility of vHIT in diagnosis of VN was 87.9%. Among 33 VN patients, 22 were diagnosed with superior vestibular nerve dysfunction, 7 were found with inferior vestibular nerve dysfunction and 3 were with both dysfunction; and 1 case was not distinguished. Conclusion: Video head impulse test can quantitatively evaluate the vestibular dysfunction of VN and can help early diagnosis of VN, which may be widely used in clinic.
目的: 探讨视频头脉冲试验(vHIT)评估前庭神经炎(VN)和良性发作性位置性眩晕(BPPV)患者前庭眼反射(VOR)的临床应用价值。
方法: 收集2015年3月15日至9月10日在浙江大学医学院附属邵逸夫医院和宁波市第二医院诊断的33例VN患者和43例BPPV患者。另选同时段两家医院的工作人员、患者亲属以及社会志愿者50名作为健康对照组。用vHIT定量测定一对水平半规管平面、两对垂直半规管平面的VOR增益值及相应三个VOR增益不对称值并分析结果和差异,同时记录眼球追赶扫视信息。
结果: 与健康对照组和BPPV组比较,VN组患侧水平及垂直VOR增益值减小,相应不对称值增大,差异均有统计学意义(均 P < 0.01);BPPV组每个VOR增益值及水平不对称值差异均无统计学意义(均 P>0.05),垂直VOR增益不对称值增大(均 P < 0.05)。与BPPV组比较,VN组患侧VOR增益值减小,相应三个不对称值增大,差异均有统计学意义(均 P < 0.01)。vHIT早期诊断VN的敏感度为87.9%。33例VN患者中,除一例无法区分外,前庭上神经功能损害22例,前庭下神经功能损害7例,前庭上、下神经功能均损害3例。
结论: vHIT通过评估VN患者前庭功能可帮助临床早期诊断VN,具有良好的临床应用前景。
References
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- GROSSMAN G E, LEIGH R J, BRUCE E N, et al. Performance of the human vestibuloocular reflex during locomotion. J Neurophysiol. 1989;62(1):264–272. - PubMed
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