震动眼震试验在眩晕诊断中的应用

Clinical Application of Vibration-induced Nystagmus in the Diagnosis of Vertigo

目的:观测震动眼震(VIN)在眩晕诊断中的临床意义。方法:健康志愿者30例作为对照组,单侧前庭周围性疾病眩晕缓解期患者67例为实验组,分别进行震动试验(VT)和摇头试验(HST),观察眼震诱发情况。眩晕患者同时还进行冷热试验(CT)。结果:实验组VT中52例(77.6%)出现VIN,主要是水平眼震,其中44例VIN方向朝向健侧,梅尼埃病和前庭神经元炎患者分别有2例、6例VIN方向朝向患侧;引出摇头眼震(HSN)46例(68.7%),CT存在一侧半规管反应减退(UW)54例(80.6%)。对照组均无VIN和HSN。结论:VIN试验具有较高的敏感性,能够为评定前庭损伤侧别提供有益信息,安全性强、患者无痛苦、简便、易于推广,适合各级眩晕门诊的快速筛查。

Objoctive： To clarify the clinical significance of vibration-induced nystagmus （VIN）in the diagnosis and differential diagnosis of vertigo. Mothods： Sixty-seven patients with unilateral peripheral vestibular disorders in relieving stage and 30 healthy volunteers as contrast underwent vibration test （VT）and head shaking test （HST）. And those with vertigo underwent caloric test（CT）. Rosults： Of the 67 patients, 52（77.6% ）showed VIN which were mainly horizontal. The direction of VIN in 44 patients was toward the healthy side, whereas in 2 patients with Meniere＇s disease and 6 patients with vestibular neuronitis, it was toward the affected side. The sensitivity of VIN was 77.6%. Head shaking nystagmus（ HSN）was evoked in 46（68.7% ）patients and 54（ 80.6% ）patients showed unilateral weakness（ UW）with caloric test（CT）. None of 30 healthy subjects showed VIN and HSN. Conclusion： With higher sensitivity, VIN test is a simple, safe and well-tolerated clinical test. It can be applied for fdtrating of patients with vertigo in the out-patient.