水平半规管壶腹嵴顶结石症两种位置试验的眼震特征

The nystagmus characteristics of two positions of the horizontal semicircular canal cupulolithiasis

目的分析水平半规管壶腹嵴顶结石症(horizontal semicircular canal cupulolithiasis, HSC-Cup)患者在滚转试验和Dix-Hallpike试验中的眼震特征。 方法2016年12月至2017年12月天津市第一中心医院良性阵发性位置性眩晕(BPPV)患者164例入组,其中水平半规管管石症(horizontal semicircular canal canalithiasis, HSC-Can)124例,HSC-Cup 40例。应用视频眼震图仪分别记录BPPV患者滚转试验和Dix-Hallpike试验所诱发的眼震,比较分析其在各试验头位诱发的眼震方向、强度等参数特征。结果124例HSC-Can患者滚转试验均诱发出与转头方向一致的水平眼震,患、健侧的水平眼震强度分别为(41.3±20.1)°/s(均数±标准差,下同)和(21.9±9.4)°/s,差异有统计学意义(t=6.709,P<0.05);40例HSC-Cup患者滚转试验均诱发出与转头方向相反的水平眼震,患、健侧的水平眼震强度分别为(12.9±6.4)°/s和(29.1±9.3)°/s,差异有统计学意义(t=9.066,P<0.05)。124例HSC-Can患者中120例在Dix-Hallpike试验左右悬头位记录到与转头方向一致的水平眼震,患、健侧的水平眼震强度分别为(15.1±10.0)°/s和(9.4±7.4)°/s,差异有统计学意义(t=2.365,P<0.05),与滚转试验诊断结果一致性达97%;40例HSC-Cup患者在Dix-Hallpike试验左右悬头位均记录到与头位方向相反的水平眼震,患、健侧水平眼震强度分别为(5.3±2.8)°/s和(13.9±4.4)°/s,差异有统计学意义(t=10.579,P<0.05),与滚转试验诊断结果的一致性达100%。结论HSC-Cup患者在滚转试验和Dix-Hallpike试验均能诱发出特征性水平相眼震,Dix-Hallpike试验也可以用于HSC-Cup的初步定位。

Objective To analyze the characteristics of nystagmus of horizontal semicircular canal cupulolithiasis(HSC-Cup) in Roll test and Dix-Hallpike test. Methods Between December 2016 and December 2017, a total of 164 patients with BPPV from Tianjin First Center Hospital, 124 HSC-Can BPPV and 40 HSC-Cup BPPV, were involved.The induced nystagmus in Roll test and Dix-Hallpike test were recorded by video-nystagmograph(VNG), whose direction and intensity characteristics were compared in various BPPV. Results HSC-Can patients were induced a horizontal nystagmus with Roll test, the nystagmus intensity of the disease and healthy side were (41.3±20.1)°/s (mean standard deviation)and(21.9±9.4)°/s respectively, the difference was statistically significant (t=6.709, P<0.05). HSC-Cup patients were induced a horizontal nystagmus that was opposite to the direction of the Roll test, the nystagmus intensity of the disease and the healthy side were (12.9±6.4)°/s and(29.1±9.3)°/s respectively, with significant difference (t=9.066, P<0.05). Among 124 cases of HSC-Can patients, 120 cases of horizontal nystagmus were recorded in the left and right sides of the Dix-Hallpike test in the same direction as the turning direction, the horizontal nystagmus intensity of the disease and the healthy sides were (15.1±10.0)°/s and(9.4±7.4)°/s respectively, the difference was statistically significant (t=2.365, P<0.05). And 40 cases of HSC-Cup patients were recorded at the head of the Dix-Hallpike test in the opposite direction to the horizontal eye earthquake.The horizontal nystagmus intensity of the disease and the healthy side were (5.3±2.8)°/s and(13.9±4.4)°/s respectively, the difference was statistically significant (t=10.579, P<0.05). Conclusions Characteristic horizontal nystagmus can be induced by HSC-Cup in both roll test and Dix-Hallpike test. Preliminary localization of Dix-Hallpike Test can also be used for HSC-Cup.