耳石器在复发性原发性良性阵发性位置性眩晕中的作用

The roles of otolith organs in the recurrence primary benign paroxysmal positional vertigo

目的:通过检测前庭诱发肌源性电位(VEMPs)研究耳石器在原发性良性阵发性位置性眩晕(BPPV)发作以及复发中的作用。方法:收集2014-09-2014-11期间就诊的17例复发性原发性BPPV患者和同期就诊的42例非复发性原发性BPPV患者资料。所有患者均进行VEMP检查,包括颈肌前庭诱发肌源性电位(cVEMP)和眼肌前庭诱发肌源性电位(oVEMP)。VEMP波形未引出或双侧不对称率>29%称为异常。结果:BPPV患者中,cVEMP与oVEMP异常率差异有统计学意义(P<0.05),oVEMP阳性率更高。复发与非复发组oVEMP异常率差异有统计学意义(P<0.01),cVEMP异常率差异无统计学意义(P>0.05)。复发与非复发组年龄及性别比较差异不存在统计学意义。结论:原发性BPPV患者耳石器尤其是椭圆囊功能受损与BPPV发生有关。椭圆囊功能异常可能与BPPV复发有关。性别及年龄段与BPPV复发不存在直接联系。

Objective：To explorethe roles of otolith organs in the occurrence and recurrence of primary benign paroxysmal positional vertigo（BPPV）by vestibular evoked myogenic potential （VEMP） test; Method： We enrolled 17 recurrent primary BPPV patients and 42 non-recurrent primary BPPV patients between September 2014 and November 2014. All patients underwent VEMPtests, including cervicalvestibular evoked myogenic potential （ cVEMP and ocular vestibular evoked myogenic potential （oVEMP） tests. The abnormal case was defined as non- elicitation or asymmetry rate between bilateral sides is larger than 29 %. Result：Significant difference was found in abnormalrate between cVEMP and oVEMP（P〈0.05 ） in BPPV patients. The abnormal rate of oVEMP was higher than that of cVEMP. Significant difference was found in abnormal rate in oVEMP test between recurrent and non-recurrent groups（P〈0.01） but not in cVEMP（P〉0.05）. No significant difference was found in sex and age between recurrent and non-recurrent groups （P〉0.05）. Conclusion.. The impairment of otolith organs, espe- cially the utricle, is related to primary BPPV. Dysfunction of utricle may play a role in recurrence of BPPV. Re- currence of BPPV is not correlated with sex and age.