颅骨振动诱发眼震试验在梅尼埃病患者的初步观察

A Preliminary Observation of Vibration-Induced Nystagmus Test in Meniere's Disease

目的探讨颅骨振动诱发眼震试验(vibration-induced nystagmus test,VINT)在单侧外周前庭病变的眩晕患者损伤评估中的临床价值。方法选取2016年9月~2017年5月确诊为间歇期单侧梅尼埃病患者25例,以及18~60岁无眩晕疾病病史的正常人25例作为对照。所有受检者接受温度试验及VINT试验。通过手持式振动器于受检者额部及乳突分别施加60Hz、120 Hz的振动刺激,利用视频眼震图仪的软件记录眼震。结果确诊为梅尼埃病的患者VINT阳性眼震均为快相朝向健侧。梅尼埃病患者临床分期Ⅱ期2人、Ⅲ期18人、Ⅳ期5人,VINT的引出率分别为0%、55%、80%。随着病情程度加重,VINT阳性率逐渐升高。25例正常对照患者均未诱发出眼震。结论尽管VINT在病程早期可能为阴性,但它反映前庭高频性损伤,可以指示前庭损伤侧别。其操作简便、快速、无损伤、易判定,是其他前庭功能检测手段的补充,有助于全面评估多频率前庭功能,值得临床推广。

Objective To explore vibration-induced nystagmus test（VINT） in evaluating partial unilateral vestibular loss. Methods Using caloric test and VINT , we examined in a group of 25 Meniere＇s Disease patients and a control group of 25 healthy subjects. Vibratory stimuli（60 Hz and 120 Hz）were presented to the mastoids and the foreheads, and nystagmus was recorded by videonystagmography software. Results Normal controls didn＇t show any nystagmus by VINT. Among the Meniere＇s Disease patients, there were 2 patients of stageII, 18 patients of stage III, and 5 patients of stageIV according to the clinical stage standard. Vibration-induced nystagmus was observed in 0%,55% and 80% of cases respectively. Conclusions Among the diagnosed Meniere＇s Disease patients, vibration-induced nystagmus beated toward the healthy ears, and more patients showed such nystagmus as vestibular damage got worse during the late stage. VINT reflects high- frequency vestibular damage and indicates the side of the vestibular loss, although it might be negative during the early stage. It is a simple, rapid, non-invasive and useful test to complement information of other common vestibular tests in the multi-frequency analysis of vestibular function. Its use in clinical practice seems to predict a wider development as a future promising bedside test.