管石复位治疗后出现残余症状的良性阵发性位置性眩晕患者VEMP特点

Features of vestibular evoked myogenic potential in patients with residual dizziness after canalith repositioning procedures for benign paroxysmal positional vertigo

目的:探讨管石复位治疗成功后出现残余症状的良性阵发性位置性眩晕(BPPV)患者的前庭诱发肌源性动作电位(VEMP)特点。方法:对97例成功进行了管石复位治疗的后半规管BPPV患者的颈性VEMP和眼性VEMP的检测结果进行回顾性分析,按照是否出现残余症状将患者分为残余症状组和无残余症状组,以健康成人的VEMP检测结果为对照,对2组患者眼性VEMP N1P1复合波异常率和颈性VEMP P1N1复合波异常率进行比较。结果:残余症状组中眼性VEMP的异常率为64.5%,颈性VEMP的异常率为28.1%,无残余症状组中眼性VEMP的异常率为17.9%,颈性VEMP的异常率为12.5%,残余症状组眼性VEMP异常率远高于无残余症状组(χ~2=19.228,P=0.000),而2组颈性VEMP异常率差异无统计学意义(χ~2=3.342,P=0.068)。结论:BPPV患者进行管石复位后残余症状的发生与眼性VEMP的异常有关,表明椭圆囊功能异常与管石复位后残余症状的发生有关。

Objective：To ananlyze the characteristics of the vestibular evoked myogenic action potential of patients with residual dizziness after successful canalith repositioning procedures（CRP）for idiopathic benign paroxysmal positional vertigo（IBPPV）.Method：Ninety-seven consecutive patients with IBPPV of the unilateral posterior semicircular canal and health controls were initially enrolled.The patients received 500 Hz tone-burst-evoked ocular vestibular evoked myogenic potentials（oVEMP）and cervical vestibular evoked myogenic potentials（cVEMP）.After successfully CRP,the patients were divided into two groups：group with residual symptoms and group without residual symptoms.The abnormality of results of both oVEMP and cVEMP were compared between three groups.Result：In the group with residual symptoms,the abnormal rate were 64.5% for oVEMP and 28.1% for cVEMP.In the group without residual symptoms,the abnormal rate were 17.9% for oVEMP and 12.5% for cVEMP.The abnormal rate of oVEMP in the group with residual symptoms was significantly higher than that in the group without residual symptoms（χ^2=19.228,P=0.000）.However,there was no significant difference in the abnormal rate of cVEMP between these two groups（χ^2=3.342,P=0.068）.Conclusion：In patients with IBPPV underwent successful CRP,the occurrence of residual symptoms is correlated to the abnormalities of oVEMP.It is indicated that the dysfunction of the utricle is related to the presence of residual symptoms after the CRP for IBPPV.