前庭性偏头痛的眼震视图表现及诊断价值

The manifestation and diagnostic value of video nystamography in vestibular migraine

目的比较前庭性偏头痛(VM)和健康受试者的眼震视图(VNG)表现,明确VNG检查在VM中的诊断价值.方法前瞻性连续纳入2018年8月至2019年8月在新乡医学院附属人民医院神经内科就诊的VM患者55例和体检中心健康受试者45例,所有患者及健康受试者在条件允许下行VNG检查,包括视动性试验(扫视试验、平稳跟踪试验、视动性试验)、前庭功能试验(温度试验、摇头眼震)、自发性眼震、诱发性眼震检查(静态位置性试验).采用χ^2检验比较两组之间VNG结果的差异.结果VM组与健康受试者组之间人口统计学差异无统计学意义(均P>0.05).扫视试验:VM组有17例(30.9%)异常,健康受试者组异常例数3例(6.7%;χ^2=9.091,P<0.05);平稳跟踪实验:VM组异常20例(36.4%),健康受试者组异常5例(11.1%;χ^2=8.418,P<0.05);视动性眼震检查:VM组异常例数24例(43.6%),健康受试者组异常例数6例(13.3%;χ^2=10.823,P<0.05);温度试验:VM组有13例(23.6%)异常,健康受试者组中异常2例(3.6%;χ^2=7.150,P<0.05);摇头眼震:VM组有11例(20.0%)异常,健康受试者组异常2例(3.6%;χ^2=5.295,P<0.05);自发性眼震检查:VM组中异常10例(18.2%),健康受试者组异常4例(8.9%;χ^2=1.775,P>0.05);静态位置性眼震检查:VM组共有22例(40.0%)异常,健康受试者组中共有7例异常(16.5%;χ^2=7.183,P<0.05).结论VM组的总VNG检查异常率高于健康受试者组,说明VNG检查有助于VM的诊断,且其表现提示VM患者中枢及外周均有损害的迹象.

Objective To compare the visual nystagmus(VNG)manifestations of vestibular migraine(VM)and healthy subjects,and to clarify the diagnostic value of VNG in VM.Methods A prospective analysis of 55 patients with VM and 45 healthy patients who were treated in the Department of Neurology in the Affiliated People's Hospital of Xinxiang Medical University from August 2018 to August 2019 was conducted.All subjects were were examined with VNG under the permitted conditions,including optokinetic test(saccade test,stationary tracking experime,optokinetic nystagmus examination),vestibular function test(caloric test,head shaking nystagmus),spontaneous nystagmus test,evoked nystagmus test(static position nystagmus).χ^2 test was used to compare the differences in VNG results between the two groups.Results There was no significant demographic difference between VM group and healthy subjects group(P>0.05).Saccade test:There were 17 abnormalities in the VM group(30.9%)and 3(6.7%)in the healthy subjects group(χ^2=9.091,P<0.05).Stationary tracking experiment:There were 20 patients(36.4%)were abnormal in the VM group,and 5(11.1%)in the healthy group(χ^2=8.418,P<0.05).Optokinetic nystagmus examination:There were 24 cases(43.6%)were abnormal in the VM group,and 6(13.3%)in the healthy group(χ^2=10.823,P<0.05).Caloric test:There were 13 cases(23.6%)were abnormal in the VM group,2(3.6%)in the healthy subject group(χ^2=7.150,P<0.05).Head shaking nystagmus:There were 11 cases(20.0%)were abnormal in the VM group,2(3.6%)in the healthy subject group(χ^2=5.295,P<0.05);Spontaneous nystagmus:There were 10 patients(18.2%)were abnormal in the VM group,and 4(8.9%)in the healthy subject group(χ^2=1.775,P>0.05).Static position nystagmus:There were 22 abnormalities(40.0%)in the VM group and 7(16.5%)in the healthy subject group(χ^2=7.183,P<0.05).Conclusions The abnormal rate of total VNG examination in the VM group was higher than that in the healthy subject group,indicating that the VNG examination is helpful for the diagnosis of VM,and its performance suggests signs of damage to the center and periphery of VM patients.