儿童常见周围性眩晕视频头脉冲结果分析

Video Head Impulse Test Results in Children with Common Peripheral Vertigo Diseases

目的分析儿童常见周围性眩晕的视频头脉冲试验(video head impulse test,vHIT)结果并探讨vHIT的诊断价值。方法回顾性选取2020年1月至2022年3月就诊于苏州大学附属第二医院眩晕诊治中心的儿童常见周围性眩晕患儿78例,根据年龄将患儿分为≤10岁组26例和>10岁组52例,分析其vHIT检查结果。结果78例周围性眩晕患儿中儿童良性阵发性眩晕(benign paroxysmal vertigo of childhood,BPVC)28例,前庭性偏头痛(vestibular mi⁃graine,VM)20例,前庭神经炎(vestibular neuritis,VN)15例,突发性聋伴眩晕(sudden deafness with vertigo,SD)8例,梅尼埃病(Meniere's disease,MD)7例。vHIT检查结果异常47例,其中BPVC14例,VM12例,VN14例,SD3例,MD4例。儿童vHIT检查中出现伪迹的概率更高,最常见的伪迹类型为眨眼,高增益值及追踪震荡,≤10岁组vHIT检查出现伪迹多于>10岁组,差异有统计学意义(P<0.001)。结论儿童周围性眩晕最常见的病因主要为BPVC及VM,vHIT在儿童眩晕的诊断中具有很高的特异性,但出现伪迹的概率较高,检查过程中需注意甄别并防范。

Objective To report video head impulse test(vHIT)results in children with common peripheral vertigo and it diagnostic potentials.Methods vHIT results from 78 children with common peripheral vertigo who visited the Vertigo Diagnosis and Treatment Center at the Second Affiliated Hospital of Soochow University from January 2020 to March 2022 were retrospectively reviewed.The children were divided into two groups based on age:≤10 years(26 cases)and>10 years(52 cases).Results Diagnoses included childhood benign paroxysmal vertigo(BPVC,n=28),vestibular migraine(VM,n=20),vestibular neuritis(VN,n=15),sudden deafness with dizziness(SD,n=8)and Meniere’s disease(MD,n=7).Abnormal vHIT results were found in 47 children with BPVC(n=14),VM(n=12),VN(n=14),SD(n=3)and MD(n=4).These children demonstrated higher ratios of vHIT artifacts than adults,including eye blinking,high gains and tracking oscillations.The ratio of vHIT artifacts in children older than 10 years was significantly lower than that in those younger than 10 years(P<0.001).Conclusion The most common causes of peripheral vertigo in children are BPVC and VM.vHIT shows high specificity in the diagnosis for children with common peripheral vertigo,but also higher rates of artifacts than in adults.Efforts are required to ensure accurate interpretation of vHIT test in children.