前庭神经炎床旁前庭功能查体特点分析

Analysis of Features of Bedside Vestibular Function Physical Examination for Patients with Vestibular Neuritis

目的评估前庭神经炎患者床旁前庭功能查体的特点,明确对诊断有意义的实用性体征。方法对随机选取2014年1月—2015年5月该院确诊的100例前庭神经炎患者均进行床旁前庭功能查体,包括眼震,头脉冲试验,眼倾斜反应,Romberg征,Fukuda原地踏步。结果 100例前庭神经炎患者中,84例(84.0%)可见周围前庭眼震,快相向健侧,87例(87.0%)患侧头脉冲试验阳性,8例(8%)患侧眼倾斜反应,20例(20.0%)Romberg征阳性20例,偏患侧18例,Fukuda原地踏步阳性85例(85.0%),偏患侧50例。结论前庭神经炎的床旁前庭功能查体中周围前庭眼震、头脉冲试验阳性提示外周性前庭神经病变,阳性率高,可以作为床旁前庭功能重点检查项目。

Objective To evaluate the characteristics of bedside vestibular function physical examination and identify the signs conducive to the diagnosis. Methods 100 patients with vestibular neuritis confirmed between January 2014 and May2015 underwent bedside vestibular function physical examination including nystagmus, head impulse test, ocular tilt reaction, Romberg sign, Fukuda stepping. Results In all the 100 patients with vestibular neuritis, peripheral vestibular nystagmus with fast velocity towards healthy side was observed in 84 patients(84.0%);87(87.0%) patients were found with positive responses in impulse test on the affected side of head; ocular tilt reaction of the affected side was found in 8 patients(8%);20(20.0%) patients were found Romberg sign-positive and 18 of them were found in the affected side; 85(85.0%)patients were found Fukuda stepping-positive and 50 of them were in the effected side. Conclusion In the bedside vestibular function physical examination, peripheral vestibular nystagmus and positive responses in head impulse test can indicate peripheral vestibular nerve lesion with high positive rate, and they can be considered as key inspection items.