视频眼震检查在主诉非典型眩晕患者中的临床应用价值

Clinical Value of VNG for the Patients Complained of Atypical Vertigo

目的:探讨视频眼震检查在主诉非典型眩晕患者中的临床应用价值。方法:分析118例主诉非典型眩晕患者的裸眼眼震、视频眼震,结合查体、已有的或者后续的双温试验、听力学检查以及影像学等临床资料,评估视频眼震检查的应用对前庭疾病临床诊断的意义。结果:主诉持续头昏沉感患者10例、飘飘感23例;低头、抬头、坐起、躺下、翻身等头部位置改变时不穏感50例;或者上述动作引起瞬间旋转感35例。以上患者均行自发性眼震检查和位置试验,裸眼下观察到眼震的患者有19例(19/118,16.1%),均得到临床诊断;视频下记录到眼震67例(67/118,56.8%),其中60例(60/118,50.8%)得出临床诊断。两种方法的眼震检出率比较差异有显著的统计学意义(P<0.05),视频眼震检查的检出率显著高于裸眼下观察。结论:视频眼震检查所采用的眼罩有暗室诱发的效果,方便快捷,较裸眼观察,可显著地增加以下几种主诉非典型(转头时飘飘感,低头、抬头、坐起、躺下、翻身等头部位置改变时不穏感或者瞬间旋转感)眩晕患者眼震的临床诱发率,提供进一步的诊查方向,提高临床上对主诉非典型眩晕患者的诊断率。

Objective: To investigate the clinical value of Videonystagmograph(VNG) for the diagnosis of patients complained of atypical vertigo. Methods: The results of nystagmus test in 118 cases of patients complained of atypical vertigo under naked eye and VNG were analysed, combined with physical examination, the existing or subsequent bithermal caloric test, audiological tests and imaging examination, and the significance of the application of VNG to the clinical diagnosis of vestibular disease was evaluated. Results: Among the 118 cases, there were 10 patients with persistent dazed, 23 cases of floating sensation, 50 cases of unsteadiness and 35 cases with sensation of rotation for the blink of an eye when patients Lower or raise they head, or sit up, or lie down, or turn over. All of the above patients underwent spontaneous and positional nystagmus test, and 19(19/118, 16.1%) cases were observed under the naked eye, all of which were clinically diagnosed. There were 67(67/118, 56.8%) cases were recorded under VNG, 60 of which were clinically diagnosed(60/118, 50.8%). There was a significant difference between the two methods(P<0.05). The detection rate of nystagmus under VNG was significantly higher than that of the naked eye. Conclusion: VNG can eliminate the influence of eyelid overlapping and illumination,which can significantly increase the detection rate of nystagmus in patients complained of atypical vertigo, provide further inspecting direction, and improve the clinical diagnosis rate of patients with atypical of vertigo.