高刺激率测试BAEP对TIA眩晕的观察

Observation of increasing stimulus rate BAEP for vertigo caused by transient lschemic attack

目的 :探讨常规脑干听觉诱发电位 (BAEP)检查和高刺激率测试BAEP对短暂脑缺血发作 (TIA)眩晕的诊断价值。方法 :对 5 6例TIA发作所致的眩晕患者 ,进行了口服西比灵前后BAEP检测 ,同时以 5 0例正常人作为对照组 ,分别进行 10～ 90Hz高刺激率 (自 10Hz开始 ,每次增加 10Hz ,至 90Hz结束 )的BAEP检测。结果 :瞬间眩晕发作时 (本实验室把瞬间眩晕时间暂定为 10s以内 ,TIA眩晕时间为 10s以上 ,2 4h以内恢复 )。 10Hz检查时Ⅲ、Ⅴ波潜伏期 (PL)延长 ,发作停止后各波PL恢复正常 ,再行 30Hz、5 0Hz刺激时Ⅲ波PL延长 0 2 1± 0 0 4ms ,Ⅴ波PL延长 0 4 4± 0 0 9ms。TIA患者 10Hz检查时 ,Ⅲ、Ⅴ波PL延长 ,发作停止后各波PL均正常 ,再行 30～ 5 0Hz刺激时Ⅴ波PL延长 0 4 4± 0 0 9ms,Ⅲ波延长 0 2 1± 0 0 4ms。口服西比灵 8h后 ,临床症状已经改善 ,患者头晕减轻或已经消失 ,在 30～ 5 0Hz刺激时 ,Ⅴ波PL仍然延长。 5 0例正常人在作各频段检查时 ,10Hz各频段时各波PL均无改变 ,30Hz、5 0Hz刺激时Ⅲ、Ⅴ波PL延长 ,其中 5 0Hz时 ,波Ⅲ延长 0 2± 0 0 3ms ,波Ⅴ延长 0 4 2± 0 0 9,6 0～ 90HzPL亦延长。结论 :BAEP检测对各种原因引起的缺血是比较敏感的 。

Objective:To explore the diagnostic value of routine and increasing stimulus rate(ISR) brainstem auditory evoked potentials(BAEP) for transient vertigo caused by transient ischemic attack(TIA). Methods:BAEP detection were performed on 56 cases of patients with transient vertigo caused by TIA before and after administration of sibelium. Another 50 cases of normal subjects were included in the study as the control group. BAEP were carried out with the ISR ranging from 10～90Hz. Results:Trasient vertigo attack in this study was divided into two types, vertigo lasts less than l0 minutes and more than 10 minutes respectively, the later recovered within 24 hours. When transient vertigo attacked, the dormant period of wave Ⅲ and V was prolonged At the stimulating point of l0 Hz, and the latency restored to normal after the attack stopped. At the stimulating point of 30 and 50 Hz, of wave Ⅲ was prolonged by 0.21±0.04 ms and wave V by 0 44±0.09 ms respectively. At the stimulating point, the latency of wave Ⅲ and V was found prolonged in patients with TIA, but restore to normal after the attack stopped. At the stimulating point of 30 and 50 Hz, the latency of wave Ⅲ was prolonged 0.21±0.04 ms and wave V 0.44±0.09 ms respectively. The clinical symptoms were improved 8 hours after the administration of sibelium. The vertigo either was alleviated or disappeared completely.At the stimulus of 30～50 Hz, the latency of wave V was still prolonged. As for the 50 normal subjects, no change was observed in the latency of all waves at the stimulus of 10Hz, but the the latency wave Ⅲ and V were prolonged at the stimulus of both 30 and 50 Hz.At the stimulus of 50Hz. dormant period of wave Ⅲ was prolonged 0.2±0.03 ms and wave V 0.42±0.09 ms. The the latency all waves were also prolonged at stimulus 60 ～ 90Hz.Conclusion:BAEP might be sensitive to ischemia of various causes and ISR examination might be suitable for research.