Significance of Vestibular Testing on Distinguishing the Nerve of Origin for Vestibular Schwannoma and Predicting the Preservation of Hearing

Background： Determining the nerve of origin for vestibular schwannoma （VS）, as a method for predicting hearing prognosis, has not been systematically considered. The vestibular test can be used to investigate the function of the superior vestibular nerve （SVN） and the inferior vestibular nerve （IVN）. This study aimed to preoperatively distinguish the nerve of origin for VS patients using the vestibular test, and determine if this correlated with hearing preservation. Methods： A total of 106 patients with unilateral VS were enrolled in this study prospectively. Each patient received a caloric test, vestibular-evoked myogenic potential （VEMP） test, and cochlear nerve function test （hearing） before the operation and 1 week, 3, and 6 months, postoperatively. All patients underwent surgical removal of the VS using the suboccipital approach. During the operation, the nerve of tumor origin （SVN or IVN） was identified by the surgeon. Tumor size was measured by preoperative magnetic resonance imaging. Results： The nerve of tumor origin could not be unequivocally identified in 38 patients （38/106, 35.80%）. These patients were not subsequently evaluated. In 26 patients （nine females, seventeen males）, tumors arose from the SVN and in 42 patients （18 females, 24 males）, tumors arose from the IVN. Comparing with tile nerve of origins （SVN and IVN） of tumors, the results of the caloric tests and VEMP tests were significantly different in tumors originating from the SVN and the IVN in our study. Hearing was preserved in 16 of 26 patients （61.54%） with SVN-originating tumors, whereas hearing was preserved in only seven of 42 patients （16.67%） with IVN-originating tumors. Conclusions： Our data suggest that caloric and VEMP tests might help to identify whether VS tumors originate from the SVN or IVN. These tests could also be used to evaluate the residual function of the nerves after surgery. Using this information, we might better predict the preservation of hearing for patients.

SLC26A4 mutation testing for hearing loss associated with enlargement of the vestibular aqueduct

nPendred syndrome （PS） is characterized by autosomal recessive inheritance of goiter associated with a defect of iodide organification, hearing loss, enlargement of the vestibular aqueduct （EVA）, and mutations of the SLC26A4 gene. However, not all EVA patients have PS or SLC26A4 mutations. Two mutant alleles of SLC26A4 are detected in 1/4 of North American or European EVA populations, one mutant allele is detected in another 1/4 of patient populations, and no mutations are de-tected in the other 1/2. The presence of two mutant al-leles of SLC26A4 is associated with abnormal iodide or-ganification, increased thyroid gland volume, increased severity of hearing loss, and bilateral EVA. The pres-ence of a single mutant allele of SLC26A4 is associated with normal iodide organification, normal thyroid gland volume, less severe hearing loss and either bilateral or unilateral EVA. When other underlying correlations are accounted for, the presence of a cochlear malformation or the size of EVA does not have an effect on hearing thresholds. This is consistent with observations of an Slc26a4 mutant mouse model of EVA in which hearing loss is independent of endolymphatic hydrops or in-ner ear malformations. Segregation analyses of EVA in families suggest that the patients carrying one mutant allele of SLC26A4 have a second, undetected mutant allele of SLC26A4, and the probability of a sibling hav-ing EVA is consistent with its segregation as an autoso-mal recessive trait. Patients without any mutations are an etiologically heterogeneous group in which siblings have a lower probability of having EVA. SLC26A4 muta-tion testing can provide prognostic information to guide clinical surveillance and management, as well as the probability of EVA affecting a sibling.

良性阵发性位置性眩晕患者的耳石器及半规管功能分析

目的探讨良性阵发性位置性眩晕(BPPV)对耳石器及半规管功能的影响及其可能的发病因素。方法选择2022年12月-2023年6月本院收治的单管良性阵发性位置性眩晕患者作为研究对象,分别行视频头脉冲试验(vHIT)、前庭肌源诱发电位(VEMP)、听性脑干反应(ABR),分析其检测结果。结果后半规管BPPV患者与水平半规管BPPV患者vHIT、cVEMP、oVEMP、ABR检查结果异常侧别分布情况比较,差异无统计学意义(P>0.05),但在老年水平半规管BPPV患者的oVEMP双侧异常率(41.2%)比后半规管BPPV患者的oVEMP双侧异常率(10.3%)高,两组差异存在统计学意义(P<0.05)。青中年BPPV患者的ABR双侧异常率(15.2%)低于老年BPPV患者的ABR双侧异常率(33.9%),差异存在统计学意义(P<0.05);青中年BPPV患者与老年BPPV患者vHIT、cVEMP、oVEMP检查结果异常侧别分布情况比较,差异无统计学意义(P>0.05)。结论BPPV可见于半规管弥漫性损伤,内耳循环障碍可引起耳石器功能障碍,其可能是BPPV的发病因素。

特发性突发性聋患者前庭功能评估的研究现状

特发性突发性聋(突发性聋)是常见的耳科急症,全球范围内发病呈逐年上升趋势,28%~60%患者在听力下降的同时会伴有眩晕等前庭症状,且往往有较重的听力损伤并预后欠佳。30%~80%的突发性聋患者存在前庭功能异常,且无论是否伴有眩晕,都可能存在前庭功能损伤。虽然对突发性聋患者前庭功能的研究和报道日渐增多,但很多方面尚存在争议,为明晰相关问题,我们从突发性聋患者的前庭症状和功能评估文献进行分析和总结,以期对临床实践有所指导。

听神经瘤患者经迷路切除术前后视频头脉冲试验的变化

目的:听神经瘤(acoustic neuroma,AN)是一种良性肿瘤,通常会影响患者的听觉和前庭功能。对于AN的筛查和诊断,传统方法主要依赖于听力学检查和磁共振成像(magnetic resonance imaging,MRI),而忽略了对病变部位进行前庭功能评估的重要性。视频头脉冲试验(video head impulse test,vHIT)是一种新兴的前庭功能检测方法,已广泛应用于临床,但其应用于AN诊断的研究相对较少。本研究通过在术前及术后对经迷路入路AN切除术的单侧AN患者采用v HIT进行动态检测,以探究vHIT在AN诊断、前庭功能障碍评估、术后代偿建立中的价值。方法:回顾性纳入2020年10月至2022年3月中南大学湘雅二医院耳鼻咽喉头颈外科的27例经迷路入路AN切除术单侧患者。术前1周进行v HIT以评估前庭功能,纯音测听(pure tone audiometry,PTA)评估听力水平,耳部MRI评估肿瘤大小;分别于术后1周、1个月、6个月、1年复查vHIT,并分析vHIT与听力、肿瘤大小之间的相关性。结果:术前vHIT显示患侧后半规管是前庭眼反射(vestibulo-ocular reflex,VOR)增益降低最常见的半规管。术前患侧vHIT的VOR增益与听力水平(r=-0.47,P<0.05)或肿瘤大小(r=-0.54,P<0.01)存在显著相关性。术后患侧vHIT结果显示水平半规管和前半规管的平均VOR增益随时间略有上升;3个半规管显性扫视的振幅和扫视波百分比均增加,而潜伏期时间缩短,并且在术后1周变化最明显。结论:vHIT能有效监测AN患者手术前后的前庭功能变化,对辅助诊断和治疗AN患者前庭功能障碍具有临床应用价值。

Video head impulse test (vHIT) in migraine dizziness

Background and objective: Migraine is an extremely prevalent primary headache disorder that frequently associates parallel symptoms such as dizziness, tinnitus and hearing loss. Our aim is to investigate differences in video head impulse (vHIT) results with patients suffering from vestibular migraine (VM) and healthy people, taking into consideration mean values of vestibule ocular reflex (VOR) gain, occurrence of the compensatory saccades latency and amplitude. According to the results, determine the usefulness of vHIT in vestibular migraine diagnostics. Methods: A total number of 120 subjects were enrolled in the study, 80 of them were vestibular migraine patients (VM), while the other 40 were a control group of age matched healthy subjects. History was taking during the evaluation; videonystagmography and the video head impulse test were done.Results: The rate of saccades is much more higher in the VM group compared to the healthy subjects group, only 7.5% of the VM group showed a low VOR gain with compensatory saccades denoting a vestibular deficit. Conclusion: The refixation saccades are an important sign that could underlie different vestibular problems. vHIT result can contribute to the completion of full mosaic of vestibular migraine diagnostics. ? 2018 PLA General Hospital Department of Otolaryngology Head and Neck Surgery. Production and hosting by Elsevier(Singapore) Pte Ltd. This is an open access article under the CC BY-NC-ND license http://creativecommons.org/licenses/by-nc-nd/4.0/).

前庭神经炎视频头脉冲试验及双温试验结果分析

目的回顾性分析前庭神经炎(vestibular neuritis,VN)患者急性期视频头脉冲试验(video head impulse test,vHIT)及双温试验结果,探讨其对于VN诊断的意义及二者相关性。方法回顾性选取2019年1月至2022年10月唐山市眩晕诊疗康复中心收治的VN急性期患者40例,依据半规管轻瘫(cannal paralysis,CP)值患者分为A组(CP>50%)15例,B组(25%≤CP≤50%)17例,C组(CP<25%)8例,比较分析其vHIT、双温试验结果。结果水平半规管、前半规管vHIT阳性均高于后半规管,差异有统计学意义(P<0.001)。双温试验结果阳性率80.00%。A组受损侧水平半规管vHIT增益值低于B组、C组,差异均有统计学意义(P<0.05);B组受损侧水平半规管vHIT增益值低于C组,差异有统计学意义(P<0.05)。结论VN患者水平半规管、前半规管高频受损概率高于后半规管。双温试验CP值越大,相应水平半规管vHIT的增益值越低。VN超早期水平半规管可能出现低频损伤反应延迟现象,需联合vHIT共同评估半规管功能。

急性前庭综合征患者脑梗死的临床特征及相关因素分析

背景急性脑梗死是急性前庭综合征中较为危重的疾病。急性前庭综合征患者起病急,症状重,CT诊断急性脑梗死的灵敏度低,而核磁共振检查又不易立即实施,这使得表现为急性前庭综合征的急性脑梗死诊断具有一定挑战性,因此有必要探究适用于急性前庭综合征患者的检查和评价方法。目的分析急性前庭综合征患者中急性脑梗死发生的相关危险因素,为急性前庭综合征中急性脑梗死的诊断提供借鉴,争取急性脑梗死患者的黄金治疗时间。方法收集2021年4月—2022年7月就诊于哈尔滨医科大学附属第四医院神经内科急性前庭综合征患者102例,录入相关临床体征,以核磁共振检查结果作为脑梗死诊断的金标准,分为脑梗死组(16例)与非脑梗死组(86例),对比两组患者临床特点,采用单因素和多因素Logistic回归分析探究急性前庭综合征中脑梗死发生的相关影响因素,并绘制受试者工作特征(ROC)曲线评价相关影响因素对脑梗死的预测价值。结果脑梗死组患者吸烟史、饮酒史、头脉冲试验-眼震-眼位偏斜试验(HINTS)阳性比例、ABCD2评分均高于非脑梗死组(P<0.05)。单因素Logistic回归分析显示HINTS阳性、ABCD2评分、吸烟史、饮酒史、听力下降是脑梗死发生的影响因素(P<0.05),多因素Logistic回归分析显示HINTS阳性(OR=99.043,95%CI=8.120~1208.090)和ABCD2评分(OR=2.820,95%CI=1.188~6.696)是脑梗死发生的影响因素(P<0.05)。多指标联合、HINTS阳性、ABCD2评分、吸烟史、饮酒史、听力下降预测脑梗死的ROC曲线下面积(AUC)为0.949、0.874、0.734、0.643、0.649和0.604。结论急性前庭综合征患者中非脑梗死比例较大,其中以前庭神经炎最常见,HINTS阳性和ABCD2评分与急性前庭综合征中脑梗死的发生密切相关。

速度阶跃试验的新认知

速度阶跃试验(velocity step test,VST)是一种评估前庭功能的旋转试验,能够反映水平半规管前庭眼反射功能和速度存储机制。我们对VST的机制、检查方法、临床表现及影响因素进行了综述。在VST中,衰减时间常数(time constant,Tc)与峰值增益是两个主要参数,较短的Tc常见于单侧或双侧外周病变,而较长的Tc可能与中枢处理缺陷有关。虽然峰值增益重要性略逊于Tc,但其可以为Tc提供补充信息。Tc与正弦谐波加速试验的相位可进行换算,这两种方法可在临床上互为补充。在实际应用中,Tc会受到检查顺序、转椅速度、头部位置、适应性和警觉性、乙醇作用和视觉条件等因素的影响。目前,VST在前庭领域的研究主要限于描述前庭双温和晕动症的表现,对于其在其他领域的应用,仍需要进一步的研究。

前庭功能联合眼震视图检查在原发性良性阵发性位置性眩晕临床诊断中的意义

目的探究前庭功能联合眼震视图(nystagmus view,VNG)检查在原发性良性阵发性位置性眩晕(BPPV)临床诊断中的意义。方法比较裸眼检查和VNG对BPPV患者的检出率,并采用冷热试验检测BPPV患者前庭功能异常情况。结果VNG和裸眼检查原发性BPPV总检出率分别为91.18%、67.65%,两种检查方法总检出率差异有统计学意义(χ^(2)=17.270,P=0.000)。水平半规管型、后半规管型BPPV患者VNG和裸眼检查检出有明显差异(χ^(2)=4.457、11.942,P<0.05)。不同类型的BPPV患者凝视检测、扫视异常数和平稳跟踪检测结果异常无明显差异(P>0.05);冷热试验显示BPPV异常患者与正常患者分别为66.67%和33.33%。结论前庭功能联合VNG检查对原发性BPPV有一定临床诊断价值。

无眩晕突发性耳聋患者前庭功能初步分析

目的探讨无眩晕突发性耳聋患者前庭功能情况。方法回顾性选取2020年9月至2022年4月新华-崇明区域医联体耳鼻咽喉科病房收治的单侧突发性耳聋患者118例(突聋组),根据突发性耳聋听力损失程度分为非全聋组61例和全聋组57例。纳入陪同就诊听力正常成年人15例(对照组)。观察受试对象前庭器官是否存在损伤及损伤程度的联系。结果对照组前庭功能均正常,与突聋组比较,差异有统计学意义(P<0.05)。非全聋组前庭功能与全聋组比较,差异无统计学意义(P>0.05)。非全聋组痊愈2例,显效15例,有效22例,无效22例。结论即使无眩晕的突发性耳聋患者,仍有前庭功能损伤的可能,提示突发性耳聋患者的前庭功能可能经中枢代偿后抑制了眩晕症状的表现。

急性单侧外周前庭病变病因初步探究

目的:通过分析急性单侧外周前庭病变(acute unilateral peripheral vestibular dysfunction,AUPVD)患者的基本信息、前庭功能、影像学检查、治疗效果等指标,探究AUPVD的可能病因、累及部位。方法:收集2022年2月~4月我科收治的符合纳入标准的AUPVD患者36例的临床资料,其中30例接受视频头脉冲(v HIT)检查,26例接受激素治疗,3例行迷路钆造影增强扫描。分析、比较患者的检查结果及脑血管病危险因素。结果:30例行v HIT检查的患者中,结果异常25例,其中12例(48%)水平半规管vHIT异常,但前管正常;部分迷路钆造影增强检查的患者可见病变侧前庭迷路强化信号,未观察到前庭神经的强化信号;26例使用激素治疗的患者中,17例(65.4%)效果较好,9例(34.6%)效果欠佳,后者平均年龄及至少合并1项脑血管病危险因素占比明显高于前者(P<0.05)。结论:AUPVD的病因可能包括炎性、缺血等多种机制;可能累及前庭神经、前庭迷路等多处部位。

伴自发性眼震与摇头眼震患者扫视波特征的自动量化分析

目的:通过开发一款新的量化评估软件,分析自发性眼震(SN)和摇头眼震(HSN)患者的扫视波参数,以揭示前庭功能障碍患者的扫视波特征及其在不同代偿状态下的变化。方法:回顾性分析2023年9月至2024年6月在中国人民解放军总医院第一医学中心眩晕诊疗中心就诊患者的临床数据,采用自主开发的Saccades All in One(v1.0)软件处理视频头脉冲测试(vHIT)的原始数据,对SN组、HSN组和无眼震(None)组患者的扫视波参数进行分析。结果:SN组和HSN组患侧在第一和第二扫视波的数量、幅度和增益均显著高于健侧,且随代偿进展,受累侧的扫视波数量和幅度逐渐下降,到达时间提前,而健侧变化不明显。统计分析进一步证实了3组间扫视波参数存在显著差异,尤其在扫视波的数量和幅度方面。结论:通过本研究开发的量化工具能有效评估并区分代偿与未代偿状态下的扫视波特征,有助于前庭功能障碍患者的诊断与治疗。

晕宁合剂治疗急性单侧前庭病临床观察

目的观察晕宁合剂治疗急性单侧前庭病(AUVP)的临床疗效。方法选取120例患者随机分为对照组与治疗组。对照组采用甲泼尼龙琥珀酸钠,治疗组在对照组的基础上加用晕宁合剂,治疗开始前和治疗后第3、7、14天分别进行视频头脉冲试验(vHIT),记录增益值及不对称值,同时比较炎性因子[肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、超敏C反应蛋白(hs-CRP)、中性粒细胞/淋巴细胞比值(NLR)、血小板/淋巴细胞比值(PLR)]、眩晕障碍量表(DHI)评分、视觉模拟量表(VAS)评分以及中医症状积分的变化。结果治疗后治疗组的炎性因子(TNF-α、IL-6、hs-CRP、NLR、PLR)、DHI评分、VAS评分、中医症状积分低于对照组(P<0.05);治疗组vHIT的增益值高于对照组(P<0.05),不对称值低于对照组(P<0.05);治疗组的临床总有效率为93.33%,优于对照组的78.33%(P<0.05)。结论晕宁合剂联合甲泼尼龙琥珀酸钠对AUVP的治疗效果优于单纯使用甲泼尼龙琥珀酸钠。

摇头倾斜抑制试验和视频头脉冲试验鉴别前庭性偏头痛和梅尼埃病的应用研究

背景 摇头倾斜抑制试验(HSTST)与前庭小脑介导的中枢储存机制有关,视频头脉冲试验(vHIT)对外周前庭疾病的诊断起重要作用。目的 探索HSTST及vHIT在诊断前庭性偏头痛(VM)和梅尼埃病(MD)中的临床应用价值。方法 选取2021年7月—2022年12月就诊于贵阳市第二人民医院神经内科以眩晕或头晕为主诉、诊断为VM及MD的患者。完成病史采集、床旁查体;有听力损害者完善纯音测听检查;所有患者进行前庭功能检查,包括摇头试验(HST)、HSTST、温度试验及vHIT,计算倾斜抑制指数(TSI)。比较HST阳性的VM及MD患者临床特征及检查结果,绘制TSI鉴别HST阳性的VM和MD患者的受试者工作特征(ROC)曲线。结果 研究共纳入VM患者50例,其中HST阳性22例(44.0%),包括水平眼震19例(86.4%),垂直眼震3例(13.6%);MD患者45例,其中HST阳性23例(51.1%),均为水平眼震。对HST阳性的VM及MD的患者分析显示:VM患者女∶男=4.5∶1,MD患者女∶男=1∶1.3,VM患者头痛家族史比例高于MD患者(P<0.05);VM患者伴随呕吐、耳鸣、耳闷感、听力下降症状的比例(31.8%、18.2%、13.6%、13.6%)低于MD患者(73.9%、100.0%、82.6%、100.0%),伴随头痛症状的比例(77.3%)高于MD患者(8.7%)(P<0.05);纯音测听结果显示MD患者听力下降比例高于VM患者(P<0.001);VM与MD患者vHIT结果比较,差异有统计学意义(P<0.05);VM与MD患者的TSI比较[(25.41±12.15)%与(78.71±13.76)%],差异有统计学意义(P<0.05),TSI鉴别HST阳性VM和MD的灵敏度为0.90,特异度为0.95,ROC曲线下面积为0.962(95%CI=0.91~1.00),最佳截断值为0.66。结论 VM主要是中枢机制,HSTST联合v HIT可以作为鉴别VM和MD的辅助检查工具。

Implementation of a Subjective Visual Vertical and Horizontal Testing System Using Virtual Reality

Subjective visual vertical(SVV)and subjective visual horizontal(SVH)tests can be used to evaluate the perception of verticality and horizontality,respectively,and can aid the diagnosis of otolith dysfunction in clinical practice.In this study,SVV and SVH screen version tests are implemented using virtual reality(VR)equipment;the proposed test method promotes a more immersive feeling for the subject while using a simple equipment configuration and possessing excellent mobility.To verify the performance of the proposed VR-based SVV and SVH tests,a reliable comparison was made between the traditional screen-based SVV and SVH tests and the proposed method,based on 30 healthy subjects.The average results of our experimental tests on the VR-based binocular SVV and SVH equipment were−0.15◦±1.74 and 0.60◦±1.18,respectively.The proposed VR-based method satisfies the normal tolerance for horizontal or vertical lines,i.e.,a±3◦error,as defined in previous studies,and it can be used to replace existing test methods.

Assessment of Balance and Vestibular Functions in Patients with Idiopathic Sudden Sensorineural Hearing Loss

This study investigated the relationship among the severity of hearing impairment,vestibular function and balance function in patients with idiopathic sudden sensorineural hearing loss（ISSNHL）.A total of 35 ISSNHL patients（including 21 patients with vertigo） were enrolled.All of the patients underwent audiometry,sensory organization test（SOT）,caloric test,cervical vestibular-evoked myogenic potential（cV EMP） test and ocular vestibular-evoked myogenic potential（o VEMP） test.Significant relationship was found between vertigo and hearing loss grade（P=0.009）,and between SOT VEST grade and hearing loss grade（P=0.001）.The abnormal rate of o VEMP test was the highest,followed by the abnormal rates of caloric and c VEMP tests,not only in patients with vertigo but also in those without vertigo.The vestibular end organs were more susceptible to damage in patients with vertigo（compared with patients without vertigo）.Significant relationship was found between presence of vertigo and SOT VEST grade（P=0.010）.We demonstrated that vestibular end organs may be impaired not only in patients with vertigo but also in patients without vertigo.The cochlear and vestibular impairment could be more serious in patients with vertigo than in those without vertigo.Vertigo does not necessarily bear a causal relationship with the impairment of the vestibular end organs.SOT VEST grade could be used to reflect the presence of vertigo state in the ISSNHL patients.Apart from audiometry,the function of peripheral vestibular end organs and balance function should be evaluated to comprehensively understand ISSNHL.Better assessment of the condition will help us in clinical diagnosis,treatment and prognosis evaluation of ISSNHL.

Evaluation of Vestibular Function in Diagnosis of Vestibular Schwannomas

Vestibular schwannomas(VS)are benign tumors of the vestibular nerve.The common first symptoms are hearing loss and tinnitus,followed by imbalance,vertigo,and facial nerve involvement.The subjective symptoms of VS patients are not consistent with the severity of vestibular lesions and the results of vestibular tests,which often interfere with clinicians’diagnoses.Thus,the main screening and diagnostic methods for VS are audiometry and magnetic resonance imaging(MRI),ignoring the evaluation of vestibular function at the source of pathological lesions.With the development and improvement of vestibular evaluation technology and its wide application in the clinic,modern vestibular examination technology can reflect the severity and frequency of vestibular lesions and compensation from multiple perspectives,providing an objective basis for the diagnosis and treatment of vestibular diseases.In this report,we review the results and characteristics of vestibular tests in VS patients and further clarify the clinical value of vestibular function assessment in the diagnosis and treatment of VS.

Vestibular Rehabilitation for the Patients with Intractable Vestibular Neuritis

Objective: To clarify whether vestibular rehabilitation is effective in improving spontaneous nystagmus in patients with intractable vestibular neuritis. Methods: The subjects were 8 patients (6 females and 2 males) with vestibular neuritis who revealed long-lasting (more than 2 months since the onset) horizontal spontaneous nystagmus toward the healthy side. We used thumbs-up head shaking for vestibular rehabilitation. This exercise involves active head shaking (1 Hz) while staring at one’s thumb nail. One set is 10 cycles. We asked the patient to do 3 sets (morning, afternoon, and night) every day. Results: The mean value of the slow-phase velocity of spontaneous nystagmus before treatment was 4.1&deg;/s, and that 3 months after vestibular rehabilitation was 4.1&deg;/s. No improvement was observed. Conclusion: Vestibular rehabilitation is not always effective in improving spontaneous nystagmus in patients with intractable vestibular neuritis. Therefore, clinicians should consider the possibility of long-term incomplete central compensation.

视频眼震电图和视频头脉冲检查在急性前庭综合征患者快速定位诊断中的应用效果

目的探讨视频眼震电图和视频头脉冲检查(vHIT)在急性前庭综合征(AVS)患者快速定位诊断中的应用效果。方法选取中枢血管性AVS与前庭外周性AVS患者各149例,分别设为中枢组、外周组。所有患者入院后均进行视频眼震电图检查、vHIT,观察两组患者检测结果差异。结果中枢组的病理性自发眼震、病理性凝视眼震的检出率均高于外周组,位置性眼震的检出率低于外周组(均P<0.05)。中枢组患者的平稳跟踪试验结果、扫视试验结果、静态平衡姿势试验结果的异常率均高于外周组,转椅旋转-急停试验结果异常率低于外周组(均P<0.05);中枢组患者的Ⅲ型曲线、Ⅳ型曲线、扫视欠冲、慢扫视、本体觉异常、反向或垂直眼震的检出率均高于外周组,眼震增益单侧减弱的检出率低于外周组(均P<0.05)。中枢组患者的vHIT异常率、代偿性扫视阳性率均低于外周组,低频前庭眼动反射增益值、视跟踪异常率均高于外周组(均P<0.05)。结论中枢血管性AVS患者具有明显的视眼动系统功能异常,可伴不同程度的前庭脊髓反射功能与前庭眼动系统异常,前庭周围性AVS患者主要为体位相关性自发前庭反应和单侧前庭眼动系统功能异常。视频眼震电图与vHIT可为AVS患者的病变定位诊断提供可靠依据。