CAJ | 학술논문

目的：通过实验室检查来评估前庭性偏头痛(vestibular migrain,VM)患者的前庭功能，探寻该疾病的前庭功能特点。方法对37例确诊为前庭性偏头痛的患者及30例健康志愿者分别行冷热试验（caloric test）、摇头试验（head-shaking nystagmus，HNS）、速度阶梯试验及颈肌性前庭诱发电位（cervical Vestibular-Evoked Myogenic Potentials， cVEMP）检查，对两组冷热试验、摇头试验及速度阶梯试验的异常结果进行分析，对100dB的短音刺激情况下cVEMP不对称性进行分析。结果前庭性偏头痛患者水平半规管功能的异常率显著高于对照组，差异有统计学意义（P＜0.05）。37例VM患者中，有11例（29.7%）出现冷热试验异常，14例（37.8%）出现摇头试验异常，7例（18.9%）出现速度阶梯试验异常。30例健康志愿者中，有2例（6.7%）出现冷热试验异常，1例（3.3%）出现摇头试验异常，无患者出现速度阶梯试验异常。总体而言，28例（76％）VM患者至少在一个水平半规管功能试验中出现异常，异常率最高的是摇头试验，其次是冷热试验和速度阶梯试验。前庭性偏头痛患者的cVEMP异常率（21.6%）要显著高于对照组（3.3%），差异有统计学意义（P＜0.05）。结论76％的前庭性偏头痛患者被发现存在前庭功能异常，在冷热试验的基础上加用摇头试验和旋转试验，可以提高VM患者前庭功能异常的检出率。前庭性偏头痛患者显示的cVEMP结果，反映了球囊功能的异常及VM患者在球囊-颈反射通路上有所损害。前庭性偏头痛患者存在不同程度的前庭功能异常。
목적：통과실험실검사래평고전정성편두통(vestibular migrain,VM)환자적전정공능，탐심해질병적전정공능특점。방법대37례학진위전정성편두통적환자급30례건강지원자분별행랭열시험（caloric test）、요두시험（head-shaking nystagmus，HNS）、속도계제시험급경기성전정유발전위（cervical Vestibular-Evoked Myogenic Potentials， cVEMP）검사，대량조랭열시험、요두시험급속도계제시험적이상결과진행분석，대100dB적단음자격정황하cVEMP불대칭성진행분석。결과전정성편두통환자수평반규관공능적이상솔현저고우대조조，차이유통계학의의（P＜0.05）。37례VM환자중，유11례（29.7%）출현랭열시험이상，14례（37.8%）출현요두시험이상，7례（18.9%）출현속도계제시험이상。30례건강지원자중，유2례（6.7%）출현랭열시험이상，1례（3.3%）출현요두시험이상，무환자출현속도계제시험이상。총체이언，28례（76％）VM환자지소재일개수평반규관공능시험중출현이상，이상솔최고적시요두시험，기차시랭열시험화속도계제시험。전정성편두통환자적cVEMP이상솔（21.6%）요현저고우대조조（3.3%），차이유통계학의의（P＜0.05）。결론76％적전정성편두통환자피발현존재전정공능이상，재랭열시험적기출상가용요두시험화선전시험，가이제고VM환자전정공능이상적검출솔。전정성편두통환자현시적cVEMP결과，반영료구낭공능적이상급VM환자재구낭-경반사통로상유소손해。전정성편두통환자존재불동정도적전정공능이상。
Objective To evaluate vestibular function in patients with vestibular migraine by laboratory tests. Meth-ods Thirty-seven patients with vestibular migraine (VM) and 31 healthy volunteers completed caloric test, HNS, rotational test and VEMP, and the results were compared between the two groups. The asymmetry of cVEMP induced by 100 dB tone-pip stimuli was also compared between the two groups. Results The rate of abnormal horizontal semicircular canal function in the VM group was significantly higher than that in control subjects (P<0.05). Of the 37 VM patients, 11 (29.7%), 14 (37.8%) and 7 (18.9%) exhibited abnormal caloric, HSN, and rotational test results, respectively, in contrast to 2 (6.7%), 1 (3.3%) and 0 of the 30 healthy volunteers exhibiting corresponding abnormal results. Overall, 76% of patients with VM had abnormalities in at least one of the horizontal semicircular canal function tests, with the highest. abnormality rates seen in HSN, followed by rota-tional and the caloric tests. The rates of abnormal cVEMP in VM patients (21.6%) were significantly higher than those (3.3%) in the control group (P<0.05). Conclusions Most (76%) vestibular migraine patients have vestibular dysfunction. Detection of vestibular abnormality in patients with VM can be enhanced by adding HSN and rotational tests to caloric test. Patients with vestibular migraine may have abnormal function of the saccule and sacculocollic pathway damage as indicated by cVEMP. Ves-tibular dysfunction may be common among vestibular migraine patients to varying degrees.