CAJ | 학술논문

目的探讨前庭中枢性眩晕和前庭周围性眩晕患者视频眼震图(videonystagmography,VNG)的参数特点.方法收集2011年3~12月首都医科大学附属北京天坛医院神经内科住院的69例后循环缺血所致前庭中枢性眩晕患者和眩晕会诊中心就诊的108例前庭周围性眩晕(梅尼埃病12例、良性阵发性位置性眩晕96例)患者的临床资料,分析并比较其VNG参数特点和临床特征.结果69例前庭中枢性眩晕患者和108例前庭周围性眩晕患者相比,临床特点:男性多见(P<0.001),年龄更大(P=0.009),病程更短(P<0.001),更多出现视物成双(P<0.001)、偏身麻木无力(P<0.001)、言语不利(P<0.001)等症状,较少出现耳蜗症状(P=0.021),眩晕持续时间更长(P<0.001),发病多与体位改变无关(P<0.001);VNG参数特点:视跟踪异常(40.6% vs 0.9%, P<0.001)、定标试验异常(13.0% vs 0.0%,P<0.001)、视动试验异常(10.1% vs 0.0%,P=0.003)、凝视试验异常(10.1% vs 0.0%,P=0.003)、自发性眼震(8.7% vs 0.0%,P=0.007)或位置性眼震(8.7% vs 0.0%,P=0.007)发生比例前庭中枢性眩晕组高于前庭周围性眩晕组;而变位试验阳性(14.5% vs 74.1%,P<0.001)前庭中枢性眩晕组低于前庭周围性眩晕组.结论 VNG参数特点能客观地反映前庭中枢性眩晕和前庭周围性眩晕患者的眼震情况,结合临床特征有助于前庭系统性眩晕的定位诊断.
목적탐토전정중추성현훈화전정주위성현훈환자시빈안진도(videonystagmography,VNG)적삼수특점.방법수집2011년3~12월수도의과대학부속북경천단의원신경내과주원적69례후순배결혈소치전정중추성현훈환자화현훈회진중심취진적108례전정주위성현훈(매니애병12례、량성진발성위치성현훈96례)환자적림상자료,분석병비교기VNG삼수특점화림상특정.결과69례전정중추성현훈환자화108례전정주위성현훈환자상비,림상특점:남성다견(P<0.001),년령경대(P=0.009),병정경단(P<0.001),경다출현시물성쌍(P<0.001)、편신마목무력(P<0.001)、언어불리(P<0.001)등증상,교소출현이와증상(P=0.021),현훈지속시간경장(P<0.001),발병다여체위개변무관(P<0.001);VNG삼수특점:시근종이상(40.6% vs 0.9%, P<0.001)、정표시험이상(13.0% vs 0.0%,P<0.001)、시동시험이상(10.1% vs 0.0%,P=0.003)、응시시험이상(10.1% vs 0.0%,P=0.003)、자발성안진(8.7% vs 0.0%,P=0.007)혹위치성안진(8.7% vs 0.0%,P=0.007)발생비례전정중추성현훈조고우전정주위성현훈조;이변위시험양성(14.5% vs 74.1%,P<0.001)전정중추성현훈조저우전정주위성현훈조.결론 VNG삼수특점능객관지반영전정중추성현훈화전정주위성현훈환자적안진정황,결합림상특정유조우전정계통성현훈적정위진단.
@@@@Objective To analyze the characteristics of videonystagmography(VNG) parameters of vestibular central and peripheral vertigo patients. Methods Data on clinical manifestations and parameters of VNG were collected from 69 cases of vestibular central vertigo and 108 cases of vestibular peripheral vertigo, and then these data were analyzed and compared respectively. Results Compared with patients with vestibular peripheral vertigo, those with vestibular central vertigo were more common in male(P<0.001), older(P=0.009), shorter in course(P<0.001). The symptoms of diplopia(P<0.001), hemianesthesia weakness(P<0.001), slurred speech(P<0.001) were more often in patients with vestibular central vertigo. And cochlear symptoms(P=0.021) were more frequent in patients with vestibular peripheral vertigo. The duration of vertigo attack of vestibular central vertigo was longer(P<0.001). The onset of vestibular central vertigo was more related to body position(P<0.001). As compared with patients with vestibular peripheral vertigo, those with vestibular central vertigo demonstrated more abnormal in eye tracking test(40.6%vs 0.9%, P<0.001), calibration test(13.0%vs 0.0%, P<0.001), optokinetic test(10.1%vs 0.0%, P=0.003), gaze test(10.1%vs 0.0%, P=0.003), spontaneous nystagmus(8.7%vs 0.0%, P=0.007) or positional nystagmus(8.7%vs 0.0%, P=0.007). And positive positioning test was more common in patients with vestibular peripheral vertigo(14.5%vs 74.1%, P<0.001). Conclusion The features of VNG parameters are objective responses of nystagmus in vestibular vertigo patients. Combined with clinical features, they could help us distinguish vestibular central and peripheral vertigo.