Application of vestibular autorotation test in patients with vestibular migraine

Transcription

1 Chinese Journal of Otorhinolaryngology - Skull Base Surgery Vol. 22 No. 5 Oct DOI /j. issn vestibular autorotation testvat vestibular migraine VM 26 VM 20 VAT 1 VAT VAT VM % 2 10% P < VM % VM % 13 5 VM % VM 2. 0 ~ 2. 7 Hz 3. 5 ~ 5. 9 Hz VM VAT VM R A Application of vestibular autorotation test in patients with vestibular migraine LIU JingZHANG Xiao-liGAO Xia Department of Otolaryngology-Head and Neck SurgeryDrum Tower HospitalMedical School of Nanjing UniversityNanjing China Abstract Objective To investigate the value of vestibular autorotation test VAT for assessing vestibular function in patients with vestibular migraine VM. Methods VAT was performed with 26 patients suffering from vestibular migraine VM group and 20 normal subjects control group. Parameters analyzed in this study included horizontal gainhorizontal phasevertical gainvertical phase and asymmetry. parameters was abnormal could be defined as abnormal VAT. Results That any of the above-mentioned five % patients in the VM group were abnormal and 2 10% in the control group were abnormal. The difference of detection rate of abnormal vestibular function between both groups was statistically significant P < In the VM groupgain was found to be abnormal in % patients including 12 with increased gain in horizontal testing4 with increased gain in vertical testingone with decreased gain in horizontal testing2 cases with partly increased and partly decreased gains in horizontal testing. Phase delay was observed in 16 patients % including 13 cases with lagged phase in horizontal testing and 5 cases in vertical testing. The abnormal asymmetry was detected in % patients and the right side was weaksuggesting asymmetry of bilateral vestibular function. The abnormal gains were given priority to frequencies ranged from 2. 0 Hz to 2. 7 Hz. The lagged phases were given priority to frequencies ranged from 3. 5 Hz to 5. 9 Hz. Conclusion VAT is mainly characterized by high gains and lagged phases in patients with VM. Of them horizontal tests are more sensitive. VAT can effectively evaluate vestibular function in patients with VM and provide valuable reference to the diagnosis. Key words Vestibular autorotation test Vestibular migraine Vertigo vestibular autorotation test VAT O Leary 1 xiagaogao@ hotmail. com 370 VAT

2 5 vestibular migraine VM VM 7. 5% VM VM 3 VAT VAT VM < ± 10% VM SPSS % % 29 ~ ± ICHD-3 VM 2 2 CT MR 2. 1 VM 20 1 VM 1. 2 VAT VAT 2. 0 ~ 6. 0 Hz vestibular Ocular Reflex VOR VOR VOR VAT 1 h % 1 ~ 24 h % 24 ~ 72 h % VM 2 cm 1. 5 m % % % 2. 0 Hz 6. 0 Hz 2. 2 VAT VM 2 18 s6 s 12 s 7. 69% 3 VM VAT % % VAT VAT VAT 18 90% % 1 1 VOR VAT VM VOR P < VM 1 > 1 VAT 1 2 VAT < > 10% 10% 1 VAT P < VM VM % 21 ~ ~ > VM 5 min

3 22 1 VM VAT a 2. 0 ~ 5. 9 Hz b 2. 3 ~ 5. 9 Hz c d e 2 VAT a b c d e 2 VM VAT % VM VM VM % VM VM VM % VM VM % 372 VM 2. 3 VM 3 3 VM 2. 0 ~ 2. 7 Hz Hz 3 VM

4 ( ) (Hz) 3 VM VM VAT VM 3. 5 ~ 5. 9 Hz % VAT VM VM VAT 4 Hz (Hz) VM VM 3 3 VM 5 VM 1 VM VM 3. 2 VAT VAT VM VM P < VM VM 3 VM VAT VM 2. 0 ~ 2. 7 Hz 3. 5 ~ 5. 9 Hz VM 3. 3 VAT Jones GM and Milsum JH ~ 5. 0 Hz 5 3 caloric test CT 3. 1 VM Hz sinusoidal harmonic acceleration test SHA ~ Hz VM 1 Hz 2 Hz 6 373

5 22 VM VAT 2. 0 ~ 6. 0 Hz VAT CT 44. 0% ~ 64. 1% 6 SHA 45. 5% ~ 51. 0% % ~ 60. 0% 9 VAT 92% 10 VM CT 29. 7% % cvemp 21. 6% 37. 8% 11 VAT VM % VAT 3 VM VAT VAT VOR VOR VOR Iwasaki S Ito K Abbey K head-shaking nystagmus test J. Acta Otolaryngol VAT J J VAT 13 VAT 24 h J Schmal F 4 VM 514. VAT VM 374 1O Leary DPDavis LL. High-frequency autorotation testing of the vestibulo-ocular reflex J. Neurologic Clinics Headache classification committee of the international headache society IHS. The international classification of headache disorders 3rd edition beta version J. Cephalagia Lempert TOlesen JFurman Jet al. Vestibular migraine diagnostic criteria consensus document of the Barany Society and the international headache societyj. Nervenarzt Jones GM and Milsum JH. Spatial and Dynamic Aspects of Visual Fixation J. IEEE Transactions on Biomedical Engineering M Dumas G Lavieille JP Schmerber S. Vibratory test and head shaking test and caloric test a series of 87 patients J. Ann Otolaryngol Chir Cervicofac Hirvonen TP Pyykko I Aalto H et al. Vestibulo-ocular reflex function as measured with the head autorotation test J. Acta Otolaryngol Corvera J Corvera-Behar G Lapilover V et al. Evaluation of the vestibular autorotation test VAT for measuring vestibular oculomotor reflex in clinical research J. Arch Med Res et al. Prediction of canal paresis using J Kunz R. The vertical liner vestibuloocular reflex in patients with hyperactive response during horizontal angular acceleration J. Acta Otolaryngol Perez N Martin E & Garcia-Tapia R. Results of Vestibular Autorotation Testing at the end of intratympanic gentamicin treatment for Meniere s DiseaseJ. Acta Otolaryngol