22 5 2016 10 Chinese Journal of Otorhinolaryngology - Skull Base Surgery Vol. 22 No. 5 Oct. 2016 DOI 10. 11798 /j. issn. 1007-1520. 201605008 210008 vestibular autorotation testvat vestibular migraine VM 26 VM 20 VAT 1 VAT VAT VM 21 80. 77% 2 10% P < 0. 05 VM 18 69. 23% 12 4 1 2 VM 16 61. 54% 13 5 VM 3 11. 54% VM 2. 0 ~ 2. 7 Hz 3. 5 ~ 5. 9 Hz VM VAT VM R764. 3 A 1007-1520 2016 05-0370 - 05 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 210008 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 21 80. 77% 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 < 0. 05. In the VM groupgain was found to be abnormal in 18 69. 23% 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 61. 54% including 13 cases with lagged phase in horizontal testing and 5 cases in vertical testing. The abnormal asymmetry was detected in 3 11. 54% 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 Email xiagaogao@ hotmail. com 370 VAT
5 vestibular migraine VM VM 7. 5% VM VM 3 VAT VAT VM < ± 10% 1 1. 1 26 VM 1. 3 6 SPSS 18. 0 23. 08% 20 76. 92% 29 ~ 68 47. 2 ± 11. 8 2013 ICHD-3 VM 2 2 CT MR 2. 1 VM 20 1 VM 1. 2 VAT 1. 2. 1 VAT 2. 0 ~ 6. 0 Hz vestibular Ocular Reflex VOR VOR VOR 1. 2. 2 VAT 1 h 9 34. 62% 1 ~ 24 h 12 46. 15% 24 ~ 72 h 5 19. 23% VM 2 cm 1. 5 m 18 69. 23% 15 57. 69% 9 34. 62% 2. 0 Hz 6. 0 Hz 2. 2 VAT VM 2 18 s6 s 12 s 7. 69% 3 VM VAT 5 19. 23% 21 80. 77% VAT 1. 2. 3 VAT VAT 18 90% 1 2 10% 1 1 VOR VAT VM VOR P < 0. 05 VM 1 > 1 VAT 1 2 VAT < 1 2 2 371 > 10% 10% 1 VAT P < 0. 05 1 26 VM VM % 21 ~ 40 8 4 15. 38 4 15. 38 41 ~ 60 14 1 3. 85 13 50. 00 > 60 4 1 3. 85 3 11. 54 VM 5 min
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 15 57. 69 1 10 1 3. 85 0 2 7. 69 0 16 61. 54 1 10 3 11. 55 0 5 19. 23 18 90. 0 2. 2. 1 VM VM 18 69. 23% 12 4 2 1 VM 2. 2. 2 VM VM 16 61. 54% 13 5 2. 2. 3 VM VM 3 11. 54% 372 VM 2. 3 VM 3 3 VM 2. 0 ~ 2. 7 Hz Hz 3 VM 2. 0 10 2 0 1 0 13 2. 3 9 2 0 1 0 12 2. 7 7 2 0 1 0 10 3. 1 4 0 0 0 0 4 3. 5 4 0 1 1 0 6 3. 9 4 0 1 1 0 6 4. 3 3 0 1 1 0 5 4. 7 3 0 1 1 0 5 5. 1 2 1 0 1 0 4 5. 5 1 2 0 2 0 5 5. 9 1 2 0 2 0 5
5 15 12 9 ( ) 6 3 0 2.0 2.3 2.7 3.1 3.5 3.9 4.3 4.7 5.1 5.5 5.9 (Hz) 3 VM 4 4 0. 05 VM VAT VM 3. 5 ~ 5. 9 Hz 80. 77% VAT VM VM VAT 4 Hz 6 4 2. 0 2 1 3 2. 3 5 1 6 2. 7 6 0 6 3. 1 6 0 6 3. 5 9 0 9 3. 9 9 1 10 4. 3 8 1 9 4. 7 8 0 8 5. 1 7 1 8 5. 5 8 1 9 5. 9 8 1 9 10 8 2 0 2.0 2.3 2.7 3.1 3.5 3.9 4.3 4.7 5.1 5.5 5.9 (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 3. 3. 1 1965 Jones GM and Milsum JH - - 4 4 0. 1 ~ 5. 0 Hz 5 3 caloric test CT 3. 1 VM 0. 025 Hz sinusoidal harmonic acceleration test SHA 0. 01 ~ 0. 64 Hz VM 1 Hz 2 Hz 6 373
22 VM VAT 2. 0 ~ 6. 0 Hz 7 3. 3. 2 VAT CT 44. 0% ~ 64. 1% 6 SHA 45. 5% ~ 51. 0% 8 46. 0% ~ 60. 0% 9 VAT 92% 10 VM CT 29. 7% 808. 18. 9% cvemp 21. 6% 37. 8% 11 VAT VM 80. 77% VAT 3 VM VAT 3. 3. 3 VAT VOR VOR VOR 12-15 9Iwasaki S Ito K Abbey K head-shaking nystagmus test J. Acta Otolaryngol 803-806. 10 3. 3. 4 VAT 2006 4 4266-268. 11 J. 2014 12 2257-261. 12 J. 2006 VAT 13 VAT 24 h J. 2010 7 277-81. 14Schmal F 4 VM 514. VAT VM 374 1O Leary DPDavis LL. High-frequency autorotation testing of the vestibulo-ocular reflex J. Neurologic Clinics 1990 8 2297-312. 2Headache classification committee of the international headache society IHS. The international classification of headache disorders 3rd edition beta version J. Cephalagia 2013 33 9 629-3Lempert TOlesen JFurman Jet al. Vestibular migraine diagnostic criteria consensus document of the Barany Society and the international headache societyj. Nervenarzt 2013 84 4 511-516. 4Jones GM and Milsum JH. Spatial and Dynamic Aspects of Visual Fixation J. IEEE Transactions on Biomedical Engineering 1965 12 2 54-62. 5. M. 2013 134-148. 6Dumas G Lavieille JP Schmerber S. Vibratory test and head shaking test and caloric test a series of 87 patients J. Ann Otolaryngol Chir Cervicofac 2004 121 122-32. 7Hirvonen TP Pyykko I Aalto H et al. Vestibulo-ocular reflex function as measured with the head autorotation test J. Acta Otolaryngol 1997 117 5 657-662. 8Corvera 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 2000 31 4 384-387. et al. Prediction of canal paresis using 2004 124 7. J... 20 16724-727.. Kunz R. The vertical liner vestibuloocular reflex in patients with hyperactive response during horizontal angular acceleration J. Acta Otolaryngol 2003 123 5 606-611. 15Perez N Martin E & Garcia-Tapia R. Results of Vestibular Autorotation Testing at the end of intratympanic gentamicin treatment for Meniere s DiseaseJ. Acta Otolaryngol 2003 123 4 506-2016 - 04-01