前庭诱发肌源性电位  

Vestibular Evoked Myogenic Potentials(VEMP)

作　　者：张左华[1] 张连山[1] 

机构地区：[1]北京协和医院耳鼻咽喉科

出　　处：《听力学及言语疾病杂志》1999年第3期126-129,共4页Journal of Audiology and Speech Pathology

摘　　要：目的探讨用高强度短声刺激一侧球囊在双侧颈部屈肌（胸锁乳突肌）记录肌源性电位来反映人的前庭丘脑通路完整性的方法。方法实验中对２７例正常人及２５例末梢性前庭病变和１５例重度感音神经性聋患者的前庭诱发肌源性电位进行了研究。记录电极分别放置在双侧胸锁乳突肌中部，通过标定耳机分别给双耳脉宽０．１ｍｓ的短声。结果在正常人颈部记录到的短潜伏期肌电位具有五个正负波，在同侧和对侧颈肌分别记录时各波的峰潜伏期无明显差别，而波幅有明显差异，即同侧记录时波幅明显高于对侧。ｐⅠ－ｎⅡ电位与冷热试验有很高的相关性。结论ｐⅠ－ｎⅡ电位可能源于球囊，暗示着一个快速的双突触的传导通路，其潜伏期代表着从感受器兴奋传到脑干再从桥脑到胸锁乳突肌运动神经元的中枢传导以及从运动神经元到肌肉的末梢传导的总和。Objective To research vestibular evoked myogenic potentials(VEMP) testing as a conventional methods in assessing install vestibulocollic pathways in humans. Methods In twenty-seven normal subjects and twenty-five documented unilateral peripheral vestibular disorder and fifteen severe sensorineural hearing loss patients, electromyograms(EMG) were recorded from surface electrodes over the sternomastoid muscles (middle point) and averaged in response to 0.1 millisecond clicks played through calibrated headphones, two ears received stimuli respectively. Results The comtrol potients demonstrated EMG 5 positive-negative potentials(p-n). We identified them only as pnpn and p, the four identified peak to peak amplitudes, named p-n,n-p,p-n and n-p. Conclusion\ We suspect the origin of the response may be in the saccule. The observed latency represents the sum of the delays due to activation of receptors, conduction to the brainstem, central conduction from the pons to the motor nucleus of the sternomastiod muscle, and peripheral conduction from the motor nucleus to the muscle itself.

关 键 词：前庭诱发电位 球囊 短声刺激 

分 类 号：R338.3[医药卫生—人体生理学] R338.8[医药卫生—基础医学]