周围性眩晕和中枢性眩晕电生理特点的比较  

Comparison of electrophysiological features in peripheral vertigo and central vertigo

作　　者：薛海龙[1] 肖文[1] 李仓霞[1] 

机构地区：[1]解放军第三医院神经内科,宝鸡721004

出　　处：《临床神经病学杂志》2015年第4期262-264,共3页Journal of Clinical Neurology

摘　　要：目的比较周围性眩晕和中枢性眩晕的电生理特点。方法对周围性眩晕组(85例)和中枢性眩晕组(61例)患者进行眼震电图和脑干听觉诱发电位(BAEP)检查。结果周围性眩晕组眼震电图异常67例(78.8%),其中视测距障碍试验过冲及欠冲6例(7.1%);自发性眼震5例(5.9%);凝视试验异常16例(18.8%);视跟踪试验Ⅰ型42例(49.4%),Ⅱ型17例(20.0%),Ⅲ型8例(9.4%);视动性眼震试验双侧不对称19例(22.4%);变位性眼震阳性51例(60.0%);冷热试验异常31例(36.5%)。中枢性眩晕组眼震电图异常42例(68.9%),视测距障碍试验过冲及欠冲19例(31.1%);自发性眼震13例(21.3%);凝视试验异常23例(37.7%);视跟踪试验Ⅰ型35例(57.4%),Ⅱ型13例(21.3%),Ⅲ型8例(13.1%),Ⅳ型5例(8.2%);视动性眼震试验双侧不对称33例(54.1%);变位性眼震阳性2例(3.3%);冷热试验异常6例(9.8%)。与周围性眩晕组比较,中枢性眩晕组视测距障碍试验、凝视试验、视跟踪试验、视动性眼震试验异常率显著升高,变位实验和冷热实验异常率显著降低(均P<0.05)。周围性眩晕组BAEP异常32例(37.6%),中枢性眩晕组BAEP异常31例(50.8%)。与中枢性眩晕组比较,周围性眩晕组Ⅰ波潜伏期及Ⅰ-Ⅲ波的波峰潜伏期显著升高,Ⅴ波潜伏期及Ⅰ-Ⅴ波峰潜伏期显著降低(均P<0.05)。结论眼震电图视测距障碍试验、凝视试验、视跟踪试验、视动性眼震试验对中枢性眩晕敏感性较高,变位性眼震实验对耳石症检出率高,冷热实验对半规管功能评价敏感度高。BAEP阳性率较低,但可对眩晕患者定位提供客观依据。Objective To compared the electrophysiological features in peripheral vertigo and central vertigo. Methods The electronystagmograph （ENG） and brainstem auditory evoked potentials （BAEP） were applied in peripheral vertigo group（85 cases） and central vertigo group（61 cases）. Result ENG abnomal was in 67 cases （78.8%） in peripheral vertigo group. Overshoot or undershoot of dysmetria test was in 6 cases （7. 1% ）; spontaneous nystagmus was in 5 cases（5.9% ） ; abnormal of gaze test was in 16 cases（ 18.8% ） ; eye tracking test type Iwas in 42 case（49.4% ） , typelI was in 17 eases（20.0% ） , and type 11I was in 8 cases（9.4% ） ; bilateral asymmetry of optokinetic nystagmus test was in 19 eases（22.4% ） ; positioning nystagmus was in 51 eases（60. 0% ） ; abnormal of cold and hot test was in 31 cases（36.5% ）. ENG abnomal was 42 eases（49.4% ） in central vertigo group. Overshoot or undershoot of dysmetria test was in 19 case（31.1% ） ; spontaneous nystagmus was in 13 cases （21.3%） ; abnormal of gaze test was in 23 eases（37.7% ） ; eye tracking test type Iwas in 35 eases（57.4% ） , type 11 was in 13 eases（21.3% ） , and type IH was in 8 cases（ 13.1% ） ; bilateral asymmetry of optokinetic nystagmus test was in 33 cases（54.1% ） ; positioning nystagmus was in 2 cases（3.3% ） ; abnormal of cold and hot test was in 6 cases （9.8%）. Compared with peripheral vertigo group, the abnormal rates of optokinetie nystagmus test, gaze test, eye tracking test, optokinetic nystagmus test in central vertigo group were significantly increased, and the abnormal rates of positioning nystagmus, cold and hot test in central vertigo group were significantly decreased （ all P 〈 0. 05 ）. There were 32 cases（37.6% ） in peripheral vertigo group with BAEP abnormal, and 31 cases（50. 8% ） were in central vertigo group with BAED abnormal. Compared with central vertigo group, the latency of Iwave and Ⅰ-Ⅲ wave latency delayed in peripheral vertigo group wer

关 键 词：周围性眩晕 中枢性眩晕 电生理特点 

分 类 号：R741[医药卫生—神经病学与精神病学]