视频头脉冲试验检测前庭神经炎急性期半规管的受损情况及其恢复特点的应用  

Application of video head impulse test in detecting damage and recovery features of semicircular canal of patients with acute vestibular neuritis

作　　者：陈瑛[1] 庄建华[1] 李斐[1] 周晓闻[1] 

机构地区：[1]第二军医大学长征医院神经内科,上海200003

出　　处：《第二军医大学学报》2018年第1期97-100,共4页Academic Journal of Second Military Medical University

摘　　要：目的探讨应用视频头脉冲试验检查前庭神经炎急性期半规管的受损情况及受损半规管的恢复特点。方法对2015年3月至2016年3月间第二军医大学长征医院神经内科确诊的28例急性前庭神经炎患者进行临床分析及定期随访,应用视频头脉冲试验检查各半规管功能的受损和恢复情况。结果在发病急性期,28例(100.00%)患者均存在水平半规管功能异常,24例(85.71%)存在前半规管功能异常,4例(14.29%)存在后半规管功能异常。发病2个月后随访显示,发病时水平半规管受损严重(增益值<0.5)者随访时增益值均未恢复正常,而发病时受损相对较轻(增益值为0.5~0.8)者中80.00%(12/15)的患者随访时恢复正常;发病时前半规管受损严重(增益值<0.5)者中82.35%(14/17)的患者随访时增益值未恢复正常,而发病时受损相对较轻(增益值为0.5~0.7)者随访时均恢复正常。结论在前庭神经炎中前庭上神经支配半规管受损多于前庭下神经支配的半规管,视频头脉冲试验适用于受损半规管的检测和随访。受损半规管的恢复程度与发病时受损的严重程度有关。Objective To investigate the application of video head impulse test in detecting the impairment of semicircular canal of patients with acute vestibular neuritis and the recovery features of the damaged semicircular canal. Methods The clinical data of 28 patients with acute vestibular neuritis, who were diagnosed in the Department of Neurology, Changzheng Hospital, Second Military Medical University from Mar. 2015 to Mar. 2016, were analyzed and regularly followed up. The damage and recovery of each semicircular canal function were evaluated by video head impulse test. Results During the onset period, the horizontal semicircular canal function was abnormal in 28 patients（100.00%）, the anterior semicircular canal function was abnormal in 24 cases（85.71%）, and the posterior semicircular canal function was abnormal in 4 cases（14.29%）. After 2 months of follow-up, the gain of the patients with severe damage of horizontal semicircular canal（gain0.5） at onset did not return to normal, while that of 80.00%（12/15） of the patients with less damage of horizontal semicircular canal（gain ranged from 0.5 to 0.8） recovered; 82.35%（14/17） of the patients with severe damage of anterior semicircular canal（gain0.5） at onset did not recover, while that of the patients with less damage of anterior semicircular canal（gain ranged from 0.5 to 0.7） returned to normal. Conclusion In patients with vestibular neuritis, the damage of semicircular canal dominated by superior vestibular nerve is more severe than that dominated by inferior vestibular nerve. Video head impulse test is suitable for the detection and follow-up of the function of impaired semicircular canal. The recovery of impaired semicircular canal is related to its severity at onset.

关 键 词：前庭神经炎 视频头脉冲试验 冷热试验 半规管 

分 类 号：R764.4[医药卫生—耳鼻咽喉科]