小脑性共济失调患者视频眼震电图特点  

Characteristics of the video nystagmography in patients with cerebellar ataxia

作　　者：陈芳[1] 户宁宁 杨冬菊[1] 刘静[1] 刘爱华[1] 樊春秋[1] CHEN Fang;HU Ningning;YANG Dongju;LIU Jing;LIU Aihua;FAN Chunqiu(Department of Neurology,Xuanwu Hospital Capital Medical University,Beijing 100053,China)

机构地区：[1]首都医科大学宣武医院神经内科,北京100053

出　　处：《中国医药导报》2022年第8期69-71,76,共4页China Medical Herald

基　　金：国家重点研发计划“重大慢性非传染性疾病防控研究”专项项目子课题(2017YFC1310901)。

摘　　要：目的明确小脑性共济失调患者视频眼震电图特点,为早期诊断小脑性共济失调和鉴别前庭中枢性和周围性病变提供眼动异常依据。方法收集2019年10月至2020年5月首都医科大学宣武医院神经内科住院诊治小脑性共济失调患者20例,对其视频眼震图各个项目包括自发性眼震、视动性眼震、平稳跟踪试验、扫视试验、凝视试验、位置试验和双温试验进行分析,总结各个项目的表现特点。结果自发性眼震试验:7例(35%)出现各种类型眼震和扫视侵扰;视动性眼震:3例(15%)出现双侧慢相角速度不对称,19例(95%)出现增益异常;平稳追踪试验:18例(90%)出现Ⅲ型和Ⅳ型曲线,10例(50%)出现增益异常;凝视试验:10例(50%)出现异常眼动;扫视试验:13例(65%)出现峰速度下降、12例(60%)出现准确度异常和1例(5%)出现潜伏期异常;静态位置试验:15例(75%)出现异常眼动;前庭双温试验:1例(5%)出现半规管功能亢进。结论视动性眼震的增益异常、平稳追踪试验曲线波形异常提示前庭中枢异常,是早期诊断小脑性共济失调的依据之一。Objective To clarify the characteristics of the video nystagmography in patients with cerebellar ataxia,and to provide evidence for early diagnosis of cerebellar ataxia and differentiation of vestibular central and peripheral lesions of eye movement abnormalities.Methods A total of 20 patients with cerebellar ataxia treated in Department of Neurology,Xuanwu Hospital Capital Medical University from October 2019 to May 2020 were collected.The performance characteristics of the video nystagmography including spontaneous nystagmus,visual nystagmus,stationary tracking test,saccades test,gaze test,position test and double temperature test were analyzed,and the performance characteristics of each project were summarized.Results Spontaneous nystagmus test:7 cases(35%)had various types of nystagmus and saccade;visual nystagmus:asymmetric slow phase velocity was found in 3 cases(15%),and abnormal gain was found in 19 cases(95%);stationary tracing test:18 cases(90%)showed type Ⅲ and type Ⅳ curves,and 10 cases(50%)showed abnormal gain;gaze test:10 cases(50%)had abnormal eye movement;saccade test:peak velocity decreased in 13 cases(65%),accuracy abnormal in 12 cases(60%),and latency abnormal in 1 case(5%);static position test:15 cases(75%)showed abnormal eye movement;vestibular double temperature test:1 case(5%)showed hypersemicircular canal function.Conclusion The abnormal gain and smooth tracing curve of optic nystagmus indicate abnormal vestibular center,which is one of the basis for early diagnosis of cerebellar ataxia.

关 键 词：小脑性共济失调 视频眼震电图 前庭中枢 早期诊断 

分 类 号：R744.7[医药卫生—神经病学与精神病学]