健康青年人骨导前庭诱发肌源性电位临床正常值的建立北大核心CSCD

目的 建立本实验室健康青年人骨导前庭诱发肌源性电位(bone-conducted vestibular evoked myogenic potential)的临床正常值范围。方法 选择30名(60耳)健康青年人为研究对象,男15人,女15人,平均年龄(25.28±4.32)岁,使用B81骨振子进行骨导振动(bone-conducted vibration,BCV)诱发的颈肌前庭诱发肌源性电位(cervical vestibular evoked myogenic potentials,cVEMP)和眼肌前庭诱发肌源性电位(ocular vestibular evoked myogenic potentials,oVEMP)检测,以60dB nHL给声强度作为起始刺激强度,记录BCV-cVEMP和BCV-oVEMP的引出率、潜伏期、波间期、波幅和阈值,采用SPSS22.0统计软件进行统计学分析。结果 BCV-cVEMP和BCV-oVEMP的引出率均为100%(60/60);BCV-cVEMP的阈值为(41.80±2.99)dB nHL,P1、N1潜伏期分别为(16.05±1.76)ms和(26.43±2.66)ms,波间期为(10.11±2.03)ms,波幅为(86.93±60.45)μV;BCV-oVEMP的阈值为(45.00±3.50)dB nHL,P1、N1潜伏期分别为(18.25±2.40)和(12.19±2.31)ms,波间期为(6.09±0.99)ms,波幅为(10.33±9.90)μV。受试者左右耳BCVcVEMP和BCV-oVEMP的P1潜伏期(P=0.421,P=0.672),N1潜伏期(P=0.889,P=0.662),波间期(P=0.116,P=0.553),波幅(P=0.819,P=0.509)和阈值(P=0.425,P=0.090)差异均无统计学意义(P>0.05)。结论 BCV-VEMP对于健康青年人是一项稳定可靠的前庭功能检查。本实验室健康青年人BCV-VEMP正常值的建立,可为BCV-VEMP的临床应用提供参考。     

直流电刺激诱发的前庭诱发肌源性电位儿童检测方法的建立

目的 建立健康儿童直流电刺激诱发(galvanic vestibular stimulation, GVS)的颈肌前庭诱发肌源性电位(cervical vestibular evoked myogenic potential, cVEMP)和眼肌前庭诱发肌源性电位(ocular vestibular evoked myogenic potential, oVEMP)的检测方法,并确定正常范围。方法 对健康儿童20例(3～14岁)和健康成人24例(18～30岁)分别进行GVS-cVEMP和GVS-oVEMP检测,儿童组直流电刺激强度不超过3 mA,成人组最大刺激强度5 mA,记录两组GVS-cVEMP和GVS-oVEMP的引出率和特点,并进行不同刺激强度下的疼痛评分。结果 GVS-cVEMP和GVS-oVEMP在儿童组和成人组的引出率均为100.0%。儿童组GVS-cVEMP的p1潜伏期、n1潜伏期和p1-n1波间期分别为10.46±1.84 ms、16.98±2.12 ms和6.52±1.42 ms, n1潜伏期和p1-n1波间期较成人组明显缩短(P<0.05)。儿童组GVS-o...     

气导短纯音诱发的眼肌前庭诱发肌源性电位在健康青年人群中的波形特征

目的 介绍气导短纯音诱发的眼肌前庭诱发肌源性电位(ocular vestibular evoked myogenic potential,oVEMP)的引出方法;观察健康青年人群oVEMP反应,并进行参数分析和正常值计算.方法 选择25名健康成人作为研究对象,其中男12名,女13名,年龄19～ 45岁,平均年龄(24.3±5.6)岁.以500 Hz短纯音为刺激音,进行气导oVEMP检测,并计算阈值、潜伏期等参数的正常值.结果 全部受试者均引出典型的oVEMP N1-P1复合波形,引出率为100％.oVEMP的引出阈值(正常听力级)为(86.6 ±3.6)dB((x)±s,下同);N1潜伏期为(10.1 ±0.4) ms,P1潜伏期为(14.7±1.2)ms,波间期(4.5±1.0)ms;振幅(7.9±4.4) μV.除振幅耳间波动稍大外,oVEMP阈值、N1潜伏期及P1潜伏期左右耳间波动很小.结论 气导oVEMP是一种新兴的、稳定有效的前庭功能检测方法.     

气导声刺激前庭诱发肌源性电位在正常儿童中的表现

目的 探讨研究正常儿童中气导声刺激诱发的眼性前庭诱发肌源性电位(oVEMP)和颈性前庭肌源性诱发电位(cVEMP)的各项参数指标,并对正常值进行统计学处理分析。 方法 选择4~10岁听力正常健康儿童52例,以500 Hz短纯音作为刺激音,分别行 oVEMP和cVEMP检测,记录左、右耳引出率及波形参数,并采用SPSS统计软件进行统计学处理分析。 结果 双耳皆未引出oVEMP 2例,单耳可引出oVEMP4例,oVEMP总体引出率为92%。双耳皆未引出cVEMP 2例,cVEMP总体引出率为96%。oVEMP与cVEMP的P1潜伏期分别为(17.07±0.89)ms、(15.55±1.58)ms;N1潜伏期分别为(12.39±0.91)ms、(23.10±2.29)ms;N1P1间期分别为(4.68±0.88)ms、(7.83±1.56)ms;oVEMP与cVEMP的振幅分别为(7.24±4.79)μV、(197.40±118.37)μV。双耳间oVEMP及cVEMP振幅不对称比分别为(19.03±12.50)%、(22.16±18.64)%。患儿左右耳的潜伏期,P1N1间期及振幅差异无统计学意义(P>0.05)。 结论 绝大部分正常儿童经气导声刺激可引出oVEMP与cVEMP。该检测患儿依从性高,可用来评估儿童前庭功能。此研究结果可为我国的儿童气导VEMP提供正常参考值范围。     

骨导振动刺激下前庭诱发肌源性电位在传导性耳聋患者中的应用

目的探索骨导振动(BCV)刺激诱发的眼肌和颈肌前庭诱发肌源性电位(oVEMP,cVEMP)在传导性耳聋患者中的应用。方法从2018.1-2018.6在门诊及住院部选取传导性耳聋患者65耳,双耳均行纯音听阈、听性脑干反应、声导抗、耳声发射、颞骨CT、气导声刺激(ACS)及骨导振动刺激的VEMPs检查,数据行统计分析。结果 1.传导性耳聋患者中,平均骨气导差(PTA)大于20dB与小于20dB的BCV-VEMPs引出率比较均无统计学差异。2.传导性耳聋患者中BCV-VEMPs和ACS-VEMPs引出率比较均有统计学差异。3.其中36例单耳传导性耳聋患者中患侧和健耳BCV-VEMPs引出率比较均无统计学差异。该36例患者患耳及健耳BCV-VEMPs的阈值、振幅、n1潜伏期、p1潜伏期、波间期等参数分别进行比较,oVEMP的阈值、振幅两者比较有统计学意义,余均未见有统计学差异。结论骨导振动刺激诱发的VEMPs在传导性听力损失的患者中可稳定引出,在临床上可以将骨导振动刺激诱发的VEMPs作为气导声刺激诱发的VEMPs的替代检查。     

同步检测眼性和颈性前庭诱发肌源性电位的可行性研究

目的 探讨同步检测眼性前庭诱发肌源性电位(ocular vestibular-evoked myogenic potential,oVEMP)和颈性前庭诱发肌源性电位(cervical vestibular-evoked myogenic potential,cVEMP)的可行性.方法 对20例正常人及23例梅尼埃病患者分别进行oVEMP和cVEMP同步检测和单独检测,两种检测方式所用仪器和坐姿相同,检测参数设置相同,分别比较两种检测方式下两组对象oVEMP和cVEMP的振幅、潜伏期、波间期及双侧耳不对称比.结果 正常人左、右耳的oVEMP及cVEMP的引出率、振幅、潜伏期、波间期与不对称比在两种形式同步检测与各方式单独检测之间无显著差异;两种方式同步检测时梅尼埃病患者的患耳及对侧耳的oVEMP及cVEMP引出率、振幅、潜伏期、波间期及不对称比与各方式单独检测的结果也无显著差异.结论 对正常人和梅尼埃病患者,oVEMP和cVEMP检测可同步进行,但检测参数应与单独检测时设置一致.     

后循环缺血性眩晕患者的前庭功能变化

目的　通过检测后循环缺血性眩晕（posterior circulation ischemic vertig, PCIV）患者前庭神经电生理和眼动功能的变化以探讨PCIV的前庭功能变化。 方法　对已经由临床和磁共振动脉成像或CT血管造影证实为PCIV的患者分别进行颈性前庭诱发肌源电位（cervical vestibular evoked myogenic potential, cVEMP）、眼性前庭诱发肌源电位（ocular vestibular evoked myogenic potential,oVEMP）、视频眼震电图（videonystagmography, VNG）及前庭双温交替试验（alternate bithermal caloric test, BT） 等检查,并将各项检测数据与对照组的相应数据进行统计学分析。结果　病例组cVEMP, oVEMP的潜伏期及左侧峰间振幅与对照组比较差异有统计学意义。病例组和对 照组cVEMP左右侧潜伏期差异分别为（t =11.4、9.55、 7.17和7.71, P＜0.00）。左侧峰间振幅差异（t =3.07, P＜0.00）。oVEMP左右侧潜伏期差异分别为（t =7.88、5.35、 7.58和6.39, P＜0.00）。左侧峰间振幅差异为（ t =2.33, P＜0.00）;右侧峰间振幅及双侧振幅差比值比较差异无统计学意义（P＞0.05）; VNG检查病例组扫视试验、平稳跟踪试验及视动试验的异常率明显增高,与对照组比较差异有显著性意义（扫视试验：χ2=7.35, P＜0.01;平稳跟踪试验及视动试验： χ2=8.08, P＜0.005）。病例组半规管轻瘫指数阳性率43%,对照组18%,两组半规管轻瘫指数对比差异有统计学意义（χ2=4.40, P＜0.05）。结论　VEMP主要检测前庭神经的电生理变化, VNG和BT注重于视眼动和视前庭功能检测,能够在神经体征和影像学变化出现前敏感检测出PCIV的前庭功能异常变化,对PCIV的诊断、治疗和预后判断具有较大的价值,值得临床推广应用。     

原发性良性阵发性位置性眩晕患者前庭诱发肌源性电位检测的意义

目的：探讨检测眼肌前庭诱发肌源性电位（oVEMP）和颈肌前庭诱发肌源性电位（cVEMP）对单侧原发性良性阵发性位置性眩晕（BPPV）患者进行可能发病部位的定位诊断价值。方法：对52例单侧原发性BP-PV患者（BPPV组）和38例正常人（对照组）分别进行气导短纯音诱发的oVEMP和cVEMP检测,分析两种反射的引出率、潜伏期、振幅等数据。结果;BPPV组患侧oVEMP的引出率为46．15％,cVEMP的引出率为67．31％;其健侧oVEMP的引出率为48．08％,cVEMP的引出率为65．38％。对照组左侧oVEMP的引出率84．21％,cVEMP的引出率92．11％;右侧oVEMP的引出率为81．58％,cVEMP的引出率为94．74％。对照组双侧cVEMP和oVEMP的P1、N1潜伏期及N1-P1振幅值差异均无统计学意义。BPPV组和对照组cVEMP和oVEMP耳间振幅比及不对称率差异有统计学意义（P〈0．05）。结论：单侧原发性BPPV患者双侧前庭耳石器传导通路功能受损状况,可以通过oVEMP和cVEMP检测进行客观评估,并且oVEMP的异常率比cVEMP高。     

正常志愿者前庭诱发肌源性电位测试正常值及其临床意义

前庭诱发肌源性电位（vestibular evoked myogenic potential,VEMP）是指用高强度声波刺激一侧球囊时在紧张的胸锁乳突肌上记录到的肌源性电位。VEMP反映人前庭-颈反射通路的功能,是一种客观无创的电生理检查方法。VEMP分为前庭诱发的颈部肌源性电位（cervical vestibular evoked myogenic potential,cVEMP）和前庭诱发的眼部肌源性电位（ocular vestibular evoked myogenic potentials,oVEMP）两种。VEMP对前庭系统及其相关疾病的诊断与鉴别诊断具有重要价值,但判断VEMP异常的一些指标,国内和国际上目前还处于探索研究中,并没有统一的标准。北京首大耳鼻喉医院听力与前庭功能检测室于2013年10月～2014年3月对96名正常志愿者进行cVEMP测试,建立本实验室检查的正常值,为今后研究眩晕相关疾病奠定实验基础。     

急性低频感音神经性听力损失患者前庭诱发肌源性电位的频率调谐特征

分析急性低频感音神经性听力损失（acute low-frequency sensorineural hearing loss, ALHL）和听力正常健康人前庭诱发肌源性电位（ve s t i b u l a r evoked myogenic potential,VEMP）,包括颈肌性前庭诱发电位（cervical vestibular evoked myogenic potential,cVEMP）和眼肌性前庭诱发电位（ocular vestibular evoked myogenic potential,oVEMP）的特征。方法　选取33例ALHL患者（实验组）和45名听力正常健康人（对照组）,分别分析500 Hz、1000 Hz的cVEMP和oVEMP的引出情况及振幅比值结果。结果　对照组500 Hz和1000 Hz的cVEMP引出率分别为100%（45/45）和86.67%（39/45）;500 Hz和1000 Hz的oVEMP引出率分别为97.78%（44/45）和84.44%（38/45）。实验组患耳500 Hz和1000 Hz的cVEMP引出率分别为66.67%（22/33）和63.64%（21/33）;对侧耳500 Hz和1000 Hz的cVEMP引出率分别为87.88%（29/33）和75.76%（25/33）。实验组患耳500 Hz和1000 Hz的oVEMP引出率分别为84.85%（28/33）和72.73%（24/33）;对侧耳500 Hz和1000 Hz的oVEMP引出率分别为84.85%（28/33）和72.73%（24/33）。实验组双耳与对照组500 Hz和1000 Hz的cVEMP和oVEMP引出情况比较,仅500 Hz的cVEMP实验组双耳与对照组差异有统计学意义。实验组cVEMP患耳与对侧耳500 Hz/1000 Hz的AR平均比值（AR1）为1.17和1.52,对照组AR值2.23,患耳与对照组两者比较,差异有统计学意义（t =3.942,P =0.000）,对侧耳与对照组两者比较,差异有统计学意义（t =3.27,P =0.001）。实验组oVEMP患耳与对侧耳500 Hz/1000 Hz的AR平均比值（AR2）为1.45和1.59,对照组AR值2.06,患耳与对照组两者比较,差异有统计学意义（t =3.385, P =0.001）。结论　与对照组相比,ALHL中cVEMP与oVEMP的频率调谐特点均表现为向高频迁移,对侧耳也表现出类似特点。推测ALHL患者患耳与对侧耳球囊及椭圆囊功能均不同程度受到影响,引起cVEMP和oVEMP的共振频率调谐发生改变。     

Comparison of cervical vestibular evoked potentials evoked by air-conducted sound and bone-conducted vibration in vestibular Schwannoma patients

Abstract

Objective: The vestibular evoked myogenic potential (VEMP) is associated with otolithic afferents and can be used to evaluate the function of the saccule and utricle. In this study, we compared cervical VEMP evoked by stimulation with Air-conducted sound (ACS) and bone-conducted vibration (BCV) to the forehead and investigated whether BCV can be used as a substitute for ACS.

Methods: Data were obtained from 33 patients with vestibular schwannoma. Vestibular examinations were performed preoperatively. VEMP was obtained upon stimulation with ACS (ACS cVEMP) and BCV to the forehead using a minishaker (BCV cVEMP). Vestibular function was also analyzed using the caloric test and ocular VEMP (oVEMP) testing. oVEMP was measured using bone-conductive vibration to the forehead. The results of BCV cVEMP, ACS cVEMP, and oVEMP were compared by the caloric test.

Results: Rates of patients with abnormal ACS cVEMP, BCV cVEMP, oVEMP, and caloric test results were 78.8%, 75.8%, 78.8%, and 69.7%, respectively. BCV cVEMP did not correlate with ACS cVEMP, but correlated with oVEMP and caloric test results.

Conclusion: BCV cVEMP did not correlate with ACS cVEMP. Therefore, BCV cVEMP cannot be used as a substitute for ACS cVEMP.     

骨导刺激与气导刺激的眼肌前庭诱发肌源性电位对比研究

目的探索利用骨导耳机振子、激振器输出振动直接刺激颅骨记录眼肌前庭诱发肌源性电位(bone conducted ocular vestibular evoked myogenic potential,BC-oVEMP),为BC-oVEMP的临床应用提供最理想的振动刺激参数;比较骨导振动刺激和气导声刺激引出电位波形的参数差异。方法2017年3-5月,选取空军军医大学第一附属医院耳鼻咽喉头颈外科招募的健康志愿者共20名,其中男10名,女10名,年龄20~25(22.05±2.01)岁。声学分析仪采集骨导耳机振子、激振器的输出振动刺激的信号频谱和瞬态波形,依据国际标准计算得到输出的振动作用力的峰值等效力值(peak-to-peak equivalent force level,peFL)。分析选择可以获得稳定骨导振动刺激的最优参数。20名志愿者同时接受最大输出强度的气导声刺激、振动力刺激,记录双侧oVEMP波形及N1潜伏期、P1潜伏期、振幅等参数。数据采用SPSS 24.0统计学软件分析,正态分布两组间数值方差齐采用t检验,不齐则采用校正t检验。偏态分布两组间数值比较采用Mann-Whitney U检验。结果不同频率的原始声刺激信号经声学分析仪记录到输出振动刺激的时域波形图、频谱图,输出振动的峰值频率与原始声信号频率一致。相同的原始信号强度时,500 Hz信号对应的频谱图输出峰值最高。原始声刺激参数频率相同时激振器的输出振动刺激的峰值等效力值随刺激声强度增加而增加,相同强度时激振器的输出振动刺激的峰值等效力值随频率增加而减小;以500 Hz短纯音输出的峰值等效力值最大,为139.8 dB peFL;同时大于相同原始声刺激信号时通过骨导耳机振子输出的峰值等效力值130 dB peFL。40耳中5耳在气导声刺激下未记录到对侧oVEMP电位波,即气导刺激和骨岛刺激的N1-P1波引出率分别为87.5%(35/40)和100%(35/40)。气导声刺激和骨导振动刺激N1的潜伏期分别为(11.33±1.05)ms和(10.14±0.38)ms,P1潜伏期分别为(16.24±1.56)ms和(15.65±1.19)ms,波间期分别为(4.59±1.26)ms和(5.55±0.81)ms,左右耳对称性系数分别为12.22%[5.5%,21.85%]和8.74%[3.37%,14.08%],振幅分别为3.07[2.05,4.43]μV和11.96[7.42,14.75]μV;N1潜伏期、P1潜伏期、波间期、振幅值差异均有统计学意义(P值均<0.05)。结论500 Hz短纯音原始刺激经激振器获得振动输出能最大,优于B-81骨导耳机振子;与传统气导声刺激相比,BC-oVEMP的引出率更高,波形幅度更大,更稳定可靠,更具临床应用价值。     

年龄因素对直流电刺激诱发的前庭诱发肌源性电位的影响

目的 评估年龄因素对直流电刺激(GVS)诱发的颈肌前庭诱发肌源性电位(cVEMP)和眼肌前庭诱发肌源性电位(oVEMP)的影响。 方法 选择健康志愿者61名(122耳)作为研究对象,22~81岁,平均(45.0±13.8)岁。按年龄分为20~40岁组(26例,52耳)、41~60岁组(24例,48耳)以及>60岁组(11例,22耳),分别记录GVS-cVEMP和GVS-oVEMP。计算GVS-c/oVEMP在不同年龄段的引出率、阈值、潜伏期、振幅、振幅不对称比(interaural amplitude asymmetryratio,IAR),采用SPSS18.0软件进行统计学分析。 结果 GVS-cVEMP在20~40岁、41~60岁、>60岁年龄段的引出率分别为96.15%、89.58%和95.45%,组间比较差异无统计学意义(P>0.05)。GVS-oVEMP在20~40岁、41~60岁、>60岁年龄段的引出率分别为98.07%、91.67%和72.13%,随着年龄增长逐渐降低(P<0.05)。从参数分析来看,cVEMP的引出率、阈值、p1潜伏期、n1潜伏期、振幅和振幅不对称比在不同年龄组间差异无统计学意义(P>0.05);随着年龄增大,oVEMP的引出率下降、阈值增高、振幅减小(P<0.05),其他参数年龄组间差异无统计学意义(P>0.05)。 结论 随着年龄的增长,周围前庭系统的功能降低,有可能会对直流电刺激诱发的VEMP产生影响。     

Superior canal dehiscence reveals concomitant unilateral utricular loss (UUL)

Conclusion: We report enhanced symmetrical cervical vestibular evoked myogenic potential (cVEMP) but asymmetrical ocular VEMP (oVEMP) responses in a patient with CT-verified bilateral superior semicircular canal dehiscence (SCD) but with acute vestibular syndrome. This implies that absence of unilateral utricular macula function alone is sufficient to cause symptoms of acute vertigo. Acute vertigo should not automatically be presumed to originate from semicircular canal dysfunction. Objectives: To identify the cause of an acute vertigo attack in a patient with bilateral SCD. Methods: The functional state of all peripheral vestibular sense organs was tested using the video head impulse test (vHIT) for all semicircular canals and VEMPs to air-conducted sound (ACS) or bone-conducted vibration (BCV) to test all otolith organs. The cVEMP tested mainly saccular function and the oVEMP mainly utricular function. Results: All semicircular canals showed normal function. The cVEMPs showed enhanced, but symmetrical saccular function. In contrast, oVEMPs showed an enhanced but asymmetric n10 component – it was greatly reduced beneath the left eye, implying decreased function in the right utricular macula. That result was confirmed using very high frequency stimuli which are effective in SCD: 4000 Hz BCV stimuli showed that oVEMP n10 was present beneath the right eye but absent beneath the left eye.     

原发性良性阵发性位置性眩晕患者VEMP异常率的临床观察

目的 比较原发性初发和复发良性阵发性位置性眩晕(BPPV)患者的前庭诱发肌源性电位(VEMPs)特点,探索原发性BPPV屡次复发的可能发病机制。 方法 收集首次就诊即确诊为单侧原发性BPPV的患者57例,其中初发患者36例,复发患者21例。所有患者均进行气导声刺激条件下的颈肌VEMP(cVEMP)和眼肌VEMP(oVEMP)检查,对比分析初发组和复发组cVEMP和oVEMP结果的差异。 结果 (1)初发和复发BPPV组在性别、发病侧别及受累半规管均无统计学差异(P>0.05),年龄存在统计学差异(P<0.05);(2)57例BPPV患者中21例(36.84%)cVEMP异常,35例(61.40%)oVEMP异常,oVEMP异常率更高(P<0.05);分别对初发组中和复发组中的cVEMP和oVEMP异常率进行比较,结果显示两组oVEMP异常率更高,差异具有统计学意义(P<0.05);(3)初发BPPV组cVEMP异常有16例(44.45%),复发BPPV组异常有5例(23.81%);初发BPPV组oVEM异常有19例(52.79%),复发BPPV组中oVEMP异常有16例(76.19%);两组cVEMP和oVEMP异常率均无统计学差异(P>0.05);(4)复发2次组和复发3次以上组,与初发组进行VEMPs异常率比较显示三组间cVEMP及oVEMP异常率均无统计学差异(P>0.05)。 结论 原发性初发组和复发组BPPV患者的cVEMP和oVEMP异常率差异均无统计学意义,提示耳石器功能异常可能不是原发性BPPV患者反复复发的发病机制。     

Vestibular evoked myogenic potential (VEMP) results in migraine and migrainous vertigo

Abstract

Background: The pathophysiology of vertigo is not fully known; thus, it is difficult to diagnose vestibular migraine (VM) in some migraine patients with vertigo symptoms.

Aims/objectives: We aimed to evaluate the diagnostic value of cervical vestibular evoked myogenic potential (cVEMP) in patients with VM.

Materials and Methods: Thirty-two patients diagnosed with migraine and 31 patients with VM were prospectively included in this study. The cVEMP responses were obtained, and P1-N1 latency, interpeak amplitude, amplitude asymmetry ratio were calculated. The patients' demographics, results of physical and audiometric examinations, and VEMP records as well as absence of responses were evaluated and compared between groups.

Results: The incidence of ears with absence VEMP responses was found to be numerically higher in the migraine group than in the VM group (p?=?.106). Additionally, there were no statistically significant differences detected between the groups in terms of the p13 or n23 latency, interpeak amplitude, and amplitude asymmetry ratio measured in both right and left ears (p?>?.05).

Conclusions: The increased rate of absent VEMPs was associated with the hypoperfusion of the sacculo-collic reflex pathway in migraine patients. In addition, it was concluded that VEMP reflex responses appear to be insufficient to differentiate between VM and migraine diagnoses.     

前庭诱发肌源性电位对前庭下神经炎的诊断价值

目的　探讨前庭诱发肌源性电位（VEMP）对前庭下神经炎的诊断价值。方法　回顾分析我科眩晕门诊18例前庭下神经炎的临床资料,尤其是VEMP检测结果。结果　18例患者中,15例表现为旋转性眩晕,3例为平衡障碍,所有患者纯音测听、冷热试验及眼性前庭诱发肌源性电位（oVEMP）正常而颈性前庭诱发肌源性电位（cVEMP）异常。其中14例cVEMP检查不能引出,4例振幅低下。3个月后复诊10例患者症状消失,复查cVEMP 9例恢复正常,1例振幅低下;半年复诊18例患者症状全部消失,复查cVEMP只有2例振幅低下,其余均恢复正常。结论　VEMP检查对前庭下神经炎的精准诊断及判断预后有重要临床价值,值得临床推广。     

Ocular vestibular evoked myogenic potentials to air conduction (AC oVEMP): useful in clinical practice?

Cervical vestibular-evoked myogenic potential (cVEMP) and ocular VEMP (oVEMP) stimuli can be used to measure otolith function using air (AC) and bone conducted (BC) stimuli. Cervical VEMPs reflect saccular function and can be recorded using air conduction (AC), whereas oVEMPs reflect probably predominantly utricular function. Air- and bone-conducted vibration can be used, because AC oVEMP methodology seems to be fast and simple in clinical practice to measure otolith function. In this study we discuss the advantages and problems of AC oVEMP stimulation. AC oVEMP can be easily and quickly obtained within a few seconds. N10 (first negative peak) and p15 (first positive peak) latencies may be used as parameters for clinical interpretation but amplitude fluctuations are relatively large. For daily clinical use of VEMP visualization in a normogram seems feasible. Especially the AC oVEMP methodology (100 dB nHL, tone burst 500 Hz) is fast and efficient in clinical practice to measure otolith function, predominantly utricular function.