Fast-phase instabilities in normally sighted relatives of congenital nystagmus patients—autosomal dominant and x-chromosome recessive modes of inheritance

Verification of inheritance in congenital nystagmus (CN) is only possible through the identification of more than one affected member in a family, since in a single case there are no accurate clinical differentiations between spontaneous and inherited CN. We performed electronystagmographic examinations (ENG) to search for abnormal involuntary eye movements as a sign of heredity in seemingly unaffected members of CN families.ENG registrations were performed under three test conditions: (1) with the subject fixating a target, (2) with the room lights off and (3) with closed eyes.Fifty normally sighted individuals (group (a) underwent the test procedure to provide a baseline of normality. Five CN families (three dominant, two sex-linked recessive) were tested as group (b). The eye movement recordings were analysed in terms of nystagmus intensity (amplitude x frequency of the involuntary saccade). In every one of the five families, abnormalities in seemingly non-affected members could be demonstrated: in four families, fastphase instabilities, in the fifth family a true (CN) (slowphase instability).All certain gene carriers were diagnosed correctly by the ENG.These findings indicate a method for detecting slightly affected members in dominant pedigrees and female gene carriers in sex-linked mode of transmission.     

先天性眼球震颤药物疗效的眼震电图评定

为评定 Ａ 型肉毒毒素治疗先天性眼球震颤的疗效,于治疗前后对 ６２ 例患者行眼震电图检查。结果表明,用 Ａ 型肉毒毒素治疗前后眼震电图差异有高度显著性（ Ｐ＜ ０．００１）,用 Ａ 型肉毒毒素治疗眼震总有效率为 ９０．３％ 。眼震电图为临床研究先天性眼震所必需,可根据眼震电图的描记对治疗效果作出评价。     

正常成人不同年龄组眼震电图的观察与定量分析

目的　定量分析正常成人眼震电图 (ENG)的特点及其与年龄、性别的关系 ,旨在为临床诊断提供可靠依据。方法　 1 80名 2 0～ 79岁正常成人 ,其中男 88名 ,女 92名 ,按年龄分成 6组 ,每 1 0年一个年龄组 ,每组 30名。进行ENG系列试验 ,包括扫视试验、平稳跟踪试验、视动试验、水平凝视试验、自发眼震试验及摇头试验。结果　扫视试验中的延迟时间、跟踪试验中的增益值、失真度及视动试验中的增益值等主要参数 ,各年龄组有明显的不同 (P <0 0 5)。随着年龄的增加 ,延迟时间呈逐渐延长趋势 [由 (1 80 55± 2 2 39)ms增至 (2 1 3 58± 31 30 )ms,r =0 33] ;跟踪试验的增益值逐渐减小(r=- 0 37) ,失真度逐渐加大 (r=0 41 ) ;视动试验的增益值也呈下降趋势 (r =- 0 42 )。但不受性别影响 (P >0 2 )。所有个体在水平凝视、自发及摇头眼震试验中均未见眼震。结论　扫视、跟踪及视动试验的主要参数受年龄影响 ,与性别无关。针对不同年龄组的患者 ,应选择相应的诊断标准     

糖尿病患者前庭功能的改变及其临床意义

目的:探讨糖尿病患者前庭功能的改变及其临床意义.方法:对76例糖尿病患者(糖尿病组)和60例健康成年人(对照组)用跟震电图测试仪进行自发性眼震试验、位置试验、摇头试验、转颈试验、温度试验和视眼动系统检查(凝视试验、扫视试验、平稳跟踪试验),对上述各项试验数据进行相应的定性及定量分析.结果:糖尿病组前庭功能异常为68.4%,对照组为8.3%,两组比较差异有统计学意义(x2=15.472,P＜0.01).结论:糖尿病患者的眩晕症状与前庭功能减退有一定关系,且多为外周性眩晕,眼震电图可提供客观的临床检测.     

Prognostic factors for vestibular impairment in sensorineural hearing loss

The clinical course and prognosis in sensorineural hearing loss (SNHL) may be even worse if vestibular system is also involved, especially due to near location of anatomical structures in the inner ear. The aim of the study was to determine prognostic value of some clinical, audiological and demographic factors associated with SNHL in predicting a possibility of vestibular impairment. The study was conducted on 124 consecutive patients (183 ears) diagnosed for sensorineural hearing loss during 1 year in our department. In all of them, audiological (pure-tone, speech and impedance audiometry, ABR) and ENG examinations (visual ocular–motor, positional, kinetic and caloric tests) were performed. The correlations between ENG outcome and the following variables associated with sensorineural hearing loss were investigated: audiological (degree and location of hearing loss, audiogram configuration), clinical (tinnitus, vertigo, dizziness) and demographic (age, sex) factors. Normal ENG was recorded in 26.6%, vestibular impairment of peripheral type in 38.7%, and central type in 34.7% of the patients. In a multivariate stepwise linear regression analysis, the degree of hearing loss was the main variable correlating with abnormal ENG result. Tinnitus and location of hearing loss were also found to be the two other variables which, to some minor extent, can influence the ENG outcome. Peripheral vestibular impairment was observed more frequently in patients with residual hearing/deafness. The degree of hearing loss, presence of tinnitus and location of hearing loss are factors predicting the possibility of abnormal ENG outcome in sensorineural hearing loss.     

Spontaneous and positional nystagmus in healthy persons demonstrated only by electronystagmography: Physiological spontaneous nystagmus or “functional scar”?

Summary We wanted to ascertain whether a physiological horizontal vestibular spontaneous nystagmus is existent, or whether the spontaneous and positional nystagmus seen in clinically healthy persons in the electronystagmogram — when fixation had been excluded completely — was always the result of earlier damages to the vestibular system (Jatho). For this purpose we tried to detect a spontaneous and positional nystagmus in 102 healthy persons from 6 age groups (17 each) between 11 and 70 years of age. When the ENG was registered with open eyes in darkness, 63 out of the 102 test persons had a horizontal spontaneous or positional nystagmus, however, under the Frenzel glasses there was a nystagmus in only 2 out of these test persons. With open eyes in darkness, the frequency and intensity was the same in all age groups. With this, we believe to have proved that a physiological horizontal vestibular nystagmus does exist. We share Kornhuber's opinion that the examination with the Frenzel glasses in a dark room, together with the head shaking test and positional test, at the present time represents the best method for differentiating between physiological and pathological spontaneous nystagmus.This study is dedicated to Prof. Dr. D. Zühlke commemorating his 50th Birthday     

Occupational exposure to solvents and cerebellar,brainstem and vestibular functions

Summary Forty-eight persons (age 44, SD 9 years) exposed to paint solvents and 40 nonexposed referents (age 45, SD 9 years) were examined. The duration of exposure was 4 to 30 (mean 20) years and the life-time exposure level was estimated to have been 10 to 330 (mean 60%) of the hygienic standard. The methods used were a neurological examination, electroencephalography, brainstem auditory-evoked potentials, electronystagmography, and posturography. Lifetime exposure was estimated on the basis of a detailed occupational history and environmental measurements made at the work places over several years. The average weekly alcohol consumption was established in a detailed interview. Due to the small number of subjects examined, the study was inconclusive. The findings classified as abnormal were slightly more common in the exposed than in the referents, and in the persons who used alcohol than in the non-users. The differences were not statistically significant, and no exposure-response relationships were found.     

眼震电刺激器的研制

眩晕症与前庭神经系统的功能异常和病理变化有着直接联系,眼震电图仪是前庭神经系统功能检查和评定的重要设备.本文首先介绍了眼震电的概念和眼震电刺激器的功能,比较了几种常见的眼震电刺激器,重点介绍了LED视屏刺激器.眼震电刺激器可以产生定标、凝视、扫视、视跟踪、视动等多种刺激方式,有控制和驱动电路简单、诱发效果好、环境适应性好、易于升级、成本低等优点,在临床上有着广泛的应用前景.     

眼震电图在椎-基底动脉供血不足性眩晕诊断中的应用

目的研究眼震电图在椎-基底动脉供血不足性眩晕诊断中的应用.方法总结104例以眩晕为主诉,经临床及影像检查为轻型椎-基底动脉供血不足患者的眼震电图变化.结果椎-基底动脉供血不足患者出现自发性眼震者占17.3%,位置性眼震占33.6%;扫视运动潜伏期延长,扫视速度减慢;跟踪实验41%呈Ⅲ型曲线,43%失真度超过正常值;视动眼震强度与正常人无显著性差异;冷热反应值较正常人低下,不对称比值增高,20.2%出现固视失败.结论眼震电图在椎-基底动脉供血不足性眩晕诊断中具有重要意义.     

歼击机飞行员垂直半规管功能的检测及其特征

目的　建立垂直半规管功能的测量方法 ,对我军部分战斗机飞行员和地面人员的垂直半规管功能进行检测 ,初步确定战斗机飞行员垂直半规管功能的特征。　方法　对 35名男性现役歼击机飞行员和 2 0名地面人员进行检测。在暗室中将受试者在转椅上通过特制头托头后仰 6 0° ,同时头左倾或右倾 4 5°,使两侧前、后垂直半规管分别位于水平面 ,采取 90°/s恒速旋转后急停刺激模式 ,记录旋转后眼震电图 ,分别对两侧前垂直半规管、两侧后垂直半规管受刺激引起的垂直眼震的持续时间、最大慢相速度、慢相速度衰减时间常数及各参数间的两侧不对称比进行计算分析 ,建立垂直半规管功能的测量方法。　结果　同地面人员相比 ,飞行员垂直眼震的最大慢相速度降低 (P <0 0 5 ) ,慢相速度衰减时间常数延长 (P <0 0 5 )。　结论　我军战斗机飞行员垂直眼震功能同地面人员存在一定差别 ,长期飞行对飞行员垂直半规管功能可能产生一定影响。