偏头痛患者听功能及前庭功能状态的临床研究

目的:探讨偏头痛患者听功能及前庭功能表现与原发病的关系。方法:随机选择31例偏头痛患者及31例对照组患者,收集详细病史,并测定其纯音听阈和声导抗以及视频眼震图。结果:偏头痛患者中有2例(3耳)出现听阈上升,均为感音神经性耳聋,声导抗无明显异常。偏头痛患者中有10例出现眩晕症状(对照组无明显眩晕症状)。偏头痛组视频眼震图各参数与对照组相比有不同程度的差异。结论:偏头痛患者有听功能的下降,无中耳传音功能的异常。一部分偏头痛患者出现眩晕,与偏头痛发作有密切关系。偏头痛患者不仅有周围性前庭功能的异常,也可以有中枢性前庭功能的异常。偏头痛患者进行前庭功能的检查,有助于该病的诊断和治疗。     

Audiovestibular function in patients with juvenile idiopathic arthritis (JIA)

Conclusion: It was found that JIR children had potential sensory neural hearing loss and vestibular affection. Therefore, this study recommends: early complete audiologic evaluation of JIA child followed by regular follow-up, including TOAEs, extended high-frequency audiometry, and VNG. This follow-up is important for preliminary diagnosis and management in order to prevent the negative impact of hearing loss on a child’s life.

Objective: The aim of this study was to assess hearing in children with Juvenile idiopathic arthritis (JIA) and compare them with a healthy control group. In addition to conventional audiometry, extended high-frequency audiometry and Transient otoacoustic emission (TOAEs) were used. This study also tried to investigate the vestibular function in JIR children by videonystagmography (VNG).

Patients and methods: The study group comprised of 28 children with JIR and 28 healthy children. All subjects were examined audiologically using basic audiological evaluation, high-frequency audiometry, TOAEs, and VNG.

Results: Children with JIR had apparent normal peripheral hearing in conventional audiometry; sub-clinical sensory neural hearing loss was detected. This sub-clinical hearing loss appeared in statistically significant difference between them and normal in high-frequency audiometry and TOAEs. VNG test results showed affected tracking and second tests.     

BPPV诊断中VNG的应用及发病风险模型的构建

目的探讨良性阵发性位置性眩晕(BPPV)诊断中视频眼震电图(VNG)的应用及构建发病风险模型。 方法选取BPPV患者64例,均给与VNG及裸眼检查,比较两种检查方式的VNG检出率。将患者分为原发性组(n＝52例)和继发性组(n＝12例),问卷调查患者性别、年龄、家族疾病史、既往疾病史,进行相关听力学、头部、椎动脉和颈椎影像学检查；Logistic回归分析构建BPPV发病风险模型。 结果后半规管型、前半规管型、水平半规管型BPPV的VNG检出率均高于裸眼检出率(P＜0.05)。继发性组过度疲劳、合并中耳疾病、全身疾病、脑力和体力劳动、精神和心理因素患者占比均高于原发性组(P＜0.05)。Logistics回归分析构建BPPV发病风险的影响因素为过度疲劳、合并中耳疾病、脑力和体力劳动、精神和心理因素(P＜0.05)。 结论VNG对前、后、水平半规管型BPPV诊断准确性高于裸眼检查,需结合过度疲劳、合并中耳疾病、脑力和体力劳动、精神和心理因素等BPPV发病影响因素来进行综合判断。     

Sensitivity evaluation in air and water caloric stimulation of the vestibular organs using videonystagmography

Introduction

The aim of the study was to compare air and water caloric stimulation of the vestibular organs using videonystagmography (VNG).

Material and methods

The study covered 18 women aged 21–63 and 11 men aged 21–74 years hospitalized at the ENT, without complaints for vertigo and/or balance disorders. The alternate binaural bithermal caloric test with cool 30 °C and warm 44 °C air or water irrigations (after 2 h interval for the recordings) with the use of VNG was done.

Results

All parameters of air and water vestibular caloric stimulations, assessed in the VNG, differed significantly but were within the normal range. The research showed a statistically significant difference between canal paresis but only for the left ear at 30 °C and 44 °C. Absolute directional preponderance, relative directional preponderance, vestibular excitability, slow component velocity, frequency were different statistically for both ears at both temperatures.

Conclusions

Our study showed that both air and water caloric stimulations were able to distinguish physiological and impaired vestibular function. The obtained results showed statistically higher response for water than air stimulation.     

The interpretation of static positional nystagmus in a balance clinic

Objective: To review the current criteria for the interpretation of positional nystagmus (PN). Design: Videonystagmography data on PN was collected for 90 patients presenting for balance testing with a history of vertigo or imbalance (excluding those diagnosed with benign paroxysmal positional vertigo). These were compared to normative data from 90 asymptomatic subjects. A literature review was carried out regarding threshold criteria for clinically significant PN. These were evaluated using the data collected. Study sample: Clinic group: 90 patients; 37 male, 53 female. Age range 15–82 years. Normative group: Ninety subjects; 31 male, 59 female. Age range 21–79 years.

Results: PN was seen in 75.6% of the clinic group and in 50% of the normative group. The prevalence of nystagmus of slow phase velocity (SPV)?>?3°/s was significantly higher in the clinic group than the normative group. The maximum SPV recorded in each position was greater from the clinic group than the normative group. Conclusions: This study supports the use of normative thresholds for SPV for both horizontal and vertical PN. A normative threshold of >3°/s for horizontal and >7°/s for vertical nystagmus is proposed.     

Neurovestibular analysis and falls in Parkinson's disease and atypical parkinsonism

The primary aim of our study was to determine the extent of vestibular dysfunction in patients with Parkinson's disease (PD). Our secondary aim was to determine if vestibular dysfunction in PD is a risk factor for falling. The tertiary aim was to determine both the extent of vestibular dysfunction and if this dysfunction is a risk factor for falling in patients with atypical parkinsonism (AP). Twenty‐five healthy subjects, 30 PD patients and 14 AP patients were matched for age and gender in a case‐control study design. All subjects underwent clinical neurological and neurotological assessments, cervical and ocular vestibular evoked myogenic potentials (VEMPs), brainstem auditory evoked potentials (BAEPs), subjective visual vertical measurements, and videonystagmography with caloric and rotatory chair stimulation. Ninety per cent of PD patients (27 of 30) and all 14 AP patients had signs of vestibular dysfunction on laboratory examinations. The evoked potential (VEMPs and BAEPs) test results of PD patients showed significant prolongation of the p13, n1 and interpeak III–V latencies on the symptomatic brainstem side (0.003 ≤  P ≤ 0.019) compared with healthy subjects. Also, vestibular testing abnormalities were correlated with an increased risk for falling when fallers among PD and AP patients were compared with the non‐fallers (P ≤ 0.001). To conclude, vestibular dysfunction on vestibular laboratory testing is highly prevalent in both PD and AP patients compared with healthy subjects, and is associated with an increased risk for falling.     

伴有先天性眼球震颤的眩晕症患者VNG特点分析:2例报道

目的探讨伴有先天性眼震的眩晕症患者通过眼震视图诊断前庭功能的可行性。方法通过VNG记录知觉缺陷型先天性眼震及运动缺陷型先天性眼震患者自发性眼震、静态位置性眼震、变位性眼震,扫视试验、视动性眼震、平稳跟踪试验、温度试验及其固视抑制试验,分析其VNG各测试项目特点。结果 1对于方向及慢相角速度恒定的先天性眼震,其扫视试验及平稳跟踪试验结果为:扫视及跟踪曲线与视靶曲线吻合良好,仅在扫视及跟踪曲线上叠加恒定的细小眼震波,向低视力侧扫视时欠冲,0.4Hz平稳跟踪试验可见Ⅲ型曲线;2对于恒定的水平型先天眼震(CN),温度试验及其固视抑制可不受干扰;3CN对BPPV的测试结果干扰较大,曲线杂乱无法分析。结论先天性眼震非VNG检查的绝对禁忌症,对于方向及慢相角速度恒定的水平型CN,扫视试验、平滑跟踪、温度试验及其固视抑制依然可用于对眩晕症病变部位的诊断。     

Age predicts the absence of caloric-induced vertigo

Introduction

The absence of vertigo during the caloric test, despite a robust response, has been suggested to represent a central vestibular system phenomenon. The purpose of this investigation was to determine the prevalence of absent caloric-induced vertigo perception in an unselected group of patients and to assess possible predicting variables.

偏头痛患者前庭功能状态的临床研究

目的探讨偏头痛患者前庭功能表现及与原发病的关系。方法随机选择31例偏头痛患者及31例对照组患者。收集详细病史，并测定其视频眼震图（VNG）并评估其前庭功能。结果偏头痛患者中有10例存在眩晕症状。对照组无明显眩晕症状。偏头痛组视频眼震图部分参数与对照组相比有显著性差异。结论部分偏头痛患者出现眩晕。与偏头痛发作有密切关系。偏头痛患者不仅可以有周围性前庭功能的异常，也可以有中枢性前庭功能的异常。VNG检查结果对评估偏头痛患者的前庭功能。有一定的参考价值。     

Lectin histochemical studies on the olfactory gland and two types of gland in vomeronasal organ of the brown bear

Olfaction is mediated by the vomeronasal and main olfactory systems, and the peripheral vomeronasal organ (VNO) processes species-specific chemicals that are associated with various behaviors in mammals. Sensory epithelial surfaces of the olfactory mucosa and VNO are covered by mucosal fluid that contains secretory products derived from associated glands, and glycoconjugates in the mucosal fluid are involved in odorant reception. The VNO of brown bears contains two types of glands; submucosal vomeronasal glands (VNG) and multicellular intraepithelial glands (MIG). The present study determined the labelling profiles of 21 lectins in the olfactory glands (OG), VNG and MIG of young male brown bears. The OG reacted with 12 lectins, and the VNG and MIG were positive for seven and eight lectins, respectively. Six lectins bound only to the OG, while four reacted with both or either of the VNG and MIG, but not the OG. The differences of lectin labelling pattern between the OG and glands in the VNO suggest that glycans in covering mucosal fluids differ between the olfactory mucosa and VNO. In addition, Bandeiraea simplicifolia lectin-I, Sophora japonica agglutinin and Jacalin reacted with the MIG but not the VNG, whereas Datura stramonium lectin and concanavalin A bound to the VNG, but not the MIG. These findings indicate that the properties of secretory substances differ between the two types of glands in the bear VNO, and that the various secretions from these two types of glands may function in the lumen of VNO together.