梅尼埃病与偏头痛性眩晕的听-前庭功能比较

目的探讨梅尼埃病与偏头痛性眩晕的听功能及前庭功能状态的不同特点，进行比较分析，为二者的鉴别诊断提供帮助。方法回顾性分析2007年5月至2008年9月山东省立医院眩晕门诊52例梅尼埃病患者与36例偏头痛性眩晕患者的临床资料，全部患者均在急性期或亚急性期行纯音测听、视频眼震电图、冷热试验、前庭诱发的肌源性电位检查，部分梅尼埃病及全部偏头痛性眩晕患者行高刺激率听性脑干反应检查，对二者的听力与前庭功能检查结果进行比较分析。结果梅尼埃病患者共52例，男24例，女28例，年龄14-70岁，平均45.8岁。纯音测听异常52例，均为单侧感音神经性聋。视频眼震电图检查示中枢性异常眼动10例。冷热试验异常37例，均为单侧半规管反应低下。前庭诱发的肌源性电位检查异常31例。行高刺激率听性脑干反应检查共32例，5例异常。偏头痛性眩晕患者共36例，男8例，女28例，年龄16-62岁，平均43.6岁。纯音测听异常9例，均为单侧轻至中度感音神经性聋。视频眼震电图检查示中枢性异常眼动17例。冷热试验异常8例，均为单侧半规管反应低下。前庭诱发的肌源性电位检查异常18例，高刺激率听性脑干反应检查异常22例。经统计学分析，二者纯音测听、中枢性眼动检查、冷热试验及高刺激率听性脑干反应的检查结果差异有显著性。结论与梅尼埃病相比，偏头痛性眩晕患者纯音测听及冷热试验异常较少见，中枢性服动检查及高刺激率听性脑干反应异常率较高。在结合患者病史及临床表现的基础上.以上检查可为二者的鉴别提供辅助参考。

Auditory and vestibular functions in Meniere's disease and migrainous vertigo

Objective To compare features of auditory and vestibular functions in Meniere's disease and migrainous vertigo for their potentials in differential diagnosis of the two diseases.Methods Clinical data of 52 patients with Meniere's disease and 36 patients with migrainous vertigo treated at a specialty vertigo clinic from May 2007 to September 2008 were retrospectively analyzed.All patients underwent pure-tone audiometry,videonystagmography,caloric test,vestibular evoked myogenic potential studies.Some Meniere's disease patients and all migrainous vertigo patients were subjected to high stimulating rate ABR tests.The results of the hearing and vestibular function tests were compared and analyzed.Results The 52 cases of Meniere's disease included 24 men and 28 women,aged 14-70 years(mean=45.7years).All 52 cases of Meniere's disease demonstrated unilateral sensorineural hearing loss on pure-tone audiometry.Videonystagmography showed abnormal ocular motion function in 10 cases.Calorie test was abnormal in 37 cases and vestibular evoked myogenic potentials were abnormal in 31 cases.Of the 32 cases of Meniere's disease that received high stimulating rate ABR test,5 showed abnormal results.The 36 cases of migrainous vertigo consisted of 8 men and 28women,aged 16-62 years(mean=43.6 yeam).Pure-tone audiometry was abnormal in 9 cases showing mild to moderate sensorineural hearing loss.Calorie test was abnormal in 8 cases.Videonystagmography showed abnormal ocular motion function in 18 cases.High stimulating rate ABRs were abnormal in 22 cases.The differences in pure-tone audiometry,ocular motion function,vestibular evoked myogenic potential and high stimulating rate ABRs between these two groups were statistically significant.ConclusionCompared with Meniere's disease,patients with migrainous vertigo showed lower rate of abnormal pure-tone audiometry and caloric test,but higher rate of abnormal results in ocular motion function and high stimulating rate ABRs.Pure-tone audiometry,ocular motion function,caloric test,and high stimulating rate of ABRs are helpful in separating these two disorders.