前庭自旋转试验在位置性眩晕患者中的检测

摘要

Objective To evaluate the value of vestibular autorotation test (VAT) in differentiating central and peripheral etiologies in patients with positional vertigo. Methods Clinical data of 140 patients with positional vertigo without hearing loss, tinnitus and vestibular hypofunction were reviewed, including history, physical exam, videonystagmogra-phy (VNC), VAT, brain MRI, positional tests and physical manipulation. Results The 138 patients with BPPV all had normal brain MRI and horizontal gain on VAT. Their positional down beating nystagmus (pDBN) disappeared after physical manipulation. In the 2 patients with Arnold-Chiari malformation, diagnosed by abnormal brain MRI, there was increased horizontal gain on VAT, and pDBN persisted after physical manipulation. Conclusion VAT may be of adjuvant value in diagnosis and etiology differentiation in BPPV.%目的 通过对位置性眩晕患者进行前庭自旋转试验(Vestibular autorotation test,VAT)检查,探讨VAT用于鉴别中枢性和外周性位置性眩晕的作用.方法 回顾性分析140例位置性眩晕患者的临床资料,均无耳聋、耳鸣或前庭功能低下.患者资料包括病史,专科检查,视频眼震电图(videonystagmography,VNG),VAT,头颅磁共振(MRI),位置试验,手法复位治疗.结果 138例良性阵发性位置性眩晕(benign paroxysmal positional vertigo,BPPV),VAT参数水平增益正常,部分患者的垂直向下的眼震(positional down beating nystagmus,pDBN)通过手法复位消失,经MRI排除其他疾病.2例颅底凹陷综合征(Arnold-Chiari malformation,ACM)通过头颅MRI得到确诊,其VAT水平增益增高,手法复位后pDBN不消失.结论 VAT可用以辅助BPPV的鉴别诊断.