目的 观察前庭阵发症 (vestibular paroxysmia, VP) 患者前庭诱发肌源性电位 (vestibular evoked myogenic potentials, VEMPs) 的引出率和各参数指标, 探讨其临床诊断及应用价值.方法 将20例伴有神经血管交互压迫 (neurovascular cross compression, NVCC) 的VP患者作为VP组, 并以同期20例年龄、性别分布相仿磁共振检查未见NVCC的健康体检者作为对照组.对所有入组者行眼肌前庭诱发电位 (ocular vestibular evoked potential, o VEMP) 和颈肌前庭诱发电位 (cervical vestibular evoked potential, c VEMP) 检查, 对其VEMPs的引出率和各参数进行组间和组内比较, 进一步对VP的VEMPs特点进行分析.结果 (1) VP组o VEMP引出22耳 (55％) , 其非NVCC侧引出16耳 (84. 21％) 、NVCC侧6耳 (28. 57％) , 差异具有统计学意义 (χ2=10. 33, P <0. 05) , 对照组引出35耳 (87. 50％); VP组c VEMP引出26耳 (65％) , 其中非NVCC侧引出17耳 (89. 47％) , NVCC侧9耳 (42. 86％) , 差异具有统计学意义 (χ2=7. 59, P <0. 05) , 对照组引出35耳 (87. 50％); VP组NVCC侧与对照组o VEMP、c VEMP引出率经组间比较, 差异均具有统计学意义 (χ2=21. 70, P <0. 05;χ2=13. 65, P <0. 05); VP组非NVCC侧与对照组o VEMP、c VEMP引出率经组间比较, 差异均无统计学意义 (χ2=0. 00, P> 0. 05;χ2=0. 00, P> 0. 05) . (2) 在VP组, c VEMP与o VEMP引出率比较, 差异无统计学意义 (χ2=0. 83, P> 0. 05) . (3) VP组NVCC侧潜伏期延长、振幅下降, 与非NVCC侧VEMPs各参数值经组内比较, 差异均有统计学意义 (P值均<0. 05); VP组NVCC侧与对照组VEMPs各参数值经组间比较, 差异均有统计学意义 (P值均<0. 05); VP组非NVCC侧与对照组VEMPs各参数值经组间比较, 差异均无统计学意义 (P值均>0. 05) .结论 VP患者NVCC侧VEMPs引出率较低、潜伏期延长、振幅下降, NVCC是VP的发病机制之一且VEMPs有助于鉴别病变侧; VP患者NVCC侧前庭上、下神经传导通路均有一定的异常.%Objective To observe the extraction rate and parameters of vestibular evoked myogenic potentials (VEMPs) in patients with vestibular paroxysmia (VP) , and to explore the clinical diagnosis and application value of VEMPs. Methods 20 VP patients with neurovascular compression (NVCC) were selected as VP group, and 20 healthy subjects with similar age, sex distribution and no NVCC were used as control group. The ocular vestibular evoked potential (o VEMP) and the cervical vestibular evoked potential (c VEMP) were examined in all subjects. The extraction rate and parameters of VEMPs were compared between and within groups, and the characteristics of VP VEMPs were analyzed. Results (1) In VP group, 22 ears (55％) were induced by o VEMP, 16 ears (84. 21％) were induced by non-NVCC side (28. 57％) , 6 ears (28. 57％) of NVCC, the difference was statistically significant (P < 0. 05) , and 35 ears (87. 50％) in control group; In VP group, 26 ears (65％) were induced by c VEMP, 17 ears (89. 47％) were induced by non-NVCC side, which was significantly higher than 9 ears (42. 86％) by NVCC side (P < 0. 05) , and 35 ears (87. 50％) by control group.There were significant differences in the extraction rates of o VEMP、c VEMP between the NVCC side of VP group and the control group (P < 0. 05) . There was no significant difference between the non-NVCC side of VP group and the control group (P> 0. 05) . (2) In group VP, there was no significant difference in the extraction rate between c VEMP and o VEMP (χ2= 0. 83, P> 0. 05) . (3) In VP group, the latency of NVCC side was prolonged and the amplitude was decreased, VEMPs parameters were significant differencest between NVCC side and non-NVCC side (P < 0. 05) . There were significant differences between NVCC side of VP group and control group (P < 0. 05) . There was no significant difference between non-NVCC side of VP group and control group (P> 0. 05) . Conclusion Extraction rate of VEMPs on the NVCC side of VP patients were decreased, latency prolonged, amplitude decreased, NVCC is one of the pathogenesis of VP, VEMPs can help to distinguish the lesion side. In the patients with VP, the superior and subvestibular nerve conduction pathwaieys were abnormal on the side of NVCC.
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