本文介绍了Bárány学会分类委员会对老年性前庭病(PVP)的诊断标准。PVP被定义为一种以不稳定为特征的慢性前庭综合征,步态紊乱,和/或在存在轻度双侧前庭缺损的情况下反复跌倒,实验室检查的结果介于正常值和双侧前庭病建立的阈值之间。PVP的诊断是基于患者的病史,床边检查和实验室评估。PVP的诊断需要双侧降低前庭眼反射(VOR)的功能。这可以诊断为高频范围的VOR与视频命中(vHIT);中频范围与旋转椅测试;和低频范围与热量测试。对于PVP的诊断,两侧的水平角VOR增益应<0.8和>0.6,和/或每侧用温水和冷水刺激的慢相热量诱导的眼球震颤的最大峰值速度之和应<25°/s和>6°/s,和/或在旋转椅上进行正弦刺激时,水平角度VOR增益应当>0.1和<0.3。PVP通常与其他与年龄相关的视力缺陷一起发生,本体感受,和/或皮质,小脑和锥体外系功能也有助于甚至可能是不稳定症状的表现所必需的,步态紊乱,和瀑布。这些标准只是考虑这些症状的存在,随着前庭功能受损的记录,在老年人中。
This paper describes the diagnostic criteria for presbyvestibulopathy (PVP) by the Classification Committee of the Bárány Society. PVP is defined as a chronic vestibular syndrome characterized by unsteadiness, gait disturbance, and/or recurrent falls in the presence of mild bilateral vestibular deficits, with findings on laboratory tests that are between normal values and thresholds established for bilateral vestibulopathy.The diagnosis of PVP is based on the patient history, bedside examination and laboratory evaluation. The diagnosis of PVP requires bilaterally reduced function of the vestibulo-ocular reflex (VOR). This can be diagnosed for the high frequency range of the VOR with the video-HIT (vHIT); for the middle frequency range with rotary chair testing; and for the low frequency range with caloric testing.For the diagnosis of PVP, the horizontal angular VOR gain on both sides should be < 0.8 and > 0.6, and/or the sum of the maximal peak velocities of the slow phase caloric-induced nystagmus for stimulation with warm and cold water on each side should be < 25°/s and > 6°/s, and/or the horizontal angular VOR gain should be > 0.1 and < 0.3 upon sinusoidal stimulation on a rotatory chair.PVP typically occurs along with other age-related deficits of vision, proprioception, and/or cortical, cerebellar and extrapyramidal function which also contribute and might even be required for the manifestation of the symptoms of unsteadiness, gait disturbance, and falls. These criteria simply consider the presence of these symptoms, along with documented impairment of vestibular function, in older adults.