本文介绍了急性单侧前庭病(AUVP)的诊断标准,前庭神经炎的同义词,由Bárány协会前庭疾病分类委员会定义。由于外周前庭功能的急性单侧丧失,AUVP表现为急性前庭综合征,没有急性中枢或急性听力学症状或体征的证据。这意味着AUVP的诊断是基于患者的病史,床边检查,and,如有必要,实验室评估。主要症状是急性或很少亚急性发作的旋转或非旋转性眩晕,伴有不稳定,恶心/呕吐和/或呕吐。一个主要的临床症状是自发性外周前庭眼震,这是方向固定的,并通过去除视觉固定来增强,其轨迹适合所涉及的半规管传入(通常是水平扭转)。委员会将诊断标准分为四类:1.“急性单侧前庭病”,2.“进化中的急性单侧前庭病”,3.“可能的急性单侧前庭病”和4。“急性单侧前庭病病史”。这些的具体诊断标准如下:“急性单侧前庭病”:A)持续旋转或非旋转性眩晕的急性或亚急性发作(即,急性前庭综合征)中度至重度,症状持续至少24小时。B)自发性外周前庭眼震,其轨迹适合所涉及的半规管传入,通常水平扭转,方向固定,并通过去除视觉固定来增强。C)与自发性眼球震颤的快速相方向相反的一侧的VOR功能降低的明确证据。D)没有急性中枢神经的证据,耳科或听力学症状。E)无急性中枢神经体征,即没有中央眼运动或中央前庭体征,特别是没有明显的偏斜偏差,没有凝视诱发的眼球震颤,没有急性听力学或耳学体征。F)不能更好地解释另一种疾病或障碍。“演变中的急性单侧前庭病”:A)持续旋转或非旋转性眩晕的急性或亚急性发作,症状持续3小时以上,但还没有持续至少24小时,当见患者时;B)-F)如上所述。此类别可用于诊断原因,以区分急性中央前庭综合征,开始特定的治疗,以及将患者纳入临床研究的研究。“可能的急性单侧前庭病变”:与AUVP相同,但未明确观察到或记录单侧VOR缺陷。“急性单侧前庭病病史”:A)眩晕的急性或亚急性发作史持续至少24小时,强度缓慢下降。B)无同时出现急性听力学或中枢神经症状的病史。C)单方面降低VOR功能的明确证据。D)没有同时出现急性中枢神经体征的病史,即没有中央眼运动或中央前庭体征,也没有急性听力学或耳学体征。E)不能更好地解释另一种疾病或障碍。此类别允许在急性期后进行良好检查的单侧外周前庭缺陷和急性前庭综合征病史的患者中进行诊断。重要的是要注意,对于AUVP没有明确的测试。因此,它的诊断需要排除中央病变以及各种其他外周前庭疾病。最后,这篇共识论文将讨论AUVP的其他方面,如病因,病理生理学和实验室检查,如果它们与分类标准直接相关。
This paper describes the diagnostic criteria for Acute Unilateral Vestibulopathy (AUVP), a synonym for vestibular neuritis, as defined by the Committee for the Classification of Vestibular Disorders of the Bárány Society. AUVP manifests as an acute vestibular syndrome due to an acute unilateral loss of peripheral vestibular function without evidence for acute central or acute audiological symptoms or signs. This implies that the diagnosis of AUVP is based on the patient history, bedside examination, and, if necessary, laboratory evaluation. The leading symptom is an acute or rarely subacute onset of spinning or non-spinning vertigo with unsteadiness, nausea/vomiting and/or oscillopsia. A leading clinical sign is a spontaneous peripheral vestibular nystagmus, which is direction-fixed and enhanced by removal of visual fixation with a trajectory appropriate to the semicircular canal afferents involved (generally horizontal-torsional). The diagnostic criteria were classified by the committee for four categories: 1. \"Acute Unilateral Vestibulopathy\", 2. \"Acute Unilateral Vestibulopathy in Evolution\", 3. \"Probable Acute Unilateral Vestibulopathy\" and 4. \"History of Acute Unilateral Vestibulopathy\". The specific diagnostic criteria for these are as follows:\"Acute Unilateral Vestibulopathy\": A) Acute or subacute onset of sustained spinning or non-spinning vertigo (i.e., an acute vestibular syndrome) of moderate to severe intensity with symptoms lasting for at least 24 hours. B) Spontaneous peripheral vestibular nystagmus with a trajectory appropriate to the semicircular canal afferents involved, generally horizontal-torsional, direction-fixed, and enhanced by removal of visual fixation. C) Unambiguous evidence of reduced VOR function on the side opposite the direction of the fast phase of the spontaneous nystagmus. D) No evidence for acute central neurological, otological or audiological symptoms. E) No acute central neurological signs, namely no central ocular motor or central vestibular signs, in particular no pronounced skew deviation, no gaze-evoked nystagmus, and no acute audiologic or otological signs. F) Not better accounted for by another disease or disorder.\"Acute Unilateral Vestibulopathy in Evolution\": A) Acute or subacute onset of sustained spinning or non-spinning vertigo with continuous symptoms for more than 3 hours, but not yet lasting for at least 24 h hours, when patient is seen; B) - F) as above. This category is useful for diagnostic reasons to differentiate from acute central vestibular syndromes, to initiate specific treatments, and for research to include patients in clinical studies.\"Probable Acute Unilateral Vestibulopathy\": Identical to AUVP except that the unilateral VOR deficit is not clearly observed or documented.\"History of acute unilateral vestibulopathy\": A) History of acute or subacute onset of vertigo lasting at least 24 hours and slowly decreasing in intensity. B) No history of simultaneous acute audiological or central neurological symptoms. C) Unambiguous evidence of unilaterally reduced VOR function. D) No history of simultaneous acute central neurological signs, namely no central ocular motor or central vestibular signs and no acute audiological or otological signs. E) Not better accounted for by another disease or disorder. This category allows a diagnosis in patients presenting with a unilateral peripheral vestibular deficit and a history of an acute vestibular syndrome who are examined well after the acute phase.It is important to note that there is no definite test for AUVP. Therefore, its diagnosis requires the exclusion of central lesions as well as a variety of other peripheral vestibular disorders. Finally, this consensus paper will discuss other aspects of AUVP such as etiology, pathophysiology and laboratory examinations if they are directly relevant to the classification criteria.