目的:探讨伴耳蜗症状或偏头痛史的良性复发性眩晕(BRV)患者的临床表现及前庭诱发肌源性电位(VEMP)特点。方法:纳入34例BRV患者(57耳)和30例健康志愿者(60耳)。他们分为4组:A组包括17例诊断为BRV并伴有耳蜗症状的患者(21耳),B组包括11例诊断为有偏头痛史的BRV患者(22耳),C组包括7例BRV患者,无耳蜗症状和偏头痛史(14耳)。D组,作为正常控制(NC)组,由30名没有偏头痛和耳蜗症状病史的健康志愿者组成。分别进行详细咨询和VEMP测试。VEMPs激发率,比较分析4组不同频率下的振幅比和振幅统计。结果:颈前庭诱发肌源性电位(cVEMP)的振幅在D组和A组之间具有显着差异。C组,在500Hz下(PAD=.017,PBD=.052,PCD=.044),但cVEMP的振幅在D组和A组之间有显著差异,和B组1000Hz以下,分别(PAD=.008,PBD=.020,PCD=.119)。眼前庭诱发肌源性电位(oVEMP)的振幅在D组和A组之间有显著差异,B组,500Hz以下,分别(PAD=.029,PBD=.005,PCD=.198)。在1000Hz下,D组和A组之间的oVEMP振幅显着不同(PAD=.049,PBD=.079,PCD=.103)。NC组和实验组之间cVEMP和oVEMP的诱发率没有统计学差异(cVEMP:PAD=.525,PBD=.917,PCD=.374;oVEMP:PAD=.678,PBD=.523,PCD=.427)。此外,VEMP和VEMP频率振幅比在NC组和实验组之间没有显着差异(P>.05)。结论:VEMPs可作为BRV患者耳蜗症状的诊断指标。BRV的发病机制可能与耳部器官的损伤有关。
Objectives: To explore the clinical manifestations and vestibular-evoked myogenic potential (VEMP) characteristics in patients diagnosed with benign recurrent vertigo (BRV) accompanied by cochlear symptoms or migraine history. Methods: A total of 34 patients were diagnosed with BRV (57 ears) and 30 healthy volunteers (60 ears) were recruited. They were divided into 4 groups: Group A consisted of 17 patients diagnosed as BRV with cochlear symptoms (21 ears), Group B consisted of 11 patients diagnosed as BRV with migraine history (22 ears), and Group C consisted of 7 patients with BRV without cochlear symptoms and migraine history (14 ears). Group D, as a Normal control (NC) group, consisted of 30 healthy volunteers without a history of migraine and cochlear symptoms. Detailed consultations and VEMP testing were performed separately. The VEMPs elicitation rate, amplitude ratio at different frequencies and amplitude statistics were compared and analyzed among the 4 groups. Results: The amplitudes of cervical vestibular evoked myogenic potential (cVEMP) have significant differences between Groups D and A, and Group C, under 500 Hz (PAD = .017, PBD = .052, PCD = .044), but the amplitudes of cVEMP have significant differences between Groups D and A, and Group B under 1000 Hz, respectively (PAD = .008, PBD = .020, PCD = .119). The amplitudes of ocular vestibular evoked myogenic potential (oVEMP) have significant differences between Groups D and A, and Group B, under 500 Hz, respectively (PAD = .029, PBD = .005, PCD = .198). oVEMP amplitudes significantly differ between Groups D and A under 1000 Hz (PAD = .049, PBD = .079, PCD = .103). The statistical difference was absent in elicit rates of cVEMP and oVEMP between the NC and experimental groups (cVEMP: PAD = .525, PBD = .917, PCD = .374; oVEMP: PAD = .678, PBD = .523, PCD = .427). Moreover, there is no significant difference between the NC group and experimental groups among VEMPs and VEMP frequency amplitude ratio (P > .05). Conclusion: VEMPs could be a diagnostic indicator for BRV patients with cochlear symptoms. The pathogenesis of BRV may be related to damage to the otolithic apparatus.