■探讨前庭神经炎(VN)患者自发性眼球震颤(SN)成分的方向和SPV(慢相速度)以及SN成分与受累半规管(SCC)之间的相关性。此外,我们旨在阐明外周SN的方向特征在诊断急性前庭综合征中的作用。
■对2022年至2023年在我院诊断为VN的38例患者进行了回顾性分析。分析了三维视频眼震描记术(3D-VNG)记录的SN分量的方向和SPV以及每个SCC的视频头脉冲测试(vHIT)增益作为观察指标。我们检查了上下前庭神经损伤与SN成分的方向和SPV之间的相关性,和VN患者的vHIT增益值。
■在38名VN患者(17名右VN和21名左VN)中,症状发作和测试时刻之间的中位疾病持续时间为6天。总的来说,31例前庭上神经炎(SVN),7例患有完全前庭神经炎(TVN)。在38例VN患者中,均具有SPV为(7.66±5.37)°/s的水平分量,25(65.8%)具有垂直向上分量,SPV为(2.64±1.63)°/s,和26(68.4%)具有SPV为(4.40±3.12)°/s的扭转分量。38例VN患者的vHIT结果显示,前庭眼反射角(aVOR)增益(A),横向(L),同时侧的后部(P)SCC分别为0.60±0.23、0.44±0.15和0.89±0.19,而另一侧的增益分别为0.95±0.14、0.91±0.08和0.96±0.11。A-之间的aVOR增益有统计学上的显着差异,同病侧的L-SCC和其他SCC(p<0.001)。A-的aVOR收益,L-,31例SVN患者的同侧和P-SCC分别为0.62±0.24、0.45±0.16和0.96±0.10,而另一侧的aVOR增益分别为0.96±0.13、0.91±0.06和0.98±0.11。A-之间的aVOR增益有统计学上的显着差异,同病侧的L-SCC和其他SCC(p<0.001)。在7名TVN患者中,A-的AVOR增益,L-,同侧和P-SCC分别为0.50±0.14、0.38±0.06和0.53±0.07,而相对侧的aVOR增益分别为0.93±0.17、0.90±0.16和0.89±0.09。A-之间的aVOR增益有统计学上的显着差异,L-,和同损侧的P-SCC和其他SCC(p<0.001)。38VN中L-SCC的aVOR增益不对称性为36.3%。对于有和没有垂直向上分量的VN患者,双侧A-SCC和双侧P-SCC之间的aVOR增益不对称性分别为12.8%和8.3%,有统计学意义(p<0.05)。对于有和没有扭转分量的VN患者,双边垂直SCC的aVOR增益不对称性为17.0%和6.6%,有统计学意义(p<0.01)。进一步分析显示,在所有VN患者中,L-SCC的aVOR增益不对称性与SN水平分量的SPV之间存在显着正相关(r=0.484,p<0.01)。以及26例VN患者双侧垂直SCC的不对称性与扭转分量的SPV之间(r=0.445,p<0.05)。然而,在25例VN患者中,双侧A-SCC和P-SCC的aVOR增益不对称性与垂直分量的SPV之间无显著相关性.
■SN的三维方向和SPV特性与VN患者中vHIT的aVOR增益之间存在相关性。这些方向特征可以帮助评估单侧前庭疾病患者的不同SCCs损伤。
UNASSIGNED: To explore the direction and SPV (slow phase velocity) of the components of spontaneous nystagmus (SN) in patients with vestibular neuritis (VN) and the correlation between SN components and affected semicircular canals (SCCs). Additionally, we aimed to elucidate the role of directional features of peripheral SN in diagnosing acute vestibular syndrome.
UNASSIGNED: A retrospective analysis was conducted on 38 patients diagnosed with VN in our hospital between 2022 and 2023. The direction and SPV of SN components recorded with three-dimensional videonystagmography (3D-VNG) and the video head impulse test (vHIT) gain of each SCC were analyzed as observational indicators. We examined the correlation between superior and inferior vestibular nerve damage and the direction and SPV of SN components, and vHIT gain values in VN patients.
UNASSIGNED: The median illness duration of between symptom onset and moment of testing was 6 days among the 38 VN patients (17 right VN and 21 left VN). In total, 31 patients had superior vestibular neuritis (SVN), and 7 had total vestibular neuritis (TVN). Among the 38 VN patients, all had horizontal component with an SPV of (7.66 ± 5.37) °/s, 25 (65.8%) had vertical upward component with a SPV of (2.64 ± 1.63) °/s, and 26 (68.4%) had torsional component with a SPV of (4.40 ± 3.12) °/s. The vHIT results in the 38 VN patients showed that the angular vestibulo-ocular reflex (aVOR) gain of the anterior (A), lateral (L), and posterior (P) SCCs on the ipsilesional side were 0.60 ± 0.23, 0.44 ± 0.15 and 0.89 ± 0.19, respectively, while the gains on the opposite side were 0.95 ± 0.14, 0.91 ± 0.08, and 0.96 ± 0.11, respectively. There was a statistically significant difference in the aVOR gain between the A-, L-SCC on the ipsilesional side and the other SCCs (p < 0.001). The aVOR gains of A-, L-, and P-SCC on the ipsilesional sides in 31 SVN patients were 0.62 ± 0.24, 0.45 ± 0.16, and 0.96 ± 0.10, while the aVOR gains on the opposite side were 0.96 ± 0.13, 0.91 ± 0.06, and 0.98 ± 0.11, respectively. There was a statistically significant difference in the aVOR gain between the A-, L-SCC on the ipsilesional side and the other SCCs (p < 0.001). In 7 TVN patients, the aVOR gains of A-, L-, and P-SCC on the ipsilesional side were 0.50 ± 0.14, 0.38 ± 0.06, and 0.53 ± 0.07, while the aVOR gains on the opposite side were 0.93 ± 0.17, 0.90 ± 0.16, and 0.89 ± 0.09, respectively. There was a statistically significant difference in the aVOR gain between the A-, L-, and P-SCC on the ipsilesional side and the other SCCs (p < 0.001). The aVOR gain asymmetry of L-SCCs in 38 VN was 36.3%. The aVOR gain asymmetry between bilateral A-SCCs and bilateral P-SCCs for VN patients with and without a vertical upward component was 12.8% and 8.3%, which was statistically significant (p < 0.05). For VN patients with and without a torsional component, the aVOR gain asymmetry of bilateral vertical SCCs was 17.0% and 6.6%, which was statistically significant (p < 0.01). Further analysis revealed a significant positive correlation between the aVOR gain asymmetry of L-SCCs and the SPV of the horizontal component of SN in all VN patients (r = 0.484, p < 0.01), as well as between the asymmetry of bilateral vertical SCCs and the SPV of torsional component in 26 VN patients (r = 0.445, p < 0.05). However, there was no significant correlation between the aVOR gains asymmetry of bilateral A-SCCs and P-SCCs and the SPV of the vertical component in 25 VN patients.
UNASSIGNED: There is a correlation between the three-dimensional direction and SPV characteristics of SN and the aVOR gain of vHIT in VN patients. These direction characteristics can help assess different SCCs impairments in patients with unilateral vestibular diseases.