山东大学耳鼻喉眼学报 ›› 2020, Vol. 34 ›› Issue (5): 56-60.doi: 10.6040/j.issn.1673-3770.1.2020.077

• 临床研究 • 上一篇    下一篇

头晕眩晕与眼震强度的关系研究

邓巧媚1,王巍1,2,温超1,刘强1,毛翔1,韩曦2,李姗姗2,陈太生1,徐开旭1,2,林鹏1,2   

  1. 耳鼻咽喉科学)天津市耳鼻喉科质量控制中心, 天津 300192
  • 收稿日期:2020-08-06 发布日期:2020-11-17
  • 基金资助:
    国家自然科学基金(81971698)

Study of the relationship of dizziness and vertigo sensations with the nystagmus intensity

  • Received:2020-08-06 Published:2020-11-17

摘要: 目的 通过冷热试验诱发头晕和/或眩晕时的眼震强度,探讨头晕眩晕与眼震强度的关系。 方法 对399例前庭周围性疾病患者进行常规冷热试验检查,以双耳冷热气刺激诱发出头晕和/或眩晕感时的眼震强度为指标,比较分析头晕及眩晕感与眼震强度的关系。 结果 冷热刺激诱发头晕眩晕及关联眼震总体分析,出现眩晕时的眼震强度总是大于头晕。左右耳冷热气刺激诱发头晕、眩晕的眼震阈值分别为:左耳冷4.2°/s、5.9°/s,左耳热4.2°/s、8°/s,右耳冷4.6°/s、6.2°/s,右耳热5.3°/s、 6.5°/s。399例患者进行双耳冷热交替刺激,共计1 596次试验,诱发出头晕513次(32.14%),其中312次仅有头晕、201次在头晕后10 s左右还出现眩晕;诱发出眩晕906次(56.77%),其中705次直接出现眩晕,无从头晕向眩晕进行过渡,另201次眩晕出现在头晕10 s左右之后;未引出头晕眩晕378次(23.68%)。 结论 眩晕对应的眼震强度阈高于头晕,眼震较弱时患者表现为头晕,较强时则呈现眩晕。冷热气刺激诱发眼震强度由弱到强及同时存在的由头晕到眩晕现象,提示头晕眩晕症状与两侧前庭张力差的大小相关。

关键词: 眩晕, 头晕, 眼震, 冷热试验, 慢相角速度

Abstract: Objective To explore the relationship between dizziness-vertigo and nystagmus intensity, according to the nystagmus accompanied by dizziness and/or vertigo during caloric test. Methods The relationship between dizziness and vertigo sensations and nystagmus intensity was analyzed in 399 patients with peripheral vestibular disorders,who underwent routine caloric test. The nystagmus intensity is as an index, accompanied by dizziness and/or vertigo sensations induced during caloric test. Results Warm and cold stimulation induced dizziness and vertigo and associated nystagmus overall analysis, the intensity of nystagmus was always greater than that of dizziness when vertigo occurred. The nystagmus thresholds for dizziness and vertigo induced by warm and cold air stimulation in the left ears were 4.2°/s and 5.9°/s for cold, 4.2°/s and 8°/s for warm, in the right ears were 4.6°/s and 6.2°/s for cold, 5.3°/s and 6.5°/s for warm, respectively. Three hundred ninety nine patients were subjected to alternating warm and cold stimulation in both ears for a total of 1596 times, which induced dizziness 513 times(32.14%), of which 312 times only dizziness and 201 times vertigo ten seconds after dizziness. Vertigo was induced 906 times(56.77%), of which 705 occurred directly without transitioning from dizziness to vertigo, and another 201 times vertigo occurred after ten seconds of dizziness; 378(23.68%)times did not induce dizziness and vertigo. Conclusions Vertigo corresponds to a higher nystagmus intensity threshold than dizziness, with patients showing dizziness when the nystagmus is weak and vertigo when it is stronger. Warm and cold air stimulation induced nystagmus intensity from weak to strong, and from dizziness to vertigo sensations induced at the same time, suggesting that the symptoms of dizziness and vertigo are related to the asymmetric between the two vestibular tension.

Key words: Vertigo, Dizziness, Nystagmus, Caloric test, Slow phase velocity

中图分类号: 

  • R764
[1] Bisdorff AR, Staab JP, Newman-Toker DE. Overview of the international classification of vestibular disorders[J]. Neurol Clin, 2015, 33(3): 541-550, vii. doi:10.1016/j.ncl.2015.04.010.
[2] Bisdorff A, Von Brevern M, Lempert T, et al. Classification of vestibular symptoms: towards an international classification of vestibular disorders[J]. J Vestib Res, 2009, 19(1/2): 1-13. doi:10.3233/ves-2009-0343.
[3] Alexandre R.Bisdorff, Jeffrey P.Staab, David E.Newman-Toker, 等. 前庭疾病国际分类概述[J]. 神经损伤与功能重建, 2019, 14(2): 55-60. doi:10.16780/j.cnki.sjssgncj.2019.02.001. BISDORFF AR, STAAB JP, NEWMANTOKER DE, et al. Overview of the international classification of vestibular disorders[J]. Neural Injury and Functional Reconstruction, 2019, 14(2): 55-60. doi:10.16780/j.cnki.sjssgncj.2019.02.001.
[4] 吴子明, 张素珍. 前庭症状国际分类与解析[J]. 中华耳科学杂志, 2015, 13(1): 187-189. doi:10.3969/j.issn.1672-2922.2015.01.39.
[5] Baloh RW, Halmagyi GM, Zee DS. The history and future of neuro-otology[J]. Continuum(Minneap Minn). 2012,18(5 Neuro-otology):1001-1015. doi:10.1212/01.CON.0000418371.49605.19.
[6] Herdman S.J.T.R. Vestibular Rehabilitation[M]. Davis Company, Philadelphia, Pennsylvania, 2007:234.
[7] Lee J, Choi B, Noh H, et al. Nystagmus in Ramsay Hunt syndrome with or without dizziness[J]. Neurol Sci, 2020. doi:10.1007/s10072-020-04536-w.
[8] Newman-Toker DE, Cannon LM, Stofferahn ME, et al. Imprecision in patient reports of dizziness symptom quality: a cross-sectional study conducted in an acute care setting[J]. Mayo Clin Proc, 2007, 82(11): 1329-1340. doi:10.4065/82.11.1329.
[9] Newman-Toker DE, Dy FJ, Stanton VA, et al. How often is dizziness from primary cardiovascular disease true vertigo? A systematic review[J]. J Gen Intern Med, 2008, 23(12): 2087-2094. doi:10.1007/s11606-008-0801-z.
[10] Mijovic T, Remillard A, Zaia EH, et al. A closer look at subjective caloric sensations: Is there more to Vertigo than spinning?[J]. J Vestib Res, 2018, 27(5/6): 271-277. doi:10.3233/VES-170624.
[11] Qiu PH. The statistical evaluation of medical tests for classification and prediction[J]. J Am Stat Assoc, 2005, 100(470): 705. doi:10.1198/jasa.2005.s19.
[12] Dieterich M, Bense S, Stephan T, et al. fMRI signal increases and decreases in cortical areas during small-field optokinetic stimulation and central fixation[J]. Exp Brain Res, 2003, 148(1): 117-127. doi:10.1007/s00221-002-1267-6.
[13] Brandt T, Dieterich M. Vestibular syndromes in the roll plane: topographic diagnosis from brainstem to cortex[J]. Ann Neurol, 1994, 36(3): 337-347. doi:10.1002/ana.410360304.
[14] Chiarovano E, Vidal PP, Magnani C, et al. Absence of rotation perception during warm water caloric irrigation in some seniors with postural instability[J]. Front Neurol, 2016, 7: 4. doi:10.3389/fneur.2016.00004.
[1] 许嘉, 李欣, 陈雯婧, 高娟娟, 卢星星, 伊海金. 联合应用内淋巴囊减压和局部激素治疗难治性梅尼埃病的短期与长期疗效分析[J]. 山东大学耳鼻喉眼学报, 2022, 36(4): 17-21.
[2] 张瑶瑶,王海涛. 内耳钆造影磁共振成像技术在梅尼埃病诊疗中的应用[J]. 山东大学耳鼻喉眼学报, 2021, 35(6): 101-107.
[3] 李佳威,刘晓阳,杨星昱,孙晓明,李曦丹. 重复经颅磁刺激治疗慢性前庭综合征疗效评价[J]. 山东大学耳鼻喉眼学报, 2021, 35(1): 7-10.
[4] 蒋黎娜,于倩如,于杰,关本岭,鹿玉,于淑东. 前庭性眩晕疾病患者焦虑和抑郁状况研究[J]. 山东大学耳鼻喉眼学报, 2020, 34(6): 1-5.
[5] 杨军,郑贵亮. 外周前庭疾病的诊断和治疗[J]. 山东大学耳鼻喉眼学报, 2020, 34(5): 1-6.
[6] 刘宇鹏,梁敏,何景春,郑贵亮,李姝娜,张青,杨军. 梅尼埃病前庭功能分级的探讨[J]. 山东大学耳鼻喉眼学报, 2020, 34(5): 14-19.
[7] 梁敏,吴悔,陈建勇,张勤,李姝娜,郑贵亮,何景春,陈向平,杨军. 前庭诱发肌源性电位预测突聋患者疗效的临床价值[J]. 山东大学耳鼻喉眼学报, 2020, 34(5): 27-32.
[8] 吴悔,梁敏,陈建勇,张勤,李姝娜,郑贵亮,何景春,陈向平,杨军. 全聋型突发性耳聋患者的预后与前庭症状及前庭功能关系的回顾性分析[J]. 山东大学耳鼻喉眼学报, 2020, 34(5): 33-38.
[9] 刘宇鹏,吴文瑾,何景春,郑贵亮,张青,杨军. 迷路后径路前庭神经切断术治疗难治性梅尼埃病75例[J]. 山东大学耳鼻喉眼学报, 2020, 34(5): 46-50.
[10] 陈建勇, 孙夏雨, 沈佳丽, 汪玮, 王璐, 贺宽, 张勤, 马孝宝, 沈敏, 陈向平, 杨军. 原发性良性阵发性位置性眩晕患者VEMP异常率的临床观察[J]. 山东大学耳鼻喉眼学报, 2020, 34(5): 51-55.
[11] 郑贵亮, 刘凌峰, 陈建勇, 张青, 杨军. 基于移动互联网的前庭康复训练指导平台的开发与应用[J]. 山东大学耳鼻喉眼学报, 2020, 34(5): 78-81.
[12] 赵欢娣,成颖杨军,张青. 3D-FLAIR MRI在内耳出血所致的SSNHL诊断中的作用[J]. 山东大学耳鼻喉眼学报, 2020, 34(5): 97-101.
[13] 魏馨雨,杨方园杨军,张青. 耳源性细菌性迷路炎研究进展[J]. 山东大学耳鼻喉眼学报, 2020, 34(5): 102-107.
[14] 王玥, 上官翰京 蔡成福. 睡眠对良性阵发性位置性眩晕影响的研究进展[J]. 山东大学耳鼻喉眼学报, 2020, 34(5): 108-112.
[15] 伊海金,杨仕明. 重视耳部外伤诊疗工作[J]. 山东大学耳鼻喉眼学报, 2020, 34(1): 1-3.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
[1] 林彬,王挥戈 . 功能性内镜鼻窦手术后鼻黏膜纤毛转归的研究[J]. 山东大学耳鼻喉眼学报, 2006, 20(6): 481 -487 .
[2] 公 蕾,孙 洁,薛子超,李敬华,薛卫国 . 鼻腔鼻窦恶性肿瘤细胞周期的DNA分析[J]. 山东大学耳鼻喉眼学报, 2008, 22(3): 193 -195 .
[3] 陈文文 . 1例T/NK淋巴瘤17年演进[J]. 山东大学耳鼻喉眼学报, 2006, 20(5): 472 -472 .
[4] 栾建刚,梁传余,文艳君,李炯 . 抑制表皮生长因子受体基因表达的pSIREN-ShuttleRNAi表达载体的构建[J]. 山东大学耳鼻喉眼学报, 2006, 20(1): 4 -8 .
[5] 马敬, 钟翠萍 . 手术治疗侵犯翼腭窝的鼻咽纤维血管瘤的方法(附5例报告)[J]. 山东大学耳鼻喉眼学报, 2006, 20(1): 30 -32 .
[6] 刘强和,罗香林,耿宛平,陈 晨,雷 迅,刘芳贤,邓 明 . 快速老化小鼠的听功能和耳蜗螺旋神经元的增龄性变化[J]. 山东大学耳鼻喉眼学报, 2008, 22(3): 215 -217 .
[7] 郑鹏凌,陈卫国,易笃友,黄清秀,卢 俊 . 耳内镜下吸引清除耳道耵聍55例并文献复习[J]. 山东大学耳鼻喉眼学报, 2008, 22(3): 223 -226 .
[8] 马 敬,钟翠萍,严 星,安 飞 . 耳屏软骨修补无残余软骨的鼻中隔穿孔15例[J]. 山东大学耳鼻喉眼学报, 2008, 22(3): 246 -247 .
[9] 崔哲洙,严永峰,崔春莲,金顺吉 . 嗜酸性粒细胞在变应性鼻炎合并慢性鼻窦炎的分布特点[J]. 山东大学耳鼻喉眼学报, 2008, 22(3): 250 -252 .
[10] 赵鲁新,翟 洪,潘 洁 . 超声乳化吸除联合晶状体植入治疗急性闭角型青光眼伴白内障23例[J]. 山东大学耳鼻喉眼学报, 2008, 22(3): 260 -262 .