儿童前庭神经炎的前庭诱发肌源性电位结果

doi:10.6040/j.issn.1671-7554.0.2024.0757

摘要/Abstract

摘要： 目的分析前庭诱发肌源性电位(vestibular evoked myogenic potential, VEMP),探讨VEMP检查在儿童前庭神经炎(vestibular neuritis, VN)中的应用价值。方法选取2023年1月至2024年3月就诊于山东大学附属儿童医院耳鼻喉门诊的59例儿童,分为对照组(n=36)和VN组(n=23)并进行回顾性分析,均按要求完成VEMPs检查。结果颈肌前庭诱发肌源性电位(cervicalvestibular-evoked myogenic potential, cVEMP)检测结果显示,VN组患儿双耳的P1-N1振幅较对照组下降,差异有统计学意义(P<0.05);两组患儿双耳P1潜伏期和N1潜伏期的差异无统计学意义(P>0.05);VN组cVEMP振幅不对称比(anymmetry ratio, AR)值>35%的患儿数量高于对照组,差异有统计学意义(P<0.05)。眼肌前庭诱发肌源性电位(ocular vestibular-evoked myogenic potential, oVEMP)检测结果显示,VN组患儿右耳的N1-P1振幅较对照组下降,差异有统计学意义(P<0.05);两组患儿左耳的N1-P1振幅、双耳P1潜伏期和N1潜伏期的差异无统计学意义(P>0.05);VN组oVEMP AR值 >21%的患儿数量高于对照组,差异有统计学意义(P<0.05)。结论 VN患儿的cVEMP和oVEMP波形出现异常变化,提示球囊和椭圆囊及其传导通路出现功能障碍。VEMP检查可作为VN的诊断依据,具有重要临床意义。

关键词: 儿童, 前庭神经炎, 前庭诱发肌源性电位, 球囊, 椭圆囊

Abstract: Objective To analyze the vestibular evoked myogenic potential(VEMP)and explore the application value of VEMP examination in children with vestibular neuritis(VN). Methods A total of 59 children who visited the Otolaryngology Clinic of Childrens Hospital Affiliated to Shandong University from January 2023 to March 2024 were selected and divided into the control group(36 cases)and the VN group(23 cases)for retrospective analysis. All patients completed VEMPs examinations as required. Results The cervical vestibular-evoked myogenic potential(cVEMP)test results showed that the P1-N1 amplitude of both ears in the VN group was lower than that in the control group, with a statistically significant difference(P<0.05). There was no significant difference in the P1 and N1 latency between the two groups(P>0.05). The number of children in the VN group with a cVEMP amplitude asymmetry ratio(AR)value >35% was higher than that in the control group, with a statistically significant difference(P<0.05). The ocular vestibular-evoked myogenic potential(oVEMP)test results showed that the N1-P1 amplitude of the right ear in the VN group was lower than that in the control group, with a statistically significant difference(P<0.05). There was no significant difference in the N1-P1 amplitude of the left ear, and the P1 and N1 latency of both ears between the two groups(P>0.05). The number of children in the VN group with an oVEMP AR value >21% was higher than that in the control group, with a statistically significant difference(P<0.05). Conclusion The cVEMP and oVEMP waveforms in children with VN showed abnormal changes, suggesting that there were functional disorders in the saccule, utricle, and their conductive pathways. VEMP examination can be used as a diagnostic basis for VN and has important clinical significance.

Key words: Child, Vestibular neuritis, Vestibular evoked myogenic potential, Sacculus, Utriculus

中图分类号:

R764

李东梅,边天帅,王晓华,张静,赵炎,孙素芬,牟鸿,许安廷. 儿童前庭神经炎的前庭诱发肌源性电位结果[J]. 山东大学学报 (医学版), 2026, 64(4): 38-43.

LI Dongmei, BIAN Tianshuai, WANG Xiaohua, ZHANG Jing, ZHAO Yan, SUN Sufen, MU Hong, XU Anting. Vestibular evoked myogenic potential in children with vestibular neuritis[J]. Journal of Shandong University (Health Sciences), 2026, 64(4): 38-43.

参考文献

[1] Fancello V, Palma S, Monzani D, et al. Vertigo and dizziness in children: an update[J]. Children, 2021, 8(11): 1025. doi:10.3390/children8111025
[2] 刘冰, 李蓓, 张莉, 等. 儿童眩晕病因与年龄的相关性分析[J]. 临床耳鼻咽喉头颈外科杂志, 2019, 33(6): 508-511. LIU Bing, LI Bei, ZHANG Li, et al. Correlation analysis of vertigo etiology and age in children[J]. Journal of Clinical Otorhinolaryngology Head and Neck Surgery, 2019, 33(6): 508-511.
[3] Papathanasiou ES, Murofushi T, Akin FW, et al. International guidelines for the clinical application of cervical vestibular evoked myogenic potentials: an expert consensus report[J]. Clin Neurophysiol, 2014, 125(4): 658-666.
[4] 李斐, 鞠奕, 张甦琳, 等. 前庭神经炎诊治多学科专家共识[J]. 中华老年医学杂志, 2020(9): 985-994.
[5] Yu J, Zhou YJ, Xu XD, et al. Different findings of morphological changes and functional decline in the vestibule and the semicircular canal in ipsilateral delayed endolymphatic Hydrops[J]. Clin Neurophysiol, 2020, 131(7): 1487-1494.
[6] 李晓璐, 卜行宽, Kamran Barin, 等. 实用眼震电图和眼震视图检查[M]. 2版. 北京: 人民卫生出版社, 2015: 148-157.
[7] Schuknecht HF, Kitamura K. Vestibular neuritis[J]. Ann Otol Rhinol Laryngol, 1981, 90(1_Suppl): 1-19.
[8] Lin CM, Young YH. Identifying the affected branches of vestibular nerve in vestibular neuritis[J]. Acta Otolaryngol, 2011, 131(9): 921-928.
[9] 郭莉, 芦二永, 张超. 前庭诱发肌源性电位对前庭下神经炎的诊断价值[J]. 中国耳鼻咽喉头颈外科, 2017, 24(8): 402-404. GUO Li, LU Eryong, ZHANG Chao. Value of vestibular evoked myogenic potential on the diagnosis of inferior vestibular neuritis[J]. Chinese Archives of Otolaryngology-Head and Neck Surgery, 2017, 24(8): 402-404.
[10] 刘冰, 李蓓, 张莉, 等. 儿童前庭神经炎的前庭功能特点及预后分析[J]. 中华耳鼻咽喉头颈外科杂志, 2018, 53(12): 899-903. LIU Bing, LI Bei, ZHANG Li, et al. Vestibular function features and prognosis of vestibular neuritis in children[J]. Chinese Journal of Otorhinolaryngology Head and Neck Surgery, 2018, 53(12): 899-903.
[11] Le TN, Westerberg BD, Lea J. Vestibular neuritis: recent advances in etiology, diagnostic evaluation, and treatment[J]. Adv Otorhinolaryngol, 2019, 82: 87-92. doi:10.1159/000490275
[12] Taborelli G, Melagrana A, DAgostino R, et al. Vestibular neuronitis in children: study of medium and long term follow-up[J]. Int J Pediatr Otorhinolaryngol, 2000, 54(2/3): 117-121.
[13] Arbusow V, Derfuss T, Held K, et al. Latency of herpes simplex virus type-1 in human geniculate and vestibular ganglia is associated with infiltration of CD⁸⁺T cells[J]. J Med Virol, 2010, 82(11): 1917-1920.
[14] Jeong J, Nam Y, Oh J, et al. Monthly and seasonal variations in vestibular neuritis[J]. Medicine, 2022, 101(26): e29787. doi:10.1097/MD.0000000000029787
[15] Greco A, Macri GF, Gallo A, et al. Is vestibular neuritis an immune related vestibular neuropathy inducing vertigo?[J]. J Immunol Res, 2014, 2014: 459048. doi:10.1155/2014/459048
[16] Shi XR. Physiopathology of the cochlear microcirculation[J]. Hear Res, 2011, 282(1/2): 10-24.
[17] Himmelein S, Lindemann A, Sinicina I, et al. Differential involvement during latent herpes simplex virus 1 infection of the superior and inferior divisions of the vesti-bular ganglia: implications for vestibular neuritis[J]. J Virol, 2017, 91(14): e00331-17. doi:10.1128/JVI.00331-17
[18] Lee SU, Park SH, Kim HJ, et al. Normal caloric res-ponses during acute phase of vestibular neuritis[J]. J Clin Neurol, 2016, 12(3): 301-307.
[19] 吕亚峰, 张道宫, 樊兆民, 等. 前庭神经炎患者前庭功能损伤的频率和部位特征分析[J]. 临床耳鼻咽喉头颈外科杂志, 2016, 30(8): 602-605. LYU Yafeng, ZHANG Daogong, FAN Zhaomin, et al. Frequency and position characteristics of the vestibular dysfunction in vestibular neuritis patients[J]. Journal of Clinical Otorhinolaryngology Head and Neck Surgery, 2016, 30(8): 602-605.
[20] Balatsouras DG, Koukoutsis G, Ganelis P, et al. Benign paroxysmal positional vertigo secondary to vestibular neuritis[J]. Eur Arch Otorhinolaryngol, 2014, 271(5): 919-924.

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