功能性前庭眼动反射检测试验
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摘要
<正>人体的平衡依赖于前庭觉、视觉、本体觉等综合信息的输入。而在前庭反射通路中,前庭眼动反射(vestibulo-ocular reflex,VOR)通路尤为重要。VOR的主要生理功能是维持固视,使人们在日常运动中保持清晰的视觉。目前评估VOR功能的检查方法包括:动态视敏度测试(dynamic visual acuity test,DVAT)、凝视稳定测试(gaze stabilization test,GST)、头脉冲测试(head impulse test,HIT);
In recent years,the diagnosis and treatment of vertigo and balance disorders have become a hot topic of multidisciplinary attention.The evaluation method of vestibular function has also been improved,providing important evidence for the diagnosis and differential diagnosis of vertigo related diseases.Vestibular rehabilitation is one of the important methods for the treatment of vertigo diseases.Assessing vestibular rehabilitation status in these patients is also the key for guiding treatment.The assessment of vestibulo-ocular reflex(VOR)function is an important part of vestibular functional testing.Currently,the dynamic visual acuity test(DVAT),gaze stabilization test(GST),and head impulse test(HIT)can be used to evaluate the VOR function.Based on these tests,a method of vestibular function testing has emerged internationally:functional head impulse test(fHIT).The article based on the review of relevant literatures and the principle of VOR detection and HIT detection to introduce the test methods and results interpretation of fHIT,DVAT and GST to provide reference for clinical diagnosis and treatment.
In recent years,the diagnosis and treatment of vertigo and balance disorders have become a hot topic of multidisciplinary attention.The evaluation method of vestibular function has also been improved,providing important evidence for the diagnosis and differential diagnosis of vertigo related diseases.Vestibular rehabilitation is one of the important methods for the treatment of vertigo diseases.Assessing vestibular rehabilitation status in these patients is also the key for guiding treatment.The assessment of vestibulo-ocular reflex(VOR)function is an important part of vestibular functional testing.Currently,the dynamic visual acuity test(DVAT),gaze stabilization test(GST),and head impulse test(HIT)can be used to evaluate the VOR function.Based on these tests,a method of vestibular function testing has emerged internationally:functional head impulse test(fHIT).The article based on the review of relevant literatures and the principle of VOR detection and HIT detection to introduce the test methods and results interpretation of fHIT,DVAT and GST to provide reference for clinical diagnosis and treatment.
引文
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[5]HALMAGYI G M,CURTHOYS I S.A clinical sign of canalparesis[J].Arch Neurol,1988,45:737-739.
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[7]WEBER K P,MACDOUGALL H G,HALMAGYI GM,et al.Impulsive testing of semicircular-canal function using video-oculography[J].Ann N Y Acad Sci,2009,1164:486-491.
[8]WEBER K P,AW S T,TODD M J,et al.Head impulse test in unilateral vestibular loss:vestibulo-ocular reflex and catch-up saccades[J].Neurology,2008,70:454-463.
[9]COLAGIORGIO P,RAMAT S,COLNAGHI S,et al.A new tool for investigating the functional testing of the VOR[J].Front Neurol,2013,4:165.
[10]RAMAT S,COLNAGHI S,BOEHIER A,et al.A device for the functional evaluation of the VOR in clinical settings[J].Front Neurol,2012,3:39.
[11]CORALLO G,VERSINO M,MANDALA M,et al.The functional head impulse test:preliminary data[J].J Neurol,2018,265:35-39.
[12]GOEBEL J A,TUNGSIRIPAT N,SINKS B,et al.Gaze stabilization test:a new clinical test of unilateral vestibular dysfunction[J].Otol Neurotol,2007,28:68-73.
[13]DOMENIC V,STEFAN C H,DOMINIK S,et al.A-new dynamic visual acuity test to assess peripheral vestibular function[J].Arch Otolaryngol Head Neck Surg,2010,136:686-691.
[14]WARD B K,MOHAMMAD M T,WHITNEY S L,et al.The reliability,stability,and concurrent validity of a test of gaze stabilization[J].J Vestib Res,2010,20:363-372.
[15]VOELKER C C,LUCISANO A,KALLOGJERI D,et al.Comparison of the gaze stabilization test and the dynamic visual acuity test in unilateral vestibular loss patients and controls[J].Otol Neurotol,2015,36:746-753.
[2]李晓璐,卜行宽,KAMRAN B,等.实用眼震电图和眼震视图检查[M].北京:人民卫生出版社,2015:134-136.
[3]田军茹.眩晕诊治问与答[M].北京:人民卫生出版社,2017:42-46.
[4]田军茹.眩晕诊治[M].北京:人民卫生出版社,2015:77-95.
[5]HALMAGYI G M,CURTHOYS I S.A clinical sign of canalparesis[J].Arch Neurol,1988,45:737-739.
[6]MACDOUGALL H G,WEBER K P,MCGARVIE LA,et al.The video head impulse test:diagnostic accuracy in peripheral vestibulopathy[J].Neurology,2009,73:1134-1141.
[7]WEBER K P,MACDOUGALL H G,HALMAGYI GM,et al.Impulsive testing of semicircular-canal function using video-oculography[J].Ann N Y Acad Sci,2009,1164:486-491.
[8]WEBER K P,AW S T,TODD M J,et al.Head impulse test in unilateral vestibular loss:vestibulo-ocular reflex and catch-up saccades[J].Neurology,2008,70:454-463.
[9]COLAGIORGIO P,RAMAT S,COLNAGHI S,et al.A new tool for investigating the functional testing of the VOR[J].Front Neurol,2013,4:165.
[10]RAMAT S,COLNAGHI S,BOEHIER A,et al.A device for the functional evaluation of the VOR in clinical settings[J].Front Neurol,2012,3:39.
[11]CORALLO G,VERSINO M,MANDALA M,et al.The functional head impulse test:preliminary data[J].J Neurol,2018,265:35-39.
[12]GOEBEL J A,TUNGSIRIPAT N,SINKS B,et al.Gaze stabilization test:a new clinical test of unilateral vestibular dysfunction[J].Otol Neurotol,2007,28:68-73.
[13]DOMENIC V,STEFAN C H,DOMINIK S,et al.A-new dynamic visual acuity test to assess peripheral vestibular function[J].Arch Otolaryngol Head Neck Surg,2010,136:686-691.
[14]WARD B K,MOHAMMAD M T,WHITNEY S L,et al.The reliability,stability,and concurrent validity of a test of gaze stabilization[J].J Vestib Res,2010,20:363-372.
[15]VOELKER C C,LUCISANO A,KALLOGJERI D,et al.Comparison of the gaze stabilization test and the dynamic visual acuity test in unilateral vestibular loss patients and controls[J].Otol Neurotol,2015,36:746-753.