Factors associated with spontaneous nystagmus changes in acute Ménière's disease.

IF 4.8 2区医学 Q1 CLINICAL NEUROLOGY

Journal of Neurology Pub Date : 2024-10-01 Epub Date: 2022-10-01 DOI:10.1007/s00415-022-11367-6

Munehisa Fukushima, Sadanori Waki, Saho Makino, Shiro Akahani

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引用次数: 0

Abstract

Background: Neuro-otological factors that influence changes in spontaneous nystagmus (SN) during vertigo attacks in Ménière's disease (MD) remain unclear.

Objective: To identify neuro-otological factors that might influence the initial direction of SN and the directional change of SN.

Methods: A prospective, observational study of 22 patients with definite MD to evaluate the initial direction and directional change of SN during vertigo attacks, endolymphatic hydrops (EH) volume, and the function of horizontal semicircular canal and hearing levels.

Results: SN consistently began as irritative in 17 of 22 cases, and 9 of 17 cases showed a definite change in direction after onset. SN consistently began as paralytic in 5 of 22 cases, and 3 of 5 cases showed a definite change in direction after onset. Subjects in the irritative initial SN group had less severe degrees of hearing loss, smaller cochlear and vestibular EH volume than the paralytic initial SN group (P = 0.017, < 0.001, and 0.009, respectively). Subjects in the SN direction change group had significantly smaller maximum slow phase velocity, percentage of caloric weakness and canal paresis than the no SN direction change group (P = 0.001, 0.006, and 0.001, respectively). Simple logistic regression analysis showed that smaller EH volume was significantly associated with initial irritative SN (OR = 0.867, 95% CI 0.762-0.988, P = 0.032) and that the degree of canal paresis was negatively associated with the presence of directional change of SN (OR = 0.022, 95% CI 0.002-0.289, P = 0.004).

Conclusions: The morphology of EH and canal paresis may independently affect the characteristics of SN in patients with MD.

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急性梅尼埃病患者自发性眼球震颤变化的相关因素。

背景：影响梅尼埃病（MD）眩晕发作时自发性眼球震颤（SN）变化的神经otological因素仍不清楚：方法：对梅尼埃病（MD）患者眩晕发作时的自发性眼震（SN）变化进行前瞻性观察研究：方法：对22名明确患有梅尼埃病的患者进行前瞻性观察研究，评估眩晕发作时SN的初始方向和方向变化、内淋巴水肿（EH）体积、水平半规管的功能和听力水平：在 22 个病例中，有 17 个病例的眩晕开始时始终是刺激性的，17 个病例中有 9 个病例在发病后方向发生了明确的改变。在 22 个病例中，有 5 个病例在开始时一直表现为麻痹，5 个病例中有 3 个病例在发病后表现出明确的方向性改变。与麻痹性初期 SN 组相比，刺激性初期 SN 组受试者的听力损失程度较轻，耳蜗和前庭 EH 容积较小（P = 0.017，结论）：EH的形态和耳道麻痹可能会单独影响MD患者SN的特征。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Neurology 医学-临床神经学

CiteScore

10.00

自引率

5.00%

发文量

558

审稿时长

1 months

期刊介绍： The Journal of Neurology is an international peer-reviewed journal which provides a source for publishing original communications and reviews on clinical neurology covering the whole field. In addition, Letters to the Editors serve as a forum for clinical cases and the exchange of ideas which highlight important new findings. A section on Neurological progress serves to summarise the major findings in certain fields of neurology. Commentaries on new developments in clinical neuroscience, which may be commissioned or submitted, are published as editorials. Every neurologist interested in the current diagnosis and treatment of neurological disorders needs access to the information contained in this valuable journal.