일측 전정기능 저하 환자에서 방향전환 진동유발안진의 임상적 의의와 발생 기전 제안

이동한; 박무균; 이준호; 오승하; 서명환

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자료유형: 학술저널

저자정보: 이동한 박무균 이준호 오승하 서명환

저널정보: 대한이비인후과학회 대한이비인후-두경부외과학회지 대한이비인후과학회지 두경부외과학 제61권 제11호

발행연도: 2018.1

수록면: 580 - 587 (8page)

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Background and Objectives We evaluated the clinical characteristics and vestibular functionof patients with direction changing vibration induced nystagmus (DC VIN) and unilateral vestibularhypofunction and suggest clinical implication and a proposed mechanism of DC VIN. Subjects and Method The records of 315 patients who underwent the VIN test were reviewedretrospectively. Among these, 18 patients (5.7%) showed DC VIN, and out of whom, 15patients (4.8%) were diagnosed as unilateral vestibular hypofunction by caloric, rotation chair(RCT), and video head impulse test (vHIT). We analyzed the relationship between DC VIN andthe dizziness characteristics, duration of disease, and the outcome of the vestibular function test. Results The mean age of 15 patients was 67.4±10.7 years and the mean duration of dizzinesswas 13.6±29.7 months. The caloric test revealed 25% of the patients to have significantcanal paresis [Caloric vestibular neuritis (VN)], while 75% showed normal caloric response. However, unilateral vestibular hypofunction was observed by abnormal results in RCT or vHIT(Non-caloric VN). Seven patients showed ipsilateral DC VIN (nystagmus to vibrated side) andeight patients contralateral DC VIN (nystagmus to opposite side of vibration). Patients with ipsilateralDC VIN were shown to have a significant longer duration of dizziness than those withcontralateral DC VIN. Conclusion Although rare, DC VIN can also be found in patients with unilateral vestibularhypofunction. Patients with DC VIN had a mild vestibular asymmetry with Non-caloric VNor Caloric VN in the process of compensation. The mechanism of ipsilateral DC VIN seems tobe due to the small amount of vestibular asymmetry, which is smaller than the interaural attenuationof vibration.

참고문헌 (17)

참고문헌 신청

Lücke K / 1973 / A vibratory stimulus of 100 Hz for provoking pathological nystagmus (author’s transl) / Z Laryngol Rhinol Otol 52(10):716~720

Ohki M / 2003 / Vibration-induced nystagmus in patients with vestibular disorders / Otolaryngol Head Neck Surg 129(3):255~258

Michel J / 2001 / Diagnostic value of vibration-induced nystagmus obtained by combined vibratory stimulation applied to the neck muscles and skull of 300 vertiginous patients / Rev Laryngol Otol Rhinol (Bord) 122(2):89~94

Park H / 2007 / Mechanisms of vibration-induced nystagmus in normal subjects and patients with vestibular neuritis / Audiol Neurootol 12(3):189~197

Xie S / 2013 / Vibrationinduced nystagmus in patients with unilateral peripheral vestibular disorders / Indian J Otolaryngol Head Neck Surg 65(4):333~338

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