[儿童前庭神经炎的前庭功能特点及预后]
[Vestibular function features and prognosis of vestibular neuritis in children].
作者信息
Liu B, Li B, Zhang L, Jiang S M, Chen M, Liu W, Liu H H, Zhang J
机构信息
National Center for Children's Health of China, Department of Otorhinolaryngology Head and Neck Surgery, Beijing Children' s Hospital, Capital Medical University, Beijing Key Laboratory for Pediatric Diseases of Otolaryngology-Head and Neck Surgery, Beijing Pediatric Research Institute, Beijing 100045, China.
出版信息
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2018 Dec 7;53(12):899-903. doi: 10.3760/cma.j.issn.1673-0860.2018.12.005.
To investigate the clinical characteristics, prognosis and affected branches of vestibular neuritis in children. Twenty-five patients with vestibular neuritis in ENT department, Beijing Children's Hospital, from October 2015 to October 2016, were collected. All patients were 4-14 (mean 9.8) years old including 17 boys and 8 girls. The clinical manifestations history, pure tone audiometry (PTA), vestibular function tests were done for each patient. We also took the blood samples for pathogenic virus in order to analyze the premorbid risk factors. Rotational vertigo were complained by all presents. There were 17 cases (68%, 17/25) with nausea and vomiting and 19 cases (76%, 19/25) with balance dysfunction. There were 12 cases (60%, 12/20) with positive results in 20 blood samples for virology, among which 6 cases of influenza B virus and 4 cases of herpes simplex virus, 1 case of cytomegalovirus and 1 case of coxsackie were identified. The results of PTA were normal. Bithermal caloric test was abnormal in 22 cases (88%, 22/25). The ocular vestibular-evoked myogenic potential (oVEMP) in 12 cases (48%, 12/25) and cervical vestibular-evoked myogenic potential (cVEMP) in 5 cases (20%, 5/25) were abnormal. The bithermal caloric test along with oVEMP and cVEMP in 4 cases (16%, 4/25) were abnormal. The bithermal caloric test and oVEMP in 7 cases (28%, 7/25) were abnormal. The bithermal caloric test in 11 cases (44%, 11/25) were abnormal. The oVEMP in 1 cases (4%, 1/25) was abnormal. The cVEMP in 1 cases (4%, 1/25) was abnormal. All patients recovered well, but the time varied. The symptoms of 21 patients were complete recovery within 1 month. 3 patients were complete recovery within 2 months (aged 8 - 14 years old). One patient was complete recovery within 6 months (aged 13 years old). Rotary vertigo is most commonly in children with vestibular neuritis, accompany with imbalance and vomiting. The vestibular neuritis in children might be related with upper respiratory tract infection. Audiometry test is normal. Because of the bithermal caloric test and oVEMP are obvious abnormality, therefore it is speculated that the superior vestibular nerve may most commonly be affected. The younger patients with vestibular neuritis recovered more quickly than the older children.
探讨儿童前庭神经炎的临床特征、预后及受累分支。收集了2015年10月至2016年10月在北京儿童医院耳鼻喉科就诊的25例前庭神经炎患儿。所有患儿年龄为4 - 14岁（平均9.8岁），其中男孩17例，女孩8例。对每位患儿进行了临床表现、病史、纯音听力测试（PTA）及前庭功能测试。还采集血样检测致病病毒，以分析发病前的危险因素。所有患儿均主诉有旋转性眩晕。17例（68%，17/25）有恶心呕吐，19例（76%，19/25）有平衡功能障碍。20份血样病毒学检测中12例（60%，12/20）结果阳性，其中鉴定出6例乙型流感病毒、4例单纯疱疹病毒、1例巨细胞病毒和1例柯萨奇病毒。PTA结果正常。冷热试验22例（88%，22/25）异常。眼前庭诱发肌源性电位（oVEMP）12例（48%，12/25）异常，颈前庭诱发肌源性电位（cVEMP）5例（20%，5/25）异常。冷热试验联合oVEMP和cVEMP 4例（16%，4/25）异常。冷热试验和oVEMP 7例（28%，7/25）异常。冷热试验11例（44%，11/25）异常。oVEMP 1例（4%，1/25）异常。cVEMP 1例（4%，1/25）异常。所有患儿恢复良好，但恢复时间各异。21例患儿症状在1个月内完全恢复。3例患儿在2个月内完全恢复（年龄8 - 14岁）。1例患儿在6个月内完全恢复（年龄13岁）。旋转性眩晕在儿童前庭神经炎中最为常见，常伴有失衡和呕吐。儿童前庭神经炎可能与上呼吸道感染有关。听力测试正常。由于冷热试验及oVEMP明显异常，因此推测最常受累的可能是前庭上神经。年龄较小的前庭神经炎患儿比年龄较大的患儿恢复得更快。
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