小脑性共济失调患者视频眼震电图特点

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摘要目的明确小脑性共济失调患者视频眼震电图特点，为早期诊断小脑性共济失调和鉴别前庭中枢性和周围性病变提供眼动异常依据。方法收集2019年10月至2020年5月首都医科大学宣武医院神经内科住院诊治小脑性共济失调患者20例，对其视频眼震图各个项目包括自发性眼震、视动性眼震、平稳跟踪试验、扫视试验、凝视试验、位置试验和双温试验进行分析，总结各个项目的表现特点。结果自发性眼震试验：7例（35%）出现各种类型眼震和扫视侵扰；视动性眼震：3例（15%）出现双侧慢相角速度不对称，19例（95%）出现增益异常；平稳追踪试验：18例（90%）出现Ⅲ型和Ⅳ型曲线，10例（50%）出现增益异常；凝视试验：10例（50%）出现异常眼动；扫视试验：13例（65%）出现峰速度下降、12例（60%）出现准确度异常和1例（5%）出现潜伏期异常；静态位置试验：15例（75%）出现异常眼动；前庭双温试验：1例（5%）出现半规管功能亢进。结论视动性眼震的增益异常、平稳追踪试验曲线波形异常提示前庭中枢异常，是早期诊断小脑性共济失调的依据之一。

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	陈芳户宁宁杨冬菊刘静刘爱华樊春秋▲

关键词 ：小脑性共济失调, 视频眼震电图, 前庭中枢, 早期诊断

Abstract：Objective To clarify the characteristics of the video nystagmography in patients with cerebellar ataxia, and to provide evidence for early diagnosis of cerebellar ataxia and differentiation of vestibular central and peripheral lesions of eye movement abnormalities. Methods A total of 20 patients with cerebellar ataxia treated in Department of Neurology, Xuanwu Hospital Capital Medical University from October 2019 to May 2020 were collected. The performance characteristics of the video nystagmography including spontaneous nystagmus, visual nystagmus, stationary tracking test, saccades test, gaze test, position test and double temperature test were analyzed, and the performance characteristics of each project were summarized. Results Spontaneous nystagmus test: 7 cases (35%) had various types of nystagmus and saccade; visual nystagmus: asymmetric slow phase velocity was found in 3 cases (15%), and abnormal gain was found in 19 cases (95%); stationary tracing test: 18 cases (90%) showed type Ⅲ and type Ⅳ curves, and 10 cases (50%) showed abnormal gain; gaze test: 10 cases (50%) had abnormal eye movement; saccade test: peak velocity decreased in 13 cases (65%), accuracy abnormal in 12 cases (60%), and latency abnormal in 1 case (5%); static position test: 15 cases (75%) showed abnormal eye movement; vestibular double temperature test: 1 case (5%) showed hypersemicircular canal function. Conclusion The abnormal gain and smooth tracing curve of optic nystagmus indicate abnormal vestibular center, which is one of the basis for early diagnosis of cerebellar ataxia.

Key words： Cerebellar ataxia Video nystagmography Vestibular center Early diagnosis

基金资助:国家重点研发计划“重大慢性非传染性疾病防控研究”专项项目子课题（2017YFC1310901）。

通讯作者: ▲通讯作者

引用本文:

陈芳户宁宁杨冬菊刘静刘爱华樊春秋▲. 小脑性共济失调患者视频眼震电图特点[J]. 中国医药导报, 2022, 19(8): 69-71,76.
CHEN Fang HU Ningning YANG Dongju LIU Jing LIU Aihua FAN Chunqiu▲. Characteristics of the video nystagmography in patients with cerebellar ataxia#br#. 中国医药导报, 2022, 19(8): 69-71,76.

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https://www.yiyaodaobao.com.cn/CN/ 或 https://www.yiyaodaobao.com.cn/CN/Y2022/V19/I8/69

[1] Mitoma H，Adhikari K，Aeschlimann D，et al. Consensus Paper: Neuroimmune Mechanisms of Cerebellar Ataxias [J]. Cerebellum，2016，15（2）：213-232.
[2] Zeigelboim BS，Teive HA，Sampaio R，et al. Electronystagmography findings in spinocerebellar ataxia type 3（SCA3）and type 2（SCA2）[J]. Arq Neuropsiquiatr，2011，69（5）：760-765.
[3] 中国医药教育协会眩晕专业委员会，中国康复医学会眩晕与康复专业委员会，中西医结合学会眩晕专业委员会，等.前庭功能检查专家共识（一）[J].中华耳科学杂志，2019，17（1）：117-123.
[4] 田军茹.眩晕诊治问与答[M].北京：人民卫生出版社，2017：66-70.
[5] R John L，David SZ. The neurology of eye movement-4th ed [M]. Philadelphia：F. A. Davis Company，2006，475-528.
[6] 田军茹.眩晕诊治[M].北京：人民卫生出版社，2015，77-80.
[7] 田军茹.认识眼震性质是识别眩晕疾病的重要方式[J].中国耳鼻咽喉头颈外科杂志，2018，24（6）：497-504.
[8] Ganan?觭a MM，Caovilla HH，Ganan?觭a FF. Electronystagmography versus videonystagmography [J]. Braz J Otorhinolaryngol，2010，76（3）：399-403.
[9] Eggers SDZ. Approach to the Examination and Classification of Nystagmus [J]. J Neurol Phys Ther，2019，43 Suppl 2：S20-S26.
[10] Waddington J，Harris CM. Human optokinetic nystagmus：A stochastic analysis [J]. J Vis，2012，12（12）：5，1-17
[11] Kim SH，Zee DS，du Lac S，et al. Nucleus prepositus hypoglossi lesions produce a unique ocular motor syndrome [J]. Neurology，2016，87（19）：2026-2033.
[12] Mitoma H，Buffo A，Gelfo F，et al. Cerebellar Reserve：From Cerebellar Physiology to Cerebellar Disorders [J]. Cerebellum，2020，19（1）：131-153.
[13] Mitoma H，Manto M. The physiological basis for therapies of cerebellar ataxias [J]. Ther Adv Neurol Disord，2016，9（5）：396-413.
[14] Gelfo F，Florenzano F, Foti F，et al. Lesion-induced and activity-dependent structural plasticity of Purkinje cell dendritic spines in cerebellar vermis and hemisphere [J]. Brain Struct Funct，2016，221（7）：3405-3426.
[15] Zee DS. A neurologist and ataxia: using eye movements to learn about the cerebellum [J]. Cerebellum Ataxias，2018，5：2.
[16] Walker MF，Tian J，Shan X，et al. Lesions of the cerebellar nodulus and uvula in monkeys：effect on otolith-ocular reflexes [J]. Progress Brain Res，2008，171：167-172.
[17] Ying SH，Choi SI，Perlman SL，et al. Pontine and cerebellar atrophy correlate with clinical disability in SCA2 [J]. Neurology，2006，66（3）：424-426.
[18] Lee SH，Park SH，Kim JS，et al. Isolated unilateral infarction of the cerebellar tonsil: ocular motor findings [J]. Ann Neurol，2014，75（3）：429-434.
[19] Zee DS，Leigh RJ，Mathieu-Millaire F. Cerebellar control of ocular gaze stability [J]. Ann Neurol，1980，7（1）：37-40.
[20] Tercero-Pérez K，Cortés H，Torres-Ramos Y，et al. Effects of physical rehabilitation in patients with spinocerebellar ataxia type 7 [J]. Cerebellum，2019，18（3）：397-405.
[21] Brady RO Jr，Gonsalvez I，Lee I，et al. Cerebellar-prefrontal network connectivity and negative symptoms in schizophrenia [J]. Am J Psychiatry，2019，176（7）：512-520.
[22] Depping MS，Schmitgen MM，Kubera KM，et al. Cerebellar contributions to major depression [J]. Front Psychiatry，2018，9：634.
[23] Kakei S，Lee J，Mitoma H，et al. Contribution of the cerebellum to predictive motor control and its evaluation in ataxic patients [J]. Front Hum Neurosci，2019，13：216.
[24] King M，Hernandez-Castillo CR，Poldrack RA，et al. Functional boundaries in the human cerebellum revealed by a multi-domain task battery [J]. Nat Neurosci，2019， 22（8）：1371-1378.
[25] Aoki S，Coulon P，Ruigrok TJH. Multizonal cerebellar influence over sensorimotor areas of the rat cerebral cortex [J]. Cereb Cortex，2019，29（2）：598-614.