The Study Of Vestibular Evoked Myogenic Potentials In Patients Of Benign Paroxysmal Positional Vertigo

Objective Taking vestibular evoked myogenic potentials(VEMPs)tests for patients with four types of benign paroxysmal positional vertigo and normal subjects.To explore the relationship of parameters of VEMPs such as response rate,latency,latency-interval,amplitude,asymmetry ratio,between patients with BPPV and normal subjects,as well ae among the patients with different type BPPV.Provide the basis for clinical diagnosis and treatment of BPPV.Methods Research Object:(1)The group of patients:111 indivduals(40 males and 71 females,1:1.78,arrange of 30-69 years,Ave.±SD,51.27±9.79)enrolled in this study.They were the patients of the vertigo center of the General Hosipital of Tianjin Medical University,diagnosed as primary unilateral benign paroxysmal positional vertigo from January 2016 to December 2016,with less than three months of course.These patients were divided into 4 groups according to the type of BPPV diagnosed:group1(Posterior semicircular canals BPPV):59 individuals(118ears),20 males and 39 females,1:1.95,average age(50.73±9.62)years.group2(Horizontal semicircular canals BPPV):34 individuals(68ears),13 males and 21 females,1:1.62,average age(50.76±9.46)years.group3(Anterior semicircular canals BPPV):5 individuals(10ears),2 males and 3 females,1:1.5,average age(53.20±12.23)years.group4(Multiple canals BPPV):13 individuals(26ears),5 males and 8 females,1:1.6,average age(54.31±11.00)years.(2) The group of normal subjects:49 individuals(23 males and 26 females,1:1.6,arrange of 30-69 years,Ave.±SD,51.08±7.84)enrolled in this study.They were healthy individuals diagnosed by the vertigo center at the same period with the patients groups.VEMPs were detected respectively.Research Instrument: Using the Danish international hearing auditory evoked potential(EP25)to test in sound insulation room,sound stimulus emitted by inser earphone.Subjects were sitting,electrodes were placed on the skin,then start to test.The muscle of test side must be retained in the best tension state during test.One side finish,then test the other side.Dates use SPSS 19.0 to analyze.Rusults Dates of the parameter of response rate,P1 ? N1 latency?latency-interva?amplitude?amplituder ratio?asymmetry ratio:?Cervical vestibular evoked myogenic potential parameters value respectively as fllowed :Group1 is 69.49%?(15.89±1.45)ms?(24.90±1.54)ms?(9.01±1.10)ms?(75.22±3.03)?V?(1.38±0.22)?(13.14±7.60)%?Group2 is 70.59%?(16.27±1.30)ms?(24.03±2.01)ms?(7.96±1.28)ms?(67.85±3.54)?V?(1.12±0.19)?(10.41±4.97)%?Group3 is70.00%?(15.33±1.67)ms?(24.37±2.13)ms?(8.99±1.70)ms?(77.61±4.72)?V?(1.26±0.48)?(11.77±6.81)%?Group4 is 65.38%?(16.10±1.44)ms?(25.03±1.79)ms?(8.45±0.87)ms?(56.08±5.03)?V?(1.34±0.11)?(12.77±8.04)%?Control group is 81.63%?(14.20±0.79)ms?(24.30±0.77)ms?(9.84±0.63)ms?(80.10±5.46)?V?(1.08±0.42)?(11.21±4.52)%??Ocular vestibular evoked myogenic potential parameters value respectively as fllowed :Group1 is 61.86%?(15.29±0.99)ms?(10.99±0.56)ms?(5.38±0.47)ms?(4.43±1.02)?V?(1.48±0.43)?(14.97±5.91)%?Group2 is 60.29%?(16.06±1.08)ms?(11.13±0.68)ms?(6.03±0.62)ms?(5.98±2.74)?V?(1.59±0.64)?(15.45±8.92)%?Group3 is 60.00%?(15.43±1.33)ms?(10.02±1.41)ms?(5.33±0.96)ms?(4.78±3.11)?V?(1.26±0.57)?(12.13±7.75)%?Group4 is 53.85%?(15.67±1.15)ms?(10.67±0.77)ms?(5.77±0.56)ms?(3.94±2.43)?V?(1.43±0.38)?(13.46±4.69)%?Control group is 70.41%?(14.89±0.65)ms?(10.17±0.59)ms?(4.96±0.71)ms?(6.43±4.59)?V?(1.25±0.37)?(12.74±6.08)%?Analysis:The statistical results show decline significant in cVEMP/o VEMP response rate between patients and normal controls,and response rate of o VEMP is more significant decline(p<0.05).The asymmetry ratio of o VEMP also show significant difference between patients and normal controls(p<0.05).Four types of BPPV is found significant difference in response rate,MC-BPPV is more lower then the other three groups(p<0.05).The affected ears and the contralateral ears in the affected groups is no significant difference in parameters of cVEMP/o VEMP(p>0.05).Conclusions:1?The cVEMP/o VEMP response rate of patients of BPPV is lower significantly to normal controls.So VEMPs can be applyed to patients of BPPV.2?In the affected groups,o VEMP response rate is lower than cVEMP response rate,and o VEMP asymmetry ratio is higher than cVEMP.So that o VEMP test is more sensibility to patients of BPPV than cVEMP test.3?There are two sides otolith apparatus deficiency in patients of primary unilateral benign paroxysmal positional vertigo.