Relation Between Vestibular Dysfunction And Visual Dependence In Patients With Epilepsy

Background and objective: Vertigo is a subjective motion illusion reflecting vestibular dysfunction.The Dizziness obstacle Inventory(DHI)is a common tool for evaluating Dizziness.Balance function is established through vestibular triad,which is the integration mechanism of proprioception,vision and surrounding vestibular.The degree of personal dependence on spatial visual stimuli is called visual dependence,and when the input end excessively depends on visual input,it is called high visual dependence,resulting in vertigo.Vertigo closely related to visual input is called Visual Vertigo(VV),which can be verified by Visual Vertigo Analogue Scale(VVAS).The Rod and Disc Test(RDT)is the primary tool for measuring visual dependence.The incidence of vertigo in epileptic patients is high,but there are few studies on vestibular function in epileptic patients.This study aims to investigate the status of vestibular damage in People With Epilepsy(PWE)and explore its relationship With visual dependence.Methods: The subjects of this study were PWE and healthy volunteers(control group)who met the entry criteria.DHI,VVAS and RDT tests were conducted respectively.The RDT design of this study was C1(subjective visual verticality),C2(visual dependence),C3(proprioceptive dependence)and C4(visual & proprioceptive dependence).According to DHI score,PWE were divided into non-vertigo group(0 points),mild vertigo group(1-30 points)and moderate and severe vertigo group(31-100 points).VVAS and RDT measurements were compared among all groups,and statistically compared with the control group.At the same time,PWE was subdivided into subgroups according to medication regimen,medication type and attack frequency,and RDT measurement results were statistically compared among each subgroup.Results:A total of 48 PWE and 22 healthy subjects completed the above tests.1.Grouping of DHI: among 48 cases of PWE,22 cases(45%)were in the non-vertigo group,20 cases(41.7%)in the mild vertigo group,and6 cases(12.5%)in the moderate to severe vertigo group.Compared with the control group,DHI scores of mild vertigo and moderate and severe vertigo in PWE group were higher than those in the control group,with statistical difference(P < 0.001).2.VVAS score: There was no statistical difference in VVAS score between PWE vertigo subgroups and control group.3.RDT test: C2 in moderate and severe vertigo group was significantly higher than that in control group and non-vertigo group,WHILE C4 in mild vertigo group and moderate and severe vertigo group was significantly higher than that in control group and non-vertigo group,with statistical difference(P < 0.05),while C1 and C3 showed no statistical difference between groups.According to the medication regimen,type of medication and frequency of PWE,the patients were divided into subgroups for RDT measurement.It was found that C2 and C4 in the PWE group were significantly higher than those in the PWE group,while C1 and C3 showed no statistical difference between the two groups.Conclusion: Vestibular dysfunction is found in a small number of PWE,which is associated with visual dependence and is common in patients with poor seizure control.C4 in RDT test is more responsive to the early vestibular function damage of PWE,and is a more sensitive detection tool to reflect the vestibular function damage of PWE than DHI and VVAS.