Skull vibration induced nystagmus frequency and location optimization in severe unilateral lesion patients and in anterior canal dehiscences - 09/11/16
, A. Lion 2, 4, I.S. Curthoys 3, P. Perrin 2, 5, S. Schmerber 1, 6Bienvenue sur EM-consulte, la référence des professionnels de santé.
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Résumé |
Background |
Bone conducted vibrations (BCV) applied on mastoid elicit in common unilateral vestibular lesion (UVL) patients usually a skull vibration induced nystagmus (SVIN) beating toward the intact side and conversely in unilateral superior semicircular canal dehiscence (SCD) a SVIN beating toward the lesion side. Our purpose was to establish optimal topographic and frequency stimulations in severe UVL (SUVL) and SCD patients. The second aim was to compare VIN at 100Hz in unilateral SCD (uSCD) and bilateral (bSCD) patients.
Participants and methods |
The first experiment included 11 SUVL and 10 unilateral SCD (uSCD). The SVIN, optimal frequency was studied with a MiniShaker B&K (10 to 800Hz) on each mastoid and vertex in SUVL and uSCD; the VIN slow phase velocity (SPV) was recorded with Videonystagmography. Optimal topographic stimulation study analyzed vertex and mastoids responses SPV at 100Hz. Second experiment included 27 uSCD and 13 bSCD and analyzed SVIN SPV at 100Hz.
Results |
In SUVL, the optimal stimulus frequency was 100Hz for the horizontal component VIN SPV (P<0.001). No responses were observed over 500Hz. In uSCD patients, a wider range of frequency response up to 700Hz was observed without significant optimal frequency. For the horizontal component VIN, SPV was significantly higher in uSCD than in SUVL at 400Hz (P=0.02) and at 600Hz (P=0.01); conversely VIN SPV at 100Hz was higher in SUVL than uSCD (P=0.008). In SUVL, mastoid stimulation was significantly more efficient than vertex stimulation (ANOVA P=0.01). Conversely, in uSCD SVIN SPV was significantly higher after vertex stimulation (P=0.04). A VIN was significantly more often observed in uSCD than bSCD (P=0.009) and VIN SPV was higher in uSCD than bSCD (P=0.008).
Conclusion |
In SUVL, the optimal frequency stimulation is 100Hz with no responses over 500Hz. In SCD, patients responses are observed up to 700Hz without significant optimal frequency suggesting that the BC facilitation related to the existence of a third window enables a greater sensitivity to higher range of frequencies. Vertex stimulations are more efficient in SCD patients and higher responses are observed in uSCD than bSCD. SVIN acts as a vestibular Weber test.
Le texte complet de cet article est disponible en PDF.Keywords : Anterior canal dehiscence, Severe unilateral vestibular lesion, Skull vibration induced nystagmus, High frequencies stimulations
Plan
Vol 46 - N° 4-5
P. 255-256 - novembre 2016 Retour au numéro
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