Caloric test and hearing characteristics in patients with vestibular migraine and Meniere’s disease
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摘要: 目的:分析比较前庭性偏头痛(VM)和梅尼埃病(MD)患者之间的临床特征差异,为鉴别诊断提供参考依据。方法:收集可疑的VM患者46例、确定的VM患者60例以及确定的MD患者60例,所有患者均通过详细的病史询问,然后行纯音测听检查及双温试验。分析可疑的VM与确定的VM患者之间、确定的MD与确定的VM患者之间纯音测听及双温试验结果之间的差异。结果:可疑的VM、确定的VM以及确定的MD患者之间的比较:①三组患者男女比例分别为1∶4.75、1∶5.67和1∶1;家族史阳性的比例分别为80.43%、66.67%和6.67%。②三组患者双温试验结果异常率分别为50.00%、31.67%和78.33%。③三组患者纯音测听异常率分别为60.87%、63.33%和100%。听力下降类型:46例可疑的VM患者中纯音测听异常者28例(60.87%),其中39.13%为高频下降型,15.22%为全频下降型,6.52%为低频下降型;60例确定的VM患者中纯音测听异常者38例(63.33%),其中30.00%为高频下降型,25.00%为全频下降型,6.67%为低频下降型,1.67%低频和高频均下降;60例确定的MD患者中纯音测听异常者60例(100.00%),其中93.33%为全频听力下降型,6.67%为低频下降型。④可疑的VM与确定的VM患者之间比较,纯音测听、双温试验检查异常率差异均无统计学意义(P>0.05);确定的VM与MD患者之间比较,VM患者听力下降发生率和双温试验异常率均较小(P<0.05)。结论:MD患者双温试验异常率及听力下降发生率高于VM;确定的及可疑的VM患者均可伴有听力下降,且高频下降较多;确定的VM与可疑的VM患者临床特征无差异。Abstract: Objective:This study was designed to distinguish vestibular migraine (VM) from Meniere's disease (MD) by comparing age, sex, family history, audiological and vestibular test results in patients with VM or MD.Method:Forty-six patients with suspected VM, 60 patients with confirmed VM, and 60 patients with confirmed MD were studied.All patients were asked for detailed medical history, and then underwent bithermal caloric test and audiological test.The hearing function and vestibular function were analyzed.Result:①General conditions:the sex ratio with suspected VM, confirmed VM and confirmed MD was 1:4.75, 1:5.67 and 1:1.Family history in these three groups was 80.43% (37/46), 66.67% (40/60), 6.67% (4/60), respectively.②In the three groups, the abnormal rates of caloric test were 50.00% (23/46), 31.67% (19/60) and 78.33% (47/60), respectively.③The rate of pure tone audiometry abnormality in the three groups was 60.87% (28/46), 63.33% (38/60) and 100.00% (60/60), respectively.Of 46 suspected VM patients, 18 (39.13%) had high frequency hearing loss, 7 (15.22%) had full frequency hearing loss, and 3 (6.52%) had low frequency hearing loss.Among 60 confirmed VM patients, 18 (30.00%) had high frequency hearing loss, 15 (25.00%) had full frequency hearing loss, 4 (6.67%) had low frequency hearing loss, and 1 case (1.67%) with low frequency and high frequency hearing loss.Among 60 confirmed MD patients, 56 (93.33%) had full-frequency hearing loss, and 4 (6.67%) had lowfrequency hearing loss.④The difference of audiological test between patients with confirmed VM and patients with suspected VM was not statistically significant (P>0.05).The difference of bithermal caloric test between patients with confirmed VM and patients with suspected VM was not statistically significant (P>0.05).Compared with MD patients, the incidence of hearing loss and the incidence of abnormal bithermal caloric test in VM patients is lower (P<0.05).Conclusion:The abnormality rate of caloric test and the incidence of hearing loss in MD patients were higher than VM.The confirmed and suspected VM patients can be accompanied by hearing loss mainly with high hearing frequency decline.There was no difference in clinical characteristics between confirmed and suspected VM patients.
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Key words:
- vestibular migraine /
- Meniere's disease /
- pure tone audiometry /
- caloric tests
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