Zusammenfassung
Aufgrund der Entwicklung neuer Methoden, wie den vestibulär evozierten myogenen Potenzialen und dem Video-Kopfimpulstest, befindet sich die klinische Vestibularisdiagnostik gegenwärtig im Wandel. Mit dem Spektrum der zur Verfügung stehenden diagnostischen Methoden ist erstmals eine spezifische, quantitative und objektive Analyse vestibulärer Reflexe möglich. Die Kombination unterschiedlicher Verfahren erlaubt darüber hinaus eine Einschätzung unterschiedlicher Arbeitsbereiche. Das Konzept einer differenzierten Analyse der vestibulären Rezeptorfunktion beinhaltet neben einer topologischen Diagnostik die Beurteilung frequenzspezifischer Arbeitsbereiche (Frequenzdynamik) sowie die Erfassung von funktionellen Veränderungen im Zeitverlauf (zeitliche Dynamik). Damit ist eine neue Sichtweise auf das Resultat physiologischer Testergebnisse entstanden. Vestibuläre Störungen können so in der klinischen Praxis umfassend beurteilt und verstanden werden.
Abstract
Due to the development of new methods such as the vestibular evoked myogenic potential and the video head impulse tests, clinical vestibular diagnostic procedures are currently in an era of change. The spectrum of available techniques renders a specific, quantitative and objective analysis of vestibular reflexes possible for the first time. Moreover, a combination of different methods permits the assessment of different functional areas of the vestibular receptor. In addition to a topological diagnosis, the concept of a differentiated analysis of vestibular receptor function includes evaluation of frequency-specific functional areas (dynamic frequency analysis) and monitoring of temporal changes (time-dependent diagnostics). Consequently, the overall outcome of physiological tests can be viewed from a new perspective. This enables a comprehensive assessment of vestibulopathies in clinical practice and furthers the understanding of these disorders.
Literatur
Agrawal Y, Zuniga MG, Davalos-Bichara M et al (2012) Decline in semicircular canal and otolith function with age. Otol Neurotol 33:832–839
Ahn BH, Kim HA, Yi HA et al (2011) Abnormal cervical vestibular-evoked myogenic potential in anterior inferior cerebellar artery territory infarction: frequency, pattern, and a determinant. J Neurol Sci 307(1–2):114–119
Bartl K, Lehnen N, Kohlbecher S, Schneider E (2009) Head impulse testing using video-oculography. Ann N Y Acad Sci 1164:331–333
Brandt T, Strupp M, Benson J (1999) You are better off running than walking with acute vestibulopathy. Lancet 354:746
Byun JY, Hong SM, Yeo SG et al (2010) Role of subjective visual vertical test during eccentric rotation in the recovery phase of vestibular neuritis. Auris Nasus Larynx 37:565–569
Clarke AH, Engelhorn A (1998) Unilateral testing of utricular function. Exp Brain Res 121:457–464
Clarke AH, Schönfeld U, Helling K (2003) Unilateral examination of utricle and saccule function. J Vestib Res 13:215–225
Colebatch JG, Halmagyi GM (1992) Vestibular evoked potentials in human neck muscles before and after unilateral vestibular deafferentation. Neurology 42:1635–1636
Fujimoto C, Murofushi T, Chihara Y et al (2009) Assessment of diagnostic accuracy of foam posturography for peripheral vestibular disorders: analysis of parameters related to visual and somatosensory dependence. Clin Neurophysiol 120:1408–1414
Fujimoto C, Murofushi T, Chihara Y et al (2010) Effects of unilateral dysfunction of the inferior vestibular nerve system on postural stability. Clin Neurophysiol 121:1279–1284
Govender S, Rosengren SM, Colebatch JG (2011) Vestibular neuritis has selective effects on air- and bone-conducted cervical and ocular vestibular evoked myogenic potentials. Clin Neurophysiol 122:1246–1255
Halmagyi GM, Curthoys IS (1988) A clinical sign of canal paresis. Arch Neurol 45:737–739
Hamann KF, Schuster EM (1999) Vibration-induced nystagmus – a sign of unilateral vestibular deficit. ORL J Otorhinolaryngol Relat Spec 61:74–79
Heide G, Luft B, Franke J et al (2010) Brainstem representation of vestibular evoked myogenic potentials. Clin Neurophysiol 121(7):1102–1108
Herdman SJ (1998) Role of vestibular adaptation in vestibular rehabilitation. Otolaryngol Head Neck Surg 119:49–54
Jacobson GP, McCaslin DL, Piker EG et al (2011) Patterns of abnormality in cVEMP, oVEMP, and caloric tests may provide topological information about vestibular impairment. J Am Acad Audiol 22:601–611
Kim HA, Hong JH, Lee H et al (2008) Otolith dysfunction in vestibular neuritis: recovery pattern and a predictor of symptom recovery. Neurology 70:449–453
Kremmyda O, Kirchner H, Glasauer S et al (2012) False-positive head-impulse test in cerebellar ataxia. Front Neurol 3:162
Lücke K (1973) A vibratory stimulus of 100 Hz for provoking pathological nystagmus. Z Laryngol Rhinol Otol 52:716–720
MacDougall HG, McGarvie LA, Halmagyi GM et al (2013) Application of the video head impulse test to detect vertical semicircular dysfunction. Otol Neurotol: Epub ahead of print: 24. Mai 2013
Manzari L, Burgess AM, Curthoys IS (2012) Ocular and cervical vestibular evoked myogenic potentials in response to bone-conducted vibration in patients with probable inferior vestibular neuritis. J Laryngol Otol 126:683–691
Manzari L, Burgess AM, Curthoys IS (2012) Does unilateral utricular dysfunction cause horizontal spontaneous nystagmus? Eur Arch Otorhinolaryngol 269:2441–2445
Manzari L, Burgess AM, MacDougall HG et al (2011) Rapid fluctuations in dynamic semicircular canal function in early Ménière’s disease. Eur Arch Otorhinolaryngol 268:637–639
Manzari L, Burgess AM, MacDougall HG, Curthoys IS (2011) Objective verification of full recovery of dynamic vestibular function after superior vestibular neuritis. Laryngoscope 121:2496–2500
Manzari L, Macdougall HG, Burgess AM, Curthoys IS (2012) New, fast, clinical vestibular tests identify whether a vertigo attack is due to early Ménière’s disease or vestibular neuritis. Laryngoscope 123: 507–511
Manzari L, Tedesco AR, Burgess AM, Curthoys IS (2010) Ocular and cervical vestibular-evoked myogenic potentials to bone conducted vibration in Ménière’s disease during quiescence vs during acute attacks. Clin Neurophysiol 121:1092–1101
Paige GD, Seidman SH (1999) Characteristics of the VOR in response to linear acceleration. Ann N Y Acad Sci 28:123–135
Park HJ, Migliaccio AA, Della Santina CC et al (2005) Search-coil head-thrust and caloric tests in Ménière’s disease. Acta Otolaryngol 125:852–857
Ramat S, Zee DS, Minor LB (2001) Translational vestibulo-ocular reflex evoked by a „head heave“ stimulus. Ann N Y Acad Sci 942:95–113
Sandhu JS, Low R, Rea PA, Saunders NC (2012) Altered frequency dynamics of cervical and ocular vestibular evoked myogenic potentials in patients with Ménière’s disease. Otol Neurotol 33:444–449
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Interessenkonflikt. L.E. Walther gibt an, dass kein Interessenkonflikt besteht. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.
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Walther, L. Anwendung neuer Diagnostik beim Symptom Schwindel. HNO 61, 730–737 (2013). https://doi.org/10.1007/s00106-013-2738-8
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DOI: https://doi.org/10.1007/s00106-013-2738-8