Vestibularni evocirani miogeni potencijali i video head impulse test kod pacijenata s vrtoglavicom, zanašanjem i neravnotežom

master's thesis

• Title (english): Vestibular evoked myogenic potentials and video head impulse test in patients with vertigo, dizziness and imbalance
• Author: Berislav Ruška
• Mentor: Mario Habek (mentor)
• Committee member: Ervina Bilić (predsjednik povjerenstva)
• Committee member: Zdravka Poljaković (član povjerenstva)
• Committee member: Mario Habek (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Neurology); Zagreb
• Defense date and country: 2018-07-13, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Neurology

Abstract

Cilj je ovog istraživanja bio usporediti rezultate vestibularnih evociranih miogenih potencijala (VEMP-a) i video head impulse testa (vHIT-a) u bolesnika s vrtoglavicom i zanašanjem. Retrospektivno smo analizirali rezultate svih bolesnika kojima je glavni simptom bio vrtoglavica, zanašanje ili poremećaj ravnoteže, a kojima su učinjeni VEMP i vHIT u razdoblju od siječnja 2015. do siječnja 2016. Ukupno je 117 bolesnika (73 žene, srednje dobi 53.92 ± 16.76) zadovoljilo uključne kriterije: skupina 1 uključivala je bolesnike s konačnom dijagnozom vestibularnog neuritisa (VN) (N=31(16 desni i 15 lijevi VN)), skupina 2 uključivala je bolesnike s konačnom dijagnozom vrtoglavice centralnog podrijetla (N=23), a skupina 3 uključivala je bolesnike s konačnom dijagnozom nespecificirane vrtoglavice (N=63). Značajna korelacija pronađena je između asimetrije oVEMP-a te 60 ms gain asimetrije lateralnih kanalića vHIT-a (r=0.225, p=0.026). Značajna korelacija između oVEMP i vHIT asimetrije bila je prisutna kod bolesnika s VN-om (r = 0.749, p < 0.001), dok ista korelacija kod ispitanika 2. i 3. skupine nije pronađena. Asimetrije oVEMP-a i vHIT-a lateralnih kanalića bile su značajno veće u bolesnika s vestibularnim neuritisom. Nadalje, pronađene su pozitivne korelacije amplituda oVEMP-a s 60 ms gainom lateralnih polukružnih kanalića i slope-om anteriornih polukružnih kanalića na vHIT-u, te cVEMP-a sa slope-om posteriornih polukružnih kanalića na vHIT-u. Ove promjene bile su značajno izraženije u bolesnika s vestibularnim neuritisom. Zaključno, podatci VEMP-a i vHIT-a trebali bi biti korišteni komplementarno: asimetrija na obje pretrage snažno upućuje na promjene perifernog dijela vestibularnog sustava.

Abstract (english)

The aim of this study was to compare vestibular evoked myogenic potentials (VEMP) and video head impulse test (vHIT) results in patients presenting with vertigo and dizziness. We retrospectively analyzed the data of all patients with the chief complaint of vertigo, dizziness, or imbalance that underwent VEMP and vHIT from January 2015 to January 2016. A total of 117 patients (73 females, mean age 53.92 ± 16.76) fulfilled the inclusion criteria: group 1 included patients with the final diagnosis of vestibular neuritis (VN) (N = 31 (16 right and 15 left VN)), group 2 included patients with the final diagnosis of vertigo of central origin (N = 23) and group 3 included patients with the final diagnosis of unspecified dizziness (N = 63). There was a significant correlation between oVEMP asymmetry and asymmetry of the lateral canals 60 ms gains on vHIT (r = 0.225, p = 0.026). A significant correlation between oVEMP and vHIT asymmetry was present in VN patients (r = 0.749, p < 0.001), while no correlation was found in groups 2 and 3. oVEMP and vHIT lateral canals asymmetries were significantly greater in patients with vestibular neuritis. Furthermore, positive correlations of oVEMP amplitudes with 60 ms gain of the lateral semicircular canal and slope of the anterior semicircular canal on vHIT, and cVEMP with slope of the posterior semicircular canal on the vHIT, were found. These changes were significantly more pronounced in patients with vestibular neuritis. In conclusion, VEMPs and vHIT data should be used complementarily; asymmetry on both tests strongly supports a peripheral vestibular system involvement.

• Keywords: vrtoglavica; zanašanje; vestibularni evocirani miogeni potencijali; video head impulse test
• Keywords (english): vertigo; dizziness; vestibular evoked myogenic potentials; video head impulse test
• Language: croatian
• URN:NBN: urn:nbn:hr:105:599666
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2019-01-04 10:58:06