Objective: To investigate the spontaneous nystagmus (SN) and the frequency characteristics of affected semicircular canals in patients with vestibular neuritis (VN). Methods: This is a cross-sectional study. A total of 61 patients with VN admitted to the Department of Neurology of Shanxi Bethune Hospital from June 2020 to October 2021, 39 were male and 22 were female, with a mean age of (46±13) years old and male to female ratio of 1.77∶1. According to SN characteristics, 61 patients were divided into non-nystagmus group(nSN), horizontal nystagmus group(hSN) and horizontal-torsional nystagmus group (htSN). Clinical data were collected, and SN, unilateral weakness (UW), directional preponderance (DP), and video head impulse test (vHIT) gain were used as observation indicators. Statistical analysis by SPSS23.0 software. Normal distributed quantitative data (age, semicircular canal gain, SN intensity) were expressed by x¯±s, non-normal distributed quantitative data (disease course, UW, DP) were expressed by M(Q1,Q3), qualitative data were expressed by rate and composition ratio, difference analysis by one-way ANOVA, rank sum test, Chi-square test or Fisher's exact probability method, considered by P value<0.05. Results: (1)The disease course of nSN, hSN and htSN was 7.0 (4.0, 12.5), 6.0 (3.5, 11.5), and 3.0 (2.0, 6.5) days respectively, and there were statistical differences (χ2=7.31,P=0.026).(2)The horizontal nystagmus intensity of htSN was (16.8±8.6)°/s, which was significantly higher than that of (9.8±4.7)°/s in hSN (t=3.71, P<0.001). There was no significant difference in the positive rate of UW between the three groups (P=0.690), and there was a significant difference in the positive rate of DP in the three groups (χ2=12.23, P=0.002). The horizontal nystagmor intensity in the htSN was positively correlated with the vertical nystagmus intensity (r=0.59, P=0.001).(3)The gain of the affected horizontal canal of the three groups was statistically different (F=8.28, P=0.001), and the gain of the horizontal canal of hSN and htSN was significantly lower than that of nSN (t=2.74, P=0.008; t=4.05, P<0.001); The gain of the affected anterior canal in the three groups was statistically different (F=5.32, P=0.008). The gain of the anterior canal in both nSN and hSN was significantly higher than that in htSN (t=3.09, P=0.003; t=2.15, P=0.036). The horizontal canal gain of htSN is positively correlated with the anterior canal gain (r=0.74, P<0.001).(4)The affected semicircular canals in the two groups with no-vertical-component nystagmus (nSN and hSN) and the htSN were counted. The composition ratio of the affected semicircular canals in the two groups was different (χ2=8.34, P=0.015). Conclusion: The occurrence of SN in patients with VN is related to many factors, such as the disease course, low and high frequencies, and the severity of the condition in the affected semicircular canal.
目的： 观察前庭神经炎（VN）患者自发性眼震（SN）及受累半规管频率特征。 方法： 横断面研究。选取2020年6月至2021年10月山西白求恩医院神经内科收治的临床确诊的61例VN患者，其中男性39例`、女性22例，平均年龄（46±13）岁，男女比例1.77∶1。根据SN特点分为无眼震组（nSN）、水平眼震组（hSN）及水平伴扭转眼震组（htSN）。收集患者临床资料，以SN、单侧减弱指数（UW）、优势偏向（DP），视频头脉冲试验（vHIT）增益为观察指标进行分析。采用SPSS23.0软件进行统计学分析，正态分布的定量资料（年龄、半规管增益、SN强度）使用x¯±s表示，非正态分布的定量资料（发病天数、UW、DP）使用M（Q1，Q3）表示，定性资料使用率及构成比表示，采用单因素方差分析、秩和检验、卡方检验或Fisher确切概率法进行差异分析，P<0.05为差异有统计学意义。 结果： （1）nSN、hSN、htSN三组患者病程分别为7.0（4.0，12.5），6.0（3.5，11.5），3.0（2.0，6.5）d，差异有统计学意义（χ2=7.31，P=0.026）。（2）htSN组水平眼震强度（16.8±8.6）°/s，显著大于hSN组（9.8±4.7）°/s（t=3.71，P<0.001）；三组UW阳性率差异无统计学意义（P=0.690），三组DP阳性率差异有统计学意义（χ2=12.23，P=0.002）。htSN组水平眼震强度与垂直眼震强度呈正相关（r=0.59，P=0.001）。（3）三组患侧水平管增益差异有统计学意义（F=8.28，P=0.001），hSN组及htSN组水平管增益均显著低于nSN组（t=2.74，P=0.008；t=4.05，P<0.001）；三组患侧前管增益差异有统计学意义（F=5.32，P=0.008），nSN组及hSN组患侧前管增益均显著高于htSN组（t=3.09，P=0.003；t=2.15，P=0.036）。htSN组患侧水平管增益与前管增益呈正相关（r=0.74，P<0.001）。（4）无垂直成分眼震组（nSN和hSN）和htSN组患侧损伤半规管进行计数，两组受累半规管构成比不同（χ2=8.34，P=0.015）。 结论： VN患者SN与病程、受累半规管的低、高频率、严重程度等多方面因素有关。.