Clinical Study Of Vestibular Function Test In Common Vertigo Diseases And Analysis Of Sleep Disorders In BPPV Patients

Part I: Analysis of results of vestibular function test in patients with vestibular migraine,vestibular neuritis,and Meniere’s diseaseObjective: To analyze the vestibular function of patients with acute attack stage of vestibular migraine(VM),vestibular neuritis(VN),and Meniere’s disease(MD),so as to provide evidence for clinical differential diagnosis among the three.Methods: From January 2018 to September 2019,73 VM patients,70 VN patients and 68 MD patients in acute attack stage who met the criteria of disease diagnosis were recruited from the neurology emergency department,inpatient department,outpatient department and vertigo center of our hospital.All patients completed the video nystagmography(VNG)and video head impulse test(v HIT)examination,analyze the results of vestibular function tests for three types of diseases.Results:In this study:(1)(1)There was no statistical difference between the abnormal rate of caloric test and v HIT in VM patients.(2)Compared with VN and MD,the abnormal rate of caloric test in VM patients was lower(P < 0.05);Compared with VN,the abnormal rate of v HIT was lower(P < 0.05),compared with MD,there was no statistical difference;The incidence of spontaneous nystagmus was lower than VN(P < 0.05),there was no statistical difference compared with MD.(2)(1)There was no statistical difference between the abnormal rate of caloric test and v HIT in MD patients.(2)Compared with VN,the abnormal rate of caloric test was lower in MD patients(P < 0.05);Compared with VN,the abnormal rate of v HIT was lower(P <0.05),the incidence of spontaneous nystagmus was lower than VN(P <0.05).(3)(1)There was no statistical difference between the abnormal rate of caloric test and v HIT in VN patients.(2)Compared with VM and MD,VN has a higher abnormal rate of caloric tests(P<0.05);Compared with VM and MD,the abnormal rate of v HIT is higher(P <0.05),and the incidence of spontaneous nystagmus is higher(P<0.05).Conclusions:(1)The incidence of spontaneous nystagmus was lower in VM patients during acute attack than in VN patients,but there was no difference between VM patients and MD patients;Although there was no difference between the abnormal rates of caloric test and v HIT in VM patients during acute attack,it suggested that the peripheral vestibular function of low-frequency and high-frequency semicircular canals was damaged.(2)The vestibular function damage of MD patients during acute attack not only affects the low frequency function of semicircular canal,but also the high frequency function..(3)The abnormal rate of caloric test and v HIT in VN patients during acute attack is high.(4)VNG combined with v HIT can provide the basis for differential diagnosis among VM,MD and VN.Part II: Analysis of clinical characteristics and results of sleep disorders in patients with BPPVObjective: To analyze the clinical characteristics of BPPV patients in the Department of Neurology emergency,inpatient department,outpatient department and vertigo center of our hospital,and to explore the subjective and objective sleep disorder characteristics of patients with Benign Paroxysmal Positional Vertigo(BPPV),so as to provide basis for comprehensive diagnosis and treatment of BPPV.Methods: From January 2018 to September 2019,981 BPPV patients in the Department of Neurology emergency,inpatient department,outpatient department and vertigo center of Baotou central hospital were continuously recruited.Forty-one BPPV inpatients who met the inclusion criteria of this study were randomly enrolled.And in the same period of medical examination patients,Forty healthy control group matched with the BPPV group gender and age met the exclusion criteria were selected.Subjective and objective sleep disorders were assessed by Pittsburgh Sleep living scale(PSQI)and Polysomnography(PSG).Results:(1)Among 981 BPPV patients,288 were male,accounting for 29.4%;693were female,accounting for 70.6%;Male to female ratio 1: 2.41.(2)In 981 BPPV patients,left PC-BPPV accounted for 25.9%,right PC-BPPV 35.8%,left HC-BPPV11.4%,right HC-BPPV 14.7%,left HC crest-BPPV 3.9%,right HC crest-BPPV6.9%,mixed BPPV 1.4%.(3)Forty-one BPPV patients were randomly enrolled in this study.(1)Subjective Sleep Disorder Indicators(PSQI scores):The total score of PSQI,PSQI sub-score(sleep time,sleep efficiency,factors related to sleep disorders,hypnotics and daytime dysfunction)The BPPV group had statistical significance compared with the control group(P < 0.05).(2)Objective Sleep Disorder Indicators(PSG Results):The total sleep time decreased,the sleep efficiency decreased,and the awake time increased after falling asleep in the BPPV group,which was statistically significant compared with the control group(P < 0.05);there were no significant differences between the two groups in wake-up times,sleep stage conversion times, the proportion of sleep in total sleep time and limb activity in sleep cycle.The proportion of sleep apnea hypopnea index(AHI)≥ 5 times / h in BPPV group was significantly higher than that in control group(P < 0.05).Conclusions:(1)In this study,BPPV patients were more female than male,right PC-BPPV was the most common and mixed BPPV was the least common.(2)BPPV patients have a higher proportion of sleep disorders than normal controls,the changes in its sleep structure were mainly due to reduced sleep time,reduced sleep efficiency,and increased awake time after falling asleep,the proportion of sleep in each period did not change significantly,and AHI increased.