VNG S00017184-00

BPPV benign paroxysmal positional vertigo CNS CP central nerve system canal paresis CRP DP corneorentinal potential direction preponderance ENG electronystagmorgraphy EOG electrooculography FI fixation index G gain GT gaze test HC-BPPV horizontal canal BPPV BPPV HSN head shaking nystagmus MT(MCT) monothermal caloric test MCT motor coordination test MTCT monothermal cold test MTWT monothermal warm test OKN optokinetic nystagmus OKR optokinetic reflex PC-BPPV posterior canal BPPV BPPV PG(PSG) posturography PT pursuit test SHAT sinusoidal harmonic acceleration test SN spontaneous nystagmus SOT sensory organization test SPGIII static posturography type III III SPV slow phase velocity ST saccade test VAT vestibular autorotation test VOR vestibular-ocular reflex VSR vestibular-spinal reflex VNG videonystagmography

videonystagmography VNG 27 28 VNG VNG 1 27 1 28 2 14 13 13 3 78.6% 92.3% 100% 4 8 7 5 FI SPV T 6 ST PT OKN CP 92.9% 92.7% 92.7% 78.5% 97.6% 92.7% 61.5% 100% 90.6% 53.8% 100% 90.6% 1 VNG 2 VNG VNG

Clinical assessment of VNG System Department of Otolaryngology & Head-Neck Surgery Peking University First Hospital Postgraduate Han li Advisor Associate Prof. Xiao shuifang ABSTRACT Objective To compare and analyse the nystagmus recording of patients and the healthy people with VNG system, and to evaluate the effectiveness and reliability of the VNG system. Materials and Methods Vestibular functions of 27 patients with vertigo and 28 healthy persons were assessed with the VNG system. Among the patients, 14 of them were diagnosed with cerebellum diseases, and 13 of them were diagnosed with peripheral vestibular disorders. The consistency of the vestibular function tests and the clinical diagnosis were evaluated with the results of the tests. Results 1. Spontaneous nystagmus Among the 27 patients only 1 of them showed SN and none of the health showed SN. 2. Saccade test Among the 14 patients with central lesions 8 of them showed over-shoot 5 of them showed under- shoot and one is normal. Among the 13 patients with peripheral disorders, 3 of them showed under-shoot, and the others were normal. Among the 28 healthy persons all of them showed normal square wave. The mean bilateral gains of the patients showed statistically significant difference with those of the healthy people. The sensitivity, specificity and diagnostic accuracy of ST were 92.9% 92.7% and 92.7% respectively. 3. Pursuit test Among the 14 patients with central lesions 3 of them were type II 8 of them were type III 3 of them were type IV. Among the 13 patients with peripheral disorders, 4 of them were type I 7 of them were type II the other two were type III and type IV respectively. The accordance with clinical diagnosis is 78.6% 92.3% and 100% respectively. The sensitivity, specificity and diagnostic accuracy of PT were 78.5% 97.6% and 92.7% respectively. 4. Optokinetic nystagmus Among

the 14 patients with central lesions 8 of them showed abnormal in gain and 7 of them showed abnormal in CP but all of the peripheral disorders and the healthy people showed normal results. The mean bilateral gains of the patients showed statistically significant differences with those of the healthy people. According to gain, the sensitivity, specificity and diagnostic accuracy of OKN were 61.5% 100% and 90.6% respectively and according to CP the sensitivity, specificity and diagnostic accuracy of OKN were 53.8% 100% and 90.6% respectively. 5. Caloric test The bilateral FI of the central diseases, the peripheral disorders and the normal subjects were significantly different. The mean SPV and T of the peripheral disorders showed statistically significant differences between the affected and healthy sides of the ears. Conclusion 1. The VNG system could record the nystagmus precisely and monitor minute eye movements. 2. The VNG system could assess the vestibular function objectively and quantitatively, and it could be used as a useful tool for clinical diagnosis. Keywords videonystagmography vestibular function nystagmus

- [1][2] [3] Romberg 1846 1907 1906 [4] 1922

ENG 1929 Meyers 1936 Mowrer corneorentinal potential CRP CRP e EOG 1939 Jung 1955 Henriksson [5-7] [3][8][9] ENG 8 5 [6] ENG [7] optokineti OKR saccade ST pursuit test PT optokinetic OKN nystagmus ENG [8-10] ST PT

ENG [3][8][9] 1952 Dix [11] (benign paroxysmal positional vertigo, BPPV) BPPV (posterior canal BPPV PC-BPPV) Dix-Hallpike BPPV BPPV(horizontal canal BPPV HC-BPPV) [12][13] Dix-Hallpike (vestibular autorotation test VAT) VAT Dix-Hallpike VAT [14] ENG - 1 ENG 2 ocular reflex VOR 1942 Fitzgerald Hallpike [15], 30 44 bithermal caloric BTCT test 24 50 8 /

60 50 [16] Tole 31 43 6 90 31 43 30 44 Tole [17] Henning E.Von Gierke [18] monothermal caloric MCT test,mt Torok 10ml 20 5 100ml 20 [19][20], Torok 362 monothermal warm test,mtwt monothermal cold test,mtct 14% 25% 22% 15% [21] [22] Torok [23] [23][24] BTCT MCT MT BTCT,

SPV CP DP [25], [26-28] 3 1906 Barany [29] ENG EOG ENG ENG ENG [4] 1986 Barany 1990 [29], 20 5ml 4 0.025Hz VOR

ENG ENG [30] 80 [31] 90 [32] ENG phase velocity SPV [33-35] [36] SPV [37] Barany 1907 20 10 1965 Niven 0.02-0.2Hz Wolfe sinusoidal harmonic SHAT acceleration test VOR VOR [38-41] VAT 1988 head HSN shakin

HSN CP [42][43] [44] 1-4 ENG VOR PSG VSR Romberg 1846 SPG 80 dynamic DPG posturogra [45][46] computerized dynamic posturography CDP DPG Sensory SOT orga Motor MCT coordination SOTtest [47-49] DPG- [50] III static posturography, SPGIII VSR VOR [51-55] VOR VSR system, CNS [56][57] 1 ENG ENG

ENG 2 3 ENG 1 [6[[58] 2 CRP CRP CRP [6] 65 68% ENG [59] 3 VOR [6][7] 4 [5] [60] ENG ENG Yagi [61]

[62] [63] BPPV [64] [65] FG ; [61] ENG vedionystagmogra VNG CCD VNG Frenzel Frenzel glasses, FG [66] [67-69] ENG VOR PG VSR ENG

CCD SHAT SHAT [40-42] PG VSR PG VOR PG CDP ENG VNG ENG ENG SHAT SPGIII