Different results of vestibular examinations and blood flow in cases with transient vascular vertigo/dizziness with or without central nervous system symptoms

Abstract

Background

The condition of vestibular dysfunction and blood flow in the vertebral artery (VA) in transient vascular vertigo/dizziness (TVV) is not well established.

Objectives

To clarify the pathophysiology of TVV, especially the difference between the isolation of vestibular symptoms.

Materials and methods

Ten TVV patients with central nervous system symptoms (TVVw) and 12 TVV patients without central nervous system symptoms (TVVo) underwent duplex color-coded ultrasonographic evaluation of VAs, caloric test, and cervical vestibular-evoked myogenic potential (cVEMP).

Results

The mean flow velocity (MV) ratio (peak MV of contralateral VA divided by target VA) was significantly higher in TVVw than in TVVo. There was no difference in the occurrence of canal paresis between TVVw and TVVo. Abnormal asymmetry ratios (ARs) of cVEMP were observed only in TVVo cases (6 of 12 cases), revealing a statistically significant difference in the number of cases between TVVw and TVVo.

Conclusions and significance

Measuring VAs using duplex color-coded ultrasonography and cVEMP may help evaluate TVV. Different results of MV ratio and cVEMP between TVV cases with or without central nervous system symptoms may indicate differences in the pathophysiology between TVVw and TVVo.

Chinese Abstract

背景：暂时性血管性眩晕/头晕（TVV）患者的前庭功能障碍和椎动脉（VA）血流状况尚未完全确定。

目的：阐明 TVV 的病理生理学, 特别是与前庭症状分割之间的差异。

材料与方法：10 名有中枢神经系统症状（TVVw）的 TVV 患者和 12 名没有中枢神经系统症状 (TVVo) 的TVV患者接受了 VA双重彩色编码超声评估、热量测试和颈椎前庭诱发肌源性电位 (cVEMP) 。

结果：平均流量（MV）比（对侧 VA 的峰值 MV 除以目标 VA）, TVVw 显著高于 TVVo。耳道麻痹的发生率在TVVw 和 TVVo之间无差异。仅在 TVVo 病例（6 个12 例）中发现cVEMP的异常不对称比, 显示数例病例的 TVVw 和TVVo之间存在统计学显著差异。

结论和意义：使用双色彩色超声测量 VA和 cVEMP也许有助于评估 TVV。有或无 中枢神经系统症状的TVV 病例之间的 MV 比率和 cVEMP 的不同结果, 可能表明 TVVw 和TVVo之间的病理生理学差异。

Keywords:

• Transient vascular vertigo/dizziness
• duplex color-coded ultrasonography
• vestibular evoked myogenic potentials
• caloric test

Disclosure statement

No potential conflict of interest was reported by the author(s).