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[Analysis of the difference between the results of caloric tests and video head pulse tests in patients with vestibular migraine and vestibular neuritis].

Objective: To compare the results of caloric tests and video head impulse tests (VHIT) in patients with vestibular migraine (VM) and vestibular neuritis (VN), so as to provide help for the differential diagnosis of the two patients. Method: Retrospectively analyze VM and VN patients within 2 weeks of onset from August 1, 2016 to December 31, 2017 in neurology clinic of the Changzheng Hospital of Second Military Medical University, all patients were examined by caloric tests and VHIT, and the results of the two groups were compared and analyzed. Result: The 40 cases of VM patients, among them, 23 cases were abnormal in caloric test, 17 cases showed unilateral canal paresis, 6 cases showed bilateral weakness, the unilateral abnormality rate was higher than that of bilateral abnormality( P <0.01). 8 cases were abnormal in VHIT, 3 cases had unilateral vestibulo-ocular reflex (VOR) gain decline, 5 cases had bilateral VOR gain decline, unilateral and bilateral VHIT abnormal rate had no difference ( P >0.05). The 45 cases of VN patients. Among them, 45 cases were abnormal in caloric test, 37cases showed unilateral canal paresis, 8 cases showed bilateral weakness, the unilateral abnormality rate was higher than that of bilateral abnormality( P <0.001). 35 cases were abnormal in VHIT, 21 cases had unilateral VOR gain decline, 14 cases had bilateral VOR gain decline, unilateral and bilateral VHIT abnormal rate had no difference ( P > 0.05). By statistical analysis, the abnormal rate of caloric test of VN and VM were higher than that of VHIT, and the abnormal rate of caloric test and VHIT in VM patients were lower than that of VN. The slow phase velocity (SPV) and the VHIT gain of the three group of semicircular canals of strong and weak caloric response sides in the VM patients were higher than those of the corresponding canals in the VN patients. Conclusion: The low frequency damage of vestibule function of semicircular canals in VN and VM patients is more than that of high frequency. Compared with VM, the high and low frequency damage of the semicircular canals in VN patients are more common( P <0.05), and prone to high and low frequency simultaneous involvement ( P <0.001). From the SPV of caloric test and VHIT gain values, the degree of damage to the high and low frequency semicircular canals of in VN patients was more serious than that in VM patients.

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