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前庭誘發肌性電位檢查的臨床應用

Clinical Application of VEMP Test

摘要


藉由氣導音聲或骨導振動刺激可成功地產生「前庭誘發肌性電位」(VEMP),而紀錄在頸部肌肉上,謂之「前庭誘發頸肌電位」簡稱cVEMP;或在眼外肌上記錄,謂之「前庭誘發眼肌電位」簡稱oVEMP。這兩項近年來新崛起的神經學檢查,開啟了科學家與臨床醫師探索耳石器官(球囊與橢圓囊)的紀元,並進而分別檢測「球囊-頸肌反射」與「橢圓囊-眼肌反射」的徑路。伴隨著傳統的聽力檢查與溫差測驗,現代化的全套內耳功能檢查包括聽力檢查、cVEMP檢查、oVEMP檢查、及溫差測驗,將有助於內耳器官諸如耳蝸、球囊、橢圓囊、與半規管功能的通盤檢討。臨床上,這一項方興未艾全套的內耳功能檢查已廣泛地被應用在內耳病變或中樞前庭系病變上。一般咸信,藉由全套內耳功能檢查將有助於釐清過去醫學上的盲點,並進一步地闡明內耳及中樞前庭系病變的機轉。

並列摘要


Stimulation via air-conducted sound or bone-conducted vibration enables recording of vestibular-evoked myogenic potential (VEMP) from cervical muscles (called cervical VEMP, cVEMP) and extraocular muscles (called ocular VEMP, oVEMP). These two emerging tests expand the test battery available to clinicians for exploring dynamic otolithic function, and create a potential use for the sacculo-collic reflex and utriculoocular reflex, respectively. Coupled with audiometry and caloric test, the inner ear test battery is designed to assess the inner ear function including the cochlea, saccule, utricle and semicircular canals. Clinically, the inner ear test battery has been widely adopted in cases of peripheral and central vestibular disorders. It is believable that comprehensive assessment of the inner ear function via an inner ear test battery may stimulate to elucidate the mechanism of peripheral and central vestibular disorders.

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