著者

永井 賀子 萩原 晃 河口 幸江 小川 恭生 服部 和弘 河野 淳 鈴木 衞

出版者

一般社団法人 日本聴覚医学会

雑誌

AUDIOLOGY JAPAN (ISSN:03038106)

巻号頁・発行日

vol.59, no.1, pp.58-65, 2016-02-28 (Released:2016-08-31)

参考文献数

14

被引用文献数

2 7

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要旨: 突発性難聴例の治療開始後の聴力改善経過と改善率について検討した。2009年1月から2013年12月までの5年間に東京医科大学病院耳鼻咽喉科を受診し, 入院加療を行った Grade3 または 4 であった突発性難聴121例, 121耳を対象とした。Grade3 は70例, Grade4 は51例であった。治療開始後7日以内に5周波数の平均聴力が 20dB 以上改善した例を早期改善群, 8日以上14日以内に改善した例を中期改善群, 14日以内に改善がみられない例を改善なし群に分類した。治癒率は早期改善群で68%, 改善なし群で8.2%であり, 早期改善群で有意に高い結果であった。早期改善群では聴力予後は良好で, 改善なし群では聴力予後が不良であった。

著者

小川 恭生

出版者

一般社団法人 日本めまい平衡医学会

雑誌

Equilibrium Research (ISSN:03855716)

巻号頁・発行日

vol.82, no.2, pp.114-119, 2023-04-30 (Released:2023-06-14)

参考文献数

6

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Differentiation of central from peripheral lesions is important when examining patients with dizziness or vertigo. Nystagmus is one of the most important clues to the differential diagnosis between central and peripheral lesions. It is not rare in patients with central lesions to have no neurologic symptoms other than nystagmus in the acute phase. Direction-changing gaze-evoked nystagmus, upbeat nystagmus, downbeat nystagmus and direction-changing apogeotropic positional nystagmus are known as characteristic findings of central vertigo. In this article, we report a case with direction-changing gaze-evoked nystagmus, a case with upbeat nystagmus, a case with downbeat nystagmus, and a case with direction-changing apogeotropic positional nystagmus, and explain/speculate on the mechanism of nystagmus in each case.

著者

永井 賀子 小川 恭生 萩原 晃 大塚 康司 稲垣 太郎 河口 幸江 鈴木 衞 富山 俊一

出版者

一般社団法人 日本めまい平衡医学会

雑誌

Equilibrium Research (ISSN:03855716)

巻号頁・発行日

vol.74, no.2, pp.58-65, 2015-04-30 (Released:2015-06-01)

参考文献数

23

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Autoimmune inner ear disease (AIED) was reported by McCabe in 1979 and was characterized by episodic vertigo and fluctuating hearing loss. Some patients develop total deafness and severe disequilibrium which disturbs their activities of daily living (ADL). Steroids or immune suppressing agents are used to control symptoms, but they have to be given repeatedly, because the symptoms tend to recur. We analyzed 22 AIED patients diagnosed by the presence of a 68kDa protein. The patients with low grade hearing loss showed some recovery of their hearing, However, hearing recovery was not noted in any patient with severe hearing loss. It is important to diagnose AIED and start treatment as soon as possible.

著者

近藤 貴仁 小川 恭生 大塚 康司 北島 尚治 稲垣 太郎 清水 重敬 小林 賀子 鈴木 衞

出版者

一般社団法人 日本めまい平衡医学会

雑誌

Equilibrium Research (ISSN:03855716)

巻号頁・発行日

vol.69, no.4, pp.213-217, 2010 (Released:2010-10-01)

参考文献数

14

被引用文献数

5

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When examining patients with vertigo, it is essential to differentiate between central and peripheral lesions. It has been reported that some infarctions associated with the posterior inferior cerebellar artery (PICA) can mimic peripheral vertigo, such as benign paroxysmal positional vertigo (BPPV). We report on a case that had been treated as BPPV at another institution and eventually turned out to be cerebellar infarction in the PICA legion. Two infarction lesions were observed in the cerebellum. Obstruction of the left vertebral artery was found on MRA. Six months from the first consultation, the BPPV decreased. We should be aware of cases of cerebellar infarction in which nystagmus mimics BPPV.

著者

許斐 氏元 鈴木 衞 小川 恭生 大塚 康司 萩原 晃 稲垣 太郎 井谷 茂人 斉藤 雄

出版者

一般社団法人 日本めまい平衡医学会

雑誌

Equilibrium Research (ISSN:03855716)

巻号頁・発行日

vol.73, no.6, pp.502-511, 2014-12-31 (Released:2015-02-01)

参考文献数

25

被引用文献数

1 14

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This study was performed to determine the frequency and degree of sleep disturbance in patients with dizziness using the Pittsburgh Sleep Quality Index, Japanese Version (PSQI-J), and investigate the relationship between dizziness and sleep disturbance. Fifty-two patients (20 male, 32 female) with a chief complaint of dizziness visited the dizziness clinic of the Department of Otolaryngology, Tokyo Medical University, for 3 months in 2013. The patients' age (average ± standard deviation) was 54.4±17.0 years (range, 10-88 years). The average PSQI global score was 7.6±4.2 points, which exceeds the 5.5-point cut-off for insomnia. In total, 67.3% of patients scored >6 points, and 35.8% scored >9 points, indicating definite sleep disturbance. With respect to the demography of disease groups, patients with Meniere's disease scored an average of 7.9 points, those with autonomic imbalance scored 8.8 points, and those with psychogenic dizziness scored 9.7 points; all of these diseases were associated with high PSQI scores. Patients with benign paroxysmal positional vertigo and patients with no abnormal findings showed relatively low scores (6.7 and 5.3 points, respectively). Patients with suspected sleep apnea syndrome, restless leg syndrome, and parasomnias tended to show high scores (>10 points). A high rate and high grade of sleep disturbance were confirmed in patients with dizziness, indicating that sleep quality affects several types of dizziness and vertigo. Understanding sleep disorders is helpful for the diagnosis and treatment of dizziness and provides a new perspective on the etiology of dizziness.

著者

久米 淳子 小川 恭生 萩原 晃 市村 彰英 鈴木 衞

出版者

耳鼻咽喉科臨床学会

雑誌

耳鼻咽喉科臨床 (ISSN:00326313)

巻号頁・発行日

vol.99, no.8, pp.623-633, 2006-08-01 (Released:2011-10-07)

参考文献数

11

被引用文献数

2 4

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Cerebral infarction occurs predominantly in the elderly, but may occur in young adults, especially when complicated with collagen disease, heart disease, and dissecting aneurysm. Four patients (range: 31-47 years old) complaining of a sudden onset of vertigo and nausea without a history of trauma are presented. Emergency computed tomography was initially interpreted as normal, but subsequent magnetic resonance imaging and a magnetic resonance angiogram disclosed vertebral artery (VA) dissection. Arterial dissection resulting in embolic stroke in the area of the ipsilateral posterior inferior cerebellar artery was suspected. All patients were treated conservatively without sequelae. Spontaneous VA dissection should be suspected in young patients presenting with ischemic stroke but without predisposing risk factors or associated trauma.