著者

関根 和教 今井 貴夫 立花 文寿 松田 和徳 佐藤 豪 武田 憲昭

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.1, pp.47-51, 2010 (Released:2010-04-01)

参考文献数

15

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We report a case of Costen's syndrome that showed chewing-induced nystagmus and vertigo. A 31-year-old woman visited our hospital complaining of chewing-induced vertigo 5 days after dental therapy. During chewing a stick of gum, she complained of vertigo and showed nystagmus beating to the right, the direction of which changed to the left thereafter. No spontaneous and positional nystagmus or any abnormalities in the neurological examination could, however, be found. The chewing-induced nystagmus and vertigo gradually disappeared within 2 weeks. Costen's syndrome is associated with various symptoms due to temporomandibular dysfunction. In the case, it is suggested that malinterdigitation after dental therapy caused temporomandibular dysfunction, resulting in the chewing-induced nystagmus, therefore, Costen's syndrome was diagnosed.Eustachian tube hypothesis, Tensor tympani hypothesis and otomandibular ligament hypothesis that accounted for temporomandibular dysfunction-induced aural symptoms in patient with Costen's syndrome had been proposed, but recently were withdrew. On the other hand, it is reported that reciprocal connections between trigeminal and vestibular nuclei. The trigeminal somatosensory input associated with temporomandibular dysfunction after dental therapy may cause chewing-induced nystagmus via the trigemino-vestibular connection in the brainstem in the case.

著者

松田 和徳 堀 洋二 雫 治彦 武田 憲昭

出版者

The Society of Practical Otolaryngology

雑誌

耳鼻咽喉科臨床 (ISSN:00326313)

巻号頁・発行日

vol.98, no.10, pp.809-814, 2005

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In the present study, we evaluated daytime sleepiness in 32 patients with obstructive sleep apnea syndrome (OSAS) using epworth sleepiness scale (ESS). ESS scores of patients with OSAS were significantly higher than those of patients with simple snoring and healthy subjects. ESS scores of patients with OSAS were significantly correlated with apnea-hypopnea index, the longest apnea time, but not with the lowest oxygenation. It is suggested that ESS score is a predictive index of the severity of OSAS. We then examined whether ESS in combination with body mass index (BMI) can identify patients with OSAS among patients complaining of snoring. When the cut off points were 11 in ESS and 25 in BMI, the combination of ESS and BMI correctly classified 18 of 25 patients with OSAS (sensitivity=72.0%) and 7 of 10 patients without OSAS (specificity=70.0%). We concluded that the combination of ESS and BMI was useful for screening of sleep apnea syndrome.

著者

松田 和徳 関根 和教 佐藤 豪 雫 治彦 植村 哲也 武田 憲昭

出版者

耳鼻と臨床会

雑誌

耳鼻と臨床 (ISSN:04477227)

巻号頁・発行日

vol.59, no.3, pp.115-121, 2013 (Released:2014-06-01)

参考文献数

16

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今回、われわれはめまいによりもたらされる日常生活の障害の程度を客観的に評価できるアンケートを用い、ジフェニドールとベタヒスチンの治療効果を比較検討した。ジフェニドールは 4 週間投与で、めまいによる社会活動性の障害、めまいを増悪させる身体の動き(頭位、視覚)、めまいによる身体行動の制限(全般的、体動)、めまいによる感情障害、めまいによる対人関係の障害、めまいによる不快感のすべての因子を有意に改善させた。ジフェニドールは抗めまい作用に加えて制吐作用を持つことから、めまいによる機能障害およびめまいに伴う不快感を改善させ、その結果、めまいによる社会的障害およびめまいによる感情障害を改善させたものと考えられた。ベタヒスチンは 4 週間投与で、めまいによる社会活動性の障害、めまいによる対人関係の障害を有意に改善させたが、その他の因子には有意な改善を認めなかった。薬理作用の点から、ベタヒスチンは 2 カ月以上の長期投与を推奨している報告もあり、めまいにより引き起こされる日常生活の障害に対するベタヒスチンによる効果を明らかにするためには、さらに長期間の投与による検討が必要であると考えられた。