著者

乾 崇樹 荒木 倫利 田中 朝子 服部 康人 竹中 洋

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.198-206, 2010 (Released:2010-10-01)

参考文献数

21

被引用文献数

1

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Seventeen patients with central vertigo that began with vertigo, seen between 2000 and 2008 at the Department of Otorhinolaryngology of Osaka Medical College Hospital, were investigated. The patients included 14 males and three females. Their mean age was 59.2 years (range 27-82). The cases consist of six cerebellar infarctions, two anterior inferior cerebellar artery (AICA) syndromes, two Wallenberg syndromes, two medial longitudinal fasciculus (MLF) syndromes, three other brain-stem infarctions, one viral encephalitis, and one acute cerebellar ataxia. Thirteen cases (77%) had a history of a disorder that might reduce the cerebral blood flow, and six (46%) had multiple risk factors. The mean interval between the appearance of symptoms and the first visit to our hospital was 6.5 days, and it took 3.8 days to reach a diagnosis. Eleven patients (65%) were transported to hospital by ambulance. Seven (41%) had a delayed neurological abnormality other than vertigo. Nystagmus that was seen at the first visit suggested central vertigo in seven cases and peripheral vertigo in seven cases. In four cases (24%), the nystagmus changed over time, and initially three patients had nystagmus that suggested peripheral vertigo. In some cases, we made the diagnosis based on a neurological abnormality other than vertigo. In other cases, the diagnosis was based on the discordance between the neuro-otological findings and disturbed equilibrium that was inconsistent with peripheral vertigo. When diagnosing central vertigo that began with vertigo, it is important to consider not only neurological abnormalities but also neuro-otological findings and a balance disorder that cannot reasonably be explained as peripheral vertigo.

著者

奥 雄介 松延 毅 冨岡 拓矢 荒木 倫利

出版者

日本口腔・咽頭科学会

雑誌

口腔・咽頭科 (ISSN:09175105)

巻号頁・発行日

vol.29, no.2, pp.251-255, 2016-06-10 (Released:2016-09-27)

参考文献数

18

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睡眠時無呼吸症候群 (Sleep Apnea Syndrome: SAS) を疑う場合, 問診, 簡易スクリーニング検査を施行し, 必要に応じて終夜睡眠ポリグラフ検査 (Polysomnograph: PSG) をおこなうことが一般的である. 現在本邦において CPAP の保険導入適応は, 簡易モニターで無呼吸低呼吸指数 (Apnea Hypopnea Index: AHI)≧40または PSG で AHI≧20となっている. しかし, 簡易モニターでは SAS 以外の睡眠障害を把握できないため, 診断には脳波, 筋電図, 眼電図なども含まれる PSG が望ましい. PSG 施行中にてんかん波形がみられた症例を経験したので報告する. PSG で SAS に加えて脳波異常が認められ, その後の脳波検査で特発性全般てんかんと診断された. 本症例のように SAS に他の睡眠障害が合併する可能性も留意しておく必要がある.