著者

重野 浩一郎

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.1, pp.34-40, 2015-02-28 (Released:2015-04-01)

参考文献数

29

被引用文献数

1 3

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Cases of recurrent benign paroxysmal positional vertigo (BPPV) were evaluated retrospectively to examine the affected semicircular canal, the pathophysiology (canalithiasis or cupulolithiasis), and the affected side. The subjects were 152 patients with recurrent BPPV out of 571 consecutive BPPV patients treated at one clinic over a period of 10 years and 5 months. The subjects had up to 5 BPPV recurrences and there were 260 recurrences in total. Of these, 97 (37%) affected the same ear and the same canal and were caused by the same pathophysiology; 93 (36%) occurred on the same side, but affected a different canal and/or were caused by a different pathophysiology; 11 (4%) occurred on the same side, but affected a different canal and were suspected to have been caused by a different pathophysiology; 43 (17%) affected the contralateral side; and 16 (6%) were suspected to have affected the contralateral side. The affected side was defined as the side on which a deposit of otoliths detached from the utriculus. The affected canal and the pathophysiology were also defined based on a lesion with otolith deposits. Our results showed that about 75% of recurrent BPPV cases occur on a fixed side on which otoliths are likely to be detached, while 25% may have a general risk factor such as osteoporosis that can cause detachment of otoliths from the utriculus on both sides. About one-third of recurrent BPPV cases affected the same ear and canal, and were caused by the same pathophysiology; and another one-third occurred in the same ear and affected different canals and/or had a different pathophysiology. These findings suggest that a preference for head position during sleep may be related to the lesion site in which otoliths are deposited.

著者

一般社団法人日本めまい平衡医学会 診断基準化委員会 担当理事: 池園 哲郎 堀井 新 委員長: 今井 貴夫 副委員長: 中村 正 委員: 渡辺 行雄 重野 浩一郎 高橋 幸治 浅井 正嗣 山本 昌彦 武井 泰彦 池田 卓生 橋本 誠

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.78, no.3, pp.228-229, 2019-06-30 (Released:2019-08-02)

被引用文献数

9

著者

重野 浩一郎

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.3, pp.191-198, 2015-06-30 (Released:2015-08-01)

参考文献数

21

被引用文献数

11 5

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The healthy-ear-down 135°maneuver (H-135°M) was devised for the treatment of lateral semicircular canal benign paroxysmal positional vertigo (BPPV) exhibiting paroxysmal geotropic positional nystagmus (geotropic N) and the affected-ear-down 135°maneuver (A-135°M) was devised for the treatment of lateral semicircular canal BPPV exhibiting Persistent apogeotropic positional nystagmus (apogeotropic N). Keeping the head in the healthy-ear-down 135°position could easily force the debris into the utricle. Rolling the head from the affected-ear-down 135°position to the supine position could detach the debris from the canal side of cupula and move it further in the posterior direction. After undergoing one H-135°M, the patients were evaluated with the head roll test the next day. After undergoing one A-135°M, the patients were immediately evaluated with the head roll test. Ninety-five percent (55/58) of patients with geotropic N treated by H-135°M exhibited disappearance of geotropic N, and 5% (3/55) did not. Forty-five patients exhibited complete resolution of nystagmus and 4 patients converted to posterior semicircular canal BPPV. Seventy-one percent (15/21) of patients with apogeotropic N treated with A-135°M converted to geotropic N, and 29% (6/21) did not change. H-135°M and A-135°M had some advantages including easily changing the head and body positions, the treatment could be conducted successively after the head roll test, and treatment could even be performed for patients with cervical spondylosis and obesity. In particular, H-135°M had the advantage of confirming the affected side, as it would have been misdiagnosed if there was vertigo in the healthy-ear-down 135°position. To date, there has been no specific treatment established for apogeotropic N. However, A-135°M can elicit conversion to geotropic N in about 70% of apogeotropic N cases, and H-135°M can bring about good resolution of geotropic N in 95% of geotropic N cases.

著者

診断基準化委員会 担当理事:池園 哲郎 伊藤 彰紀 武田 憲昭 委員長:武田 憲昭 副委員長:中村 正 委員:浅井 正嗣 池田 卓生 今井 貴夫 重野 浩一郎 高橋 幸治 武井 泰彦 山本 昌彦 渡辺 行雄

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.76, no.3, pp.233-241, 2017-06-30 (Released:2017-08-01)

被引用文献数

12 29

著者

重野 浩一郎

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.76, no.6, pp.661-673, 2017-12-31 (Released:2018-02-03)

参考文献数

51

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Benign Paroxysmal Positional Vertigo (BPPV) is the most common and representative vestibular disease of peripheral origin. The three original monographs of BPPV are introduced and commented upon. In addition, a series of essential up-to-date papers are described, focusing particularly on the pathophysiology of BPPV: cupulolithiasis and canalolithiasis, the treatment of posterior canal BPPV, the characteristics of lateral canal BPPV and anterior canal BPPV.

著者

重野 浩一郎

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.75, no.3, pp.115-122, 2016-06-30 (Released:2016-08-01)

参考文献数

20

被引用文献数

1

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We investigated otolith function using the subjective visual vertical (SVV) in 54 patients with persistent geotropic positional nystagmus (Light cupula), 30 patients with persistent apogeotropic positional nystagmus (Heavy cupula) and 45 healthy subjects. To compare benign paroxysmal positional vertigo (BPPV), SVV was also measured in 56 patients with posterior canal canalolithiasis (PC) and 38 patients with lateral canal canalolithiasis (LC). Patients attended the clinic within 1 week after the onset of vertigo, and the SVVs were examined prior to treatment. The affected sides of Light cupula and Heavy cupula were estimated based on the neutral position at which the horizontal nystagmus direction was reversed. The average SVV toward the affected side showed significantly higher values, in this order: Light cupula>LC/PC>healthy subjects and Light cupula>Heavy cupula. Otolith dysfunction could be demonstrated on the affected side in Light cupula, whereas Heavy cupula exhibited a lesser degree of otolith dysfunction. The average SVV value toward the affected side of 0.9 is recommended as a cut-off value for Light cupula (sensitivity: 0.75, specificity: 0.86). The average SVV value>1.4 toward the affected side is also recommended as a cut-off for the detection of otolith dysfunction in Light cupula, PC and LC (specificity>0.93).

著者

一般社団法人日本めまい平衡医学会 診断基準化委員会 担当理事: 飯田 政弘 池園 哲郎 伊藤 彰紀 委員長:武田 憲昭 副委員長:中村 正 委員:渡辺 行雄 重野 浩一郎 鶴岡 尚志 浅井 正嗣 山本 昌彦 武井 泰彦 今井 貴夫 池田 卓生

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.74, no.2, pp.126-133, 2015-04-30 (Released:2015-06-01)

参考文献数

5

被引用文献数

1 1