著者

道祖尾 弦 隈上 秀高 髙橋 晴雄

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.528-532, 2014-12-31 (Released:2015-02-01)

参考文献数

18

---

We hereby report on our experience regarding a case of rotatory vertigo exhibiting vestibular disorder-like findings accompanying normal pressure hydrocephalus (NPH). The case pertains to a 60-year-old man. Gait disturbance, dysuria, and so on, appeared from around 2007, and he was diagnosed as having NPH by the Department of Neurology of our hospital?. Rotatory vertigo suddenly appeared in October 2011, and he was admitted to the Department of Neurology and subsequently referred to our department on the 2nd sick day. Third degree of horizontal rotatory nystagmus to the left was observed, with no difference between the left and right observed upon a hearing test, and although he was observed with an increased threshold in the high sound area appropriate to his age, no other neurologic symptoms were observed. An equilibrium test was carried out at a later date under the suspicion of right vestibular neuronitis, however, no decline in semicircular canal function was observed upon caloric testing, with no difference between the left and right observed as well upon vestibule-ocular reflex (VOR), and so a follow-up was carried out with a diagnosis of vertebrobasilar insufficiency. The symptoms subsequently rapidly improved, however, nystagmus to the left at III° appeared again one week later, with the same nystagmus appearing again two months later. Lightheadedness was prolonged when rotatory vertigo attacks were not observed and so the patient consulted the Department of Neurology and underwent a tap test taking into consideration his dizziness caused by NPH, as a result of which his dizziness rapidly disappeared compared to the day prior, along with the other symptoms including improved gait disturbance and dysuria, which all continued to improve further. Subsequently, all dizziness disappeared after undergoing an endoscopic third ventriculostomy.

著者

原 稔 高崎 賢治 江夏 薫 海江田 哲 隈上 秀高 小室 哲 高橋 晴雄

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.7, pp.555-559, 2006-07-01 (Released:2011-10-07)

参考文献数

10

被引用文献数

1

---

We report three cases of isolated oculomotor nerve palsy caused by paranasal disease. All patients complained of double vision but showed no sign of brain aneurysm or diabetes mellitus. These patients had unilateral disturbance of ocular movement and ptosis, but there was no visual impairment on opthalmologic examination. In two cases, computed tomography (CT) demonstrated soft tissue density (STD) in the posterior ethmoid and sphenoid sinuses and also inside the ipsilateral anterior clinoid process (ACP) of the sphenoid bone. In the other case, CT and magnetic resonance imaging showed STD in the ethmoid sinus and pneumatization in the ACP. In all cases, a bony defect was identified at the inferior wall in ACP, adjacent to the superior orbital fissure. We performed endoscopic sphenoidectomy in two cases and conservatively treated the other case with steroid and antibiotics. In all three cases, ocular movement became normal approximately one month later. Since the oculomotor nerve coursed just under the pneumatized ACP in these cases, we speculated that compression and/or inflammation through the ACP might have induced oculomotor nerve palsy.