著者

武田 憲昭

出版者

Japan Society for Equilibrium Research

雑誌

Equilibrium Research (ISSN:03855716)

巻号頁・発行日

vol.55, no.4, pp.335-342, 1996 (Released:2009-06-05)

参考文献数

10

被引用文献数

6 9

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Neural mechanisms of gaze, vertical and rotatory nystagmus are reviewed. For all eye movements, eye velocity is an oculomotor parameter. Eye velocity signals are transformed by a neural integrator in the brain stem to obtain the eye position signal. A lesion of neural integrator leads to gaze-evoked nystagmus. Vertical nystagmus arises from a lesional or functional tone imbalance, which is due to disruption of the central vestibulo-ocular reflex pathway in the pitch plane. Downbeat nystagmus is caused by lesions between the vestibular nuclei or flocculus. Upbeat nystagmus is caused by lesions in the brachium conjunctivum, the ventral tegmental pathway and the prepositus hypoglossal nucleus. Rotatory nystagmus involves an epicodic ocular tilt reaction, which is a clinical sign of an imbalance of the central vestibulo-ocular reflex in the roll plane. Unilateral infarction of the brain stem leads to rotatory nystagmus.

著者

高橋 正紘

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.67, no.3, pp.213-221, 2008 (Released:2008-08-01)

参考文献数

23

被引用文献数

1 1

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From numerous clinical investigations and questionnaire surveys, I have obtained the following results regarding Meniere's disease. 1. Patients with Meniere's disease, as compared to the control population, differ little in lifestyles or daily anxieties, but possess significantly (p<0.01) stronger self-inhibition and engrossment. Meniere's disease may be caused by discontent with others' expression of gratitude or appraisal. 2. Low-tone sensorineural hearing loss, which resembles Meniere's disease except in not being associated with vertigo, is a milder form of Meniere's disease that occurs when the causative factors, both personal and environmental, are less severe or more transient. 3. Methods for prevention and therapy of Meniere's disease have been provided by our studies. Patients should be instructed (1) to understand the causative factors, (2) to decrease self-inhibition and not be concerned about others' expression of gratitude or appraisal, (3) to sleep well and to perform aerobic exercises, and (4) to enjoy chatting, singing or hobbies. 4. Long-lasting 60-dB hearing loss recovered to normal hearing in a 66-year-old patient with Meniere's disease after he performed aerobic exercises three times a week for several months. The results in this case suggest that the most important aspect in the treatment of Meniere's disease is increase of the local blood flow, which can be achieved by continuous aerobic exercises.

著者

花川 隆

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.71, no.2, pp.115-119, 2012 (Released:2012-06-01)

参考文献数

17

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The control of extraocular and neck movements relies on the information from the vestibular organs. The brainstem and cerebellum are in charge of these processes. Further, the higher-order processing of vestibular information is mediated by the posterolateral part of the thalamus (“vestibular thalamus”), which in turn projects to multiple cortical areas including the parieto-insular vestibular cortex and thus constitutes the “thalamo-cortical vestibular system”. Recent advances in neuroimaging techniques have enabled researchers to visualize brain activity changes in the thalamo-cortical vestibular system in response to unilateral vestibular perturbation by means of electric or caloric stimulation. Clinically, neuroimging studies on peripheral vestibular disorders have shown abnormal responses of the thalamo-cortical vestibular system to vestibular perturbation. Studies have also revealed anatomo-functional reorganization of non-vestibular cortical areas (such as visual or somatosensory cortices) in peripheral vestibular disorders. Moreover, such reorganization may be correlated with functional recovery after peripheral vestibular disorders. Studies on cerebrovascular disorders involving the vestibular thalamus support the importance of this area for controlling posture. These imaging studies have begun to cast light on the otherwise unknown pathophysiology and compensatory mechanisms of vestibular disorders, although many issues still remain to be answered.

著者

三輪 徹 竹田 大樹 蓑田 涼生

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.76, no.6, pp.712-719, 2017

被引用文献数

3

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<p> Genetic defects are a major cause of hearing loss in newborns. Numerous causative genes for genetic hearing loss have been identified. Most genes cause only hearing loss which is referred to as non-syndromic deafness. On the other hand, some genes cause not only congenital hearing loss but also vestibular dysfunction,<i> etc</i>., which is referred to as syndromic deafness. However, presently, there are no truly curative treatments for this condition. One of the feasible treatments for congenital inner ear disease is "gene therapy during the embryonic stages" before the expression of abnormal morphology and function of the inner ear. In 2008, Gubbles et al. reported on gene transfer by transuterine-mediated injection into the embryonic inner ear (otocyst) and electroporation at embryonic day 11.5 (E11.5). We also utilized those methods, and performed electroporation-mediated transuterine gene transfer into otocysts (EUGO) for two models of congenital inner ear disease. One is the Connexin (Cx) 30 knockout (KO) mouse in which GJB6 gene coding Cx30 is deleted. The other is the pendrin KO mouse in which the SLC26A4 gene coding pendrin is deleted. The former is the model of non-syndromic deafness, the latter is the model of syndromic deafness. EUGO caused the vast expression of normal genes in the inner ear and successfully improved the hearing and vestibular function in both models. Although we utilized the otocyst at E11.5, this method must be demonstrated before the beginning of gene expression in the inner ear. Thus, the timing of embryonic gene therapy is important, because each gene has a different timing of expression in the inner ear. Herein, we describe state-of-the-art research on genetic inner ear disease treatment through gene therapy and discuss the obstacles to overcome in curative treatments of genetic inner ear diseases in humans.</p>

著者

時田 喬 宮田 英雄 青木 光広

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.72, no.4, pp.238-246, 2013-08-31 (Released:2013-10-01)

参考文献数

12

被引用文献数

2 1

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Frequency analysis of the sway of the body center of gravity appearing in the upright standing posture is important as one of the measurements in stabilometry. However, although analysis using the FFT method is now widely used, it is difficult to interpret the results. Therefore, using MEM method, we made a scatter diagram showing the frequency on the x-axis and the spectral peak area on the y-axis. In the scatter plot, we filled in the power law distribution curve and the approximate expression. This diagram (the peak-area spectrum) was the object of this study. The results obtained were as follows.1) In healthy cases, the area spectra showed the power law distribution. 2) In a case with labyrinthine failure, the spectrum showed an increase of the area of the maximum peak frequency. We considered the finding is caused by a disorder of the labyrinthine righting reflex. 3) In a case with cerebellum disturbance, irregularities were observed in the power law distribution of the peak areas. The findings are interpreted as due to a coordination disorder in standing posture regulation. 4) In a case of Parkinson's disease, the slope of the power law distribution curve became flat. The findings are interpreted as due to postural control disorder caused by muscle rigidity. Examination of the peak area spectrum is useful for quantitative assessment of the body sway in an upright standing posture.

著者

井須 尚紀 河合 敦夫 桝井 文人

出版者

Japan Society for Equilibrium Research

雑誌

Equilibrium Research (ISSN:03855716)

巻号頁・発行日

vol.63, no.3, pp.183-193, 2004 (Released:2009-06-05)

参考文献数

26

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The sensation of rotation derived from the semicircular canal system during a Coriolis stimulus, or cross-coupled rotation, was estimated by an mechanical approach by giving some hypotheses and simplifications on the semicircular canal system. By solving an equation of motion of the endolymph during a Coriolis stimulus with a moderate time course, the rotating angle of the endolymph was obtained, and the sensation of rotation derived from each semicircular canal was estimated. Then, the sensation was integrated in the whole semicircular canal system, which was considered to be composed of three orthogonal semicircular canals. The sensation of rotation derived from the semicircular canal system comes into conflict with those from the otolithic and somatosensory system. The conflict causes an illusion such that the head rotates vertically while keeping inclination at a constant tilt angle. The nauseogenic severity of motion sickness caused by a Coriolis stimulus is enhanced in accordance with the integrated angle of rotation perceived by the illusion.

著者

中山 明峰 浅井 友詞

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.77, no.4, pp.298-303, 2018-08-31 (Released:2018-10-02)

参考文献数

10

---

One of the hazards in performing vestibular rehabilitation therapy is the lack of an adequate evidence base. McDonnell and Hillier reported a large cohort study that summarized all the available articles regarding evidence-based vestibular rehabilitation therapy and found that only 29 out of 1586 articles were actually evidence-based. This was a striking result, and unfortunately none of the 29 evidence-based reports were from Japan. However, several applications for vestibular rehabilitation have recently been accepted by the Grants-in-Aid for Scientific Research program of the Japan Society for the Promotion of Science. Thus, evidence-based vestibular rehabilitation therapy has just started. This report will discuss how to perform evidence-based vestibular rehabilitation therapy.

著者

中島 成人

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.66, no.4, pp.150-155, 2007 (Released:2008-10-10)

参考文献数

18

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Three patients suspected of having intractable Meniere's disease had shown no effect via the usual treatment of inner ear hydrops for 7, 13, and 15 years. They were re-evaluated and managed for neurovascular compression syndrome (NVC) of the 8th cranial nerve based on their distinctive vertigo, hearing loss, and tinnitus, followed by symptomatic relief with cinnarizine or a papaverine-containing drug. In addition to these symptoms, two of three patients showed ipsilateral displacement of the basilar artery (BA) on the axial view of MRI.Patients with NVC of the 8th cranial nerve may show rapid relief from sudden onset, recurrent vertigo with severe nystagmus, even in the case of canal paresis, marked fluctuating hearing loss with or without vestibular symptoms, and slowly progressive (unrecognized) hearing loss accompanied by tinnitus of a varying intesity. Patients have experienced symptomatic relief with carbamazepine, cinnatizine, or papaverine-containing drugs.Suspected cases of NVC have shown dolichoectatic ipsilateral convexity of the BA at the level of the internal auditory meatus on the axial view on MRI at a rate of 86.5%, which has been suggested to serve as a diagnostic feature of NVC.

著者

中村 将裕 石井 正則 近澤 仁志 丹羽 洋二 山崎 ももこ 伊藤 洋

出版者

Japan Society for Equilibrium Research

雑誌

Equilibrium Research (ISSN:03855716)

巻号頁・発行日

vol.63, no.4, pp.335-345, 2004 (Released:2009-06-05)

参考文献数

21

被引用文献数

3 2

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Falls and falling accidents occurring in hospitals have become a problem in recent years, and some of those events have been documented to have occurred after patients ingested sleep-inducers (hypnotics). One of the pharmacological actions of hypnotics is muscle-relaxing activity, and it has been clarified in animal studies that this activity causes falls and falling accidents. However, this association has not yet been proven in humans.In this study, conducted in eight healthy adult volunteers, we compared the manifestation of balance disorders after ingestion of four test drugs, consisting of two ultra-short-acting hypnotics (zolpidem and triazolam), a long-acting hypnotic (qazepam) and a placebo (i.e., the control). Zolpidem and qazepam, which are said to express weak muscle-relaxing activity, both caused balance disorders. Also, strong correlations were found between the manifestation of balance disorders after drug ingestion and the plasma concentrations of zolpidem, triazolam and some of the metabolites of qazepam. In addition, in the case of zolpidem, which caused the most severe balance disor-ders, gaze deviation nystagmus was detected. For this reason, it was surmised that balance disorders occurring after ingestion of hypnotics involve some inhibition of the central nervous system, including the cerebellum and brain stem, rather than the mus-cle-relaxing activity of the drugs.Differences were observed among the tested hypnotics in relation to the time of occurrence of balance disorders postmedication and also to the severity of the symp-toms. Accordingly, for the prevention of falling accidents, it is considered necessary that the physician be fully cognizant of the patient's age, medical history and physical condition, as well as not only the characteristics of the hypnotics but also the time-course changes in their concentration in the blood. Then, adequate caution must be applied with regard to the time period in which the patient is in a half-awake state.

著者

横田 淳一 太田 康 矢部 多加夫 霜田 里絵

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.1, pp.7-15, 2016-02-26 (Released:2016-04-01)

参考文献数

30

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Opalski's syndrome is considered to be a variant of lateral medullary infarction (Wallenberg's syndrome) with ipsilateral hemiplegia. Although dizziness/vertigo or ocular motor abnormalities commonly occur in Wallenberg's syndrome, these abnormalities are scarcely encountered in Opalski's syndrome. In the present study, two patients with Opalski's syndrome experiencing vertigo/dizziness were evaluated by electronystagmography (ENG). The characteristic findings of ENG were as follows: (1) horizontal nystagmus beating toward the contralateral side of the lesion, (2) tonic conjugate deviation to the side of the lesion (case 2), (3) hypometric saccade toward the side of the lesion and hypermetric saccade toward the contralateral side, (4) smooth pursuit was impaired to the ipsilateral side of the lesion, (5) slow phase peak velocities of OKN were reduced bilaterally, while the steady-state velocities were preserved, and (6) impaired visual suppression (VS) of the slow phase of caloric nystagmus on the ipsilateral side. Among these features, (3) and (4) were the most remarkable findings in our patients. In our present cases, the characteristic directional preponderance of the saccadic and smooth-pursuit eye movement disorders was just the reverse of those observed in Wallenberg's syndrome. Several lines of neurophysiological evidence suggest that in Wallenberg's syndrome, the impaired saccadic and smooth-pursuit movements are caused by dysfunction of the caudal fastigial nuclei. In contrast, after experimental lesioning of the posterior vermis (lobules VI and VII), the directional preponderance of the saccadic and smooth-pursuit eye movements is just the opposite. The findings in our cases were consistent with these observations. Consequently, the findings in our case were presumed to be originated from dysfunction of the posterior vermis. As for reduction of the bilateral slow-phase peak velocities of OKN, it appears to be derived from dysfunction of the flocculus/paraflocculus, and reduction of the ipsilateral VS may be derived from dysfunction of the flocculus or nodulus. MRI in our cases revealed lateral medullary infarction, but no lesions in the cerebellum. Therefore, it was assumed that the above ocular motor abnormalities in our cases may have been mainly derived from lesions of the inferior cerebellar peduncle disrupting the climbing fibers from the contralateral inferior olivary nuclei to the posterior vermis, flocculus/paraflocculus, and nodulus.

著者

山中 敏彰

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.1, pp.27-29, 2016-02-29 (Released:2016-04-01)

参考文献数

19

被引用文献数

3

著者

中村 節子 (旧姓森中

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.72, no.3, pp.145-155, 2013 (Released:2013-08-01)

参考文献数

52

被引用文献数

1

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There have been several reports about the relation between acid-base imbalance or arterial blood gas abnormalities and the occurrence of vertigo, including Meniere' disease. In animal experiments, respiratory acidosis induced by CO2 inhalation or metabolic acidosis induced by injection of NH4Cl has been shown to cause attacks of vertigo in rabbits with hemilabyrinthectomy. In clinical studies, approximately half of the patients with dizziness have arterial blood gas abnormalities when their dizziness occurs. An increase of HCO3- is found in many patients with dizziness, and the frequency of attacks is higher in patients who have arterial blood gas abnormalities during the remission period. These patients are thought to have unilateral vestibular dysfunction, and it is suggested that arterial blood gas abnormalities cause temporary vestibular dehabituation that increases the frequency of dizziness. It has also been reported from a study that the middle ear pressure difference between both ears, which is larger during periods of dizziness or recurrent dizziness than at the time of remission, might be related to blood gas abnormalities in Meniere's disease. In the same study, a difference of more than 50 decapascals was significantly more common in the patient group with blood gas abnormalities. In addition, metabolic acidosis has been reported in patients with Meniere's disease, and the base excess and bicarbonate levels were also found to be beyond the normal range in Meniere's disease. Arterial blood gas abnormalities might develop for various reasons, including underlying diseases and middle ear pressure differences. The endolymph in the endolymphatic sac is acidic (pH6.6-7). It has been reported that carbonic anhydrase, vacuolar H+-ATPase, pendrin and aquaporin may participate in the acidification process or homeostasis. The role of acid-base disturbance or arterial blood gas abnormalities in dizziness, and the relation in acid-base balance between inner ear and arterial blood gas need to be investigated further.

著者

竹村 文 河野 憲二

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.70, no.2, pp.95-103, 2011 (Released:2011-06-01)

参考文献数

13

被引用文献数

1

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In everyday life, self-movement of an observer causes the image of the visual scene on the retina to slip. Visual acuity is severely impaired when the retinal image of interest moves excessively. Naturally, the vestibular-ocular reflex (VOR) compensates for the observer's own movements through a short neural pathway from the vestibular organs to the eyes. The amplitude of the VOR is almost equal to the observer's head movement, but not perfect, and the residual retinal image motions are compensated for by visually driven ocular tracking systems.Recent behavioral studies on primates have revealed that there are three visual tracking systems that function to stabilize the gaze of the moving observer as visual back-up. One of these systems, the ‘ocular following response’, helps to stabilize gaze when the observer looks off to one side. The other two systems generate ‘vergence eye movements’ to help maintain binocular alignment on objects that lie ahead when the observer looks in the direction in which he or she is heading. One responds to the change in binocular parallax (disparity) and the other to the radial patterns of the optic flow. All three operate in a machine-like fashion to generate eye movements with ultra-short latencies.We conducted electrophysiological and chemical-lesion studies to determine whether the medial superior temporal (MST) area of the cerebral cortex, which is known to participate in visual motion processing, plays roles in eliciting these tracking eye movements or not. Despite their ultra-short latencies, electrophysiological studies in monkeys revealed a close relationship between ocular and neuronal responses in the MST, and lesions of the MST in both hemispheres significantly reduced the initial part of the tracking responses. Overall the results strongly support the hypothesis that the MST area is a primary site for producing the three visual tracking eye movements at ultra-short latencies.

著者

正木 義男

出版者

Japan Society for Equilibrium Research

雑誌

Equilibrium Research (ISSN:03855716)

巻号頁・発行日

vol.64, no.1, pp.22-28, 2005 (Released:2009-06-05)

参考文献数

32

被引用文献数

1 1

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We encountered a patient who developed dizziness due to the vasovagal reflex (VVR) during the Schellong test (ST).A 32-year-old woman had a chief complaint of dizziness. Present Illness: She had repeatedly since childhood experienced dizziness attacks associated with darkness in front of her eyes immediately after standing up. She easily developed motion sickness. Dizziness continued to occur when she was standing in a bus or train, when she was in the bath, or when she got excited. She was admitted to a hospital in the district and ECG and a blood test were conducted, but no abnormal findings were revealed. Past History: She had bronchial asthma in childhood. She had a gastric ulcer and received drug treatment in january 1997. Family history was unremarkable.She had a positive Schellong test. Immediately after standing up, her pulse rate sharply increased from 94 to 123/min., and 5 min. after standing up, the pulse rate became 127/min. She complained of dizziness immediately before the end of the testing, and the pulse rate and blood pressure measured at the time were 75/min., showing a sharp decline, and 90/55, showing a slight decrease, respectively. Thereafter, she had decreased consciousness and was immediately laid in a supine position. She soon became alert. Blood pressure recovered to 106/62 and the pulse rate to 94. Neural symptoms were absent. Treatment and Clinical Course: Although she developed WR during ST, her condition could be diagnosed as orthostatic dysregulation (OD) because it met the criteria for diagnosis of OD. However, a diagnosis of postural tachycardia syndrome (POTS) was made according to the theory that WR and OD are special types of POTS. She is under medication with an α-receptor agonist agent.Patients are always at risk, although not high, of developing VVR and falling during ST, which may be associated with injury. Therefore, after the experience of the present case in our hospital, we reevaluated the procedures of ST and decided on crite-ria for the discontinuation of the testing to prevent accidents.

著者

正木 義男

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.67, no.4, pp.269-275, 2008 (Released:2008-10-01)

参考文献数

27

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[Introduction] I encountered a patient in whom signs of the vasovagal reflex (VVR) developed when the patient underwent the Schellong test , and I also published an article describing the appropriate safety measures for performing orthostatic tests in Equilibrium Research vol. 64(1): 22-28. Specifically, we proposed that an orthostatic test should be discontinued as soon as the patient's heart rate met the relevant diagnostic criteria for the postural tachycardia syndrome (POTS). This conclusion was based on the hypothesis that VVR can be considered equivalent to POTS. I then encountered another patient who demonstrated VVR while performing the Schellong test, as described in Practica oto-rhino-laryngologica:.100(5): 341-347. Therefore, the present study was performed to examine the proportion of VVR patients fulfilling the diagnostic criteria for POTS in the course of an orthostatic test. [Subjects] Six patients who were all diagnosed to have dizziness due to VVR. [Methods] The patients were assessed as to whether or not the maximum increase in their heart rate and the absolute maximum heart rate observed during the orthostatic test fulfilled the following two diagnostic criteria for POTS: (A) a 30/min or more increase in heart rate and (B) an absolute heart rate of at least 120 beats/min. [Results] The mean±S.D of absolute heart rate was 73.0±16.6 beats/min at rest and the maximum heart rate 95.7±18.7 beats/min. The mean±S.D. of maximum increase in heart rate was 22.7±7.7 beats/min. Only 1 (16.7%) of the 6 patients tested met the diagnostic criteria for POTS. [Discussion & Conclusion] As the remaining 5 patients failed to meet the diagnostic criteria for POTS, the hypothesis that "VVR can be considered equivalent to POTS" therefore remains questionable. It is thus considered inappropriate to use only the diagnostic criteria for POTS when assessing the safety in patients undergoing an orthostatic test.

著者

野沢 出 中山 久代 霜村 真一 橋本 かおり 今村 俊一 久松 建一 村上 嘉彦

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.52, no.4, pp.577-583, 1993 (Released:2009-06-05)

参考文献数

22

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We carried out a questionnaire. survey on orthostatic dysregulation (abbreviated OD) in 63 young female subjects aged 18-19 years. Ten of them were judged to have confirmed OD, 8 had suspected OD, and the remaining 45 were regarded as normal. Schellong test results showed some difference in three items between the confirmed OD group and normal subjects, but the positive rate of the Schellong test in itself was not significantly different among these three groups. It was our impression that a more detailed analysis of this test is needed to increase its diagnostic validity in determining OD.The Cornell Medical Index-Health Questionnaire (abbreviated CMI) which was modified for the Japanese population with emotional disturbances by Fukamachi was given to these subjects to obtain information about their underlying psychological and emotional status. According to Fukamachi's classification Type III or IV patterns, suggestive of suspicious (III) or probable (IV) neurosis were found in 5 (11.1%) of the normal subjects, in 3 (30.3%) of the subjects with confirmed OD, and in 4 (50.0%) of those with suspected OD. These data suggest a correlation between OD and emotional and/or psychogenic disturbances.Subjects with OD and patients with vertigo or dizziness who visited our clinic were noted to have similar results on CMI. This does not, however, necessarily mean that some subjects with OD are abnormal or sick, since the CMI itself is intended only as an adjunct to, and not as a substitute for, medical interviews and physical examinations.

著者

山中 敏彰

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.71, no.1, pp.47-50, 2012 (Released:2012-03-27)

参考文献数

12

著者

坂田 阿希 中原 はるか 室伏 利久

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.67, no.1, pp.13-17, 2008 (Released:2008-05-02)

参考文献数

14

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Intratympanic instillation of gentamicin is currently a well-established treatment for intractable vertigo in patients with Meniere's disease. There are, however, only a few reports of this therapy in patients with non-Meniere type of vertigo. We report the case of a 68-year-old woman with the lateral semicircular canal type of benign paroxysmal positional vertigo (BPPV) following right idiopathic sudden hearing loss. The patient was annoyed by the positional vertigo for one and a half years and was successfully treated by intratympanic gentamicin instillation. She had profound hearing loss on the right side and direction-changing apogeotropic positional nystagmus. Her caloric response on the right side was severely decreased (canal paresis 80%). Intratympanic gentamicin instillation therapy was undertaken (30mg/ml/day × 5 days), following which her positional vertigo was abolished. We propose that intratympanic instillation of gentamicin may also be applicable to selected patients with long-lasting BPPV.

著者

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.62, no.6, pp.511-519, 2003 (Released:2009-06-05)

参考文献数

21

被引用文献数

1

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We performed two experiments to investigate the relationship between motion sickness and active or passive posture control. Experiment 1: Coriolis stimulation evokes not only motion sickness but also nystagmus and body sway. Eight subjects were asked to execute head tilt with eyes open or eyes covered while standing on a force-platform attached to a turntable. Eye movements were recorded using an infrared CCD camera. The center of pressure was recorded simultaneously. While gaze and posture became passive conditions and motion sickness was evoked with eyes covered, the subjects could maintain active control of posture and motion sickness was not evoked with eyes open. Experiment 2: Head tilt angle while riding in a car recorded on videotapes was quantitatively evaluated by computer analysis. While head movements of passengers became unstable and motion sickness was evoked, the head of the driver always tilted in the same direction as the curve and motion sickness was not evoked. Motion sickness appeared when the head returned from the tilted position to the original position. These results suggest that spatial orientation (the perception of the spatial relationship between self and the outer world) determines whether posture control will be active or passive, and whether motion sickness will be evoked.

著者

時田 喬 柴田 康成 小川 剛 宮田 英雄 大野 道敏

出版者

Japan Society for Equilibrium Research

雑誌

Equilibrium Research (ISSN:03855716)

巻号頁・発行日

vol.52, no.4, pp.602-610, 1993

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A new apparatus capable of recording head and eye movements was devised to examine the vestibulo-ocular system. Horizontal and vertical head movements were recorded with a sensor of terrestrial mgnetism. Eye movenments were recorded by an electronystagmographic technique. The transmitted data were stored on a floppy disc and analyzed with a microcomputer in a specially designed program.<BR>1. The apparatus was useful as a tool for recording spontaneous and gaze nystagmus and pursuit and saccadic eye movements in patients with labyrinthine and central disturbances.<BR>2. Transfer function (gain and phase) of the vestibulo-ocular system was calculated with head and eye movements obtained from pseudo-random head oscillation in the dark. In normal subjects, gain with head movements as input signal and eye movements as output signal indicated a frequency-dependent gain enhancement;the phase difference between head eye movements was 180°.<BR>3. The vestibulo-ocular reflex (VOR) induced by the right and left labyrinth were examined with velocity recording of head and eye movements induced by quick head movements to the right and left at intervals of 1 second in the dark. Patients with unilaterl labyrinthine disturbance showed a low amplitude response in head movements toward the affected labyrinth.<BR>4. The integration mechanism in the pursuit system was examined from the velocity recording of eye movements during vertical head oscillation with fixation on a visual target. A patient with primary position upbeat nystagmus caused by nutritional deficiency encephalopathy showed a disturbance of the up neural integrator from velocity signal to position signal in the visual vestibular oculomotor system.<BR>The apparatus was usuful for the examination of the vestibulo-ocular system of patients with vertigo and equilibrium disturbances.