著者
古川 朋靖 渡辺 道隆 山川 卓也 正木 義男 加納 昭彦 市川 銀一郎
出版者
Japan Society for Equilibrium Research
雑誌
Equilibrium Research (ISSN:03855716)
巻号頁・発行日
vol.57, no.5, pp.480-486, 1998 (Released:2009-10-13)
参考文献数
15

IntroductionFor transcranial magnetic stimulation of the facial nerve, a magnetic coil is fixed to the temporal region over the nerve. It has been reported that the facial nerve can be stimulated at the distal part of the auditory canal, and it is expected that the peripheral vestibular organs are included in the time-varying magnetic field. We examined the influence of magnetic stimulation on the peripheral vestibular organs using a stabilometer.MethodsExperiments were carried out on 10 healthy adults. Magnetic stimulation was administered to the temporal region including the peripheral vestibular organs and stabilometry was performed before and after stimulation. We used a G5500 system stabilometer (Anima Co.) with a sampling time of 20 msec. and recorded body sway for 60 sec. A Mag lite (Dantec Co.) was used for magnetic stimulation and a Synax ER 1100 (NEC-Sanei Co.) was used as the trigger. The stimulus was set at 4 Hz and stimulation was done 60 times. The output was set at about 40% of 1.9 Tesla (maximum output).ResultsWe analyzed the body sway length, 8-directional body sway velocities, and the power spectrum of the lateral body sway velocity. The total length of body sway and the velocity of lateral sway increased significantly after magnetic stimulation.
著者
國弘 幸伸 相馬 啓子
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.3, pp.174-186, 2014-06-30 (Released:2014-08-01)
参考文献数
10

Postural, tension-type headache is the most prominent symptom of cerebrospinal fluid leakage. However, in otoneurological practice, dizziness and not headache is the most frequent presenting symptom in patients with this disorder. Affected patients usually describe their dizziness as a floating sensation. Rotatory vertigo occurs quite rarely. Their complaint is substantiated by high degrees of postural unsteadiness. Some patients cannot stand still even with their eyes open. They stumble and totter while walking. In contrast to such high degrees of postural ataxia, oculomotor disorders such as nystagmus, saccadic pursuit, and decrease of oculomotor nystagmus are not seen. As with other symptoms, dizziness and postural unsteadiness are influenced by the weather, and get worse when the weather is bad. The authors speculate that unsteadiness in both peripheral and central nervous systems involved in spatial orientation (integration of visual, vestibular, and proprioceptive input) underlies the dizziness, postural unsteadiness, and a variety of other symptoms of cerebrospinal fluid leakage.
著者
小林 謙 五十嵐 岳史
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.2, pp.108-114, 2008 (Released:2008-05-29)
参考文献数
15
被引用文献数
5 2

We performed a demographic analysis of 2293 vertiginous patients seen at our clinic from February 1995 to November 2005. While a definitive diagnosis could be made in 1287 cases (56%), the diagnosis remained tentative in 622 (27%), and the cause diagnosis remained unknown in 384 cases (17%). The most common vertiginous disease was benign paroxysmal positional vertigo (456 cases), followed in prevalence by Meniere's disease (232 cases). Most patients had visited other medical facilities before visiting our clinic. Analysis of the medical facilities visited by the patients suggested that the vertiginous patients visited both physicians and otolaryngologists; while. physicians saw the patients in primary care settings, otolaryngologists examined the patients at general hospitals and university hospitals. This discrepancy may complicate the care of vertiginous patients.
著者
片山 直美
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.4, pp.163-170, 2016-08-31 (Released:2016-10-01)
参考文献数
25

The cause of vertigo/dizziness varies. We may reduce vertigo/dizziness with a nutritional approach involving the circadian rhythm and chrononutrition. We can avoid hypoglycemia-mediated vertigo/dizziness by modulating the glucose intake. We can prevent anemia-mediated vertigo/dizziness through dietary supplementation with iron, copper, and vitamin C. Supplementary calcium and zinc are effective for the prevention of psychogenic vertigo/dizziness. In addition, it is effective to enforce a low salt diet at breakfast and lunch. The effective intake-time of calcium is about 1.5 hours before sleep. It is necessary to regulate one's lifestyle, and to prevent diabetes, high blood pressure, dyslipidemia and obesity. We can reduce vertigo/dizziness by preventing edema. A genetic investigation in conjunction with obesity is also necessary. A nutritional approach based on the results of a genetic analysis can be effective for prevention of obesity. Controlled eating habits through nutrition/dietetics can help in the prevention of vertigo/dizziness.
著者
藤田 信哉
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.1, pp.1-7, 2017-02-28 (Released:2017-04-03)
参考文献数
31

Correlations between vertigo, weather fronts, cold temperatures, and low pressures with episodes of Meniere's disease have been previously reported earlier. Such previous reports have indicated that sudden changes in pressure in the inner ear because of weather fronts are a leading causative factor of Meniere's disease. The insertion of a ventilation tube into the eardrum is a recognized method of maintaining a pressure equilibrium in the middle ear. Although the usefulness of this tube has been questioned, it seems to be an acceptable option when choosing between conservative therapy and invasive treatment. Cochlear symptoms and vertigo improve under a relatively positive pressure in the middle ear when patients with Meniere's disease are placed in a decompression chamber. Therefore, a new device that sends micro-pressure pulses into the ear (e.g., the Meniett® device) has become available in western countries. Because this device has not yet been approved in Japan, eardrum massage machines are expected to be used as an alternative method for the treatment of Meniere's disease.
著者
野村 泰之 戸井 輝夫
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.3, pp.167-173, 2014-06-30 (Released:2014-08-01)
参考文献数
12
被引用文献数
1 1

After the huge earthquake in Japan on March 11th 2011 (magnitude 9.0), many people in the eastern area of Japan close to the epicenter felt dizziness, as if they were rocking at a time when no aftershocks were actually occurring. There are a few reports about dizziness after major earthquakes in the world, but there has been no study so far with analysis of large numbers of cases of earthquake sickness. We conducted an epidemical clinical study and called those symptoms “post earthquake dizziness syndrome; PEDS.” Affected subjects became aware of the rocking feeling within a minute especially when indoors and seated. A significant difference was found with respect to gender, with a prevalence of females, and with the people who were prone to suffer from motion sickness. Otherwise, there was no relationship with case histories of vertigo-related diseases. On the other hand, anxiety and social stress from the disaster seemed to be contributory factors. The underlying mechanism is associated with stimuli to the vestibular and equilibrium balance systems. Emotional disorders such as post-traumatic stress disorder (PTSD) were added to the etiology. For the prevention and treatment, maintaining fitness in daily life and avoiding anxiety caused by reports in the media seemed to be important. Physiotherapy and medication also proved important to prevent symptoms from getting worse.
著者
中島 務
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.4, pp.243-251, 2017-08-31 (Released:2017-10-01)
参考文献数
48

The concept of idiopathic sudden sensorineural hearing loss appeared after the term “Meniere's disease” was widely used. Until around the middle of the 20th century, sudden sensorineural hearing loss had been reported together with Meniere's disease. Moreover, sudden sensorineural hearing loss had been reported collectively regardless of the cause of the hearing loss. In 1944, de Kleyn reported a group of patients with sudden loss of function of the octavus-system in apparently normal persons. This was the first report in the literature which collectively described idiopathic sudden sensorineural hearing loss or idiopathic sudden deafness. From around the middle of the 20th Century, the number of papers regarding idiopathic sudden sensorineural hearing loss gradually increased. Vertigo occurred frequently in patients with severe hearing loss in the high-tone frequencies or with profound hearing loss throughout the whole range of frequencies. Recently magnetic resonance imaging revealed findings not only in the cochlea but also in the vestibule on the affected side in patients with vertigo. Endolymphatic hydrops was revealed in some patients with idiopathic sudden sensorineural hearing loss. These findings may contribute to the understanding of the etiology of sudden hearing loss including the vertigo mechanism. At the present time, however, the border between Meniere's disease and idiopathic sudden sensorineural hearing loss is unclear.
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

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
中島 務 寺西 正明 片山 直美 加藤 正大
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.3, pp.197-203, 2011 (Released:2011-08-01)
参考文献数
28

The first visualization of endolymphatic hydrops in patients with Ménière's disease was performed using three-dimensional fluid-attenuated inversion recovery (3D-FLAIR) imaging with a 3 Tesla MRI unit after gadolinium contrast agent (Gd) was injected intratympanically. The 3D-FLAIR MRI could differentiate the endolymphatic space from the perilymphatic space, but not from the surrounding bone. By optimizing the inversion time, the endolymphatic space, perilymphatic space and surrounding bone could be separately visualized on a single image using three-dimensional real inversion recovery (3D-real IR) MRI. Using 3D-FLAIR and 3D-real IR MRI, various degrees of endolymphatic hydrops were observed in the basal and upper turns of the cochlea and in the vestibular apparatus after intratympanic Gd injection. Recently, visualization of endolymphatic hydrops became possible 4 h after intravenous Gd injection in patients with Ménière's disease. We applied a heavily T(2)—weighted 3D-FLAIR technique to detect Gd more sensitively for evaluation of endolymphatic hydrops after an ordinary amount of Gd was administered intravenously. Thus, newly developed MRI techniques have contributed significantly to the evaluation of endolymphatic hydrops. The intravenous administration of an ordinary amount of Gd is routinely done clinically. The relationship between endolymphatic hydrops and clinical symptoms will be investigated widely using new techniques.
著者
國弘 幸伸 相馬 啓子
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.3, pp.176-188, 2011 (Released:2011-08-01)
参考文献数
11
被引用文献数
3 1 3

The most prominent symptom of spinal cerebrospinal fluid (CSF) leakage is an orthostatic, tension-type headache. Other well-known symptoms include nausea, vomiting, photophobia, diplopia, depression, and amnesia. The authors address other commonly encountered symptoms such as dizziness, hearing disturbances, cerebrospinal fluid rhinorrhea, and gustatory and olfactory disturbances.The dizziness experienced in this disorder is essentially characterized as a kind of “floating sensation” or “walking on the clouds” and is associated with a high degree of unsteadiness. A considerable percentage of patients cannot remain standing even when their eyes are open; to-and-fro perturbations are particularly prominent in these patients. Rotatory vertigo attacks can occur in a small portion of patients, but usually only during the early stages of the disease. As with the headache, dizziness is aggravated by an upright or standing position. The weather also influences the intensity of both the headaches and dizziness: both are exacerbated when the atmospheric pressure is low or is falling rapidly. Water intake and/or the drip infusion of a physiological salt solution may temporarily improve dizziness and other symptoms.The usefulness of MRI for diagnosing spinal cerebrospinal fluid leakage is limited. MRI findings are equivocal in most cases; therefore, the authors perform 111In-DTPA scintigraphy for each patient in whom this disorder is suspected.The first choice of treatment for this disorder is bed rest and water intake and/or drip infusion. When these treatments are ineffective, an epidural autologous blood patch is attempted. However, not all patients are cured by this procedure, and dizziness, hearing, and/or tinnitus may worsen after treatment. In some patients, an exploratory tympanotomy is required to rule out associated or treatment-induced perilymphatic fistula.In conclusion, spinal CSF leakage is not a rare disorder, and because this disorder presents with an extremely wide spectrum of symptoms, all physicians in any field of specialization may encounter a patient with this disorder. All physicians should keep this disorder in mind.
著者
田中 英高
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.53-60, 2012 (Released:2012-06-01)
参考文献数
25

Dizziness is not an uncommon medical problem in children. When a child develops various physical symptoms in addition to dizziness, clinicians should include orthostatic dysregulation (OD) in their diagnosis. OD is composed of four different subsets, instantaneous orthostatic hypotension (INOH), postural tachycardia syndrome (POTS), neurally-mediated syncope and delayed orthostatic hypotension, and the former two are dominant. INOH involves dysfunction of the high-pressure system in the neural baroreflex pathway, and the low-pressure system in the case of POTS. Children with OD show a decrease in cerebral blood flow compared with unaffected children, and this might be associated with the mechanism responsible for dizziness. Further studies are anticipated in relation to OD and vestibular function.
著者
増田 毅 加我 君孝
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.4, pp.270-275, 2012 (Released:2012-10-01)
参考文献数
4

Children with inner ear anomalies resulting in severe hearing impairment may show deficits in head control and independent walking. In the present study we examined the vestibular function in children with bilateral inner ear anomalies using a rotation test, and investigated the impact of the anomalies on motor development. Children with the Michel anomaly, which is characterized by a lack of inner ear differentiation bilaterally, are markedly slow in developing head control and independent walking. As muscle tonus is increased with the myelinization of motor neurons, independent walking becomes possible. On the other hand, children with severe inner ear anomalies, such as bilateral common cavity deformity and incomplete partition type I (Mondini deformity), show vestibular ocular reflex by the rotation test as they age, and normal independent walking and running become possible. These results demonstrate that, although children with inner ear anomalies may be slow in motor development in their infancy, their motor function increases to a normal level as they grow.
著者
吉田 友英
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.3, pp.147-150, 2010 (Released:2010-08-01)
参考文献数
9
被引用文献数
6 2
著者
正木 義男 渡辺 道隆 古川 朋靖 加納 昭彦 山谷 千恵美
出版者
Japan Society for Equilibrium Research
雑誌
Equilibrium Research (ISSN:03855716)
巻号頁・発行日
vol.57, no.3, pp.297-304, 1998 (Released:2009-10-13)
参考文献数
15
被引用文献数
2 2

IntroductionVasovagal reflex (VVR) is a disease that has received attention in various fields.Recently, researchers have started to clarify its mechanism. Three patients with symptoms probably due to VVR were treated in this department and the Head up tilt test was used to diagnose dizziness due to VVR.PatientsThe three patients included a 21-year-old female (Case 1), a 26-year-old male (Case 2) and a 61-year-old female (Case 3). All three patients had chief complaints of spontaneous dizziness after standing or sitting for 5 to 30 minutes.ResultsThe duration of standing before the onset of positive findings was 9.5 minutes in Case 1 and 11 minutes in Case 2. In Case 3, positive findings were obtained 9.5 minutes after isoproterenol administration.DiscussionAll three patients showed spontaneous dizziness in either the standing or sitting position and the results of the Head up tilt test were positive. Therefore, dizziness seemed to be due to VVR in these patients. The instantaneous decrease in blood volume due to paradoxical activation of the vagus nerve may have induced dizziness, loss of consciousness and faintness. Because of severe patient stress during the Head up tilt test, this examination should be indicated only in those who are strongly suspected of VVR.
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.73, no.3, pp.158-166, 2014-06-30 (Released:2014-08-01)
参考文献数
18

I analyzed 33 patients with mal de debarquement who visited my clinic in the past 7 years and 8 months. The ratio of female to male patients was 3: 1; 78.8% of the patients who became sick were in their 20s to 40s; 45.4% of the patients had suffered longer than a year. Symptoms were first provoked following travelling on ships in 10 patients, boarding airplanes in 5, taking trains in 3, getting on vehicles in an amusement park in 2, getting in high-speed elevators in 1 (all the above comprised 63.6% of the patients), huge earthquakes in 3, shaking in the building in 1, and giving shows with a grampus dolphin in an amusement aqua-park in 1. Excepting sensuous or visible continuous body sways, patients often complained of brain fatigue, photophobia, having sleepiness in the daytime, headache, and discomfort related with changes in the atmospheric pressure and temperature. Past histories such as dropping, falling down or heavy brows on the neck were found in 48.5% of the patients. Since 4 patients were finally diagnosed to have suffered from cerebrospinal fluid hypovolemia, patients who are suspected as having mal de debarquement should be examined to rule out this disease. The peculiar phenomena associated with the syndrome may be explained by supposing that the brain maintains the illusion of existing in a moving space even after the body has returned to a standstill, or to terra firma, because the brain had been in anomalous or exhausted states.