著者

高橋 克昌 岡本 彩子 新國 摂 岡宮 智史 紫野 正人 高安 幸弘 近松 一朗

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.8-14, 2015-02-28 (Released:2015-04-01)

参考文献数

20

被引用文献数

2

---

The episodic vertigo of Meniere's disease is related to stress. Although the questionnaire method is useful in the evaluation of mental stress, it is hard to assess physical stress, in other words, fatigue. Human herpes virus-6 (HHV-6) and -7 (HHV-7) are the cause of Roseola infantum. Latent infection of those viruses is established in all Japanese adults, and viruses are re-activated and secreted into saliva under conditions of severe fatigue. Detection of HHV-6 DNA in saliva represents short-term fatigue which lasts for a week, and that of HHV-7 DNA indicates long-term fatigue which lasts for a month. Objective evaluation of fatigue is achieved by measurement of the levels of HHV-6 and 7 DNA in saliva. Patients who suffered from vertigo attacks within a week were divided into two groups, namely Meniere's disease with depression (D (+) Meniere) and without depression (D (-) Meniere), using questionnaires and investigation of mental problems. Saliva samples were collected, and viral DNA was amplified with the Loop mediated isothermal amplification method using specific primers as reported previously. HHV-7 DNA was detected at the high rate of 89% in the D (-) Meniere group, whereas it was 17% in the D (+) Meniere group, and 0% in healthy subjects. HHV-6 DNA was also detected at a higher rate of 64% in the D (-) Meniere group compared with 17% in the D (+) Meniere group and 33% in healthy subjects. A high rate of virus DNA in saliva indicated accumulated fatigue in Meniere's disease patients.

著者

野村 泰之

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.1, pp.7-15, 2019-02-28 (Released:2019-04-01)

参考文献数

42

被引用文献数

2 1

---

The present status of usage and popular usage of the popularly used drugs for dizziness and vertigo in Japan are described herein. The agents are introduced These drugs are prescribed according to the phase of the patients' symptoms (emergency, acute, subacute or chronic) and the underlying pathology, with reference to the literature as evidence. Conservative therapy for dizziness and vertigo consists of three categories; drug therapy, cognitive therapy and physical and exercise therapy. The mutual strategy using An appropriate combination of these three therapies is important for successful treatment of dizziness and vertigo. Thorough history-taking is very important for a precise diagnosis of dizziness and vertigo. Appropriate treatment is selected according to the precise diagnosis. The mainstream anti-dizziness/vertigo drugs used in Japan consists of antihistamine agents (used as anti-emetic drugs), anti-motion sickness drugs, microcirculation agents, emulgents and vitamin B12 preparations. In this manuscript, we provide a detailed description of all the anti-dizziness/vertigo drugs used currently in Japan, along with a review of the relevant literature. However, most of these drugs are already well-dated and have been traditionally used for many years. In recent years, antidepressant agents and herbal medicines have also begun to be used. There are no new drug developments in this area of vestibular pathologies. We hope that treatments for these conditions will be updated with the development of novel anti dizziness/vertigo drugs, so as to bring this area of study into the modern age of medicine.

著者

学会のあり方委員会 担当理事 : 宇佐美 真一 室伏 利久 北原 糺 委員長 : 内藤 泰 委員 : 牛尾 宗貴 城倉 健 伏木 宏彰 中村 正 関根 和教 宇野 敦彦 杉内 友理子

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.78, no.6, pp.607-610, 2019-12-31 (Released:2020-02-05)

参考文献数

4

被引用文献数

5 1

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

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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

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

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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

坪田 雅仁

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.2, pp.76-78, 2014-04-30 (Released:2014-06-01)

参考文献数

24

著者

西池 季隆

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.62, no.3, pp.268-269, 2003 (Released:2009-06-05)

参考文献数

14

著者

岩﨑 真一

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.82, no.3, pp.216-223, 2023-06-30 (Released:2023-08-01)

参考文献数

18

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Dizziness and imbalance are the most common complaints in older people, and are a growing public health concern. Although the causes of dizziness in older people are multifactorial, peripheral vestibular dysfunction is one of the most frequent causes. Every factor associated with the maintenance of postural stability deteriorates with aging. Age-related deterioration of peripheral vestibular function has been demonstrated through quantitative measurements in the vide head impulse test and evaluation of the vestibulo-collic reflex by testing of vestibular evoked myogenic potentials. Age-related decline of vestibular function has been shown to be correlated with the age-related decrease in the number of vestibular hair cells and neurons. Other factors associated with postural stability, such as somatosensation, visual acuity, cerebellar function, and muscle strength also decline with age. In examining older patients with dizziness or imbalance, it is important to assess each factor associated with postural stability. To improve postural stability, it is recommended that strategies be devised to improve the impaired functions based on the results of the above assessments.

著者

姜 静愛 田中 恒彦 八木 千裕 堀井 新

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.82, no.1, pp.16-25, 2023-02-28 (Released:2023-04-11)

参考文献数

17

被引用文献数

2

---

We report two patients with Persistent Postural- Perceptual Dizziness (PPPD) who were successfully treated by Cognitive Behavioral Therapy (CBT) after initially showing limited responses to vestibular rehabilitation and pharmacotherapy. The vestibular symptoms and psychiatric status were evaluated by the Dizziness Handicap Inventory (DHI) and Hospital Anxiety and Depression Scale (HADS), respectively, before and after six sessions of biweekly CBT intervention. The difficulties and abilities in handling activities of daily living as assessed by medical interviews improved in both patients, suggesting the effectiveness of CBT for PPPD. However, the results of assessment by the DHI/HADS differed between the two patients. Patient 1 showed improvement in the score on the DHI, but not in that on the HADS, whereas Patient 2 showed improvement in the score on the HADS, but not on that in the DHI. Given that both the patients reported improvements in the difficulties and abilities in handling the activities of daily living, we consider that the different results of assessment by the DHI may suggest the need for use of more appropriate measures to evaluate the quality of life after CBT than the DHI. These results might also suggest that CBT may not always exert equal effects on the psychiatric status and vestibular symptom status.

著者

原田 實

出版者

Japan Society for Equilibrium Research

雑誌

Equilibrium Research (ISSN:03855716)

巻号頁・発行日

vol.61, no.4, pp.187-192, 2002 (Released:2009-06-05)

参考文献数

6

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

被引用文献数

3

---

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

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

被引用文献数

1

---

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

小宮山 純

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.82, no.1, pp.3-15, 2023-02-28 (Released:2023-04-11)

参考文献数

48

---

The relationship between postural disturbance and vertical perception after cerebrovascular disease remains unclear and studies have only recently begun to be conducted. On the other hand, the symptomatic aspect is evident: body lateropulsion is ipsilateral in the case of caudal brainstem lesions and contralateral in the case of rostral brainstem and cerebral hemispheric lesions. In addition, patients with cerebral hemispheric lesions sometimes show“pusher behavior” in which they resist any attempt to correct their posture and push the body back to the paralyzed side using the healthy limbs, as they have a fear of deviation to the healthy side. The pusher behavior is always accompanied by hemiplegia and is detected in about 10% of cases of hemispheric vascular lesions. The pathogenesis of lateropulsion associated with the Wallenberg syndrome has traditionally been suggested to involve a high-level central deficit due to a subjective visual vertical (SVV) tilt of vestibular origin, but more recently it has been interpreted as being the result of neurological deficits at lower levels in the spinocerebellar and vestibulospinal tracts. On the other hand, pusher behavior is a result of a disturbance in the higher central mechanisms involved in the perception of verticality as indicated by the subjective postural vertical (SPV) tilts. However, studies on the direction of the SPV tilts have yielded conflicting results. The first pioneering report of SPV in patients with pusher behavior showed that the SPV is tilted toward the lesion side, and pusher behavior occurs on the paralyzed side to correct it. On the contrary, a subsequent study indicated that pusher behavior is an attempt to adjust oneself from a true vertical to a falsely perceived vertical that is tilted toward the paralyzed side. The SPV is derived from the somatosensory system of the trunk. The main lesion site is thought to be the posterior lateral thalamus and the parietal insula, more common in right hemispheric lesions. In recent years, neuroscience of body graviception has been discussed in terms of the internal model, which is thought to play a role in clarifying ambiguous sensory information, integrating information among visual, vestibular, and somatosensory modalities, and summarizing efferent and afferent information. As research tools for evaluation, SVV, SPV, and subjective haptic vertical have been used.

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.59, no.2, pp.93-102, 2000 (Released:2009-06-05)

参考文献数

53

被引用文献数

3

---

In the acute period, the goal of drug therapy for vertigo is suppressing the sensation of vertigo, preventing vomiting and helping restore normal balance. Intravenous injection of NaHCO3 is effective against the sensation of vertigo. Since histamine H1-receptors are involved in vomiting that is associated with vertigo, antihistamines could prevent it. Benzodiazepines may restore normal balance by stimulating the initial develop-ment of vestibular compensation, in addition to their antianxiety effects. In the chronic period, vasodilators such as diphenidol or betahistine could prevent recurrent attacks of vertigo. Benzodiazepines may act on the limbic system and relieve psychotic triggering of vertigo attacks. Meniere's disease, in which the primary pathology is endolymphatic hydrops, is specifically managed by an osmotic diuretic, isosorbide. Steroids may be helpful in patients with vestibular neuronitis.

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 3

---

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

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 7

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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

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

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.81, no.1, pp.1-15, 2022-02-28 (Released:2022-04-02)

参考文献数

58

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Postural instability occurs in some patients, and could be caused by a wide range of disorders, including neurological diseases, vestibular, visual and/or somatosensory dysfunctions, and musculoskeletal impairments. Problems in postural balance are commonly evaluated by posturography. Posturography is based on the principle of measuring changes in the center of pressure (COP), which represents the center point of the entire pressure exerted by the foot-ground contact surface on the force plate. Graphical representations called stabilograms and statokinesigrams are commonly obtained by measurement of the body sway using posturography. Stabilograms depict the time series of the COP displacement in either the anteroposterior or mediolateral direction, while statokinesigrams show the bidimensional COP trajectory on the ground extracted by the COP plot. Parameters derived from the COP trajectories to assess the patients' capabilities and performance to keep their balance include the sway path (cm), sway area (cm2), RMS (root mean square), and the Romberg quotient. A 0.2-Hz postural sway is a characteristic finding in unilateral vestibular disorders. Patients with anterior cerebellar lesions manifest a characteristic increase in sway activity in higher power spectra frequency bands, with a typical peak between 2 and 4Hz. Higher values of the Romberg quotient for variables of the sway path and area are seen in patients with vestibular or proprioceptive dysfunction. Posturography could assist in the differential diagnosis of balance disorders, and is a useful tool to evaluate the degree of postural imbalance and the effects of therapeutic interventions. Although the usefulness of posturography for the differential diagnosis of some diseases presenting with dizziness and balance disorders remains limited, several recent technological developments may offer the promise for improved diagnostic precision.

著者

城倉 健

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.82, no.4, pp.269-276, 2023-08-31 (Released:2023-10-03)

参考文献数

16

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Vestibulo-ocular reflex (VOR), one of brainstem reflexes that maintains balance, is controlled by the cerebellum. This cerebellar control system of VOR is further coordinated by the cerebrum (e.g., visual suppression of VOR). Therefore, in central lesions, dysregulated, abnormally increased VOR gain may be the underlying pathology of chronic dizziness, unlike in peripheral vestibulopathy, which always involves decreased VOR gain. The characteristics of VOR dysregulation are quite different between brainstem-cerebellar lesions and cerebral lesions. Abnormally increased VOR gain is the major mechanism underlying the chronic dizziness in patients with brainstem-cerebellar lesions, whereas decreased visual suppression rate of VOR is the major mechanism underlying the chronic dizziness in patients with cerebral lesions. Of course, there could be coexisting peripheral vestibulopathy (decreased VOR gain), so that it is necessary to consider all pathologies causing increased VOR gain, decreased visual suppression rate of VOR, and decreased VOR gain to identify the precise mechanism of dizziness, especially in eldery people.

著者

武市 紀人

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.82, no.4, pp.239-246, 2023-08-31 (Released:2023-10-03)

参考文献数

23

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Spinocerebellar degeneration (SCD) is a group of neurodegenerative disorders characterized by progressive cerebellar ataxia with or without symptoms/signs of pyramidal, extrapyramidal, or peripheral nerve involvement. Patients frequently exhibit unsteadiness of gait associated with nystagmus, which could also be observed in patients with peripheral vestibular impairment. Thus, some of these patients often initially seek consultation with an otolaryngologist. To distinguish SCD from other peripheral vestibular disorders, it is necessary for otolaryngologists to understand the characteristics of SCD. Brainstem and cerebellar lesions affect physiological eye movements, so that the patients often present with various eye movement abnormalities. Slow saccades, saccade dysmetria, down-beat nystagmus, and impairment of smooth pursuit are some of the typically observed abnormalities. Reduced bilateral VOR has been observed in MJD/SCA3 patients, especially developed more those with a disease duration of longer than six years. SCA6 patients, considered as showing pure cerebellar ataxia, show dissociation between control of gaze tracking during smooth pursuit and VOR cancellation. This result indicates that the cerebellar Purkinje cells are not involved in the non-pursuit VOR cancellation system. Therefore, it is important for otorhinolaryngologists to be alert to typical eye movement impairments.