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.157-157, 2014-06-30 (Released:2014-08-01)

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

小川 恭生

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.82, no.2, pp.114-119, 2023-04-30 (Released:2023-06-14)

参考文献数

6

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Differentiation of central from peripheral lesions is important when examining patients with dizziness or vertigo. Nystagmus is one of the most important clues to the differential diagnosis between central and peripheral lesions. It is not rare in patients with central lesions to have no neurologic symptoms other than nystagmus in the acute phase. Direction-changing gaze-evoked nystagmus, upbeat nystagmus, downbeat nystagmus and direction-changing apogeotropic positional nystagmus are known as characteristic findings of central vertigo. In this article, we report a case with direction-changing gaze-evoked nystagmus, a case with upbeat nystagmus, a case with downbeat nystagmus, and a case with direction-changing apogeotropic positional nystagmus, and explain/speculate on the mechanism of nystagmus in each case.

著者

中島 務 中田 隆文 片山 直美 杉浦 彩子 内田 育恵 寺西 正明 吉田 忠雄

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.79, no.3, pp.156-163, 2020-06-30 (Released:2020-08-05)

参考文献数

32

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We investigated the risk factors for vertigo from the results of health checkups conducted in Yakumo town. The subjects of this investigation included 525 persons (299 women and 226 men), aged 40 to 88 years (average 63.78 years). Among these, 397 persons (75.6%) had no vertigo, 116 persons (22.1%) had vertigo sometimes, and 12 persons (2.3%) suffered from vertigo frequently. Ninety-four women (31.4%) and 34 men (15.0%) had vertigo. Twenty-one (51.2%) of the 41 women in their 40s had vertigo. Logistic regression analysis revealed that subjective hearing loss, a low value of the mean corpuscular hemoglobin concentration (MCHC), headache, high level of serum creatinine and frequent urination were significantly associated with the risk of vertigo, after adjustments for age and sex. Listening difficulties in conversations between four or five people were reported more frequently than those in one-to-one conversations. Anemia should be considered in the differential diagnosis of vertigo. In the diagnosis of vertigo, information about the presence/absence of headache and the status of the headache, if any, may be necessary. In our study, migraine and headache on the ipsilateral side were associated with vertigo, but bilateral headache was not associated with vertigo. Our analysis, did not reveal smoking, drinking, exercise habit, sleep time, body mass index (BMI), body fat percentage, hemoglobin A1c, blood glucose, serum triglyceride, serum LDL cholesterol, or serum HDL cholesterol as being significantly associated with the risk of occurrence of vertigo, after adjustments for age and sex.

著者

田浦 晶子

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.77, no.2, pp.47-57, 2018-04-30 (Released:2018-06-01)

参考文献数

63

被引用文献数

1

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Cervical vertigo is known as vertigo due to a neck problem. However cervical vertigo remains controversial because there are neither reliable tests nor recognized signs. Supporters of cervical vertigo insist that it is the most common vertigo syndrome. Additionally, some studies demonstrated that stimuli applied to the neck induced nystagmus and dizziness. To date, pathophysiologically four different hypothetical mechanisms have been attributed to cervical vertigo: (1) sympathetic dysfunction; (2) proprioceptive dysfunction; (3) rotational vertebral artery compression (Bow hunter's syndrome); and (4) overlap with migraine associated vertigo. However there are no established tests to diagnose cervical vertigo and diagnosis mostly depends on the patient's past history or subjective complaint such as neck pain. Therefore vestibular or other neurological diseases must be excluded first. Treatment should be specified according to the cause of cervical vertigo. For sympathetic dysfunction due to cervical spondylosis, decompression therapy such as cervical disc decompression might be effective. Physical therapy is reported to be useful for proprioceptive cervical vertigo. In the case of cervical vertigo due to vertebral artery compression, conservative management, decompression surgery and endovascular therapy are major treatment methods. In the future, cervical vertigo is expected to increase due to the expansion of the use of electronic devices such as smartphones. Appropriate clinical examinations and diagnostic criteria should be established urgently.

著者

前田 佑輔 伏木 宏彰 角田 玲子 木下 修 阿部 靖 遠藤 まゆみ 西村 信子

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.76, no.6, pp.692-697, 2017-12-31 (Released:2018-02-03)

参考文献数

7

被引用文献数

4 1

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In the United States of America, physiotherapists are involved in vestibular rehabilitation. With the aim of clarifying the degree of interest in Japanese physiotherapists regarding vestibular rehabilitation, this study used a questionnaire to survey physiotherapists who had previously been exposed to equilibrium research at workshops and physiotherapists who had not been exposed as a control group. Approximately 80% of those in the control group were interested in vestibular rehabilitation. However, most physiotherapists had very few opportunities to receive education regarding the pathophysiology of the vestibular system and related diseases in a clinical setting. Physiotherapists who participated in workshops received this education from senior physiotherapists as their instructors. The small number of physiotherapists who were given such opportunities was engaged in vestibular system rehabilitation based on requests from otolaryngologists for a small number of cases. A question regarding vestibular rehabilitation was on the national examination for physiotherapists in 2015. However, there are few opportunities for education regarding vestibular system before and after graduation.

著者

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.79, no.2, pp.62-70, 2020-04-30 (Released:2020-06-02)

参考文献数

34

被引用文献数

2 1

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Persistent postural-perceptual dizziness (PPPD) is a newly defined diagnostic syndrome that was included in the 11th edition of the World Health Organization's International Classification of Diseases (ICD-11) in 2018. PPPD is characterized by persistent chronic vestibular syndrome, typically preceded by acute vestibular disorders, lasting for >3 months. The core vestibular symptoms of PPPD are dizziness, unsteadiness, and/or non-spinning vertigo and are exacerbated by upright posture/walking, active or passive movements, and exposure to moving or complex visual stimuli. PPPD is classified as a functional disorder, and not as a structural or psychiatric condition. No specific laboratory tests for the diagnosis of PPPD are available, and an assessment of the symptoms, exacerbating factors, and medical history is important for the precise diagnosis of PPPD. Although the exact pathophysiology of PPPD remains to be elucidated, data from physiological investigations and rapidly emerging advanced structural and functional neuroimaging studies have revealed some key mechanisms underlying the development of this disorder, including stiffened postural control, a shift in processing spatial orientation information to favor visual or somatosensory over vestibular inputs, and failure of higher cortical mechanisms to modulate the first two processes. Although PPPD is a relatively new diagnosis and will therefore be unfamiliar to many health professionals, undiagnosed or untreated dizzy patients who have been suffering for many years can be saved. Once recognized, PPPD can be managed by effective communication and individually tailored treatment strategies, including serotonergic medications, vestibular rehabilitation and cognitive behavioral therapy.

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 6

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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

松吉 秀武

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.4, pp.220-221, 2014-08-31 (Released:2014-10-01)

参考文献数

8

著者

二木 隆 深谷 卓

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.6, pp.456-465, 2012 (Released:2013-02-01)

参考文献数

24

被引用文献数

2

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Many patients who have been receiving treatment for dizziness in our clinic complained of some worsening of their symptoms or changing of their usual problems after the “Mega-quake” of 11, Mar. 2011, i.e. the Higashi-Nihon Daishinsai earthquake (Magnitude: 9.0). In order to elucidate the influence of the Mega-quake on patients with dizziness, we assessed 235 subjects within 2 weeks after the `quake' with a questionnaire. The number of new patients within the 2 weeks before and after the earthquake rose from 19 to 29. The response rate from the questionnaire was 59%, and the three most serious symptoms were as follows, “horizontal swinging of the earth”, “vertical movement of the earth”, “nausea sensation similar to motion sickness”, rather than the usual symptoms such as vertigo or blackouts. As objective findings, spontaneous and positional nystagmus was encountered 27% of the respondents and one in 5 patients showed a larger area of body sway in the Gravicorder Recording. Some of the neurological considerations were discussed based on the results of our investigation regarding the earthquake and body equilibrium.

著者

徳増 厚二 長沼 英明 橋本 晋一郎 伊藤 昭彦 和田 昌興 岡本 牧人 山根 雅昭

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.66, no.2, pp.64-72, 2007 (Released:2008-10-10)

参考文献数

17

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Hyperosmotic solution of isosorbide has been used for treatment of Meniere's disease since Kitahara et al., Larsen et al. and Nozawa et al.. In recent studies reported that ADH is acting to open water channels, AQP-2 at the endlymphatic membrane and may act worse for labyrinthine hydrops. It is important the serum concentration of isosorbide after administration because ADH should be released if the serum osmotic pressure is elevated by isosorbide above more than 2% of normal serum osmotic pressure. In this study the equation predicting isosrbide serum concentration after oral administration was proposed on the basis of the data by Wakiya's report. It was confirmed the serum osmotic pressure remains below the threshold level for increasing ADH secretion by the routine method of 30 ml/once, 3 times every day. However, the method of 30 ml/once, single or two times every day should be recommended when the serum osmotic pressure before the medication is above 289 mOsm/kg.

著者

吉本 裕

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.60, no.6, pp.492-495, 2001 (Released:2009-06-05)

著者

塩崎 智之 和田 佳郎 伊藤 妙子 山中 敏彰 北原 糺

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.79, no.4, pp.274-280, 2020-08-31 (Released:2020-10-01)

参考文献数

12

---

There are patients with floating dizziness who do not show abnormalities in current vertigo balance tests. We developed a clinical examination to quantify gravity perception as a first step to test our hypothesis that a gravity perception disturbance is the cause of floating dizziness. The gravity sensitivity can be measured accurately by adding the head tilting condition to the original subjective visual vertical (SVV) test. We named this test the Head Tilt SVV (HT-SVV). The most important measurement item in HT-SVV is head tilt perception gain (HTPG). HT-SVV measurements in 329 healthy subjects yielded an average value and standard deviation of 1.02±0.12 and a reference value of 0.80-1.25 for HTPG, and a difference between the left and right HTPG of 4.7±3.7%, i.e.,<10.0%. We could not detect age-related changes in gravitational sensitivity by the original SVV, but found that HTPG, determined by HT-SVV, increased with age. A significantly higher rate of subjective dizziness was noted in patients who tested positive in the HT-SVV than in those who tested negative among patients who developed floating dizziness after BPPV. We would like to clarify the clinical significance of the test method and establish the concept of gravitational susceptibility disorder, although a number of relevant issues still remain to be clarified.

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.59, no.3, pp.245-246, 2000 (Released:2009-06-05)

被引用文献数

1

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 32

著者

長沼 英明

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.259-267, 2013-08-31 (Released:2013-10-01)

参考文献数

18

被引用文献数

1 1

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Wistar rats were intraperitoneally injected with 0.02 units/g of AVP (Pitressin; Arg-vasopressin. Daiichi-Sankyo, Japan) in all the experiments in this study. ABR thresholds gradually increased significantly up to 60 min after the injection. When dehydration load pretreatment for 24h was added, ABR thresholds rapidly increased significantly up to 10 min after the injection. However, the morphological endolymphatic hydrops in the cochlea was not detected under light microscopy. On the other hand, the enlargement of an area lacking intracellular organelles in the intermediate cells in the stria vascularis or a so called “vacuole” was detected under transmission electron microscopy after the AVP injection. When the dehydration load pretreatment for 24h was added, the vacuole area increased with AVP injection. However, when a V2R antagonist (OPC-31260, donated by Otsuka Pharmaceutical) was administered before AVP, vacuole formation was suppressed significantly. Conversely, vacuole formation was not suppressed when a V1aR antagonist (OPC-21268, donated by Otsuka Pharmaceutical) was administered before AVP injection. As a clinical application based on above mentioned basic studies, we conducted hydration therapy for Meniere's disease. In the hydration therapy, basically the patients drank 35 ml/kg/day of water daily in addition to the normal daily beverages and foods for 2 years. Medication of 21 g was given whenever a vertiginous spell or hearing loss or aural fullness reoccurred. The outcomes were determined according to the criteria of the AAO-HNS 1995 guidelines. In the hydration therapy group, the definitive spells were controlled in 93% of the patients. The hearing in the hydration therapy group was improved significantly in comparison with the conventional therapy group.

著者

横田 誠 中山 明峰 蒲谷 嘉代子 竹村 景史 渡邊 暢浩 服部 寛一 宮崎 総一郎 村上 信五

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.2, pp.91-95, 2010 (Released:2010-06-01)

参考文献数

12

被引用文献数

1 1

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The relationship between dizzy patients and stress is well documented, but that between dizzy patients and sleep disturbance is unclear. This study focused on sleep disturbance in dizzy patients through investigations into their hypnotic medications. Six hundred and twenty two patients were studied, who complained of dizziness and visited Nagoya City University from January 1 to December 31, 2007. The major hypnotic was the benzodiazepine group (65%), and was prescribed to 226 patients (36%). Although prescription of hypnotics tended to increase with the age of the subjects, it was even prescribed often in young adults. The approximate ratio of patients taking hypnotics to those who were suffering from insomnia and without dizziness was 2:1. Poor quality of sleep may cause additional stress, leading to a vicious cycle in patients suffering from dizziness.

著者

北原 糺

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.268-273, 2013-08-31 (Released:2013-10-01)

参考文献数

18

被引用文献数

2

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Some sicknesses are well known to be provoked by inadequate adaptation to physical and/or psychogenic stress in daily life. Attacks of Meniere's disease characterized by vertigo, fluctuating hearing loss and tinnitus due to inner ear pathology represent a common example. Furthermore, this disease has been proposed to especially occur in civilized people living a stressed lifestyle, i.e. “Menierization is civilization”. However, it is very difficult to prove a significant relationship between stress and inner ear pathology, since the definition of stress is too obscure for scientific analysis of these aspects. Since the oto-pathology in Meniere's disease was first revealed to be inner ear endolymphatic hydrops through temporal bone studies in 1938, it has gradually become understood that inner ear endo-organ tissues, including the endolymphatic sac, prepare the fluid homeostatic system via water metabolism-related molecules such as vasopressin and aquaporin. Subsequently, it was proposed that the pathogenesis in Meniere's disease could be inner ear endolymphatic hydrops due to a disorder of water metabolism-related molecules. In the present paper, we would like to discuss the neuroscientific relationship between stress and inner ear pathology by reviewing plasma vasopressin (an anti-diuretic stress hormone) and its receptor, V2 receptor, in the endolymphatic sac (an inner ear endo-organ for endolymph absorption) in patients with Meniere's disease.

著者

五島 史行 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.74, no.4, pp.299-301, 2015-08-31 (Released:2015-10-01)

参考文献数

6

被引用文献数

2

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

被引用文献数

2

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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.