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.

著者

乾 崇樹 荒木 倫利 田中 朝子 服部 康人 竹中 洋

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.4, pp.198-206, 2010 (Released:2010-10-01)

参考文献数

21

被引用文献数

1

---

Seventeen patients with central vertigo that began with vertigo, seen between 2000 and 2008 at the Department of Otorhinolaryngology of Osaka Medical College Hospital, were investigated. The patients included 14 males and three females. Their mean age was 59.2 years (range 27-82). The cases consist of six cerebellar infarctions, two anterior inferior cerebellar artery (AICA) syndromes, two Wallenberg syndromes, two medial longitudinal fasciculus (MLF) syndromes, three other brain-stem infarctions, one viral encephalitis, and one acute cerebellar ataxia. Thirteen cases (77%) had a history of a disorder that might reduce the cerebral blood flow, and six (46%) had multiple risk factors. The mean interval between the appearance of symptoms and the first visit to our hospital was 6.5 days, and it took 3.8 days to reach a diagnosis. Eleven patients (65%) were transported to hospital by ambulance. Seven (41%) had a delayed neurological abnormality other than vertigo. Nystagmus that was seen at the first visit suggested central vertigo in seven cases and peripheral vertigo in seven cases. In four cases (24%), the nystagmus changed over time, and initially three patients had nystagmus that suggested peripheral vertigo. In some cases, we made the diagnosis based on a neurological abnormality other than vertigo. In other cases, the diagnosis was based on the discordance between the neuro-otological findings and disturbed equilibrium that was inconsistent with peripheral vertigo. When diagnosing central vertigo that began with vertigo, it is important to consider not only neurological abnormalities but also neuro-otological findings and a balance disorder that cannot reasonably be explained as peripheral vertigo.

著者

永井 賀子 小川 恭生 萩原 晃 大塚 康司 稲垣 太郎 河口 幸江 鈴木 衞 富山 俊一

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.74, no.2, pp.58-65, 2015-04-30 (Released:2015-06-01)

参考文献数

23

---

Autoimmune inner ear disease (AIED) was reported by McCabe in 1979 and was characterized by episodic vertigo and fluctuating hearing loss. Some patients develop total deafness and severe disequilibrium which disturbs their activities of daily living (ADL). Steroids or immune suppressing agents are used to control symptoms, but they have to be given repeatedly, because the symptoms tend to recur. We analyzed 22 AIED patients diagnosed by the presence of a 68kDa protein. The patients with low grade hearing loss showed some recovery of their hearing, However, hearing recovery was not noted in any patient with severe hearing loss. It is important to diagnose AIED and start treatment as soon as possible.

著者

渡辺 行雄 水越 鉄理 中川 肇 大井 秀哉 将積 日出夫 安村 佐都紀 中江 公裕 北原 正章 矢沢 代四郎 渡辺 勇

出版者

Japan Society for Equilibrium Research

雑誌

Equilibrium Research (ISSN:03855716)

巻号頁・発行日

vol.50, no.7, pp.1-10, 1991

被引用文献数

9 2

---

During the past 14 years from 1975 to 1989, two-nation-wide surveys of Meniere's disease have been carried out by the Vestibular Disorders Research Comittee of Japan, supported by the Ministry of Health and Welfare of Japan. However, an epidemiological case-control-study including normal subjects has not yet been performed by this committee.<BR>In this third survey, therefore, 148 patients with definite Meniere's disease, 138 with non-Meniere vertigo, 113 with rhinolaryngological disorders, and 165 normal control subjects were collected by the 16 mem-bers of the Research Committee from June 1990 to November 1990. The controls were selected to match as closely as possible the sex, age and location of the Meniere's disease patients.<BR>The characteristic epidemiological features of Meniere's disease in Japan were :<BR>1) Sex-ratio : 63 males to 85 female.<BR>2) Age-distribution : Peak at 40-49 years for males and 30-39 years for females.<BR>3) Season and Time of Onset : Often initial vertigo attacks occurred in the afternoon or in the morning.<BR>4) Occupational Distribution : There was a higher incidence of Meniere's disease among technicians or white-collar workers than among farmers, laborers engaged in blue-collar work, as in the 1st and 2nd surveys. However, the number of house-wives was lower in this 3rd survey.<BR>5) Personal characteristics : In patients with Meniere's disease, precisionism and neurosis were more frequently observed than in non-Meniere's vertigo.<BR>6) Preceding Events : Mental and physical fatigue before vertigo attacks was frequent in Meniere's disease patients.<BR>These epidemiological features reconfirm that the occurrence of vertigo attacks in Meniere's disease is influenced much more by individual factors than by environmental factors, as was found in the 1st and 2nd Nation-wide surveys. However, a marked difference in sex ratio with female preponderance was found in the 3rd survey.<BR>The incidence of bilateral Meniere's disease was 16.2% (24/148), higher than in the 1st and 2nd surveys.

著者

一條 宏明 朴沢 二郎 藤原 文明 西村 哲也

出版者

Japan Society for Equilibrium Research

雑誌

Equilibrium Research (ISSN:03855716)

巻号頁・発行日

vol.47, no.4, pp.414-419, 1988

被引用文献数

1

---

This study was performed to determine the influence of repeated rotatostimulation on the vestibulo-ocular reflex. Three figure skaters and three ballet dancers with careers of more than 10 years were examined by two rotation tests with Contraves' computerized rotary chair on the same day. The two tests were Trapezoid Rotation (TR) test (±2, 4, 6, 8, 10°/sec<SUP>2</SUP>, 10″) and Sinusoidal Harmonic Acceleration (SHA) test (0.01, 0.02, 0.04, 0.08, 0.16 Hz).<BR>1) The TR test showed that skaters and ballet dancers had equivalent values of VOR-Gains as the average of healthy untrained subjects.<BR>2) VOR-Gains measured by the SHA test were lower than the average of healthy untrained subjects.The difference was most clearly noticed with rotations of 0.16Hz.<BR>3) No subjects showed vestibular asymmetry, except for one subject who showed directional preponderance to the left.<BR>4) Nystagmus duration measured by the TR test was within the normal range.

著者

加藤 巧 伏木 宏彰

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.76, no.2, pp.79-83, 2017-04-30 (Released:2017-06-01)

参考文献数

8

被引用文献数

1

著者

菅澤 恵子

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.72, no.2, pp.112-115, 2013 (Released:2013-06-01)

参考文献数

12

著者

福田 正人

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.69, no.1, pp.1-15, 2010 (Released:2010-04-01)

参考文献数

56

被引用文献数

1 3

---

Objective: Near-infrared spectroscopy (NIRS) has been increasingly employed in psychiatry for functional neuroimaging studies of sleepiness, fatigue, personality, aging, brain activation time course, transcranial magnetic stimulation effects, and psychiatric disorders such as schizophrenia, mood disorders, panic disorder, and eating disorder, owing to its advantages over fMRI and PET such as complete noninvasiveness, small apparatus for measurements, and the natural setting for its examination.Methods: Characteristics of frontal lobe function were investigated using multichannel NIRS machines in schizophrenia, unipolar depression, and bipolar depression. Changes of oxygenated-hemoglobin concentration (oxy-Hb) were monitored every 0.1s during a verbal fluency task using a Hitachi ETG-100 and ETG-4000 system with the probes placed on the subjects' frontal and temporal regions.Results: Three psychiatric groups demonstrated different patterns of oxy-Hb changes from those in the control group. The schizophrenic group was characterized by a reduced oxy-Hb increase during the task period followed by an oxy-Hb re-increase during the post-task period, the unipolar depression group by a smaller oxy-Hb increase, and the bipolar depression group by a comparable but delayed oxy-Hb increase.Conclusion: The observed patterns of oxy-Hb changes suggest the characteristics of reactivity of frontal lobe function: inefficient, reduced, and preserved but delayed in schizophrenia, unipolar depression, and bipolar depression, respectively. NIRS can be employed as a clinical laboratory test for diagnosis and treatment of psychiatric disorders in the near future.

著者

土井 勝美

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.73, no.1, pp.8-15, 2014-02-28 (Released:2014-04-01)

参考文献数

23

---

Meniere's disease is characterized by intermittent episodes of vertigo lasting from minutes to hours, with fluctuating sensorineural hearing loss, tinnitus, and aural pressure. The primary histopathological correlate is endolymphatic hydrops. Several medical and surgical treatments have been offered to patients with Meniere's disease. It has been confirmed that no one effective treatment is available for these patients. According to the severity of the patients' symptoms, appropriate therapeutic strategies should be selected. If medical therapies including lifestyle change, diuretics, and local/systemic steroids have failed, then surgical approaches such as intratympanic gentamicin perfusion (GM), pressure pulse treatment with Meniett®, endolymphatic sac surgery (ESS) and vestibular neurectomy (VN) should be considered. Most reviews have reported relative good (80-100%) vertigo control rates with either GM, Meniett®, ESS, or VN, however, recurrence of vertigo has been noticed in certain cases. A combination of medical and surgical strategies should be recommended and the treatment algorithm for Meniere's disease indicated in “2011 Clinical practice guidelines for Meniere's disease” must be adopted.

著者

小林 泰輔 岡田 昌浩

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.68, no.3, pp.131-137, 2009 (Released:2009-08-01)

参考文献数

15

被引用文献数

3 1

---

We report on two cases of cerebellar infarction in the territory of the medial branch of the posterior inferior cerebellar artery (mPICA) mimicking acute peripheral vertigo. Case 1 was a 54-year-old man with WPW syndrome presenting with sudden vertigo. When he was admitted to our hospital, he had direction fixed horizontal nystagmus towards the left. His symptom disappeared in several days, however, MRI revealed a haemorrhagic infarct in the territory of the right mPICA. Case 2 was a 47-year-old man who was admitted with sudden rotatory vertigo. Direction fixed horizontal nystagmus towards the right was noted and head CT was normal. The nystagmus disappeared on the 5th day of the illness and caloric testing did not show canal paresis. Because of prolonged gate ataxia, a CT scan was performed again. It showed a cerebellar infarction and MRI revealed a cerebellar infarction of the left medial hemisphere and vermis. Infarcts of mPICA sometimes cause acute vertigo presenting horizontal direction fixed nystagmus mimicking peripheral vertigo. In a patient presenting with acute vertigo, head MRI should be performed when he or she has history of risk factor for cerebellar infarction such as diabetes mellitus, ischemic heart disease, and so on. The patients with prolonged ataxia and headache should also undergo MRI.

著者

坂田 英治

出版者

Japan Society for Equilibrium Research

雑誌

Equilibrium Research (ISSN:03855716)

巻号頁・発行日

vol.51, no.2, pp.219-225, 1992 (Released:2009-12-07)

参考文献数

18

---

It is generally accepted that positional vertigo might result both from lesions in the central nervous system and from lesions in the peripheral vestibular organ. In 1921, Bardny described a characteristic paroxysmal vertigo and nystagmus occurring in a certain critical position, and he suggested that the pathogenesis of this condition was related to otolith disease. In 1952, Dix and Hallpike described positional vertigo of the benign paroxysmal type (BPPN) due to a disorder of the otolith. This nyatagmus is very characteristic and nowadays is widely accepted among clinicians as a nystagmus due to otolith lesions. Furthermore, this characteristic nystagmus has become one of the most reliable signs for diagnosing vertigo due to disorder of peripheral vestibular organs. Although there have been numbers published papers describing positional vertigo due to lesions within the central nervous system (Bruns, 1902 ; Alpers and Yaskin, 1944 ; Allen and Fernandez, 1960 ; Fernandez and Alzate, 1960 ; Sakata u. a., 1979 ; Sakata, Ohtsu and Takahashi, 1984), most of these cases are not of the benign paroxysmal type. Recently, we have treated several patients with typical nystagmus of the benign paroxysmal ty-pe due to lesions in the cerebellar vermis. We discussed the differential diagnosis of BPPN, Pseudo-BPPN and MPPN.

著者

岡田 智幸

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.201-219, 2018-08-31 (Released:2018-10-02)

参考文献数

83

---

Congenital nystagmus (CN) is known as an involuntary to-and-fro movement of the eyes characterized by a wide variation in waveforms ranging from jerk to pendular types. CN is presumed to be present at birth. In antiquity, midwives or shaman occasionally noticed CN. The first description of CN, popularly known in china as “shiji,” was made around 2000 years ago. Despite its various waveforms, people with CN do not develop visual symptoms and rarely complain of oscillopsia. CN can be idiopathic but is most likely caused by gaze stability, although some reports have suggested familial cases. No detailed mechanisms have been proposed to explain the generation of CN waveforms in people with CN in whom the vestibulo-ocular reflex (VOR) cannot be established. The vestibular time constant showed a good correlation between VOR and perception in normal subjects when assessed using perceptual measures. The time constant (TC) of decay of vestibular sensation in individuals with CN was half the duration of the TC found in normal subjects. Thus, individuals with CN have short vestibular time constants, probably due to changes induced in velocity storage processing by the persistent retinal image motion present in individuals with CN. There is a fascinating paper showing that FRMD7, also known as the CN gene, is necessary for optokinetic nystagmus (OKN) in humans and mice. In the retina of FRMD7-mutant mice, horizontal direction selectivity and asymmetry of inhibitory inputs to horizontal direction-selective retinal ganglion cells (HDSCs) are both lost. This could be a hidden essential characteristic of CN. HDSCs are responsible for horizontal OKN and project to the nucleus of the optic tract (NOT), and NOT, in turn, is related to the velocity storage mechanism, vestibular adaptation, and habituation. Inversion of OKN and suppression of nystagmus with eye closure are characteristics of CN. Both of these features can be explained by abnormalities in HDSCs. So, HDSCs can only play the role in the light. In the future, innovative ideas could help to elucidate the nature of CN.

著者

岸田 杏子 野村 泰之 地家 真紀 御子柴 郁夫 岸野 明洋 木村 優介 三浦 正稔 戸井 輝夫 増田 毅 鴫原 俊太郎 大島 猛史

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.78, no.3, pp.157-163, 2019-06-30 (Released:2019-08-02)

参考文献数

15

被引用文献数

1 1

---

Purpose: This present study was aimed at evaluating the effects of our original teaching method called “Bang Bang, Hu, Kacha” on the learning efficiency. Methods: We invented this method, which involves hand modulation and vocalization of words, for medical students to enable them to easily understand and memorize the anatomy of the inner ear and vestibular organs. We evaluated its effectiveness based on self-completed questionnaires by the students. Results: The results suggested that the comprehension level of the 30 medical students of the anatomy of the inner ear organs, especially the positional relationships of the semicircular canals and cochlea improved dramatically after they underwent training using this methodology. The medical students assigned high scores to this relational hand modulation method. Conclusion: This “Bang Bang, Hu, Kacha” method seemed to be a very useful for medical education, and allowed easy comprehension and memorization of the inner ear and vestibular anatomical structures.

著者

佐藤 豪

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.80, no.3, pp.210-215, 2021-06-30 (Released:2021-08-04)

参考文献数

19

被引用文献数

2

---

Bilateral vestibulopathy is characterized by bilateral functional impairment of the peripheral vestibular system. The usual symptoms are persistent unsteadiness and oscillopsia during head and body movements. It has been reported that sensory substitution therapy, that is, vestibular rehabilitation using a sensory substitution device, which transmits other sensory information to a stimulator as a substitute for defective vestibular information, might be effective in patients with bilateral and unilateral vestibulopathy. Recently, we developed a new wearable device, TPAD (tilt perception adjustment device), that transmits vibratory input containing head-tilt information to the mandible as a substitute for defective vestibular information. We assessed the patient using the dizziness handicaps inventory (DHI), gait analysis, and visual/somatosensory dependence of postural control in the patients with unilateral vestibulopathy. Three months after therapy in patients with unilateral vestibulopathy, the DHI and walking speed improved even when the subjects were not wearing the TPAD. Moreover, the index of the visual dependence of posture control that was evaluated by posturography with/without foam rubber in the eyes open or closed condition decreased. The findings suggested that the sensory vibratory substitution with a TPAD for defective vestibular information induced brain plasticity related to sensory re-weighting to reduce the visual dependence of posture control, resulting in the improvement of dizziness and imbalance even while not wearing the TPAD in vestibulopathy patients. We then investigated the effects of sensory substitution therapy using a TPAD in patients with bilateral vestibulopathy and normal subjects. Three months after sensory substitution therapy in patients with bilateral vestibulopathy, the DHI and area with eyes closed measured by posturography improved even when the subjects did not wear a TPAD. However, the gait parameters improved only under the condition of wearing a TPAD. These findings suggest that sensory vibratory substitution with a TPAD might serve as temporary replacement for defective vestibular information in patients with bilateral vestibulopathy. Moreover, wearing of the TPAD improved posture control under the eyes-closed condition with foam rubber measured by posturography in normal subjects. TPAD might be applicable as a wearable device for improving posture control, not only in patients with bilateral vestibulopathy, but also in those with presbyvestibulopathy.

著者

佐伯 忠彦 暁 清文 山中 栄三 柳原 尚明

出版者

Japan Society for Equilibrium Research

雑誌

Equilibrium Research (ISSN:03855716)

巻号頁・発行日

vol.47, no.4, pp.428-433, 1988 (Released:2009-10-20)

参考文献数

15

被引用文献数

1

---

Vestibular findings were studied in 27 patients with acoustic neurinoma. Four of them had experienced vertigo and/or dizziness at the onset of the disease, and 14 other patients had these complaints during the course. Vestibular symptoms were more prominent with middle-sized tumors which extended to the posterior cranial fossa than with those in the internal auditory canal. Although most acoustic neurinomas originate from the vestibular nerve, the incidence of vestibular symptoms is rather infrequent. This is probably due to a compensating mechanism of the central nervous system while the tumor grows slowly. Therefore, the growth rate of the tumor is considered to be most important for the concomitance of vestibular symptoms. The origin of the tumor was identified in 13 cases; in 3 it was from the inferior vestibular nerve and in 10 from the superior vestibular nerve. No significant difference in caloric test results could be seen between the tumors of different origins. The incidence of vestibular symptoms was more frequent when the tumor originated from the superior vestibular nerve than from the inferior vestibular nerve. The recover time required from the dysequilibrium after extirpation of the tumor depended on the degree of preoperative vestibular function.

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.57, no.suppl-13, pp.1-103, 1998 (Released:2009-06-05)

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.79, no.6, pp.566-568, 2020-12-31 (Released:2021-02-02)

参考文献数

5

被引用文献数

1 1

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.5, pp.289-469, 2022-10-31 (Released:2023-01-11)

著者

田岡 俊昭

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.68, no.3, pp.113-118, 2009 (Released:2009-08-01)

参考文献数

9

---

CT and MRI are indispensable for routine medical examination of neurovascular disorders. This article describes the imaging findings in acute infarction and carotid plaques, knowledge of which is essential for clinics of equilibrium disorders. Diffusion-weighted images are indispensable for detecting acute infarction, and perfusion MRI also yields important information about the ischemic status. Carotid bifurcation is one of the frequent sites of involvement in atheromatous diseases. A variety of imaging modalities are available for the evaluation of carotid plaques, including conventional contrast angiography, CT, ultrasound, and MRI. MRI is a non-invasive imaging method that reflects the chemical composition, concentration, water content or physical status of the tissues examined.