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

---

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

---

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

---

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

---

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

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

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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

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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

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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

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

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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.