著者

鈴本 典子 五島 史行 齋藤 弘亮 金田 将治 関根 基樹 大上 研二 飯田 政弘

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.541-548, 2020

被引用文献数

1

---

<p> Dizziness can arise from diverse causes. According to reports, 20%-80% of patients presenting with vertigo have psychogenic vertigo. Diagnosis of psychogenic vertigo is not always easy. Until date, there is no objective examination tool for the diagnosis of psychogenic vertigo. Therefore, it is important for physicians to evaluate patients presenting with vertigo both physically and psychologically in order to make a definitive diagnosis of psychogenic vertigo. Posturography is the conventional method for evaluating the postural perturbation in patients with vertigo or dizziness, and there are many ways of analyzing the results of posturography. One such method is with the use of the "gravichart," and a characteristic finding in patients with psychogenic vertigo is a teardrop-shaped "gravichart." However, the detailed characteristics of patients showing the teardrop-type "gravichart" are still unknown. In this study, we attempted to identify the clinical importance of the teardrop-shaped "gravichart" in patients with psychogenic vertigo. While many patients with a teardrop-shaped "gravichart" are diagnosed as having psychogenic vertigo, not all patients with psychogenic vertigo show a teardrop-shaped "gravichart". Thus, while a teardrop-shaped "gravichart" may be useful for the diagnosis of psychogenic vertigo, it is necessary to clarify what types of patients with psychogenic vertigo show a teardrop-shaped "gravichart" in a future study.</p>

著者

飯島 淳彦

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.3, pp.194-199, 2012 (Released:2012-08-01)

参考文献数

10

---

Audio-visual technological innovation has drastically changed our visual environments. Our visual system receives an overload of visual information in our daily lives. Visual stimuli, especially unsteady video images taken with shaking hands can induce motion sickness and cause nausea and headache as autonomic dysfunctions. We analyzed autonomic functions such as pupillary responses, heart rate, and blood pressure during movie presentations. Sympathetic hyperactivity was observed in the affected subjects. Pupillary responses signify autonomic activities clearly with non-invasive methods. We applied pupillometry for evaluation of stressed subjects and diagnosis of neurological diseases. We observed parasympathetic nervous dysfunction in those subjects. Evaluations of the relationship between visual and autonomic functions could be a potential marker for understanding the visual-autonomic systems.

著者

清水 謙祐 鳥原 康治 中山 明峰 福留 真二 佐藤 伸矢 東野 哲也

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.96-102, 2012 (Released:2012-06-01)

参考文献数

14

被引用文献数

2 1

---

We report herein on psychiatric comorbidity in patients with dizziness in a psychiatric hospital with an otolaryngologist. Psychiatric comorbidity was revealed in 270 (68.9%) of 392 patients with dizziness. Of 270 patients with dizziness and psychiatric comorbidity, anxiety disorders were revealed in 149 (55.2%), mood disorders in 36 (13.3%), somatoform disorders in 5 (1.9%) and adjustment disorders or post-traumatic stress disorder in 15 (5.5%) but in addition organic mental disorders were also seen in 21 (7.8%) and schizophrenia in 15 (5.6%). Phobic postural vertigo was diagnosed in 30 (7.7%). These patients were not only treated by otolaryngologists, but also received psychiatric therapy or were prescribed psychotropic drugs. We believe that cooperation between psychiatrists and otolaryngologists in hospitals or regions can improve the mental condition and quality of life in patients suffering from dizziness with psychiatric comorbidity.

著者

野口 佳裕 伊藤 卓 川島 慶之 西尾 綾子 本田 圭司 喜多村 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.72, no.2, pp.97-106, 2013 (Released:2013-06-01)

参考文献数

40

---

Enlargement of the vestibular aqueduct (EVA) is the most common malformation of the inner ear. EVA can be observed in various disorders including DFNB4/Pendred syndrome, branchio-oto-renal/branchio-oto (BOR/BO) syndrome, and distal renal tubular acidosis (dRTA). Characteristic phenotypes of EVA include progressive, fluctuating hearing loss (HL), and repetitive vertigo. In this study, we compared the audiovestibular findings in patients with mutations of SLC26A4, ATP6V1B1 or SIX1 to clarify whether the anatomical enlargement itself was related to the characteristic phenotypes. We enrolled five Pendred syndrome patients with SLC26A4 mutations, one dRTA patient with ATP6V1B1 mutations and two BO syndrome patients with a SIX1 mutation. One patient with a SIX1 mutation showed unilateral EVA, and the others had bilateral EVA. All five patients with SLC26A4 mutations had progressive HL, fluctuating HL and/or repetitive vertigo. A patient with ATP6V1B1 mutations also showed repetitive progression HL, fluctuating HL and repetitive vertigo. Fluctuating HL and repetitive vertigo were not recognized in two patients with SIX1 mutation, although one patient showed slight progression of HL. There were no significant positive associations in patients with SLC26A4 mutations between EVA widths and pure tone averages, and the widths and maximum slow phase velocities. These findings suggested that EVA itself had no relationship with either progressive, fluctuating HL, nor repetitive vertigo. The product of SLC26A4, the Cl-/HCO3- exchanger pendrin, and the product of the ATP6V1B1, B1-subunit of H+-ATPase, can play a role in the maintainance of endolymph pH homeostasis. Therefore, a disruption of endolymph pH homeostasis can be associated with the characteristic phenotypes.

著者

佐藤 宏昭

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.77, no.3, pp.188-193, 2018-06-30 (Released:2018-08-01)

参考文献数

35

被引用文献数

1

---

Acute low-tone sensorineural hearing loss (ALHL) is the most common among the causes of acute sensorineural hearing loss. It is well known that some cases of ALHL eventually develop typical or atypical Meniere's disease. Recently, gadolinium-enhanced inner ear MRI has revealed that endolymphatic hydrops is frequently seen not only in Meniere's disease, including the atypical type, but also in cases of ALHL. Therefore, it can be said that one of the fundamental differences between ALHL and Meniere's disease is whether the condition is episodic or not. We propose to conduct a re-evaluation in the future of the classification of the causes of primary endolymphatic hydrops, such as ALHL and Meniere's disease, by gadolinium-enhanced inner ear MRI, as proposed by Gürkov.

著者

池園 哲郎

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.72, no.4, pp.215-221, 2013-08-31 (Released:2013-10-01)

参考文献数

6

被引用文献数

2 4

---

The perilymphatic fistula (PLF), defined as an abnormal communication between the inner and middle ear, presents a symptomatology of hearing loss and vestibular disorders that is indistinguishable from a number of other inner ear diseases. The methods for diagnosis remain controversial. We have shown that the protein, Cochlin-tomoprotein (CTP), was selectively detected in the perilymph and established a definite diagnostic test for PLF using CTP as a biochemical marker, and have proved high reliability of the diagnostic performance of the test. In the Japanese PLF study group, the diagnostic criteria proposed in 1983 were revised. The definite diagnosis criterion is now based on the visual identification of the fistula (not a leakage) and/or detecting CTP from the middle ear lavage (MEL). We describe herein and discuss the summarization of the characteristics of PLF revealed by our CTP detection test.

著者

平野 丈夫

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.70, no.2, pp.104-109, 2011 (Released:2011-06-01)

参考文献数

22

---

The vestibulo-ocular reflex (VOR) and optokinetic response (OKR) work cooperatively to compensate for the eye position during head movement. The floccular region of the cerebellar cortex regulates the amplitude and timing of these reflexes through the inhibitory synaptic outputs of Purkinje neurons. Both the VOR and OKR undergo adaptive changes, when the retinal slip causing the blur of visual image occurs continuously. Long-term depression (LTD), a type of plasticity at the synapses between parallel fibers and a Purkinje cell, in the flocculus, has been proposed to contribute to the adaptation of VOR and OKR. The progress in the study on cerebellar LTD has revealed numbers of molecules involved in LTD. Glutamate receptor-like molecule δ2 (GluD2) and delphilin are proteins specifically expressed at the postsynaptic membrane of Purkinje neurons and involved in LTD. GluD2 knockout mice show failure of LTD induction and impaired adaptation of VOR and OKR. On the other hand, delphilin knockout mice show facilitation of the LTD induction and the enhanced adaptation of OKR. These results suggest that the cerebellar LTD is involved in the adaptation of reflex eye movements. In addition, a delayed OKR is observed in the GluD2 knockout mice, which seems to be caused by the abnormal Purkinje neuron activities.

著者

野口 佳裕

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.71, no.4, pp.247-251, 2012 (Released:2012-10-01)

参考文献数

26

被引用文献数

1

著者

荻原 啓文 加茂 智彦 田中 亮造 加藤 巧 遠藤 まゆみ 角田 玲子 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.79, no.4, pp.218-229, 2020-08-31 (Released:2020-10-01)

参考文献数

29

被引用文献数

5

---

This study was aimed at (1) determining the risk of falls in patients with chronic dizziness/vertigo using the Timed Up and Go test (TUG), Dynamic Gait Index (DGI), Functional Gait Assessment (FGA), and Activities-specific Balance Confidence (ABC) scale, and (2) investigating the correlations and agreements among the measurements results of assessment by the aforementioned methods in these patients. A total of 52 patients with dizziness/vertigo were included in the study, and the risk of falls in these patients was evaluated by the TUG, DGI, FGA, and ABC scale. We analyzed the correlations and agreements in the fall risk assessed by the aforementioned methods using Spearman's rank correlation and kappa statistics. Of the 52 patients, 11 (21.2%), 26 (50%), 29 (55.8%), and 18 (34.6%) patients were assessed as being at a risk of falls by the TUG, DGI, FGA, and ABC scale, respectively. The results of the assessments by the above methods showed significant good correlations and agreement. However, the kappa coefficients for some results were low (TUG-DGI: k=0.423, TUG-FGA: k=0.351, TUG-ABC scale: k=0.299, DGI-FGA: k=0.885, DGI-ABC scale: k=0.385, and FGA-ABC scale: k=0.294). Risk factors for falls in patients with dizziness and vertigo include disturbances of psychological balance and gait. Multiple methods to assess the fall risk may yield more accurate results than assessment by one method alone.

著者

許斐 氏元

出版者

一般社団法人 日本めまい平衡医学会

雑誌

Equilibrium Research (ISSN:03855716)

巻号頁・発行日

vol.76, no.4, pp.286-291, 2017-08-31 (Released:2017-10-01)

参考文献数

40

被引用文献数

1 1

著者

三輪 徹 蓑田 涼生

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.78, no.2, pp.93-101, 2019-04-30 (Released:2019-06-04)

参考文献数

22

被引用文献数

1 3

---

Past major earthquakes have been associated with an increase in the prevalence of vertigo or dizziness; the 2016 Kumamoto earthquakes on April 14 and 16 (JST, moment magnitude=7.0, Shindo 7 [Japanese seismic scale]) and the large numbers of aftershocks were no exception. Several months after the initial earthquake, significant outbreaks of vertigo or dizziness occurred over a large area surrounding the epicenter of the earthquake. However, it is unclear why major earthquakes cause these symptoms. After the major earthquake in Kumamoto, we conducted a questionnaire and medical records survey to investigate post-earthquake dizziness (PED). This survey covered a total of 575 subjects who complained of exacerbation of vertigo or dizziness after the earthquake and visited the hospital for follow-up before the scheduled dates. Our results showed that the number of patients with vertigo or dizziness who visited the hospital increased after the earthquake, and peaked between 2 and 4 weeks after the earthquake. The timing of onset of vestibular disorders varied according to the underlying disease. This study also suggested that earthquake-related psychological stress or stress resulting from earthquake evacuation could cause the onset of some vestibular disorders. We speculated that PED could be caused by stimulation of the vestibular and visual systems and bathyesthesia, psychological stress, potential effects of autonomic stress on the equilibrium function, and/or sensory mismatch. Our study could contribute to establishing PED as a new concept in the area of vestibular disorders.

著者

菊地 正弘 内藤 泰

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.66-75, 2010 (Released:2010-06-01)

参考文献数

37

被引用文献数

1

---

Imaging studies in humans have confirmed the existence of several separate and distinct vestibular cortical areas, which had been identified earlier by tracer and electrophysiological studies in experimental animals. The most robust cortical vestibular structures in monkeys are the parieto-insular vestibular cortex (PIVC), the visual temporal sylvian area (VTS) in the retroinsular cortex, the superior temporal gyrus (STG), the inferior parietal lobule (IPL), the anterior cingulum, the hippocampus and area 6a. All belong to a multisensory vestibular cortical circuit. The PIVC seems to be a dominant multi-modal vestibular cortex area in monkeys and it is considered the ’core region’ within this network. During the last 10 years, many positron emission tomography (PET) and functional magnetic resonance imaging (fMRI) studies using vestibular, somatosensory and visual optokinetic stimulation have revealed that such multisensory vestibular cortical areas are located in similar sites in humans. In addition, a reciprocal inhibitory cortical interaction has been observed between different sensory systems, such as the inhibitory visual-vestibular interaction. This interaction provides a powerful means for shifting the dominant sensorial weight from one modality to the other for resolving conflicts between incongruent sensory inputs. In this article, fMRI studies on cortical processing of vestibular sensation and spatial orientation were reviewed.

著者

中山 明峰 佐藤 慎太郎

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.75, no.3, pp.91-98, 2016-06-30 (Released:2016-08-01)

参考文献数

41

---

Dizziness may be caused by multiple factors including unknown reasons. It is well known that insomnia is associated with increased psychological symptomatology and perceived stress, higher predisposition to arousal, and greater impairments to quality of health. The relationship between dizziness and stress is well documented, but that between dizziness and insomnia is unclear. In this series, we focus on Ménière's disease, which is characterized by fluctuating and progressive hearing loss, aural fullness, tinnitus, and intermittent attacks of vertigo, an illusory sensation of movement resulting from dysfunction of the labyrinth and cochlea, to investigate the relation between sleep disorders and dizziness. In our previous report, we first found that the sleep quality of Ménière's disease patients was impaired. Ménière's patients have a longer total sleeping time, lack of deep sleep stages, increased arousal, and the combination with obstructive sleep apnea syndrome and/or periodic limb movement disorder was occasionally noted. Poor quality of sleep may cause additional stress and lead Ménière's disease patients into a negative spiral of symptoms. Furthermore, poor sleep quality may result in Ménière's disease patients being refractory to medical management. Therefore, prospective treatment focusing on the sleep disorders of, not just Ménière's disease but possibly also dizziness symptoms, may become an additional new strategy for terminating the negative spiral of symptoms and reduce exacerbation of the affected patient's conditions.

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.75, no.4, pp.201-204, 2016

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

被引用文献数

7

---

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."<br> 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.<br> 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

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.67, no.3, pp.170-181, 2008 (Released:2008-08-01)

参考文献数

33

被引用文献数

5 1

---

The purpose of this paper is to give an account of the vestibular nuclei from the point of view of phylogeny, behaviors, and neural networks of the vestibular nuclei. In the early vertebrates, the vestibular endorgans developed by isolation of the lateral line organ from the body surface. Although vestibular control based on inertial inputs works ideally under a stationary space, it breaks down in moving spaces. To compensate for the shortcoming, discomfort (motion sickness) was utilized to avoid moving spaces. Along with progress of locomotion, the vestibular cerebellum developed as a supplementary route of the vestibular nuclei to stabilize the gaze and posture; the flocculus for visual-inertial integration, and the uvula-nodulus for gravito-inertial integration. Further, the vestibular cerebellum (vermis) and the somatically arranged lateral vestibular nucleus developed for coordination of posture and four-limb locomotion. The superior vestibular nucleus is distributed centrally by the canal fibers and flocculus fibers of visual origin, and peripherally by the uvula-nodulus fibers of otolith origin. The nucleus carries spatial rotation with gravito-inertial axis to the ocular motor nuclei. Body balance is maintained by a somatic-to-spatial transformation of the coordinates, that is, transfer of contents of the cerebellum-fastigial-and-vestibular nuclues routes to the vestibular nucleus-motor nucleus routes. Thus, gaze and posture are stable when spatial coordinates remain still in space, but they become unstable when the coordinates are moving in space.

著者

鈴木 法臣 守本 倫子 五島 史行

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.89-93, 2015-04-30 (Released:2015-06-01)

参考文献数

9

---

Pediatric subjects with vertigo are rare in Japan. Benign paroxysmal vertigo (BPV) is a frequent disease similar to orthostatic hypotension. We report herein on a case of BPV in which psychological dizziness had previously been diagnosed. A 5-year-old girl visited our hospital complaining of repeated attacks of vertigo for 3 years. She had intermittent strabismus, and the result of her stabilometry showed functional symptoms, so the doctor who had treated her previously at the age of 4 diagnosed psychological dizziness with visual influence, and observation was started. Her symptoms persisted for 12 months however, and she visited our hospital. Her equilibrium and neurological status were examined. And we asked her family about the situation at the time of attack in detail. Based on the interview, we discovered that she felt fear at the time of attacks, and her family had a history of migraines. Based on our finding, we diagnosed her as having BPV. Vestibular rehabilitation on its own effected a cure. History taking is so important in the diagnosis of BPV, so that we may fully understand the diagnostic criteria prior to examination of pediatric subjects with vertigo.

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.67, no.3, pp.222-227, 2008 (Released:2008-08-01)

参考文献数

8

---

The genetics of Meniere's disease (MD), including the KCNE genes, COCH gene, and HLA genes, was reviewed and discussed. Single nucleotide polymorphisms (SNPs) in the KCNE genes might determine the susceptibility to MD. Variations in the HLA genes may also be related to the development of MD. To identify more genes that might possibly be closely related to the development of MD, gene profiling of human endolymphatic sac (ES) harvested from MD patients and vestibular schwannoma (VN) patients was performed using a DNA micro-array technique. Many up- and downregulated genes in the ES harvested from the MD patients were identified. The genes were classified into several subgroups according to their physiological functions. Some potassium channel genes, including Kir4.1, and several stress-related genes were significantly downregulated in the ES harvested from the MD patients. In future, genetic studies of MD will make it possible to determine more genes whose mutations/variations could lead to the development of MD, which would make possible the invention of a DNA-Chip for the diagnosis of MD. Such a DNA-Chip might be applied clinically to prevent MD, predict individual patients' prognosis and apply the most suitable treatment for individual patients.

著者

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.77, no.6, pp.525-531, 2018-12-31 (Released:2019-02-01)

参考文献数

21

---

The history of clinical studies on vestibular migraine (migraine associated vertigo) was reviewed. Archeological studies suggested that headache itself had already existed in the Neolithic era, because bony defects in the skull which could have arisen from trepanation had been found in the remains of this era. Medical observations on migraine were made by Hippocrates of Kos, and Aretaeus of Kappadocia described migraine-associated vertigo in the 2nd century A.D. Studies on migraine and migraine-associated vertigo (vestibular migraine) began in the modern era. As hypotheses on the pathophysiology of migraine, three theories have been proposed, including the vascular theory, the neural theory, and the trigemino-vascular theory. As important articles concerning the clinical studies, three papers were published. The first was published by Bickerstaff. He reported cases of basilar-type migraine, in which vertigo occurs as an aura of migrainous headache. The second was published by Kayan and Hood. In this paper, the authors described various characteristics of vestibular migraine, which are still valid. The third was published by Neuhauser et al., in which the authors proposed diagnostic criteria for vestibular migraine, which serve as the basis for the current official diagnostic criteria. Finally, the author remarked that clarification of the pathophysiology of vestibular migraine and association with Meniere's disease are the most important issues that need to be resolved.

著者

五島 史行

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.228-233, 2016-08-31 (Released:2016-10-01)

参考文献数

13

被引用文献数

2

---

Headaches are a similar physical complaint to dizziness that is a functional disorder and it is difficult to ascertain any physical abnormality in such subjects. In addition, both of the symptoms may be caused by a possible fatal illness. Headaches are quite common in healthy subjects and it is a common comorbid disorder with dizziness. We found out that 163 (40%) of 403 patients with intractable dizziness complained of some type of headache. So far the relationship between headache and dizziness has not been intensively investigated. One reason for this is that the physicians who are specialized in vestibular disorders usually focus on the dizzy symptom and do not have much interest in the comorbid headache in the same patient. Recently the relationship between migraine and dizziness has attracted more interest than before and the diagnostic criteria of vestibular migraine have been proposed by the ICHD (International Classification of Headache Disorders). It is important to have basic knowledge concerning headaches to understand the vestibular migraine. Migraine and tension type headaches are important primarily headache disorders. It is well known that the patients with migraine are at a higher risk of having dizziness as a complaint. When we treat the dizzy patients with headache, it is important to identify the type of the comorbid headache. The prophylactic treatment is more important than the acute treatment. The point is to promote the life style change and pharmacotherapy. The first line of medical treatment is a Ca blocker, such as lomerizine hydrochloride, followed by valproic acid, and amitriptyline. Collaboration with headache specialists is also an important strategy.