著者
古川 朋靖 渡辺 道隆 山川 卓也 正木 義男 加納 昭彦 市川 銀一郎
出版者
Japan Society for Equilibrium Research
雑誌
Equilibrium Research (ISSN:03855716)
巻号頁・発行日
vol.57, no.5, pp.480-486, 1998 (Released:2009-10-13)
参考文献数
15

IntroductionFor transcranial magnetic stimulation of the facial nerve, a magnetic coil is fixed to the temporal region over the nerve. It has been reported that the facial nerve can be stimulated at the distal part of the auditory canal, and it is expected that the peripheral vestibular organs are included in the time-varying magnetic field. We examined the influence of magnetic stimulation on the peripheral vestibular organs using a stabilometer.MethodsExperiments were carried out on 10 healthy adults. Magnetic stimulation was administered to the temporal region including the peripheral vestibular organs and stabilometry was performed before and after stimulation. We used a G5500 system stabilometer (Anima Co.) with a sampling time of 20 msec. and recorded body sway for 60 sec. A Mag lite (Dantec Co.) was used for magnetic stimulation and a Synax ER 1100 (NEC-Sanei Co.) was used as the trigger. The stimulus was set at 4 Hz and stimulation was done 60 times. The output was set at about 40% of 1.9 Tesla (maximum output).ResultsWe analyzed the body sway length, 8-directional body sway velocities, and the power spectrum of the lateral body sway velocity. The total length of body sway and the velocity of lateral sway increased significantly after magnetic stimulation.
著者
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
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
栗花落 昌和 瀬尾 徹 森 裕司 阪上 雅史
出版者
Japan Society for Equilibrium Research
雑誌
Equilibrium Research (ISSN:03855716)
巻号頁・発行日
vol.54, no.6, pp.559-564, 1995 (Released:2009-06-05)
参考文献数
25
被引用文献数
1

Since he received a stranglehold during a judo bout, the patient had experienced repeated episodes of paroxysmal vertigo. The patient was a 16-year-old male with a chief complaint of horizontal oscillating vision. Plain X-ray examination during the initial consultation did not show a definite fracture of the styloid process. Balance testing disclosed no significant finding. Helical scan CT delineated a fracture in the center of the left styloid process and anterior deviation of the fractured segment.The mechanisms of oscillopia in this patient were considered to be the following; 1) the fractured segment of the styloid process stimulated the tensor muscle of the velum palatini causing a spasm, and induces symptoms of the inner ear, which is similar to the mechanism of Costen syndrome. 2) the fractured segment stimulated the autonomic nerves near the carotid artery, especially the vagal nerve when he raised his head, and induces transient hypotension, which caused an ischemic brain stem lesion.The present case was an extremely rare case involving a fracture of the styloid process with paroxysmal vertigo.
著者
國弘 幸伸
出版者
Japan Society for Equilibrium Research
雑誌
Equilibrium Research (ISSN:03855716)
巻号頁・発行日
vol.63, no.6, pp.533-548, 2004 (Released:2009-06-05)
参考文献数
87
被引用文献数
13

The subjective visual vertical (SVV) signifies the visually determined gravitational vertical. The measurement of SVV is clinically used as a method to assess the degree of dysfunction in the otolith, primary vestibular nerves, and central graviceptive pathways.Perception of vertical, however, does not depend solely on the function of those pathways, but is affected by various factors such as visual information, head position relative to gravity, and linear acceleration forces acting on the gravity vector. In addition, it undergoes a kind of 'vestibular compensation', that is, the tilt of SVV decreases within days to weeks even if the function of the organ responsible for the tilt does not restore function. In examining the patient with vertigo or dysequilibrium, the physician must be well acquainted with those factors affecting SVV and its natural course.This article also referred to the difference between SVV tilts and room tilt illusions. The former are usually stable and chronic signs and manifest as a continuum of angle of tilt up to abut 300. In contrast, the latter occur paroxysmally or transiently in 90° steps.In clinical practice, the measurement of SVV is not so commonly carried out as compared to the recordings of nystagmus. It is expected, however, that SVV be more widely taken into account in clinical practice because the tilt of SVV and the occurrence of nystagmus do not share the same anatomical structures, thus SVV can provide a greater understanding of the patient's complaints and underlying pathologies.
著者
馬塲 完仁 坂田 英治 飯田 祐起子 半田 由紀 井上 鐵三
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.396-402, 1988 (Released:2009-10-20)
参考文献数
26

Eye movements induced by the I.V. injection of ketamine hydrochloride (Group 1; n=8) and diazepam (Group 2; n=7) were axamined electro-nystagmographically in 15 healthy adults.Complete gaze nystagmus and horizontal rebound nystagmus were observed in all 8 subjects of Group 1, and rebound nystagmus in all 4 directions in 2, but none had positional nystagmus.Primary position downbeat nystagmus was observed in 5 subjects of Group 2, and horizontal gaze nystagmus in all 7, but none had rebound nystagmus, vertical gaze nystagmus or positional nystagmus.
著者
鈴木 直人
出版者
Japan Society for Equilibrium Research
雑誌
Equilibrium Research (ISSN:03855716)
巻号頁・発行日
vol.56, no.5, pp.430-435, 1997 (Released:2009-06-05)
参考文献数
12
被引用文献数
2

The visual system is considered to make a limited contribution to the maintenance of the upright posture, but is available for elaboration of postural stability, that is, for minimizing body oscillations while standing. These experiments investigated the roles of the visual framework in maintaining an upright posture. Body oscillations were measured as the deviation of the center of gravity using a gravicorder. The results were as follows. Both the area and the total length of the trace of body sway increased with the distance between the body and the wall. The standing posture also became unstable as an upper part of the wall inclined in the direction of the subject. Women were more affected than men under both conditions. These results indicate that the visual framework perceived peripherally plays an important role in postural stability while standing upright.
著者
大木 紫
出版者
Japan Society for Equilibrium Research
雑誌
Equilibrium Research (ISSN:03855716)
巻号頁・発行日
vol.56, no.4, pp.321-331, 1997 (Released:2009-06-05)
参考文献数
50

This article reviews the nucleus prepositus hypoglossi (NPH) which has been proved to contribute to generation of horizontal eye movements. In general, the NPH receives inputs from oculomotor related nuclei (e.g. the bilateral NPH, the medial vestibular nucleus and ipsilateral burst neuron areas), and projects directly to the bilateral NPH, the vestibular nuclei, the ocular motor nuclei and vestibulo-cerebellar structures. According to these different neural connections, the NPH has been divided into subdivi-sions. Several types of neural activities relating to eye movements are observed in NPH neurons, most of which are increased during ipsiversive horizontal eye movements. The majority of the neurons encode both eye velocity and position signals (burst-tonic neurons). Some of the neurons project to the abducens nucleus. In addition, a class of NPH cells show a burst of activity during a variety of rapid eye movements in cats (burster-driving neurons). These neurons receive disynaptic vestibular input contralaterally and project to burst neuron areas. There are also NPH cells encoding both eye- and head-velocity signals in monkeys (eye-head-velocity neurons). Lesions of the NPH impair gaze holding, implying that the NPH functions as, at least a part of, the neural integrator. However, saccade feedback and putative smooth-pursuit integrators are not influenced after a partial lesion in the NPH. The results suggest that distinct classes of cells spread over the NPH. In summary, the NPH is involved in several aspects of horizontal eye movements and may also function as a part of the neural integrator.
著者
中原 はるか 竹森 節子 鶴岡 尚志
出版者
Japan Society for Equilibrium Research
雑誌
Equilibrium Research (ISSN:03855716)
巻号頁・発行日
vol.57, no.4, pp.435-442, 1998 (Released:2009-10-13)
参考文献数
17

Spatial orientation is influenced by many factors such as vision, hearing, vestibular input, and so on. However, the details of when and which factor exert influence on this process remain mostly unknown. We investigated the influence of height on spatial orientation under various conditions.Body movement was recorded by stabilometry for 30 seconds under each of three visual conditions (eyes open without gaze fixation, eyes closed, and eyes open with gaze fixation) at 0 m, 1 m, 2 m, and 10 m22 cm high in 30 normal volunteers (14 males and 16 females) who had no history of vertigo or dizziness. Eight of subjects claimed to be acrophobic.The total length of the gravity center movements reflected the body sway best. The sway was minimal with eyes open and gaze fixated, and maximal with eyes closed. The sway increased at 10 m22 cm high, but was almost the same at 1 m and 2 m high. The acrophobic group was clearly worse than the non-acrophobic group at 10 m22 cm high. Their total shifting length increased because they became tense and shivered fractionally.Visual information which served as the base was useful for spatial orientation, and the mental factor of fear caused tension and the sway increased especially in the acrophobic group at 10 m22 cm high.
著者
山本 悦生 水上 千佳司 磯野 道夫 大村 正樹 広野 喜信
出版者
Japan Society for Equilibrium Research
雑誌
Equilibrium Research (ISSN:03855716)
巻号頁・発行日
vol.49, no.Suppl-6, pp.28-30, 1990 (Released:2009-06-05)
参考文献数
4

The three-dimensional imaging used so far has processed digitalized information on the morphology of organs by the computer graphics technique. However, the conventional method has not been used clinically, because the processing of information has been inadequate.We observed the external aperture of the vestibular aqueduct in vivo using three-dimensional imaging by the surface reconstruction method. The width was measured in normal and diseased ears. Significant narrowing was observed in patients with Meniere's disease, while no difference in width was noted between normal subjects and those with chronic otitis media.This technique can be used to examine not only on the vestibular aqueduct but also other structures in the temporal bone. It should be useful in clarifying the pathophysiology of inner ear diseases and also in the surgical treatment.

1 0 0 0 OA 前庭代償

著者
北原 糺
出版者
Japan Society for Equilibrium Research
雑誌
Equilibrium Research (ISSN:03855716)
巻号頁・発行日
vol.59, no.2, pp.103-111, 2000 (Released:2009-06-05)
参考文献数
49

Vestibular compensation consists of the following stages: the inhibition of the contralesional medial vestibular nucleus (contra-MVe) activities at the acute stage after unilateral labyrinthectomy (UL) and the recovery and maintenance of the ipsilesional MVe (ipsi-MVe) spontaneous activities at the chronic stage after UL. In this paper, we reviewed molecular mechanisms of vestibular compensation in the central vestibular system by means of several morphological and pharmacological approaches in rats. Based on our examinations, we propose the following hypothesis. At the acute stage after UL, the activated neurons in the ipsi-MVe project their axons into the flocculus to inhibit the contra-MVe neurons via NMDA receptor, nitric oxide (NO), acetylcholine (Ach) and/or GABA-mediated signaling, resulting in the restoration of balance between intervestibular nuclear activities. At the chronic stage after UL, the flocculus depresses the inhibitory effects on the ipsi-MVe neurons via protein phosphatase 2A (PP2A) β, protein kinase C (PKC) and/or glutamate receptor (GluR) δ-2, to help the recovery and maintenance of the ipsi-MVe activities.
著者
武田 憲昭
出版者
Japan Society for Equilibrium Research
雑誌
Equilibrium Research (ISSN:03855716)
巻号頁・発行日
vol.59, no.2, pp.93-102, 2000 (Released:2009-06-05)
参考文献数
53
被引用文献数
2

In the acute period, the goal of drug therapy for vertigo is suppressing the sensation of vertigo, preventing vomiting and helping restore normal balance. Intravenous injection of NaHCO3 is effective against the sensation of vertigo. Since histamine H1-receptors are involved in vomiting that is associated with vertigo, antihistamines could prevent it. Benzodiazepines may restore normal balance by stimulating the initial develop-ment of vestibular compensation, in addition to their antianxiety effects. In the chronic period, vasodilators such as diphenidol or betahistine could prevent recurrent attacks of vertigo. Benzodiazepines may act on the limbic system and relieve psychotic triggering of vertigo attacks. Meniere's disease, in which the primary pathology is endolymphatic hydrops, is specifically managed by an osmotic diuretic, isosorbide. Steroids may be helpful in patients with vestibular neuronitis.
著者
宇野 敦彦 中川 あや 堀井 新 武田 憲昭 久保 武
出版者
Japan Society for Equilibrium Research
雑誌
Equilibrium Research (ISSN:03855716)
巻号頁・発行日
vol.65, no.4, pp.213-222, 2006 (Released:2009-06-05)
参考文献数
52

Motion sickness is induced by unusual patterns of spatial information input, but not by a simple strong acceleration. Thus, in the process of the development of motion sickness, the disturbance of spatial orientation is noticed somewhere in the brain, leading to the expression of autonomic signs and symptoms. What part of the brain plays this key role?Peripheral vestibular input has repeatedly been proven to be necessary for motion sickness, even for visually-evoked motion sickness. The vestibular nucleus in the brain stem where spatial information including visual and somatosensory as well as vestibular inputs converge, is the primary candidate for this key structure. In the higher brain, the limbic system, particularly the amygdala, is another candidate. In our rat animal model, bilateral amygdala lesions significantly suppressed motion sickness signs, whereas hippocampus lesions did not. Using cFos protein expression as a marker for neuronal activation, we also showed that the central nucleus of the amygdala was activated by vestibular information during the hypergravity stimulation that induced motion sickness in rats.Involvement of the amygdala may explain some characteristic features of motion sickness, such as its diversity of signs ranging from sympathetic to parasympathetic, and its conditioned occurrence where by some susceptible persons become sick even in motionless vehicles.
著者
松木 則夫 田中 大祐
出版者
Japan Society for Equilibrium Research
雑誌
Equilibrium Research (ISSN:03855716)
巻号頁・発行日
vol.60, no.1, pp.3-6, 2001 (Released:2009-06-05)
参考文献数
10

Suncus murinus belongs to insectivora and has been developed as a laboratory animal in Japan. It is relatively small in size (male: 50-70g, female: 30-50g), and there are no problems in the handling, housing and breeding of the animal. We have found that administration of emetogenic drugs, X-ray irradiation and oscillation easily causes emesis in this animal. Since simple reciprocal shaking (frequency: 1 Hz, amplitude: 4cm) is enough to induce vomiting within as short as 2 min, Suncus murinus is currently the most sensitive animal to motion sickness. Information conserning the purchase and special animal chow is available at the Central Institute for Experimental Animals.Our knowledge of emesis and motion sickness is still very poor. The presence of a "vomiting center" and a "CTZ: chemoreceptor trigger zone" were proposed about a half century ago but substantiating evidence is still lacking. Antiemetic dugs have been developed to reduce the number of vomiting episodes; however, in terms of quality of life, complete blockade of nausea rather than vomiting is desirable. We believe that Suncus murinus will be a useful experimental animal for research on emesis and the development of new antiemetic drugs.
著者
武田 憲昭
出版者
Japan Society for Equilibrium Research
雑誌
Equilibrium Research (ISSN:03855716)
巻号頁・発行日
vol.55, no.4, pp.335-342, 1996 (Released:2009-06-05)
参考文献数
10
被引用文献数
6 6

Neural mechanisms of gaze, vertical and rotatory nystagmus are reviewed. For all eye movements, eye velocity is an oculomotor parameter. Eye velocity signals are transformed by a neural integrator in the brain stem to obtain the eye position signal. A lesion of neural integrator leads to gaze-evoked nystagmus. Vertical nystagmus arises from a lesional or functional tone imbalance, which is due to disruption of the central vestibulo-ocular reflex pathway in the pitch plane. Downbeat nystagmus is caused by lesions between the vestibular nuclei or flocculus. Upbeat nystagmus is caused by lesions in the brachium conjunctivum, the ventral tegmental pathway and the prepositus hypoglossal nucleus. Rotatory nystagmus involves an epicodic ocular tilt reaction, which is a clinical sign of an imbalance of the central vestibulo-ocular reflex in the roll plane. Unilateral infarction of the brain stem leads to rotatory nystagmus.
著者
井須 尚紀 河合 敦夫 桝井 文人
出版者
Japan Society for Equilibrium Research
雑誌
Equilibrium Research (ISSN:03855716)
巻号頁・発行日
vol.63, no.3, pp.183-193, 2004 (Released:2009-06-05)
参考文献数
26

The sensation of rotation derived from the semicircular canal system during a Coriolis stimulus, or cross-coupled rotation, was estimated by an mechanical approach by giving some hypotheses and simplifications on the semicircular canal system. By solving an equation of motion of the endolymph during a Coriolis stimulus with a moderate time course, the rotating angle of the endolymph was obtained, and the sensation of rotation derived from each semicircular canal was estimated. Then, the sensation was integrated in the whole semicircular canal system, which was considered to be composed of three orthogonal semicircular canals. The sensation of rotation derived from the semicircular canal system comes into conflict with those from the otolithic and somatosensory system. The conflict causes an illusion such that the head rotates vertically while keeping inclination at a constant tilt angle. The nauseogenic severity of motion sickness caused by a Coriolis stimulus is enhanced in accordance with the integrated angle of rotation perceived by the illusion.
著者
中村 将裕 石井 正則 近澤 仁志 丹羽 洋二 山崎 ももこ 伊藤 洋
出版者
Japan Society for Equilibrium Research
雑誌
Equilibrium Research (ISSN:03855716)
巻号頁・発行日
vol.63, no.4, pp.335-345, 2004 (Released:2009-06-05)
参考文献数
21
被引用文献数
3 2

Falls and falling accidents occurring in hospitals have become a problem in recent years, and some of those events have been documented to have occurred after patients ingested sleep-inducers (hypnotics). One of the pharmacological actions of hypnotics is muscle-relaxing activity, and it has been clarified in animal studies that this activity causes falls and falling accidents. However, this association has not yet been proven in humans.In this study, conducted in eight healthy adult volunteers, we compared the manifestation of balance disorders after ingestion of four test drugs, consisting of two ultra-short-acting hypnotics (zolpidem and triazolam), a long-acting hypnotic (qazepam) and a placebo (i.e., the control). Zolpidem and qazepam, which are said to express weak muscle-relaxing activity, both caused balance disorders. Also, strong correlations were found between the manifestation of balance disorders after drug ingestion and the plasma concentrations of zolpidem, triazolam and some of the metabolites of qazepam. In addition, in the case of zolpidem, which caused the most severe balance disor-ders, gaze deviation nystagmus was detected. For this reason, it was surmised that balance disorders occurring after ingestion of hypnotics involve some inhibition of the central nervous system, including the cerebellum and brain stem, rather than the mus-cle-relaxing activity of the drugs.Differences were observed among the tested hypnotics in relation to the time of occurrence of balance disorders postmedication and also to the severity of the symp-toms. Accordingly, for the prevention of falling accidents, it is considered necessary that the physician be fully cognizant of the patient's age, medical history and physical condition, as well as not only the characteristics of the hypnotics but also the time-course changes in their concentration in the blood. Then, adequate caution must be applied with regard to the time period in which the patient is in a half-awake state.
著者
正木 義男
出版者
Japan Society for Equilibrium Research
雑誌
Equilibrium Research (ISSN:03855716)
巻号頁・発行日
vol.64, no.1, pp.22-28, 2005 (Released:2009-06-05)
参考文献数
32
被引用文献数
1 1

We encountered a patient who developed dizziness due to the vasovagal reflex (VVR) during the Schellong test (ST).A 32-year-old woman had a chief complaint of dizziness. Present Illness: She had repeatedly since childhood experienced dizziness attacks associated with darkness in front of her eyes immediately after standing up. She easily developed motion sickness. Dizziness continued to occur when she was standing in a bus or train, when she was in the bath, or when she got excited. She was admitted to a hospital in the district and ECG and a blood test were conducted, but no abnormal findings were revealed. Past History: She had bronchial asthma in childhood. She had a gastric ulcer and received drug treatment in january 1997. Family history was unremarkable.She had a positive Schellong test. Immediately after standing up, her pulse rate sharply increased from 94 to 123/min., and 5 min. after standing up, the pulse rate became 127/min. She complained of dizziness immediately before the end of the testing, and the pulse rate and blood pressure measured at the time were 75/min., showing a sharp decline, and 90/55, showing a slight decrease, respectively. Thereafter, she had decreased consciousness and was immediately laid in a supine position. She soon became alert. Blood pressure recovered to 106/62 and the pulse rate to 94. Neural symptoms were absent. Treatment and Clinical Course: Although she developed WR during ST, her condition could be diagnosed as orthostatic dysregulation (OD) because it met the criteria for diagnosis of OD. However, a diagnosis of postural tachycardia syndrome (POTS) was made according to the theory that WR and OD are special types of POTS. She is under medication with an α-receptor agonist agent.Patients are always at risk, although not high, of developing VVR and falling during ST, which may be associated with injury. Therefore, after the experience of the present case in our hospital, we reevaluated the procedures of ST and decided on crite-ria for the discontinuation of the testing to prevent accidents.