平衡障害を唯一の主訴とした小児キアリ奇形I型の2例

概要

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Chiari malformation type I, a congenital condition, the distorts and displaces cerebellar tonsils, inferior cerebellum, and medulla and involoves invagination from the foramen magnum into the upper cervical canal. We report 2 such pediatric cases. Detailed medical histories were obtained for both the-7-year old girl and the boy, who was 3 years and 7 months old, together with routine equilibrium function examinations, neurootological tests, electronystagmography (ENG), and stabilometry. No choked discs were observed on fundoscopy in either case. Vertical downbeat nystagmus through the Frentzel spectales and saccadic pursuits in circular eye tracking tests (CETT) with ENG both suggested cerebellum and brainstem disturbance in the optokinetic pattern test (OKP), and obvious abnormal ities were seen in upright standing control in stabilometry, confirened in magnetic resonance imaging (MRI) centering on the posterior cranial fossa, especially the cerebellumand brainstem. Both were diagnosed with Chiari malformation type I in T1-enhanced imaging. In diagnosing subjects with dizziness and equilibrium disturbance, we can emphasize the importance of detailed inquiry backed by considerable experience among function the physician involved important information souces in both of these cases.
2010-11-01