<原著>突発性難聴症例とメニエール病症例の固視機能の検討

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概要

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• I investigated the vestibulo-ocular reflex (VOR) in patients with vestibular disorders. They included 11 patients with Meniere's disease, 17 with sudden deafness (9 with vertigo and 8 without), and 19 with vertebrobasilar insufficiency (VBI). VOR was studied based on gaze during horizontal head rotation at frequencies of 0.1 Hz to 5 Hz, with an amplitude of head rotation of 10 degrees in either the right or left direction. The findings were compared with those from 26 normal adults. Subjects were required to gaze at a target set a distance of 1 meter in front of them in a light room, while they moved their head horizontally from right to left and left to right. The same test was done in a dark room, with subjects asked to focus on an imaginary target. Gain and phase were calculated from the head and eye movements. While the control group showed a gain of 0.1 to 4.2 Hz in the light and 0.1 to 3.96 Hz in the dark room. Meniere's disease patients showed a gain of 0.1 to 2.13 Hz in the light and 0.1 to 1.25 Hz in the dark, sudden deafness patients 0.1 to 2.6 Hz in the light and 0.1 to 1.7 Hz in the dark, and VBl patients 0.1 to 2.1 Hz in the light and 0.1 to 1.3 Hz in the dark. The results and conclusions from this study may be summarized as follows : 1. Patients with each of the disorders-Meniere's disease, sudden deafness with or without vertigo, and VBI-had decreased gaze function in comparison with the control group. 2. In patients with Meniere's disease, the decrease in gain was markedly greater in the dark room than in the light, which may indicate that dark surroundings pose particular difficulties for patients with Meniere's disease in daily life. 3. In the sudden deafness group gain decreased not only in those with vertigo, but in those without vertigo as well. Abnormal vestibular function therefore cannot be ruled out even in sudden deafness patients without vertigo. 4. In patients with VBI, a greater level of abnormality was found on electronystagmography than in VOR. This may signify better preservation of vestibular function than visual input in cases of VBI. 5. The reason why none of the patients examined claimed to have difficulty in daily life may be that they are rarely exposed to head rotation at more than 2 Hz.

• 愛知医科大学の論文
• 2002-09-15

著者

• 角谷 昌昭

  愛知医科大学医学部

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