背臥位・腹臥位法による温度眼振検査の有用性 : 自発眼振を認める症例での冷温交互試験と少量注水法との比較

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Instead of the hot-and-cold caloric test proposed by Hallpike in 1942, the mono-thermal caloric test with assessment of spontaneous nystagmus has gained wide acceptance, because of its convenience, and stronger stimuli; however, no clinical evidence has been reported. The intensity of spontaneous nystagmus changes in maximum of 9.5 times according to recording conditions, i.e., with the eyes closed, during mental arithmetic, or with the eyes open in darkness, in our 57 patients suffering from vertigo. The same caloric stimulus can cause inverse caloric responses when tested in supine or in prone positions. In order to evaluate the clinical significance of the mono-thermal caloric test, first, a supine/prone mono-thermal caloric test was compared to the hot-and-cold caloric test in 5 normal subjects and 10 vertigo patients with spontaneous nystagmus, showing good correlation (100% coincident as canal plasty (CP) -diagnosis) with these two methods. Second, the best condition for measuring spontaneous nystagmus was determined by comparing the CP% of supine/prone caloric test and caloric test with consideration of spontaneous nystagmus in 57 patients with spontaneous nystagmus, resulted in taking the largest spontaneous nystagmus of any condition. CP% was correlated in the mono-thermal caloric test and the supine/prone caloric test in 89.5%, indicating the criminal evidence of the mono-thermal caloric test. Those who did not coincide were patients with benign paroxysmal positional vertigo, vertebrobasilar insufficiency, and the central vestibular disease. In conclusion, the supine/prone mono-thermal caloric test is clinically useful for excluding the influence of spontaneous nystagmus. The discrepancy of CP diagnosis in the supine/prone test and supine alone suggested non-endogens involvement.
東京女子医科大学の論文
2001-12-25

背臥位・腹臥位法による温度眼振検査の有用性 : 自発眼振を認める症例での冷温交互試験と少量注水法との比較

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