平衡障害と側方注視で下眼瞼向き眼振を呈した1症例 : 片側半規管障害と抗てんかん薬の副作用の合併例

概要

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It is well known that antiepileptic drugs can cause dizziness or vertigo. Although the diagnosis of intoxication is relatively straight forward in simple cases, it is not easy in complex cases with other diseases. We report on a 63-year-old woman who had cen-tral disequilibrium due to taking antiepileptic drugs (carbamazepin and/or sodium valproate), with peripheral vertigo and hearing loss due to Meniere disease. She presented with unsteadiness. She took sodium valproate and/or carbamazepin to suppress epileptic seizure. On examination, she had down beating nystagmus at the lateral and downward gaze, saccadic pursuit, disturbed optokinetic nystagmus, and disturbances of visual suppression. Additionally, she had absence of caloric responses on the right and right sensorineural hearing loss. Her brain MRI was unremarkable. On the basis of these findings, she was diagnosed with central disequilibrium probably due to the intoxication of carbamazepin and/or sodium valproate with right inner ear disorders. After the reduction of antiepileptic drugs her signs and symptoms of central disequilibrium disappeared. This case suggested that knowledge of drug history is crucial in the neuro-otology clinic.
日本めまい平衡医学会の論文
2005-06-01