ヒト両側内耳麻酔による垂直性眼振
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概要
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Primary eye positional down-beat nystagmus (PPDN) due to bilateral inner ear anesthesia was analyzed.<BR>In our clinic, inner ear anesthesia is used as a therapeutic modality in a variety of patients undergoing treatment for vertigo and/or tinitus. The study population included only patients with one or more of the following complaints : vertigo, dizziness, tinnitus and hearing loss. In this study, 54 subjects were selected out of the initial group.<BR>Inner ear anesthesia was performed by introducing 4% lidocaine into the tympanic cavity via the external auditory meatus.<BR>Among the 54 cases, nystagmus appeared to be due to inner ear anesthesia in 47 cases. In 37 of the these cases, the observed nystagmus was PPDN. In the remaining 10 patients, horizontal, rotatory and oblique types of nystagmus were observed.<BR>The PPDN in the present study ranged from high frequency with low amplitude to low frequency with high amplitude. The latent period between the injection and the onset of the PPDN varied from 20 to 100 minutes. The duration of the PPDN ranged from less than one hour to 3 hours in the longest case, with an average duration of between one and 2 hours. Subjective reports of vertical oscillopsia were noted at the same time.<BR>These phenomena appear to be caused by the penetration of lidocaine into the inner ear through the round window, leading to anesthesia of the inner ear, which causes transient bilateral vestibular hypofunction of the inner ear, followed by gradual recovery of function and dissappearance of the effect.