脳幹脳炎における神経耳科学的所見の推移

概要

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In 1957, Bickerstaff described eight patients with a syndrome consisting of a prodromal malaise and a downward progression of mid-brain disturbance resulting in almost total suppression of all functions having brain stem innervation but no cardiac or respiratory disorder. Maran described a similar case and introduced the title Bickerstaffs encephalitis. Subsequently there have been many reports of similar nature, but no detailed neourotological examinations have been conducted.<BR>We describe here a 60-year-old male, who showed most of the features described by Bickerstaff. Computed tomography of the brain was negative. Neurotological examinations revealed functional disturbance in the cerebellum and brain stem, including cerebellar ataxia, central bilateral vestibular deficits, abnormal findings in optokinetic nystagmus test, etc. There was a dissociation in the results of two tests of the vestibular system : abnormal caloric test with normal galvanic body sway test. It was assumed that area of disorder in the vestibular nucleus was localized. These examinations results recovered as the signs and symptoms abated.<BR>It is concluded that neurotological examination is very useful in the diagnosis and in the evaluation of therapy in Bickerstaffs encephalitis.