Bilateral Vestibular Hypofunction in Dialyzed Patients with Chronic Renal Failure

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There are fewer reports on vestibular function in patients with renal failure than on impaired hearing. Grahe reported in 1924 that 13 to 32 patients with nephritis had either spontaneous nystagmus or abnormalities on the past pointing test. According to a recent study by Yassin (1970), vertigo was noted in 37% of 114 patients with renal failure, and only 28% had normal caloric tests. We describe here 4 patients on dialysis with bilateral vestibular hypofunction whom we treated during the past year.Two patients who had received periodic hemodialysis, a 66-year-old man and a 69 year-old man, were found to have bilateral dysfunction to caloric and rotational stimuli after treatment with amikacin and gentamicin. Another patient, a 54-year-old man with suspected homochronous bilateral vestibular neuronitis, is recovering gradually. Attempts to attribute this vestibular neuronitis to immunologic abnormalities in this patient on dialysis presented difficulties despite studies of the literature on similar cases. The fourth patient a 69-year-old woman with diabetes mellitus, diabetic nephropathy, and arteriosclerosis, had a long history of bilateral impaired hearing. The dialysis fluid had been increased just at the onset of her hearing problem.It is considered that in addition to these systemic risks, vascular and/or cellular degeneration may occur in the vestibular system of the inner ear. We have analyzed the symptoms and suggested the pathogenesis of the vestibular disorders in patients on dialysis.
耳鼻咽喉科臨床学会の論文

Bilateral Vestibular Hypofunction in Dialyzed Patients with Chronic Renal Failure

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