Jumbling Phenomenon and Aminoglycosides:Otoneurological study and prognosis in 14 cases

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Fourteen patients with the jumbling phenomenon which occurred after the administration of aminoglycoside antibiotics were examined in the Department of Otorhinolaryngology, Yamaguchi University Hospital, from January 1975 to December 1983.1. Thirteen patients were treated with streptomycin sulfate (SM) and one with gentamycin.2. The accumulated dose of SM at the onset of ataxia or at the time of otoneurological consultation varied from 6 to 55 grams. There was no relationship between the onset of the jumbling phenomenon and the dose of SM.3. Disturbances of visual fixation due to probable bilateral dysfunction of the labyrinths and cerebellum, and of the cerebrum in some cases, might cause the jumbling phenomenon, in which the visible object in front of the patient moves up and down during walking.4. Equilibrium examinations revealed definite abnormality of the righting reflex. In contrast, various results were obtained in response to caloric stimulation ranging from no response to lowered excitability.5. Eleven patients were suspected of having some involvement of the lower brain stem and cerebellum, also.6. Four patients showed some improvement in the follow-up examinations, but no change in their responses to caloric stimulation.
耳鼻咽喉科臨床学会の論文