中枢性めまい病変に関する臨床的知見

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In 208 patients with vertigo of central origin diagnosed by the history of vertigo or dizziness, radiological findings and surgery, the diagnostic significance of the clinical neurotological findings was analyzed. Among the neurotological examinations, the deviation test, the stepping test, the righting reflex, the tests of spontaneous, positional, and positioning nystagmus were very important for the diagnosis of central lesions. Nystagmus caused by changes in head position or headshaking in the horizontal and vertical plane was manifested, and then vertical components were found in cases of cerebral vascular circulation disorder or vertebro-basilar insufficiency. In cases of brain tumor, especially acoustic tumor, OKN showed a hyporeactive or dysmetric pattern, and the ETT or pursuit eye movement test showed a saccadic or ataxic pattern. In the OKN test decrease of the slow phase velocity was significant in cases of vertigo of central origin. In cerebral arteriosclerosis or cerebral vascular circulation disorder, I examined erythrocytes, leucocytes, hemoglobin, hematocrit, fibrinogen, cholesterol, lipid and blood-glucose levels. In many cases the erythrocyte count was 500×104 or over, the hematcrit over 45% and the fibrinogen level over 300mg/dl; in 63.6% of all cases there was one abnormal blood value. Therefore, I considered that an increase of the blood viscosity together with an abnormality in the cranial vessels caused insufficient circulation in the brain which in turn caused dizziness or vertigo.
耳鼻咽喉科臨床学会の論文

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竹山勇
聖マリアンナ医大

中枢性めまい病変に関する臨床的知見

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