末梢性前庭機能異常症例の神経耳科学的臨床統計--メニエ-ル病,良性発作性頭位めまい,突発性難聴を中心に (前庭機能異常の研究-1-)

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In 1980, the Research Committee of Peripheral Vestibular Disorders was founded by the members, who come from various districts of Japan.In order to compare definite Meniere's disease with other typical peripheral vestibular disorders, such as positional vertigo of the benign paroxismal type and sudden deafness, a neurotological study of these three diseases was made during the past two years.48 cases with definite Meniere's disease, 42 cases of the positional vertigo and 39 cases of sudden deafness (included 20 cases with vertigo) were listed among 806 patients with dizziness and/or vertigo, according to such criteria for diagnosis of the three diseases as had been determined by the Research Committee.The clinical features of these three diseases are as follows.1) In patients with definite Meniere's disease, the male: female ratio was 17:31, and the ratio of positional vertigo was slightly greater (17:21). On the other hand, the ratio of sudden deafness was higher in male than female patients (32:7).2) The age distribution at the onset on Meniere's disease peaks at the age ground of 40-49 years, while the peak for positional vertigo is almost the same. However, the peak for sudden deafness was broader at 40-59 years.3) In patients with definite Meniere's disease, hearing impairment was characterized by deficiency in detecting low- and middle-pitched tones and fluctuation of the auditory threshold in low frequency ranges.On the other hand, hearing impairment in patients with a positional vertigo was characterized by mildly impaired hearing, i. e., in 38% of these patients (16 cases), a normal hearing was observed. Moreover, sudden deafness was characterized by highly impaired hearings, i. e., total deafness was observed in 6 cases (30%), especially in the cases with vertigo. Recruitment was observed at 67% incidence in Meniere's disease, and was frequently observed in sudden deafness cases (83%).4) The incidence of spontaneous nystagmus was almost the same in the cases with Meniere's disease as it was in cases of sudden deafness with vertigo. However, the incidence of spontaneous nystagmus in the positional vertigo was lower (23.8%) than the other diseases.In the positional vertigo, positional nystagmus was characterized by a burst of rotatory nystagmus (induced by a rapid positioning maneuver), a latency and a diminished response on repeated testings. Abnormal caloric responses were observed in 33 cases (69%) with Meniere's disease associated with the affected side. In the sudden deafness cases, abnormal caloric responses were also observed in 22 cases (56%). However, the incidence of abnormal caloric responses in the positional vertigo cases was lower (21.1%) than the other two disease. Abnormal OKN and eye-tracking were, on the other hand, observed at low incidence in the three disease.
耳鼻咽喉科臨床学会の論文

末梢性前庭機能異常症例の神経耳科学的臨床統計--メニエ-ル病,良性発作性頭位めまい,突発性難聴を中心に (前庭機能異常の研究-1-)

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