末梢前庭機能評価の観点からみた振子様手動回転による前庭眼反射検査の有用性

概要

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This study included 209 patients with vertigo of various causes who underwent both manually rotated vestibulo-ocular reflex (VOR) testing and bithermal air caloric testing at our hospital from January 2009 to July 2012. The VOR directional predominance (VOR-DP%) values in the 79 patients with greater than 30% caloric canal paresis (CP) were significantly higher than those in the 43 normal subjects. On the other hand, the VOR-DP% values in 81% of patients with CP were within normal limits, as those in the 43 normal subjects varied widely (the normal range is considered to be wide). In all of the vertiginous cases, the VOR-DP% values showed only a slight correlation with the CP% values. However, the VOR-DP% was well-correlated with the CP% in patients with vestibular neuritis, Hunt syndrome and sudden deafness with vertigo, especially in the acute stage within 2 weeks of the onset. The VOR-DP% values in these latter patients with vestibular neuritis, Hunt syndrome and sudden deafness with vertigo decreased with time, regardless of the presence or absence of recovery from CP. Manually rotated VOR testing is thought to be one of the useful tools in daily clinical practice, that allows estimation of both peripheral vestibular function and the degree of recovery from imbalance in patients with acute unilateral peripheral vestibular deficit.