抗うつ剤が奏効した小児メニエール病5例:登校拒否との関連を含めて
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概要
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We had 5 cases of MÉNIÈRE'S disease in children aged 6, 8, 12, 13 and 16 years, respectively, during the year of 1985. In 4 of these 5 cases there were vertiginous attacks, while in the remaining 1 case tinnitus was the presenting symptom. In all cases, nystagmus was present and a deviation of labyrinthine origin was noted on the stepping test. Treatment consisted primarily of rest and a drug regimen of steroids and others, leading to disappearance of the nystagmus and deviation in the stepping test. However, the post-attack periods were still fraught with troubles, some of the patients suffered recurrent attacks while others felt less energetic and unable to attend school or had to leave school earlier than usual because of feeling tired. Since these children invariably were suspected of depression (on the basis of difficulty in falling asleep and being low-spirited, particularly on awakening in the morning as reported by their families), anti-depressant therapy was attempted. The response was excellent; the patients became entirely free of symptoms and were able to attend school. While MÉNIÈRE'S disease of adulthood is well known to be complicated by depression, the demonstration that a similar phenomenon dose occur in children also is worthy of particular note. It should be stressed that both MENIERE'S disease and depression in children of school ages are often not understood by the mother, teachers and pediatricians and, accordingly, are likely to be mistaken for school phobia.
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