メニエール病は,反復するめまいと聴覚症状を呈 する末梢前庭疾患の代表として知られており,その 病態は内リンパ水腫であると考えられている。 その病態生理については,これまでに多数の基礎 的・臨床的研究がなされており,前庭性疾患のなか では比較的知見が多いといえる。一方,前庭性片 頭痛(vestibular migraine:VM)は,反復するめま いを呈する比較的あたらしい疾患概念である。以 前よりめまいと片頭痛が関連することは知られてお り,それらを片頭痛関連めまい(migraine associated vertigo),片頭痛性めまい(migrainous verMeniere’s disease refers to a peripheral vestibular disorder characterized by recurrent vertigo and cochlear symptoms, and the underlying pathophysiology is thought to be endolymphatic hydrops. Vestibular migraine is a relatively new disease concept that manifests as recurrent vertigo, whose pathophysiology still remains unclear. Comparison of the physiological characteristics of these two diseases might help in elucidating the pathophysiology of vestibular migraine, and in this paper, the similarities and differences between the two diseases are described from the viewpoint of the findings of physiological examination. Meniere’s disease is characterized by unilateral vestibular dysfunction, which is not disease-specific. Positive results of tests for endolymphatic hydrops, such as the furosemide test and furosemide-loading VEMP are specific for the disease. Patients who showed unilateral canal paresis on caloric testing did not show lower VOR gain in the video head impulse test (vHIT), which is also specific for the disease. About 18%―42% of patients with vestibular migraine show unilateral dysfunction on caloric testing. Many patients with unilateral canal paresis on caloric testing did not show a low VOR gain on vHIT, similar to the case of Meniere’s disease. The peak-to-peak amplitude of cVEMP and oVEMP may show a decrease. Some tests for endolymphatic hydrops show positive results. The findings could be summarized as follows; vestibular dysfunction is not uncommon in vestibular migraine. The tests show that endolymphatic hydrops could be associated with vestibular migraine, however, it is not clear if this is the cause or the result of the disease. パネルディスカッション「メニエール病と前庭性片頭痛:その類似点と相違点,関係性」
{"title":"Meniere's disease and vestibular migraine: similarities, differences, and relationships from the viewpoint of physiological examinations","authors":"T. Seo","doi":"10.3757/jser.80.285","DOIUrl":"https://doi.org/10.3757/jser.80.285","url":null,"abstract":"メニエール病は,反復するめまいと聴覚症状を呈 する末梢前庭疾患の代表として知られており,その 病態は内リンパ水腫であると考えられている。 その病態生理については,これまでに多数の基礎 的・臨床的研究がなされており,前庭性疾患のなか では比較的知見が多いといえる。一方,前庭性片 頭痛(vestibular migraine:VM)は,反復するめま いを呈する比較的あたらしい疾患概念である。以 前よりめまいと片頭痛が関連することは知られてお り,それらを片頭痛関連めまい(migraine associated vertigo),片頭痛性めまい(migrainous verMeniere’s disease refers to a peripheral vestibular disorder characterized by recurrent vertigo and cochlear symptoms, and the underlying pathophysiology is thought to be endolymphatic hydrops. Vestibular migraine is a relatively new disease concept that manifests as recurrent vertigo, whose pathophysiology still remains unclear. Comparison of the physiological characteristics of these two diseases might help in elucidating the pathophysiology of vestibular migraine, and in this paper, the similarities and differences between the two diseases are described from the viewpoint of the findings of physiological examination. Meniere’s disease is characterized by unilateral vestibular dysfunction, which is not disease-specific. Positive results of tests for endolymphatic hydrops, such as the furosemide test and furosemide-loading VEMP are specific for the disease. Patients who showed unilateral canal paresis on caloric testing did not show lower VOR gain in the video head impulse test (vHIT), which is also specific for the disease. About 18%―42% of patients with vestibular migraine show unilateral dysfunction on caloric testing. Many patients with unilateral canal paresis on caloric testing did not show a low VOR gain on vHIT, similar to the case of Meniere’s disease. The peak-to-peak amplitude of cVEMP and oVEMP may show a decrease. Some tests for endolymphatic hydrops show positive results. The findings could be summarized as follows; vestibular dysfunction is not uncommon in vestibular migraine. The tests show that endolymphatic hydrops could be associated with vestibular migraine, however, it is not clear if this is the cause or the result of the disease. パネルディスカッション「メニエール病と前庭性片頭痛:その類似点と相違点,関係性」","PeriodicalId":11781,"journal":{"name":"Equilibrium Research","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47579354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
nucleus and descends ipsilaterally in the ventrolateral funiculus. It mainly receives input from the oto-lith organs, extends throughout the length of the spinal cord, and exerts excitation on the ex-tensor muscles of the lower leg. Single LVST axons have multiple axon collaterals at different segments along the entire length of the spinal cord, thus playing an important role in maintain-ing the posture. In contrast, the medial vestibulospinal tract (MVST) originates in the descending, medial and lateral vestibular nuclei, and descends bilaterally in the ventromedial funiculus of the cervical cord. It conveys mainly semicircular canal inputs to the neck motoneurons, and single MVST axons have multiple axon collaterals terminating on neck motoneurons in different segments of the cervical spinal cord, thus playing an important role in the vestibulocollic re-flex.
{"title":"Anatomy and Physiology of the Vestibulospinal System","authors":"Y. Sugiuchi","doi":"10.3757/jser.80.303","DOIUrl":"https://doi.org/10.3757/jser.80.303","url":null,"abstract":"nucleus and descends ipsilaterally in the ventrolateral funiculus. It mainly receives input from the oto-lith organs, extends throughout the length of the spinal cord, and exerts excitation on the ex-tensor muscles of the lower leg. Single LVST axons have multiple axon collaterals at different segments along the entire length of the spinal cord, thus playing an important role in maintain-ing the posture. In contrast, the medial vestibulospinal tract (MVST) originates in the descending, medial and lateral vestibular nuclei, and descends bilaterally in the ventromedial funiculus of the cervical cord. It conveys mainly semicircular canal inputs to the neck motoneurons, and single MVST axons have multiple axon collaterals terminating on neck motoneurons in different segments of the cervical spinal cord, thus playing an important role in the vestibulocollic re-flex.","PeriodicalId":11781,"journal":{"name":"Equilibrium Research","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44597071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
functions in this test are evaluated by recording the head and eye movements during the vestibulo-ocular reflex (VOR). It is important to evaluate vestibular functions for making appropriate treatment deci-sions. However, caloric testing might be inappropriate for patients with external or middle ear pathologies, as in these patients, stimulation with cold water might not be transmitted appropri-ately to the horizontal semicircular canal; as examples, patients with cholesteatoma, otitis media with ANCA-associated vasculitis, acute otitis media, otitis media with effusion and facial nerve schwannoma have been cited. In this review, evaluation of the functions of the semicircular canals in patients with middle ear pathologies by vHIT are described.
{"title":"Evaluation of the functions of the semicircular canals in patients with middle ear pathologies by video Head Impulse Test (vHIT)","authors":"Keishi Fujiwara","doi":"10.3757/jser.80.264","DOIUrl":"https://doi.org/10.3757/jser.80.264","url":null,"abstract":"functions in this test are evaluated by recording the head and eye movements during the vestibulo-ocular reflex (VOR). It is important to evaluate vestibular functions for making appropriate treatment deci-sions. However, caloric testing might be inappropriate for patients with external or middle ear pathologies, as in these patients, stimulation with cold water might not be transmitted appropri-ately to the horizontal semicircular canal; as examples, patients with cholesteatoma, otitis media with ANCA-associated vasculitis, acute otitis media, otitis media with effusion and facial nerve schwannoma have been cited. In this review, evaluation of the functions of the semicircular canals in patients with middle ear pathologies by vHIT are described.","PeriodicalId":11781,"journal":{"name":"Equilibrium Research","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47590325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
vestibular system. The usual symptoms are persistent unsteadiness and oscillopsia during head and body movements. It has been reported that sensory substitution therapy, that is, vestibular rehabilitation using a sensory substitution device, which transmits other sensory information to a stimulator as a substitute for defective vestibular information, might be effective in patients with bilateral and unilateral vestibulopathy. Recently, we developed a new wearable device, TPAD (tilt perception adjustment device), that transmits vibratory input containing head-tilt information to the mandible as a substitute for defective vestibular information. We assessed the patient using the dizziness handicaps inventory (DHI), gait analysis, and visual/somatosensory dependence of postural control in the patients with unilateral vestibulopathy. Three months after therapy in patients with unilateral vestibulopathy, the DHI and walking speed improved even when the subjects were not wearing the TPAD. Moreover, the index of the visual dependence of posture control that was evaluated by posturography with/without foam rubber in the eyes open or closed condition decreased. The findings suggested that the sensory vibratory substitution with a TPAD for defective vestibular information induced brain plasticity related to sensory re-weighting to reduce the visual dependence of posture control, resulting in the improvement of dizziness and imbalance even while not wearing the TPAD in vestibulopathy patients. We then investigated the effects of sensory substitution therapy using a TPAD in patients with bilateral vestibulopathy and normal subjects. Three months after sensory substitution therapy in patients with bilateral vestibulopathy, the DHI and area with eyes closed measured by posturography improved even when the subjects did not wear a TPAD. However, the gait parameters improved only under the condition of wearing a TPAD. These findings suggest that sensory vibratory substitution with a TPAD might serve as temporary replacement for defective vestibular information in patients with bilateral vestibulopathy. Moreover, wearing of the TPAD improved posture control under the eyes-closed condition with foam rubber measured by posturography in normal subjects. TPAD might be applicable as a wearable device for improving posture control, not only in patients with bilateral vestibulopathy, but also in those with presbyvestibulopathy. シンポジウム「Bilateral vestibulopathy: How to treat and manage?」
{"title":"Sensory substitution therapy using a tilt perception adjustment device (TPAD) for patients with bilateral vestibulopathy","authors":"G. Sato","doi":"10.3757/jser.80.210","DOIUrl":"https://doi.org/10.3757/jser.80.210","url":null,"abstract":"vestibular system. The usual symptoms are persistent unsteadiness and oscillopsia during head and body movements. It has been reported that sensory substitution therapy, that is, vestibular rehabilitation using a sensory substitution device, which transmits other sensory information to a stimulator as a substitute for defective vestibular information, might be effective in patients with bilateral and unilateral vestibulopathy. Recently, we developed a new wearable device, TPAD (tilt perception adjustment device), that transmits vibratory input containing head-tilt information to the mandible as a substitute for defective vestibular information. We assessed the patient using the dizziness handicaps inventory (DHI), gait analysis, and visual/somatosensory dependence of postural control in the patients with unilateral vestibulopathy. Three months after therapy in patients with unilateral vestibulopathy, the DHI and walking speed improved even when the subjects were not wearing the TPAD. Moreover, the index of the visual dependence of posture control that was evaluated by posturography with/without foam rubber in the eyes open or closed condition decreased. The findings suggested that the sensory vibratory substitution with a TPAD for defective vestibular information induced brain plasticity related to sensory re-weighting to reduce the visual dependence of posture control, resulting in the improvement of dizziness and imbalance even while not wearing the TPAD in vestibulopathy patients. We then investigated the effects of sensory substitution therapy using a TPAD in patients with bilateral vestibulopathy and normal subjects. Three months after sensory substitution therapy in patients with bilateral vestibulopathy, the DHI and area with eyes closed measured by posturography improved even when the subjects did not wear a TPAD. However, the gait parameters improved only under the condition of wearing a TPAD. These findings suggest that sensory vibratory substitution with a TPAD might serve as temporary replacement for defective vestibular information in patients with bilateral vestibulopathy. Moreover, wearing of the TPAD improved posture control under the eyes-closed condition with foam rubber measured by posturography in normal subjects. TPAD might be applicable as a wearable device for improving posture control, not only in patients with bilateral vestibulopathy, but also in those with presbyvestibulopathy. シンポジウム「Bilateral vestibulopathy: How to treat and manage?」","PeriodicalId":11781,"journal":{"name":"Equilibrium Research","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42722439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Taura, Hiroe Ohnishi, K. Nishimura, H. Ogita, T. Miwa, J. Ito
{"title":"Possible application of regenerative medicine to bilateral vestibulopathy","authors":"A. Taura, Hiroe Ohnishi, K. Nishimura, H. Ogita, T. Miwa, J. Ito","doi":"10.3757/jser.80.216","DOIUrl":"https://doi.org/10.3757/jser.80.216","url":null,"abstract":"","PeriodicalId":11781,"journal":{"name":"Equilibrium Research","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48113069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J. Yokota, A. Inoshita, Y. Tomizawa, Atsuko Inomata
ance with gait disturbance, until she became obliged to use a cane for walking. Neurological examination revealed a cerebellar syndrome with limb, trunk and gait ataxia and downbeat nystagmus (DBN). MRI showed cerebellar atrophy, especially of the cerebellar vermis. CSF examination was negative for both oligoclonal bands and myelin basic protein. Serology for anti-YO antibodies was positive, which led us to make the diagnosis of paraneoplastic cerebellar degeneration (PCD). Eventually, abdominal ultrasonography revealed left ovarian cancer. After total hysterectomy, bilateral oophorectomy, partial omentectomy, and periaortic lymphadenectomy, the patient became able to walk again without assistance. The characteristic ENG findings were as follows: (1) In the light/dark, DBN was observed mainly during rightward gaze, and less prominently at the primary position and during leftward gaze. (2) However, when the patient lay in the supine posture, the DBN totally disappeared, even during rightward gaze. (3) Both horizontal and vertical pursuits revealed saccadic pursuit. (4) The peak slow-phase velocities and frequency of horizontal OKN were markedly reduced. (5) The horizontal OKAN disappeared bilaterally. (6) Hypermetric saccades, overshoot, were observed in both the horizontal and vertical directions. (7) Caloric nystagmus was well-induced bilaterally, although the visual suppression (VS) ratio was markedly reduced bilaterally. The above ENG findings suggest mainly impairment of the cerebellar systems, but also some dysfunction of the velocity storage systems. Presumably, impairment of smooth pursuit was derived from a lesion of the flocculus/ paraflocculus, vermis and cerebellar hemispheres. As for dysfunction of the velocity storage systems, it is considered that the velocity storage integrators themselves in the brainstem were still intact. Rather, conceivably, the visual-vestibular interaction could not function well in the velocity storage systems because of insufficient supply of visual inputs from the impaired vestibular cerebellum. 原 著
{"title":"Downbeat nystagmus and other characteristic ENG findings in a case with paraneoplastic cerebellar degeneration (PCD)","authors":"J. Yokota, A. Inoshita, Y. Tomizawa, Atsuko Inomata","doi":"10.3757/jser.80.174","DOIUrl":"https://doi.org/10.3757/jser.80.174","url":null,"abstract":"ance with gait disturbance, until she became obliged to use a cane for walking. Neurological examination revealed a cerebellar syndrome with limb, trunk and gait ataxia and downbeat nystagmus (DBN). MRI showed cerebellar atrophy, especially of the cerebellar vermis. CSF examination was negative for both oligoclonal bands and myelin basic protein. Serology for anti-YO antibodies was positive, which led us to make the diagnosis of paraneoplastic cerebellar degeneration (PCD). Eventually, abdominal ultrasonography revealed left ovarian cancer. After total hysterectomy, bilateral oophorectomy, partial omentectomy, and periaortic lymphadenectomy, the patient became able to walk again without assistance. The characteristic ENG findings were as follows: (1) In the light/dark, DBN was observed mainly during rightward gaze, and less prominently at the primary position and during leftward gaze. (2) However, when the patient lay in the supine posture, the DBN totally disappeared, even during rightward gaze. (3) Both horizontal and vertical pursuits revealed saccadic pursuit. (4) The peak slow-phase velocities and frequency of horizontal OKN were markedly reduced. (5) The horizontal OKAN disappeared bilaterally. (6) Hypermetric saccades, overshoot, were observed in both the horizontal and vertical directions. (7) Caloric nystagmus was well-induced bilaterally, although the visual suppression (VS) ratio was markedly reduced bilaterally. The above ENG findings suggest mainly impairment of the cerebellar systems, but also some dysfunction of the velocity storage systems. Presumably, impairment of smooth pursuit was derived from a lesion of the flocculus/ paraflocculus, vermis and cerebellar hemispheres. As for dysfunction of the velocity storage systems, it is considered that the velocity storage integrators themselves in the brainstem were still intact. Rather, conceivably, the visual-vestibular interaction could not function well in the velocity storage systems because of insufficient supply of visual inputs from the impaired vestibular cerebellum. 原 著","PeriodicalId":11781,"journal":{"name":"Equilibrium Research","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45349806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
one-and-a-half症候群は一側の傍正中橋網様体 (paramedian pontinereticular formation,PPRF)や 外転神経核の障害による一側への側方共同注視障害 と同側の内側縦束(medial longitudinal fasciculus, MLF)の障害による単眼の内転障害(MLF症候 群,核間性眼筋麻痺)を併発したものである。 健側眼の外転は可能である。One-and-a-half症候群 に顔面麻痺を伴うものは Eight-and-a-half症候群と 呼ばれており,PPRF及びMLFに隣接する顔面神 経核も障害を受けることで発症する。今回,左顔 面麻痺とMLF症候群,側方共同注視麻痺を呈した Eight-and-a-half症候群をきたした脳幹部悪性リンパ 腫の1例を経験したので文献的考察を含めて報告す る。 症 例 患者:60歳,男性。 主訴:左顔面麻痺 X-2年前から飛蚊症・霧視を認め近医眼科を受 診し原因不明のまま通院を自己中断していた。XPurpose: To discuss the mechanism of development of eight-a-half syndrome in a case with a pontine lesion. Case: A 60-year-old man presented with left facial palsy and abnormal eye movements. Neuro-ophthalmologic examination showed conjugate leftward gaze palsy, impaired left eye adduction, rightward gaze-evoked nystagmus of the right eye on looking rightward, and upward gaze-evoked nystagmus. Vergence movements of the eyes were preserved. Contrast-enhanced MRI revealed an approximately 3-cm lesion in the dorsal paramedial pons. Histopathology revealed diffuse large-cell malignant lymphoma. He was diagnosed as having eight-a-half syndrome due to malignant lymphoma of the pons. Eight-a-half syndrome is one-and-a-half syndrome, characterized by impairment of both the medial longitudinal fasciculus (MLF) and paramedian pontinereticular formation (PPRF), accompanied by facial palsy. Ipsilateral facial palsy can be associated with one-and-a-half syndrome, because the facial nuclei and nerve are adjacent to the MLF, PPRF, and the abducens nucleus. Conclusion: In a patient with the eight-and-a-half syndrome, neurophysiologic information would be useful to speculate the extent of the lesion. 原 著
one-and-a-half症候群是由于一侧的旁正中桥网样体(paramedian pontinereticular formation,PPRF)或外展神经核的障碍引起的一侧共同注视障碍和同侧的内侧纵束(medial longitudinal fasciculus, MLF)障碍引起的单眼内转障碍(MLF症状，核间性眼肌麻痹)并发。健侧眼的外翻是可能的。One-and-a-half症候群伴随面部麻痹者被称为eightand -and-a-half症候群，其发病原因是邻近PPRF及MLF的面部神经核也受到损害。此次，我经历了一例脑干恶性淋巴瘤病例，其表现为左面部麻痹和MLF综合征，以及侧方共同注视麻痹的Eight-and-a-half综合征，我将对其进行文献考察。病例患者:60岁，男性。主诉:左面部麻痹X-2年前开始承认飞蚊症·雾视，接受近医眼科诊断，原因不明的情况下自我中断了通院。xpurpose:To discuss the mechanism of development of eight-a-half syndrome in a case with a pontine lesion.case:A 60-year-old man presented with left facial palsy and abnormal eye movements. neuroophthalmologicexamination showed conjugate leftward gaze palsy, impaired left eye adduction，rightward盖伊-evoked nystagmus of the right eye on looking rightward，and upward gaze-evoked nystagmus. Vergence movements of the eyes were preserved. contrast -增强MRI revealed an approximately 3-cm lesion in the dorsal paramedial pons. Histopathology revealeddiffuse large-cell malignant lymphoma. He was diagnosed as having eightt -a-half syndrome due tomalignant lymphoma of the pons. eigt -a-half syndrome is one-and-a-half syndrome，characterized by impairment of both the medial longitudinal fasciculus (MLF) and paramedianpontinereticular formation (PPRF)，accompanied by facial palsy. Ipsilateral facial palsy can be associated with one-and-a-halfsyndrome, because the facial nuclei and nerve are adjacent to the MLF, PPRF，and the abducens nucleus. Conclusion:In a patient with the eight-and-a-half syndrome，neurophysiologic information would be useful to speculate the extent of the lesion.原著
{"title":"A case of eight-and-a-half syndrome due to malignant lymphoma of the brainstem","authors":"Mai Fujitsuna, M. Ohki, Hirohiko Sugimoto","doi":"10.3757/jser.80.200","DOIUrl":"https://doi.org/10.3757/jser.80.200","url":null,"abstract":"one-and-a-half症候群は一側の傍正中橋網様体 (paramedian pontinereticular formation,PPRF)や 外転神経核の障害による一側への側方共同注視障害 と同側の内側縦束(medial longitudinal fasciculus, MLF)の障害による単眼の内転障害(MLF症候 群,核間性眼筋麻痺)を併発したものである。 健側眼の外転は可能である。One-and-a-half症候群 に顔面麻痺を伴うものは Eight-and-a-half症候群と 呼ばれており,PPRF及びMLFに隣接する顔面神 経核も障害を受けることで発症する。今回,左顔 面麻痺とMLF症候群,側方共同注視麻痺を呈した Eight-and-a-half症候群をきたした脳幹部悪性リンパ 腫の1例を経験したので文献的考察を含めて報告す る。 症 例 患者:60歳,男性。 主訴:左顔面麻痺 X-2年前から飛蚊症・霧視を認め近医眼科を受 診し原因不明のまま通院を自己中断していた。XPurpose: To discuss the mechanism of development of eight-a-half syndrome in a case with a pontine lesion. Case: A 60-year-old man presented with left facial palsy and abnormal eye movements. Neuro-ophthalmologic examination showed conjugate leftward gaze palsy, impaired left eye adduction, rightward gaze-evoked nystagmus of the right eye on looking rightward, and upward gaze-evoked nystagmus. Vergence movements of the eyes were preserved. Contrast-enhanced MRI revealed an approximately 3-cm lesion in the dorsal paramedial pons. Histopathology revealed diffuse large-cell malignant lymphoma. He was diagnosed as having eight-a-half syndrome due to malignant lymphoma of the pons. Eight-a-half syndrome is one-and-a-half syndrome, characterized by impairment of both the medial longitudinal fasciculus (MLF) and paramedian pontinereticular formation (PPRF), accompanied by facial palsy. Ipsilateral facial palsy can be associated with one-and-a-half syndrome, because the facial nuclei and nerve are adjacent to the MLF, PPRF, and the abducens nucleus. Conclusion: In a patient with the eight-and-a-half syndrome, neurophysiologic information would be useful to speculate the extent of the lesion. 原 著","PeriodicalId":11781,"journal":{"name":"Equilibrium Research","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47281571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
We report a nystagmus recording system using the iPhone. The greatest advantage of this system is that nystagmus can be recorded anytime and anywhere using the iPhone. In addition, the system can synthesize the head position information as an animation over the nystagmus image. We previously reported a nystagmus and head position capture software for windows PC. We ported this software for Windows PC to this iPhone system. The software for Windows PC that we reported earlier needs medical infrared Frenzel goggles and a self-made motion sensor device. The system that we report herein needs only an iPhone. The iPhone camera is used to record the nystagmus, the head position information is obtained from the motion sensor built into the iPhone, and the head position information is synthesized as an animation over the nystagmus image using the iOS app. The iPhone camera has an infrared filter, which has the disadvantage of not being able to shoot nystagmus in the dark with infrared lighting, but it is considered to be sufficiently useful as a method for recording nystagmus during dizziness at-tacks.
{"title":"Development of a recording system for nystagmus and head positions using the iPhone","authors":"Tatsuaki Kuroda, K. Kuroda","doi":"10.3757/jser.80.239","DOIUrl":"https://doi.org/10.3757/jser.80.239","url":null,"abstract":"We report a nystagmus recording system using the iPhone. The greatest advantage of this system is that nystagmus can be recorded anytime and anywhere using the iPhone. In addition, the system can synthesize the head position information as an animation over the nystagmus image. We previously reported a nystagmus and head position capture software for windows PC. We ported this software for Windows PC to this iPhone system. The software for Windows PC that we reported earlier needs medical infrared Frenzel goggles and a self-made motion sensor device. The system that we report herein needs only an iPhone. The iPhone camera is used to record the nystagmus, the head position information is obtained from the motion sensor built into the iPhone, and the head position information is synthesized as an animation over the nystagmus image using the iOS app. The iPhone camera has an infrared filter, which has the disadvantage of not being able to shoot nystagmus in the dark with infrared lighting, but it is considered to be sufficiently useful as a method for recording nystagmus during dizziness at-tacks.","PeriodicalId":11781,"journal":{"name":"Equilibrium Research","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43914508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
for wide distribution of developed systems in the future. The 4 computer systems developed by the author were introduced: 1) ABR data process-ing software; 2) Eye-head coordination analysis software; 3) Universal ENG data analysis software; 4) Web software for drawing nystagmograms. The former 3 systems could not be distrib-uted widely, while the latter web software can be accessed by anyone via the internet. How-ever, for this system to be used as a tool for a large-scale study of the relationships between nystagmus findings and diseases, “standardization” of the drawing convention is mandatory. Although the field of vestibular science is appropriate for personal system development, supports of certain organizations are necessary for wide distribution of the developed systems.
{"title":"Experience of individual computer system developments in the field of vestibular science and suggestions of organizational supports for their wide distribution","authors":"Ken Ito","doi":"10.3757/jser.80.245","DOIUrl":"https://doi.org/10.3757/jser.80.245","url":null,"abstract":"for wide distribution of developed systems in the future. The 4 computer systems developed by the author were introduced: 1) ABR data process-ing software; 2) Eye-head coordination analysis software; 3) Universal ENG data analysis software; 4) Web software for drawing nystagmograms. The former 3 systems could not be distrib-uted widely, while the latter web software can be accessed by anyone via the internet. How-ever, for this system to be used as a tool for a large-scale study of the relationships between nystagmus findings and diseases, “standardization” of the drawing convention is mandatory. Although the field of vestibular science is appropriate for personal system development, supports of certain organizations are necessary for wide distribution of the developed systems.","PeriodicalId":11781,"journal":{"name":"Equilibrium Research","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47417359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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