Abstract
Using newly devised equilibrium tests, i. e., equilibrium test with adrenalin loading and that with anodic low frequency pulse stimulation of the neck, vertigo cases following lesions of the head and the neck were examined, and the following results were observed. The majority of these vertigo cases showed appearance or intensification of disequilibrium as results of adrenalin loading and of low frequency pulse stimulation. From these facts, we pointed out that in the background of vertigo following lesions of the head and the neck there often exist disturbances of the brain stem as well as abnormal excitability of the nuchal soft tissues. As to mechanism of vertigo in these cases, our opinion is that abnormal centripetal impulses arising from the injured cervical soft tissues would possibly hit the brain stem so as to make latent dysfunction of this brain manifest. Thus notable ataxia of the eye and the body could be produced, which, of course, leads to vertigo in the cases at hand. This consideration can be supported by our previous investigation that in an electroencephalographic study using rabbits, functional disorders of the cervical soft tissues can produce functional disturbances of the brain stem reticular formation.
Therefore, treatment for this kind of vertigo should be directed to recovery of normal function both (i) in the cervical region and (ii) in the brain stem. Among reasonable methods of the first type there were cathodic low frequency pulse stimulation of the neck, procaine injection into sore points of the cervical soft tissues and fixation of the neck with a collar. In an early stage following cervical lesions, cervical traction should be avoided. Among methods of the second type administration of Centrophenoxine as well as C. D. P.-choline was a hopeful one according to our clinical experience.
The results of the above-described two types of equilibrium tests and subjective sensation of vertigo showed a fairly close parallelism between each other through the course of the treatment. Thus these two methods of examinations are, I think, quite effective not only in diagnosis of vertigo following lesions of the head and the neck, but also in observing clinical course of vertigo objectively.
