小脳障害例の直立姿勢に現われる身体動揺の研究
1984 年 77 巻 1special 号 p. 219-258
詳細
1984 年 77 巻 1special 号 p. 219-258
Body sway while standing was examined in 24 patients with spino-cerebellar degeneration (SCD) and 12 patients with cerebellar tumor.
The subject was instructed to stand with his feet together in the center of the statograph. His head was then connected to a cephalograph fixed to the ceiling. The sway of the head and the center of gravity of the body were recorded simultaneously with two X-Y recorders and a 4-channel magnetic tape recorder for 60 seconds with eyes open and 60 seconds with eyes closed. On the basis of the X-Y recordings, measurement of the area of sway, classification of sway types and calculation of the Romberg quotient were performed. The tape recording results were used to measure the length of the sway and the number of waves and for correlation analysis and power spectral density analysis with a PDP-12 computer.
(1) Thirteen patients with the cerebellar type of SCD, including LCCA, showed a diffuse sway of large amplitude with an irregular periodicity of about 0.1-0.3Hz. Romberg's sign was negative. The sway of the head was greater than that of the center of gravity of the body. The number of waves was within normal limits.
(2) In 11 patients with SCD with brain-stem and spinal cord symptoms in addition to cerebellar symptoms, including OPCA and Menzel type atrophy, the center of gravity showed a forward and backward sway with an irregular periodicity of about 0.1-0.2Hz with the eyes open, and 0.4-0.6Hz with the eyes closed. The number of waves was about twice normal. The length of the sway was markedly increased, while the area of the sway was only slightly increased in the statograms.
(3) In 7 patients with cerebellar hemisphere tumors, the sway of the head and the center of gravity showed a large and diffuse sway with an irregular periodicity of about 0.2Hz. The length of the sway was increased, but the number of waves was less than normal. The center of the sway of these patients was displaced in various directions.
(4) In 5 cases of cerebellar vermis tumor, the head showed a large and diffuse sway with a periodicity of about 0.1-0.3Hz, and the center of gravity showed a centripetal sway with an irregular periodicity of about 0.1-0.3Hz. The number of waves of both the head and center of gravity sway was normal. The area and length of the sway in patients with vermis tumor were much larger and longer than those in patients with hemisphere tumor.
