末梢性めまいとして経過観察中にてんかんの関与が判明した1症例

抄録

Vertigo, or dizziness, is a known manifestation of temporal lobe epilepsy. We report a case of temporal lobe epilepsy with vertigo. A 65-year-old man had repeated vertigo attacks with right ear tinnitus. Upon undergoing an otoacoustic emissions examination, he was found to have moderate sensorineural hearing loss in the right ear, an absence of caloric responses in the right ear, and an inner auditory hearing loss in the right ear. A brain MRI examination was unremarkable. Although we treated him for peripheral vertigo during the early stage of disease, the remission of the vertigo attacks was not achieved. At three years after his first visit, the vertigo attacks were still occurring but were also accompanied by a clouding of consciousness. An electroencephalographic examination suggested temporal lobe epilepsy. An MRI examination revealed severe atrophy of the cerebrum and hippocampus. Our findings suggest that temporal lobe epilepsy is still an important part of the differential diagnosis of intractable vertigo and vertigo of unknown origin.