神経耳科学的所見に乏しい浮動性めまいの臨床検討

抄録

　We studied 121 patients who complained of dizziness or imbalance without nystagmus or other neurological symptoms. We divided these patients into four groups according to the initial diagnosis made at first visit. There were 30 patients with dizziness associated with headache (migraine or tension-type headache), 24 with imbalance caused by autonomic dysfunction, 39 with psychogenic dizziness, and 28 patients with unknown cause of dizziness. The patients were treated according to the initial diagnosis and their symptoms were observed. Some patients underwent vestibular testing using electro nystagmo graphy (ENG) to detect central vertigo or canal paresis. Brain magnetic resonance imaging (MRI) or computed tomography (CT) were performed for some patients with suspected central vertigo. Subsequently, 14 patients were diagnosed with central vertigo and another 14 patients with vestibular disease. Only two of 14 patients with central vertigo showed abnormal findings on MRI, however, all of them showed abnormal eye movements on ENG. Finally, we diagnosed 27 patients with dizziness associated with headache, 18 with autonomic dysfunction, and 32 with psychogenic dizziness. Sixteen cases were still with unknown causes. We administered preventive medicine or kampo for the headache on dizzy patients with associated headache and also monitoring of a diary for headache and dizziness. Most patients with dizziness associated with either headache or autonomic dysfunction have become better within 1 year. Some patients with psychogenic dizziness dropped out from our treatment, while others continued the long term treatment.