温度刺激検査時の自律神経症状と対策

嘔気症状とその原因

抄録

For patients with dizziness, the caloric test is useful to diagnose the dysfunction of the lateral semicircular canal in the inner ear. However, in some patients, stimulation induces autonomic symptoms, such as nausea and vomiting, during and after the test. The susceptibility of patients to autonomic symptoms in response to caloric stimulation was evaluated in this study in order to pinpoint these patients before the caloric test.
A bithermal caloric test was performed in 227 patients with dizziness. We used an air calorization, in which hot (50°C) or cold (24°C) air was injected into the external auditory canal for 60 sec (total 61).
Sixty-six of 227 (29.1%) subjects complained of nausea. Eight (3.5%) patients suffered from vomiting. In 11 (4.8%), the caloric test was interrupted because of severe nausea and vomiting. The autonomic symptoms were found to be more severe and more frequent in younger and female patients, patients with orthostatic hypotension, patients susceptible to motion sickness and patients with a higher maximum slow phase velocity of caloric nystagmus.