Practica Oto-Rhino-Laryngologica
Online ISSN : 1884-4545
Print ISSN : 0032-6313
ISSN-L : 0032-6313
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Volume 78, Issue 11special
Displaying 1-34 of 34 articles from this issue
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  • An Epidemiological Study of Peripheral Vestibular Disorders in Toyama Prefecture
    Kanemasa Mizukoshi, Hideo Shojaku, Yukio Watanabe, Naoki Ohashi, Hidet ...
    1985 Volume 78 Issue 11special Pages 2451-2459
    Published: November 25, 1985
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.78.11special_2451
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    Of the 1, 399 patients who visited the Neuro-Otological clinic of the Toyama Medical and Pharmaceutical University Hospital from January 1982 to December 1984, peripheral vestibular disorders were diagnosed 559 (40.0%). Of these, 61 (4.4%) had definite Mèniére's disease, 73 (5.2%) had benign paroxysmal positional vertigo (BPPV), and 45 had sudden deafness with vertigo and/or dizziness. The diagnosis of these three diseases was based on the criterca of the Research Committee of Peripheral Vestibular Disorders.
    An epidemiological study of these patients revealed the following features.
    1) The incidence of Mèniére's disease in Toyama Prefecture was 17.3per 100, 000 population on the basis of the reports of this intractable disease by the members of the Toyama Medical Association. The incidence of BPPV in Toyama was 26.3per 100, 000 population, and that of sudden deafness with vertigo was 18.5 among the patients examined at Toyama Medical and Pharmaceutical University Hospital.
    2) The male: female ratio among in patients with definite Mèniére's disease, was 21:40; for BPPV it was smaller (22:51). Among those with sudden deafness with vertigo it was 21:24.
    3) The age at the onset of Mèniére's disease peaked in the third decade in males and in the fifth decade in females. The peak for BPPV in males was in the forth decade, while in females it was in the fifth decade. Sudden deafness peaked in the fifth decade in both males and females.
    4) The number of patients with Mèniére's disease was higher in the cities of Toyama Prefecture than in the rural areas. The other diseases showed the same geographic distribution.
    5) Of the 61 patients with definite Mèniére's disease, 8 had bilateral symptoms (13.18%). Among the 45 patients with sudden deafness, there were no cases of bilateral deafness.
    This epidemiological study shows that the characteristic features of Mèniére's disease are similar to those of BPPV but different from those of sudden deafness.
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  • A Study of the Three Dimensional Structure, Surface Area, and Hair Cell Population of the Vestibular Maculae in the Bullfrog
    Ryozo Yabuta
    1985 Volume 78 Issue 11special Pages 2460-2468
    Published: November 25, 1985
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.78.11special_2460
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    The three dimensional structure of the vestibular maculae in the bullfrog was observed with a scanning electron microscope (SEM), and these surface areas were measured with a digitizer on SEM micrograph used computer. The hair cell population of three maculae was obtained by counting each hair cell on the micrographs. The results were as follows.
    1. The hair bundles were classified into three types in the utricle and the lagena and two types in the saccule.
    2. The mean value of the surface area was 0.34mm2 in the utricular macula and 0.24mm2 in the saccular macula.
    The hair cell population was 9946 in the utricular macula, 2583 in the saccular macula, and 3610 in the lagenar macula.
    3. The hair cell density of the utricle was three times as high as the saccule.
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  • Three Dimensional Ultrastructure of the Vestibular Ganglion of the Bull Frog
    Nobuharu Tagashira, Yasuo Harada, Masaya Takumida, Mamoru Ito, Akira N ...
    1985 Volume 78 Issue 11special Pages 2469-2478
    Published: November 25, 1985
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.78.11special_2469
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    The fine structure of the vestibular ganglion of the bull frog was studied three dimensionally by scanning electron microscope. The majority of the ganglion cells were myelinated bipolar cells, but non-mylinated cells were occasionally observed.
    The intracellular organella, for instance, Golgi apparatus, endoplasmic reticulm mitochondria, were clearly demonstrated as three dimensional structure. The morphological details of the Schwann cells, the myelin sheaths and the intraaxonal structures were also described.
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  • Inner Ear Damage Induced by Bacteria (Mycobacterium fortuitum)
    Masaya Takumida, Nobuharu Tagashira, Yutaka Nagasawa, Seiichi Kawamata ...
    1985 Volume 78 Issue 11special Pages 2479-2486
    Published: November 25, 1985
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.78.11special_2479
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    The changes in the inner ear of the mice with induced M. fortuitum infection were observed by electron microscope.
    In the organ of Corti the inner and outer hair cells had degenerated and disappeared. The changes in the lower turn of the cochlea were more severe than in the upper turn and the changes of the outer hair cells were more severe than those of the inner hair cells.
    In the vestibular organs, disappearance, fusion and balooning of the sensory hairs were observed.
    The bacterial extract also induced inner ear damage which was similar to that caused by viable M. fortuitum.
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  • Histopathological Study of Bacterial Labyrinthitis
    Tetsuo Ishii, Tomokazu Kamio, Shunkichi Baba
    1985 Volume 78 Issue 11special Pages 2487-2493
    Published: November 25, 1985
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.78.11special_2487
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    We report here the temporal bone histopathology of a 50-year-old woman who died of renal insufficiency due to diabetes mellitus. She had complained of profound deafness of both ears and dizziness. She had no caloric response, and spontaneous nystagmus towards the left was observed 20 days before death.
    The temporal bone findings indicated typical bacterial labyrinthitis. Infectious changes indicated typical bacterial labyrinthitis. Infectious changes invaded the cochlea through the round window and destroyed the cochlea. The pathology of the left ear was greater than that of the right ear. These inner ear changes correlated well with auditory and vestibular function tested before death.
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  • Drug Permeability of the Endolymphatic Sac and Peripheral Vestibular Disorders
    Hideo Yamane, Yoshiaki Nakai, Masao Sugiyama, Kazuo Konishi, Toshie Sa ...
    1985 Volume 78 Issue 11special Pages 2494-2500
    Published: November 25, 1985
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.78.11special_2494
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    The location of intravenously injected kanamycin sulfate (KM) in the endolymphatic sac (ES) of guinea pigs was investigated immunohistologically. Animals were sacrificed 1, 2, 5, 10 and 30 minutes after KM injection. One minute after KM injection, KM had already passed through the capillaries in the subepithelial layer of the ES and reached the epithelial layer. As time elapsed, the amount of KM in the epithelial layer of the ES increased. KM also accumuated in the floating cells in the ES.
    These results indicate that the ES is relatively permable to systemically injected drugs. Their passage into the regional endolymph should be investigated from the viewpoints of drug ototoxity and treatment of inner ear disturbances.
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  • Experimental Study of Furosemide Migration to Inner Ear Fluid
    Masaki Ohmura, Kazuo Makimoto, Akira Kamiya, Katsuhiko Okumura
    1985 Volume 78 Issue 11special Pages 2501-2506
    Published: November 25, 1985
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.78.11special_2501
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    Furosemide concentrations in the perilymph, cerebrospinal fluid (CSF) and serum were measured in guinea pigs after intravenous injections of furosemide (40mg/kg, 100mg/kg). The concentration in the serum reached its peak within 5 minutes after injection and then decreased slowly. The concentrations in the perilymph and CSF were about 1/800 of the serum level and kept increased more and more for 60 minutes after injection. Thus, the blood cochlea barrier (blood perilymph barrier) is as impermeable as the blood brain barrier (blood CSF barrier).
    The furosemide concentration in the perilymph after the injection of 100mg/kg of furosemide was about 6.5 times that after the injection of 40mg/kg. This great increase in the perilymphatic concentration is due to the large increase of free furosemide in the serum.
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  • Function of the Stria Vascularis in Endolymphatic Hydrops
    Tamotsu Harada, Mitsuhito Sano, Toru Matsunaga, Kyogusu Hong, Kozo Ino ...
    1985 Volume 78 Issue 11special Pages 2507-2516
    Published: November 25, 1985
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.78.11special_2507
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    We examined electronmicroscopically the inner ear of guinea pigs sensitized with the stria vascularis of rabbits. 25, 000 units of HRP were injected through a catheter in the right jugular vein. The tracer was observed in the stria vascularis, around the capillary vessels, in the marginal cells and in the intercellular spaces of these animals. The region of the intermediate cells in the stria vascularis was stained with HRP, and vacuolar degeneration was present in the marginal cells. This implies that the parenchymatous cells of the stria vascularis are damaged. We examined the effect of anaphylatoxins on the stria vascularis.
    Ten guinea pigs were injected with Zymosan+guinea pig serum+ε-aminocaproic acid and 10 guinea pigs with guinea pig serum+ε-aminocaproic acid into the carotid artery. Under anesthesia with nembutal, these animals were perfused with 10% neutral formalin and immobilized. Tissues were examined after HE staining. The stria vascularis of various cochlear turns showed marked atrophy except in the basal turn, and also some animals indicated the mild endolymphatic hydrops. These findings suggest that endolymphatic hydrops and other inner ear pathological conditions are related to anaphylotoxins.
    Furthermore, electronmicroscopic findings included hyperpermeability of the stria vascularis. The increase of permeability may be due to the leakage in intercellular spaces or in the destroyed region of the endothelial cells in addition to the usual vesicular transport.
    We conclude that the stria vascularis plays an important role in the development of endolymphatic hydrops.
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  • Measurement of Endolymphatic and Perilymphatic Pressure in the Guinea Pig Cochlea
    Masafumi Yoshida, Takuya Uemura
    1985 Volume 78 Issue 11special Pages 2517-2523
    Published: November 25, 1985
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.78.11special_2517
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    Hydrostatic pressure in the endolymph and perilymph was measured by a servo-controlled micropipette system in guinea pigs anesthetized with pentobarbital. During and after 3 minutes of anoxia, endolymphatic pressure showed changes similar to those observed in systemic arterial pressure and cochlear blood flow. Fine fluctuations with influences of heartbeat and respiration were observed in the endolymphatic pressure. These facts indicate that the system is applicable for the accurate measurement of inner ear pressure, especially of endolymphatic pressure. In guinea pigs with middle ear filled with a saturated sodium chloride solution, both endo- and perilymphatic pressure measurements showed a gradual decline for 15 minutes and a slow recovery during the next 25 minutes. These pressure changes indicate that water is transferred through the semipermeable membrane of the inner ear due to modified osmolarity. The absence of a pressure gradient between the two fluids during the period of observation suggests that Riessner's membrane is not stiff.
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  • Effects of an Aminoglycoside on Pregnant Mice and on the Postnatal Development of Their Offspring
    With Special Reference to Reflex and Equilibrium Funotion
    Osamu Tanaka, Yasuhiko Nakamoto, Hiroki Otani
    1985 Volume 78 Issue 11special Pages 2524-2534
    Published: November 25, 1985
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.78.11special_2524
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    Aminoglycoside treatment during pregnancy is known to have toxic effects on the postnatal development of the audiocochlear system of neonates. The authors examined postnatal physiological and morphological changes in offspring of ICR mice given intraperitoneal injections of streptomycin sulphate (SM), and kanamycin sulphate (KM) from day 12 to day 18 of gestation (250mg/kg/day of SM and 500mg/kg/day of KM). In the control group, 1ml of physiological saline was injected intraperitoneally during the same period of gestation. Sixty offspring (SM: 20, KM: 20 and control: 20) were examined functionally by behavior tests, and the morphological changes in the inner ear were studied by scanning electron microscope. The results of the behavior tests were analyzed statistically. No significant differences were found between the control and experimental groups in average body weight increase, activity, or functional development such as grooming. In the period of development of the Auditory Startle Response, the responsiveness of the KM group was significantly less than that of the SM or control group. The KM group had more severe morphological changes, characterized by polyp-like cytoplasmic extrusions of the inner hair cells in the cochlea. The Transversing Narrow Path and Rotor Rod test success rate was lower in the SM and KM groups than in the control group.
    Disarray of the step-like formation and degeneration of sensory cells were the main abnormalities along the striolas of the macula utriculi in the KM and SM groups. The damage was more severe in the SM than in the KM group.
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  • Observations on Otolithic Function in Bilateral Caloric Dysfunction
    Shigeaki Shirabe
    1985 Volume 78 Issue 11special Pages 2535-2538
    Published: November 25, 1985
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.78.11special_2535
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    Ten patients with bilateral caloric dysfunction were studied in a tilt chair for the otolithic function test.
    In 4 cases of bilateral vestibular neuronitis and 2 cases of bilateral labyrinthitis (postoperative), the nystagmus response was clearly although they were unresponsive bilaterally to caloric and rotational stimuli.
    One patient with bilateral damage after streptomycin therapy, 2 with a history of head trauma and one with syphilis of the labyrinth were unresponsive to tile stimulation. These patients had real bilateral “dead” labyrinths. The results of the tilt chair test suggest that bilateral caloric dysfunction involves not only the vestibular nerve and semicircular canal systems but also the otolith organ system.
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  • An Epidemiologic Study of Severe Bilateral Dysfunction of the Labyrinth
    Jin Okubo, Hiroyoshi Ishida, Isamu Watanabe
    1985 Volume 78 Issue 11special Pages 2539-2546
    Published: November 25, 1985
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.78.11special_2539
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    As of Feb. 1985, 87 cases of severe bilateral dysfunction of the labyrinth had been treated, 62 more than previous by reported. The age distribution of the onset of this disease was high in the fifth sixth and seventh decades and low in the fourth. The sex ratio was 1:1. In the previous medical history tuberclosis (SM) was present in 30-40%. The alleged cause of this disease was physical fatigue in 15%. The nature of the dizziness was repetition and floating in 60%, influenced by movements of the head or neck in about 60%. Tinnitus and deafness were present in 40% and 17% respectively. These findings suggest that in epidemiological studies of severe bilateral dysfunction of the labyrinth one must examine in detail the degree of hearing loss and clearly differentiate it from bilateral Ménières disease.
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  • Successive Observation of Bilateral Labyrinthine Function Loss
    Izumi Koizuka, Takeshi Kubo, Takayuki Shiraishi, Toru Matsunaga
    1985 Volume 78 Issue 11special Pages 2547-2554
    Published: November 25, 1985
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.78.11special_2547
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    Successive observations of four patients with bilateral severe labyrinthine function loss who showed marked jumbling phenomenon were performed with the use of the damped pendular rotation test, statokinesigraphy, OKN and ETT.
    1) Patients with severe hearing loss tend to visit our clinic earlier than those with less severe impairment.
    2) None four cases had nystagmus.
    3) The stepping test was also thought to be useful in detecting bilateral labyrinthine function loss.
    4) The OKN and ETT were normal in all four patients.
    5) Continuous decay of OVR-gain was observed in two of the four patients who showed gradual improvement of the jumbling phenomenon.
    7) OVR-gain seemed to be a sensitive indicater of the state of compensation.
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  • Follow-up Study on Severe Bilateral Vestibular Impairment
    Keiko Kanesada, Toru Sekitani, Takaaki Noguchi, Toshinari Kido, Yuji I ...
    1985 Volume 78 Issue 11special Pages 2555-2562
    Published: November 25, 1985
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.78.11special_2555
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    Eighteen cases of severe vestibular impairment due to aminoglycosides were followed otoneurologically. The prognosis and primary cause of the disequilibrium due to ototoxity and vulnerability were evaluated.
    (1) Fourteen patients had received streptomycin sulfate (SM), one streptomycin plus gentamycin (GM) and one streptomycin with sisomycin (SISO).
    (2) The total dose of SM at the onset of “jumbling phenomenon” was from 6 to 55 grams.
    (3) GM was given in a total dose of 5.64g and SISO in one of 1.5g.
    (4) Six of the seven patients who had dead labyrinths at the onset of disequilibrium showed no improvement, and they all complained that the jumbling phenomenon persisted.
    (5) Five patients had various degrees of renal dysfunction prior to their vestibular impairment.
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  • An Investigation of Laterotorsion after Caloric Stimulation in Patients with Bilateral Dead or Almost Non Functioning Labyrinths by a New Device
    a Head Rest and Microcomputer
    Kosuke Ishii, Takashi Futaki, Takesumi Dohi
    1985 Volume 78 Issue 11special Pages 2563-2569
    Published: November 25, 1985
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.78.11special_2563
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    The authors developed a new device an “Encorder”, which records on line three parameters: axis rotation, wipering action and sliding side to side. Criptspinal reflexes after irrigation with ice water in patients with bilateral almost nonfunctioning labyrinths were recorded. Patients with poor responses to caloric stimulation but well maintained laterotorsion did not show the “jumbling phenomenon”.
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  • Equilibrium Function Test in Patients Treated with Streptomycin
    Toshie Sakurai, Yosiaki Nakai, Hideo Yamane, Kazuo Konishi, Keiko Taen ...
    1985 Volume 78 Issue 11special Pages 2570-2582
    Published: November 25, 1985
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.78.11special_2570
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    Among 68 patients treated with streptomycin sulfate (SM) 7 with the jumbling phenomenon (JP) showed severe bilateral vestibular dysfunction. Five of them were followed for long periods to investigate the recovery of body equilibrium, which we call vestibular compensation (VC).
    The results of vestibular function tests of these patients were compared with those of patients with unilateral dead labyrinth due to C-P angle tumor or its surgical treatment.
    The patients with unilateral dead labyrinth showed good recovery of body equilibrium with eyes either open or closed. On the otherhand, in the patients with bilateral vestibular injury we could not recognize any improvement of body balance, and the center of gravity was never within the confidence limit.
    These result suggest one labyrinth is necessary for completing VC, even though its function is partial.
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  • A Case of Vestibular Ototoxicity Caused by Ribostamycin (RSM) and Dibekacin (DKB)
    Hideo Miyata
    1985 Volume 78 Issue 11special Pages 2583-2591
    Published: November 25, 1985
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.78.11special_2583
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    A 48 year old male with perianal abscess was given intramuscular injections of RSM 2gm. per day for 6 days, then a combination of RSM 1gm. and DKB 100mg per day for one day, followed by DKB 200mg per day for 8 days. He complained of equilibrium disturbances when the dose of RSM reached 13gm, and DKB (dose level unclear). The chief complaint on his first visit was not deafness but disturbance of standing and walking and of visual fixation while walking and running (jumbling phenomenon). The equilibrium test showed a marked disturbance of standing with eyes closed. Labyrinthine excitability was greatly decreased bilaterally.
    The galvanic nystagmus test revealed that the site of damage was the vestibular neuroepithelium.
    The rotatory responses had recovered slightly about 5 months after the onset.
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  • Bilateral Vestibular Hypofunction in Dialyzed Patients with Chronic Renal Failure
    Shigeaki Shirabe, Keizo Yamasaki
    1985 Volume 78 Issue 11special Pages 2592-2597
    Published: November 25, 1985
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.78.11special_2592
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    There are fewer reports on vestibular function in patients with renal failure than on impaired hearing. Grahe reported in 1924 that 13 to 32 patients with nephritis had either spontaneous nystagmus or abnormalities on the past pointing test. According to a recent study by Yassin (1970), vertigo was noted in 37% of 114 patients with renal failure, and only 28% had normal caloric tests. We describe here 4 patients on dialysis with bilateral vestibular hypofunction whom we treated during the past year.
    Two patients who had received periodic hemodialysis, a 66-year-old man and a 69 year-old man, were found to have bilateral dysfunction to caloric and rotational stimuli after treatment with amikacin and gentamicin. Another patient, a 54-year-old man with suspected homochronous bilateral vestibular neuronitis, is recovering gradually. Attempts to attribute this vestibular neuronitis to immunologic abnormalities in this patient on dialysis presented difficulties despite studies of the literature on similar cases. The fourth patient a 69-year-old woman with diabetes mellitus, diabetic nephropathy, and arteriosclerosis, had a long history of bilateral impaired hearing. The dialysis fluid had been increased just at the onset of her hearing problem.
    It is considered that in addition to these systemic risks, vascular and/or cellular degeneration may occur in the vestibular system of the inner ear. We have analyzed the symptoms and suggested the pathogenesis of the vestibular disorders in patients on dialysis.
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  • Character of Bilateral Vestibular Hypofunction Tested by Computerized Rotary Chair System
    Fumiaki Fujiwara, Jiro Hozawa, Shuji Ohta, Hiroaki Ichijo, Keiichi Ike ...
    1985 Volume 78 Issue 11special Pages 2598-2605
    Published: November 25, 1985
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.78.11special_2598
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    Bilateral vestibular hypofunction was investigated in 5 patients by the acceleration-deceleration test (±2, 4, 6, 8 and 10°/sec2, 10″) with Contraves' computerized rotary chair system.
    VOR-Gain and the Decrescendo Coeffieient (the ratio of nystagmus duration (M) to maximum eye velocity (D):D/M ratio) were used as parameters to evaluate the vestibular function. They were extremely low in patients with bilateral vestibular hypofuncion.
    A decline of the Decrescendo Coefficient was in line with enlargement of the stabilogram, and some patients with an extremely low Decrescendo Coefficient complained of the jumbling phenomenon.
    The Decrescendo Coefficient seems to be a valuable parameter in the evaluation of bilateral vestibular hypofunction.
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  • Clinical Findings of Galvanic Body Sway Test in Patients with Bilateral Vestibular Disorders
    Yukio Watanabe, Naoki Ohashi, Hideto Kobayashi, Hideya Ohi, Masayo Saw ...
    1985 Volume 78 Issue 11special Pages 2606-2610
    Published: November 25, 1985
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.78.11special_2606
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    Previously we reported that the Galvanic Body Sway Test (GBST) was a very useful method to differentiate between inner ear disorders and retro-labyrinthine lesions causing vestibular dysfunction. This paper describes clinical findings in patients with bilateral vestibular disorders.
    GBST was used in 26 patients with vertigo or disequilibrium and a bilateral depressed response to the caloric test. Eleven patients had peripheral lesions (inner ear or vestibular nerve), 9 had central lesions and 6 had combined or unknown lesions. Abnormal GBST responses were found in 13 cases (50%), a significantly higher percentage than in patients with unilateral dysfunction on the caloric test. Eight of the 9 patients with central disorders had abnormal GBST responses, but only 2 with peripheral lesions had abnormal GBST responses and these 2 patients had a very long duration of their disease. It has been considered that a depressed response in the caloric test indicates an inner ear disorder, but, as the above results show, retro-labyrinthine lesions were present in not a few patients with bilateral vestibular disorders. One should therefore take into consideration the possible presence of retro-labyrinthine lesions in the diagnosis of bilateral vestibular disorders.
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  • Clinical Significance of the Velocity of Bodily Sway of the Center of Gravity
    With Special Reference to the Evaluation of the Compensation Process in Patients with Vestibular Lesions
    Masahiko Yamamoto, Atsushi Komatsuzaki
    1985 Volume 78 Issue 11special Pages 2611-2614
    Published: November 25, 1985
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.78.11special_2611
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    An attempt was made to evaluate the compensation process in patients with vestibular lesions by studying the velocity of bodily sway of the center of gravity.
    Patients with vestibular neuronitis, Meniere's disease and bilateral vestibular hypofunction were teasted. The data of the body sway test were analyed by micro-computer to obtain the velocity of body sway. The analysis time was 60sec and the sampling time 0.1sec.
    1) In patients with acute vestibular lesions whose vergigo had persisted for a relatively long time, the velocity difference between swaying to the right and to the left disappeared earlier than did nystagmus under non-gaze conditions.
    2) The velocity difference or the abnormal high velocity of the center of body sway recovered relatively early when tested with the eyes open in patients with bilateral vestibular lesions. However, abnormal high velocity persisted longer in the non-gaze state, which seems to reflect delayed compensation of the posture.
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  • Incidence and Prevalence of Benign Paroxysmal Positional Vertigo in Sagamihara city, Kanagawa-ken
    Kohji Tokumasu, Akira Saito, Shinichi Nishihata, Akito Fujino, Kazuyos ...
    1985 Volume 78 Issue 11special Pages 2615-2621
    Published: November 25, 1985
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.78.11special_2615
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    From August 1971 to July 1978, 110 patients with benign paroxysmal positional vertigo visited the Neuro-otological Clinic of Kitasato University Hospital.
    The incidence and prevalence of benign paroxysmal positional vertigo in Sagamihara city, the population of which is about 400, 000 were estimated by the extended medical care fasility of Kitasato University Hospital.
    The mean incidence of benign paroxysmal positional vertigo for one year in Sagamihara city was 1.7per 100, 000 population and the prevalence for seven years was 10.2per 100, 000 population.
    A predominance in female and rising ratio of cases with benign paroxysmal positional vertigo to cases of Ménière's disease were observed.
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  • Comparison of Irritative Nystagmus and Paralytic Nystagmus in Eighty Patients with Unilateral Vestibular Disorder
    Jiro Hozawa, Kaoru Ishikawa, Keiji Fukuoka, Toshio Kamimura, Shuji Ota ...
    1985 Volume 78 Issue 11special Pages 2622-2628
    Published: November 25, 1985
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.78.11special_2622
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    Irritative nystagmus directed to the affected side had a large amplitude variation and a large slow phase velocity.
    Paralytic nystagmus directed to the sound side had a large interval variation and a small amplitude.
    Most of the 40 patients with irritative nystagmus complained of vertigo and the 40 patients with paralytic nystagmus complained of frequent dizzy sensations.
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  • Comparative Study of Cerebrospinal Fluid and Serological Data from Patients with Vestibular Neuronitis and Herpes Zoster
    Takaaki Matsuo, Toru Sekitani, Masaaki Hiyoshi, Yoshihiko Okinaka, Ats ...
    1985 Volume 78 Issue 11special Pages 2629-2640
    Published: November 25, 1985
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.78.11special_2629
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    Cerebrospinal fluid (CSF) was collected from seven patients with vestibular neuronitis and from seven with herpes zoster for immunological studies. Serological studies were conducted simultaneously. The patients with vestibular neuronitis were four males and three females, aged 28 to 55 years and those with herpes zoster were four males and three females aged 17 to 73 years. They were all observed for over three months. All CSF samples obtained by lumbar puncture were examined for total protein, albumin, IgG, IgA, IgM, cell count and various virus antibody titers (herpes simplex 1, varicella-zoster, cytomegalo, EB, rubeola, parainfluenza types 1-3, influenza A and B, rubella and Japanese encephalitis).
    1) The CSF in all seven cases of vestibular neuronitis showed a quite high protein content, increasing about two weeks after the onset; the cell count remained normal throughout the clinical course.
    2) The CSF/serum albumin index (CSF x 103/ serum albumin concentration ratio) and IgG index [(CSF/serum IgG)/(CSF/serum albumin)] were calculated. In vestibular neuronitis both of these indices were within the normal range and there was no significant change throughout the clinical course.
    3) Herpes simplex virus (HSV) type 1 IgG antibody titer in paired sera rose in one of the seven cases of vestibular neuronitis, but the antibody titer of the same virus in the CSF was not detected.
    4) Either HSV type 1 IgG or EB virus capsid antigen (EBV·CA) IgG antibody titer (FA) in the CSF was elevated in five cases of vestibular neuronitis.
    5) In the five cases of vestibular neuronitis the ratio of the CSF antibody titer to the serum was 1:160 for HSV IgG (FA), and≤1:80 for EBV·CA IgG (FA).
    6) In six of the seven cases of herpes zoster the CSF protein content rose slightly within a week after onset and then fell to the normal range during the clinical course.
    7) In the herpes zoster cases the CSF/serum albumin indices were all normal, while the IgG index was elevated in the two cases with lymphocytic pleocytosis in the CSF.
    8) In herpes zoster, varicella-zoster virus (VZV) IgG (FA) in the CSF was significantly elevated in the two cases with lymphocytic pleocytosis in the CSF.
    9) Either HSV IgG or EBV·CA IgG antibody titer (FA) in the CSF was elevated in four cases of herpes zoster.
    10) In the four cases of herpes zoster the ratio of the CSF antibody titer to the serum was 1:160 for HSV IgG (FA), and 1:160 to 1:320 for EBV·CA IgG (FA).
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  • Vestibular Neuronitis
    Follow-up of Serum Viral Antibody Titers (3rd report)
    Tetsuyasu Hirata, Toru Sekitani, Keiko Kanesada, Masaaki Hiyoshi, Taka ...
    1985 Volume 78 Issue 11special Pages 2641-2648
    Published: November 25, 1985
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.78.11special_2641
    JOURNAL FREE ACCESS
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    Thirty-two cases of vestibular neuronitis were investigated serologically. The viruses tested for were herpes simplex (CF), varicella-zoster (CF), adenovirus (CF), influenza A (CF) and B (CF), parainfluenza 3 (HI), mumps (HI) rubella (HI) and measles (HI). A search was also made for Mycoplasma (PHA).
    In seven of the 32 cases there was a four-fold or greater rise in antibody titers in paired sera: herpes simplex in one, adenovirus in two, influenza A in two, influenza B in three and rubella in one. It was assumed that viral infections played some role in the onset of vertigo in these patients.
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  • Analysis of Postural Change During Caloric Stimulation in Man
    Takeshi Kanaya, Masaru Shirato, Tokuji Unno
    1985 Volume 78 Issue 11special Pages 2649-2655
    Published: November 25, 1985
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.78.11special_2649
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    Postural change was analyzed during unilateral and bilateral caloric stimulation with ice water. During stimulation the normal subject was asked to maintain an upright position on a platform. Postural change was divided into postural deviation and body sway by a digital filter with reference to the power spectrum of the DC record. Right forward postural deviation and increased right-left and anterior-posterior body sway were observed during right caloric stimulation. Forward postural deviation and increased anterior-posterior body sway were observed during bilateral caloric stimulation. These results suggest that the neuronal mechanism of postural deviation and of body sway is not the same.
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  • Psychological Factors in Vestibular Dysfunction
    Sanae Katori, Shoji Takayasu
    1985 Volume 78 Issue 11special Pages 2656-2660
    Published: November 25, 1985
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.78.11special_2656
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    Possible psychological factors were investigated in 389 patients with vestibular dysfunction of recent onset treated during the past 4 years. The psychological factors were analyzed in those with a psychogenic etiology.
    Psychological factors were evident in 50 patients with recent onset (12.9% of cases of vestibular dysfunction and 1.5% of all cases of vertigo or dizziness), in 10.7% of those with typical Meniere's disease, in 12.1% of those with atypical Meniere's disease and in 32.6% of those with BPPV.
    In follow-up studies, however, psychological factors were found to be present in each attack in 14.3% of patients with BPPV, in 30% of those with atypical Meniere's disease, and in 50% of those with typical Meniere's disease.
    Psychological involvement was most common in males in their 40s and in females in their 50s. The content of the emotional problems tended to be work-related in males and home-related in females. This difference was significant.
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  • Psychological Factors in Meniere's Disease and Positional Vertigo
    Hajime Nakagawa, Kanemasa Mizukoshi, Masatsugu Asai, Naoki Ohashi
    1985 Volume 78 Issue 11special Pages 2661-2667
    Published: November 25, 1985
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.78.11special_2661
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    CMI and MPI tests were used to detect the influence of psychological factors on patients with Meniere's disease and B. P. P. N.
    The test results were compared with those of patients with chronic otitis media, or vocal cord polyps. A typical case in which psychological factors might influence the clinical course is presented.
    The conclusions are summerized as follows:
    1) Psychological factors can influence patients with B. P. P. N., as had already been noted in those with Meniere's disease.
    2) The correlation of CMI and Schellong tests was not clearly established.
    3) Either the CMI or the MPI test can inform us about the psychological aspects of patients with vestibular vertigo.
    4) The mechanics of how these psychological factors may affect vestibular vertigo, e. g. endolymphatic hydrops, is not yet clear. However, psychological factors do seem to somehow influence the onset and/or clinical course of the vertigo.
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  • Psychological Factors as a Cause of Peripheral Labyrinthine Vertigo
    From the Results of the Cornell Medical Index
    Kanae Nakamura, Yasuhiro Serizawa, Hisako Ito, Koji Kamimura, Michihik ...
    1985 Volume 78 Issue 11special Pages 2668-2673
    Published: November 25, 1985
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.78.11special_2668
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    The Cornell Medical Index (CMI) test was given to 68 patients with peripheral labyrinthine disorders to evaluate the influence of psychological factors on their vertigo. The series included 27 patients with Meniere's disease, 22 with benign paroxysmal positional vertigo (BPPV) and 19 with otogenic vertigo.
    1) CMI types III and IV were noted in 37% of those with Meniere's disease, in 28% of those with BPPV and in 32% of those with otogenic vertigo.
    2) Among females, CMI types III and IV were noted in 50% of those with Meniere's disease, in 36% of those with BPPV and in 50% of those with otogenic vertigo.
    3) The scores for physical and psychological symptoms showed no difference between Meniere's disease and BPPV.
    These results are similar to those in our previous report. The temperament of the patient seems to influence the clinical course of the vertigo.
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  • Results of Cornell Medical Index Tests in Patients with Vestibular Dysfunctions
    Keiko Taenaka, Yoshiaki Nakai, Hideo Yamane, Kazuo Konishi, Toshie Sak ...
    1985 Volume 78 Issue 11special Pages 2674-2686
    Published: November 25, 1985
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.78.11special_2674
    JOURNAL FREE ACCESS
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    The psychological factors influencing vestibular dysfunctions were tested by the Cornell Medical Index before and after therapy of patients with peripheral labyrinthine disorders: Meniere's disease, sudden deafness, vestibular neuritis, benign par oxysmal positional vertigo and otogenic vertigo.
    Before therapy, the percentage of types III and IV was almost the same in Meniere's disease, vestibular neuritis, benign paroxysmal positional vertigo and otogenic vertigo. After therapy depending on the treatment process, the result of CMI tests changed. In the patients with a worse course, psychological factors played a more important role than in those with a better course and made the symptoms of the disease more complex.
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  • Experimental Study on the Pathogenesis of Psychogenic Vertigo
    Toru Matsunaga, Kohichi Yamamoto
    1985 Volume 78 Issue 11special Pages 2687-2692
    Published: November 25, 1985
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.78.11special_2687
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    This study was performed to determine whether electrical stimulation of the autonomic centers, that is, the medial nuclei of the hypothalamus in the diencephalon causes asymmetric per-rotational nystagmus (PRN) in healthy or sympathectomized rabbits. The superior cervical ganglion was removed on one or both sides. Asymmetric PRN occurred very rarely in normal or bilaterally sympathoectomized animals, while directional preponderance (DP) appeared in more than half of the recordings in unilaterally sympathectomized animals. Although the rise in blood pressure (BP) during the intravenous influsion of norepinephrine in unilaterally sympathectomized animals also caused significant DP (previous paper), it was less than the degree of DP appearing with the same increment of BP caused by hypothalamic stimulation. Three of 5 animals with asymmetric PRN caused by stimulation showed side differences of cerebellar oxygen tension.
    These findings show that asymmetric PRN following hypothalamic stimulation can be explained by a neural action on the vestibular neurons from the hypothalamus via the brainstem reticular formation or the cerebellum in addition to the asymmetric vertebral blood flow induced by symathetic vasoconstriction. We propose that this experimental model shows how psychogenic vertigo and/or dizziness can originate from distrubances of the central autonomic nervous system.
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  • Analysis of Psychological Factors in Patients with Vestibular Dysfunction in Relation to Therapy
    (2) Patients with Non-otogenic Vertigo
    Shoji Takayasu, Sanae Katori
    1985 Volume 78 Issue 11special Pages 2693-2700
    Published: November 25, 1985
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.78.11special_2693
    JOURNAL FREE ACCESS
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    Using the CMI profile we previously studied the psychosomatic changes in patients with Meniere's disease as therapy progressed and reported two psychological factors, one causing the disease and the other changing after the onset of the disease; therapy was affected by the former.
    In this experiment, patients with non-otogenic vertigo or dizziness (Orthostatic Dysregulation and Cervical Vertigo) were examined in the same way to determine whether these characteristics are peculiar to Meniere's disease.
    The psychological profiles of the CMI were very similar at the onset of the diseases regardless of the prognosis and changed very little during treatment.
    This finding proves that the psychological features of Meniere's disease previously reported are peculiar to this disease.
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  • Correlation between Personality and Vestibular Dysfunction
    Hiroyoshi Ishida, Isamu Watanabe, Jin Okubo
    1985 Volume 78 Issue 11special Pages 2701-2707
    Published: November 25, 1985
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.78.11special_2701
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    Among 1300 patient with vestibular dysfunction surveyed epidemiologically, 843 were analysed as to personality type with disorder reference to vestibular and to subjective vertigo.
    (A) Correlation between Disease and Personality
    1) Few patients had a strong-minded or strong-willed personality.
    2) Strong-willed personality was apt to be present in patients suffering from traumatic dysfunction of the vestibular system.
    3) A social personality traits were often found in patients suffering from true Meniere's disease, suspected Meniere's disease, and advanced bilateralvestibular dysfunction.
    (B) Correlation between Subjective Vertigo and Personality
    1) In general, no differences in degree of subjective vertigo were observed among patients with different personality traits.
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  • Vertigo Affected by Psychological Factors
    Estimation by Questionnaires and Interviews
    Kiichiro Taguchi, Masato Kikukawa
    1985 Volume 78 Issue 11special Pages 2708-2713
    Published: November 25, 1985
    Released on J-STAGE: November 04, 2011
    DOIhttps://doi.org/10.5631/jibirin.78.11special_2708
    JOURNAL FREE ACCESS
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    The personalities of vertiginous patients with peripheral vestibular disorders were tested by three kinds of questionnaires and interviews. Cornell Medical Index-Health Questionnaire (CMI), Yatabe-Guilford Personality Test (Y-G Test) and Picture-Frustration Study (P-F Study) were given to patients to test the importance of pathological psychological factors.
    The results suggest that even patients who are emotionally stable and socially extrovert and aggressive can suffer from vertiginous attacks due to psychological factors and that three kinds of questionnaires, especially the P-F Study, are useful in the care of patients with vertigo.
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