発症機構が異なると考えられるＯｐｓｏｃｌｏｎｕｓ２症例の神経耳科学的検討

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  • Neurootological studies on two cases of opsoclonus assumed to be of different pathogenesis.

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Two cases of opsoclonus-polymyoclonus syndrome are presented.<BR>A 62-year-old housewife with a history of hypertension suddenly developed headache, nausea, vomiting, numbness and motor disturbance of the extremities, paresthesia, vertigo, tinnitus and deafness. Neurological examination showed difficulty and unsteadiness in gait, slurred speech, pseudobulbar palsy, left motor weakness and dysmetria of extremities with sensory deficit of the left arm. Computer tomography, electroencephalogram and virus titers revealed no abnormal findings, but left vertebral-angiography showed an abnormal double shadow of the vertebral artery. Audiometry showed low tone sensory neuralhe aringl oss on the left side. There was complete gaze directional nystagmus, butabout one monthafter admission horizontal rapid irregular eye movement (opsoclonus) with palatal myoclonic jerking was observed when the eyes were open. The abnormalities in this case seen to be due to cerebellum and brain stem lesions secondary to vertebral artery damage.<BR>A 34-year-old female had an upper respiratory infection anorexia, nausea and general fatigability one month prior to admission. Her gait gradually became unsteady and staggering. Rapid irregular eye movement (opsoclonus) synchronized with jerky movement of the larynx gradually increased in severity. She showed moderate cerebellar signs but no sensory disturbance. In the treatment of this case steroid therapy proved to be quite effective. The etiology of the opsoclonus observed in these two cases appears to differ neuropathologically.

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