せき髄小脳変性症における神経耳科学的所見

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  • Neurotological Findings in Spino-cerebellar Degeneration
  • セキズイ ショウノウ ヘンセイショウ ニ オケル シンケイ ジカガクテキ ショ

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Forty patients with spino-cerebellar degeneration were examined neurotologically. The chief findings were as follows:<br>1) Spontaneous nystagmus was relatively rare, but gaze paretic nystagmus, direction-changing positional nystagmus (especially apogeotropic type) and counter-beating vertical positioning nystagmus were observed very frequently.<br>2) Rebound nystagmus, flutter-like oscillation and transitory alternating saccade were observed in five to eleven patients.<br>3) Saccadic dysmetria and disturbance on rapid, alternating change of gaze were remarkable in about two-thirds of the patients, though the velocity of saccade itself was not influenced by the disease.<br>4) Optokinetic nystagmus and smooth pursuit movement were impaired in 80-90% of the patients.<br>5) The release phenomenon of cerebellar and/or brainstem inhibition of the vestibulo-ocular reflex was seen during the visual suppression test (after Takemori) and pendular rotation.<br>6) Disturbance of gaze control and change in the vestibulo-ocular reflex seemed to be important in the diagnosis of the cerebellar and/or brainstem lesions.

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