精神科領域のめまい

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タイトル別名
  • THE FEELING OF DIZZINESS IN PSYCHIATRY
  • セイシンカ リョウイキ ノ メマイ

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Twenty-three patients with dizziness were investigated from the point of view of psychiatry. The patients were examined in Memai (vertigo)-Center of Tachikawa National Hospital, then evaluated psychiatrically in our sanatorium. They were fifteen epileptics, two patients with depressive states, one schizophrenics, three neurotics and two organic rba in diseases. The characteristics of dizziness, diagnostic pitfalls and treatment are summarized as follows:<br>(1) Epileptic groups were divided into four subgroups in regard to the presence or absence of unequivocal epileptic seizures, duration of dizziness, neurotic tendency and epileptic findings in EEG.<br>In Type I, the dizziness was considered to be definitely epileptic. The symptom was very short in duration, and accompanied by disturbances of speech, motion, and visceral sensations. They seemd to be partial seizure with complex symptomatology of temporal origin. Carbamazepine was effective.<br>In Type II, the dizziness was thought to be probable epileptic in nature. The symptoms were a little longer in duration than Type I and had cloud of consciousness which were constant features. EEG showed no specific findings. Both ethosuximide and vatpronic acid were effective.<br>In Type III, the dizziness was supposed to be probably non-epileptic in nature. The symptoms were longer in duration and were similar to the feeling of drinking state. They had neither reproducibility or constancy in nature. Therapy was same as Type II.<br>In Type IV, the dizziness was regarded as doubtful epileptic one, had longer duration, with neurotic and inconstant features. In EEG they had temporal spikes, psychotherapy was important in this group.<br>(2) In neurotic groups, complaints of dizziness were more vague and amorphous than epileptics. Their personality were immature and emotionally unstable. They had manifold somatic and psychological precipitating factors in their background. Behind their hypochondrical and vague complaints, it was supposed to be somatic projection of labile interrelationship between environment and themselves, and of emotion of anxiety. The complaints were important reflections of the patients' dependancy. Thus, it is important therapeuticaly to show sympathy to patient's unstable human relationship and to help patient's independent thought and attitude.<br>(3) In depressives, characterstics of dizziness were dull feeling of head, morning unplesantness, daily fluctuation of mood, loss of thinking or will power, and sometimes depersonalization. Many hypochondriasis (pressure in the head or chest, fatigue, anorexia, insomnia, amenorrhea, constipation) were very important symptoms of masked depression. Anti-depressive drugs and psychotherapy were used.<br>(4) In schizophrenics, complaints of dizziness had features of something vague, bizzare and abstract, sometimes unrealistic and cosmic. Neurotropic drugs were used for the treatment.<br>(5) Frequency of dizzy feeling caused by side effects of psychotropic drugs were also mentioned.

収録刊行物

  • 医療

    医療 37 (2), 149-158, 1983

    一般社団法人 国立医療学会

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