高所めまいの成因について

DOI
  • 安田 宏一
    Department of Otorhinolaryngology, Hamanomachi Hospital, Fukuoka, Japan
  • 渡辺 晋
    Department of Otorhinolaryngology, Faculty of Medicine, Kyushu University, Fukuoka, Japan
  • 武谷 力
    Department of Psychosomatic Medicine, Faculty of Medicine, Kyushu University, Fukuoka, Japan

書誌事項

タイトル別名
  • Mechanismus of Height Vertigo (Acrophobia)

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It is well-known that height vertigo (acrophobia) influenced by visual and psychological functions. We hypothesized that it is also influenced by vestibular functions, and attempted to obtain some objective data, rarely seen in previous literatures.<BR>The subjects were 13 patients (9 males & 4 females) who visited Kyushu University hospital, because they suffered from acrophobia. The control group consisted of 10 healthy adult volunteers (6 males & 4 females). All subjects received simple vestibular examination and were found to be normal except for one acrophobia with Meniere's desease who was slightly abnormal. Subjects were also given a psychological test (Taylor's Manifest Anxiety Scale).<BR>Postural sway was measured as follows: The projection of the center of gravity to the horizontal plane of a standing subject was determined by measuring the weight at three points of the supporting plane. Each point was supported by three strain guages. Any weight change was amplified and recorded on an X-Y recorder, and its area was measured afterwards by a planimeter.<BR>Subjects were instructed to stand on the supporting plane quietly holding the stereo-photographic slide viewer. Subjecs were then instructed to look at, in a random sequence, two scenes through the viewer: (B1) a beautiful flower (color slide),(B2) a view looking down from a tall building (color slide). These subjects were questioned and their subjective experiences of fear were rated (Subjective Units of Disturbance): (B3) the subjects in this group were asked to imagine they were looking down from a tall building or high places, while holding the slide viewer and keeping their eyes closed,(B4) the same procedure as in B3 except that the eyes remained open. Subjects were also instructed to repeat the above procedures using three different head positions: (C1) horizontal position,(C2) 45 degrees to the horizontal plane, head pointing upwards,(C3) 45 degrees, head pointing downwards.<BR>A statistical analysis of the data from groups B1, B2, B3, B4 showed that the mean postural sway of the patient group was significantly greater during both visualizing and imagining great heights than during visualizing a flower (p<0.05). The control group showed no significant differences in postural sway between any of the conditions (Fig.2). Also, comparisons between the three head positions of the both groups (C1, C2, C3) showed that there were no significant differences between them (Fig.3).<BR>Mean scores for the Manifest Anxiety Scale were 20.4 for the patient group and 15.2 for the control group. Mean Subjective Units of Disturbance of group B2 were reported as 55 by the patients and 10 by the controls.<BR>Thus, we concluded that visual and psychological influences on the fear of heights are related to the actual postural sway, while the equilibrium functions were not related to it.

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