末梢前庭障害様所見を呈した正常圧水頭症によるめまいと考えられた1例

DOI 参考文献8件
  • 道祖尾 弦
    五島中央病院耳鼻咽喉科 長崎大学大学院医歯薬学総合研究科展開医療科学講座耳鼻咽喉・頭頚部外科
  • 隈上 秀高
    日本赤十字社長崎原爆病院耳鼻咽喉科
  • 髙橋 晴雄
    五島中央病院耳鼻咽喉科

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  • A case of normal pressure hydrocephalus with peripheral vestibular disorder-like findings.

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We hereby report on our experience regarding a case of rotatory vertigo exhibiting vestibular disorder-like findings accompanying normal pressure hydrocephalus (NPH).<br>　The case pertains to a 60-year-old man. Gait disturbance, dysuria, and so on, appeared from around 2007, and he was diagnosed as having NPH by the Department of Neurology of our hospital?. Rotatory vertigo suddenly appeared in October 2011, and he was admitted to the Department of Neurology and subsequently referred to our department on the 2nd sick day. Third degree of horizontal rotatory nystagmus to the left was observed, with no difference between the left and right observed upon a hearing test, and although he was observed with an increased threshold in the high sound area appropriate to his age, no other neurologic symptoms were observed. An equilibrium test was carried out at a later date under the suspicion of right vestibular neuronitis, however, no decline in semicircular canal function was observed upon caloric testing, with no difference between the left and right observed as well upon vestibule-ocular reflex (VOR), and so a follow-up was carried out with a diagnosis of vertebrobasilar insufficiency. The symptoms subsequently rapidly improved, however, nystagmus to the left at III° appeared again one week later, with the same nystagmus appearing again two months later. Lightheadedness was prolonged when rotatory vertigo attacks were not observed and so the patient consulted the Department of Neurology and underwent a tap test taking into consideration his dizziness caused by NPH, as a result of which his dizziness rapidly disappeared compared to the day prior, along with the other symptoms including improved gait disturbance and dysuria, which all continued to improve further. Subsequently, all dizziness disappeared after undergoing an endoscopic third ventriculostomy.

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