方向交代性頭位眼振の臨床

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  • Clinical Features of Direction-Changing Positional Nystagmus.
  • ホウコウ コウタイセイトウイガンシン ノ リンショウ

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There are two major types of direction-changing positional nystagmus, namely, apogeotropic and geotropic nystagmus. Both peripheral and central lesions are involved in these two types of nystagmus. Peripheral lesions include various types of disorders such as Meniere's disease, sudden deafness, vestibular neuritis, and BPPV. In our series, there were 30 peripheral, 8 central, and 8 unknown lesions. On occasion, nystagmus is so intense that a surgical procedure is indicated. The present case is a 63-year-old woman who had a disabling positional vertigo for a period of 4 months. She showed intense direction-changing apogeotropic nystagmus. Conservative treatments failed to resolve her vertigo. From the findings of the nystagmus, cupulolithiasis of the right lateral semicircular canal was suspected. Plugging of the lateral canal was performed, which successfully eliminated the nystagmus and positional vertigo. Positional vertigo can sometimes be disabling and unresponsive to conservative therapy. Careful analysis of the nystagmus may allow selection of an appropriate treatment.

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