先天性眼振症のめまいの検討

Abstract

Congenital nystagmus in itself is not a disease which causes vertigo. However, 31 of 64 patients who visited our department with congenital nystagmus during the past 12 years had vertigo.The peculiarities of the vertigo in these patients were examined by neurological and neurootological examinations, and orthostatic dysregulation was evaluated in 15 patients with congenital nystagmus and vertigo.1) Twelve patients had orthostatic dysregulation, which was evaluated by either criteria of O.D. or the Schellong test.2) Basilar artery stenosis was found in one patient examined by cerebral angiography.3) Irregular spike and wave complexes were recorded in one patient's electroencephalogram after megibal activation.4) One patient had canal paresis.The diagnoses related to vertigo in the 15 patients with congenital nystagmus were : orthostatic dysregulation in nine, circulatory disturbance of the labyrinth in two, Meniere's disease in one, cerebrovascular insufficiency in one, sequelae of head injury in one, and autonomic seizures in one. Of the 15 patients, 13 had some autonomic disturbance. The results suggest that autonomic failure is associated with disturbance of the pursuit eye movement system in some cases of congenital nystagmus.