脳幹障害の診断における聴性後耳介反応の有用性について

Abstract

The postauricular myogenic response (PAR) was evaluated for the diagnosis of brainstem lesion. 23 patients with surgically or neurologically confirmed brainstem disorders and 22 normal adults were examined in this study, and except PAR the auditory brainstem response (ABR) was recorded for comparison.Two criteria were selected as an index to show the disturbances of the PAR pathways: an absence of the contralateral or ipsilateral response and a prolongation of the latency. The response was absent in cases with clival meningioma, basal chordoma and pinealoma, also in 3 of 22 normal subjects. The latency of the response prolonged in patients with acoustic tumor, multiple sclerosis, cerebellar tumor accompahying hydrocephalus and middle cranial fossa chordoma. Simultaneous recordings of PAR and ABR in cases of multiple sclerosis were useful for determining to map the precise site of lesion in the brainstem.Those results suggest that the prolonged latencies of the PAR are very useful for the localization of disturbance in the brainstem, and a combination of PAR and ABR appears to be a useful clinical tool for the diagnosis of the brainstem lesion.