機能的眼振の1例—Flutter like oscillations様の異常眼球運動を示した登校拒否症

A Case with Abnormal Eye Movement (Flutter Like Oscillation, FLO)

I．はじめに

　flutter like oscillations（以下FLOと略す）は稀な異常眼球運動の一つで，脳炎，腫瘍，血管障害などによる小脳または小脳神経路の障害で発現すると報告^1〜3）されている。FLOと似た眼球運動にはopsoclonusと随意性眼振がある。随意性眼振とは随意的に眼振の解発と停止ができるものをいい，病的意義はない^1,4〜14）。

　われわれは，メマイ，頭痛，嘔気の症状を訴えFLOに酷似した眼球運動を示した13歳の少女の症例を経験した。心理療法を開始後，患者のメマイなどの症状の訴えとFLO様眼球運動は消失し，代わって随意性眼振が出現するという興味深い経過をみせた1例なので報告する。

　A 13-year-old girl complained of vertiginous attacks, and presented abnormal eye movements which were indistinguishable from flutter like oscillations (FLO). Examinations revealed ataxia, the FLO like eye movements and neurotic tendency.

　After several psychological interviews, the vertiginous attacks, ataxia and the FLO like eye movements disappeared, and voluntary nystagmus during convergence was appeared. We concluded that the FLO like eye movements occurred from the same origin with voluntary nystagmus and were not pathological sign. This case presented the interesting clinical features of voluntary nystagmus which was affected by psychological factors.