末梢前庭性疾患における注視方向性眼振

PERIPHERAL VERTIGO WITH GAZE NYSTAGMUS IN BILATERAL DIRECTIONS

　I．はじめに

　最近における神経耳科学の進歩とともに，異常自発眼運動の本態も解明されつつあり，眼振による病巣の局在診断もかなり的確に行なわれるようになつているが，なお，不明な点も少なくない。

　今回私どもは，明らかに末梢前庭性疾患である外耳道よりの経鼓膜的外傷による内耳損傷2症例中2例および耳石器障害が主因とされる良性発作性頭位眩暈症60例中6例において，左右注視（方向性）眼振が出現したのを観察したので，その概要を述べるとともに文献的考察を行ない，元来，中枢性障害に出現するといわれている注視方向性眼振が，末梢前庭性障害においても出現する可能性がかなり多い事を知つたので報告し，諸賢のご批判を得たい。

　Gaze nystagmus that occurred transiently in bilateral directions was observed among two cases, the recipient of inner ear injury by ear-picking in one case and an accidental piercing of the drum by a foreign body, a twig, in the other.

　Six other cases of gaze nystagmus in bilateral direction were seen in 60 cases of benign paroxysmal vertigo treated.

　Quite a few cases of gaze nystagmus in bilateral direction are reported in the literature who received inner ear injury due to labyrinthine operations such as sacculotomy, tack operation, fenestration etc. or who had vestibular disturbances not related to trauma or operations.

　These observations imply that the gaze nystagmus in bilateral direction may occur not only with cases of lesions in the central nervous system but also among those cases with lesions in the peripheral vestibular endorgans.