眩暈・前庭神經・迷路

Dizziness, Vestibular Nerve, and Labirynth.

緒言

　Goldsteinにによると，眩暈は急激に身體の自由を失い自己主宰性（Herrschaft　Über den Körp-er）をなくす時に起る一種の感覺で，主として知覺神經の強刺戟乃至異常刺戟により起されるという。前庭神經の末稍装置である迷路が強く刺戟され或は前庭神經の領域に病變が起つて眩暈の現れるのもその例であるが，この神經が他の知覺神經と比して格別眩暈を起し易いことは一般に知られている。これは，この神經が筋肉の緊張や自律神經と特種な關係を持つているからである。すなわち，反射的に眼筋の緊張を變化して眼球震盪を起したり，頸筋，四肢筋の緊張を變化して體勢を崩したり，或はまた交感，副交感神經の平衡を破つて諸器官に變調を來すので，特に自己主宰性を失う感覺が強く起されるのである。それで前庭神經，迷路を通て眩暈と筋緊張の問題，眩暈と自律神經の問題について述べることとする。なお，眩暈を主症候とする前庭神經，迷路の疾患であるMniere氏病の病理が充分明かでないので，最近の臨床的觀察を基礎としてその本態について述べる。

According to Goldstein, dizziness is said to be a sort of sensation which appears in the case of losing the control of the body. Vesti-bular or labirynthic dizziness appears due to the loss of control of the body by ocular ny-stagmus or disturbance of bodily balance. In short, dizzidess is caused by disturbance of the balance of antagonizing labirynthic muscle tonus.

Labirynthic muscule tonus is not given to all body muscles, as considered generally, but to muscles of eyes and neck, i.e, the labiryn-thic tonus is not given to muscles of extremi-ties. Ocular nystagmus is caused by the abnormalities of ocular muscle tonus due to semicircular canals, and disturbance of bodily balance is caused by abnormalities of neck-muscle tonus due to vestibular apparatus. In the case of vestibular or labirynthic dizziness, autonomic nervous symptomes, e. g., paleness of face, nausea, vomiting etc. appears simul-taneously. These are caused by the excitation of sympathetic nerve. Labirynth has connec-tion with autonomic nerve, its excitation as well as destraction can excite the sympathe-tic nerve.

For Menière's syndrome in which the vesti-bular dizziness appears as main symptome, the intravenous injecfion of aquous Sodium bicarbonate solution of high concentration is excedingly effective. Considering this disease as angiospasmus of blood vessels of vestibular area according to Kobrak's theory, it is easily comprehensive that the Sodium bicarbonate injection is effective. That is, by this injection, there evoke the dilatation of peripheral blood vessels, lowering the colloidal osmatic pressure, increase of blood Calcium, decrease of blood sugar, and the loose of angiospamus, the re-covery of edema or the difuse bleeding of lab-irynth. is expected.