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  会員専用

• ホーム
• 51巻11号
• 臨床神経, 51：1086−1088, 2011
• 51巻11号目次

＜シンポジウム25―1＞めまいの臨床：最近の進歩

Overview：めまいの臨床を理解しよう

廣瀬　源二郎

医療法人社団浅ノ川浅ノ川総合病院脳神経センター〔〒920―8621 金沢市小坂町中83〕

Vestibular syndromes are one of the commonest paroxysmal disorders in our clinical practice. These consist of vertigo, oculomotor abnormalities (nystagmus), postural changes and nausea/vomiting. Vertigo can be classified as real vertigo and dizziness, based upon the presence of clinical rotatory perception. In order to diagnose a responsible lesion for various central and peripheral vestibular syndromes, we have to carefully observe nystagmus in patients with acute vertigo. Gaze-evoked nystagmus is the most important nystagmus in patients with the central vestibular syndromes. The finding is easily found at the bed side examination. In order to keep a velocityposition neural signal such as gaze holding, the neural structure to hold and maintain the neural command for a saccade is hypothesized and this has been called as the brainstem neural integrator, which sends tonic-step commands for eccentric gaze. If this fails then the integrator becomes leaky and the eyes drift back to the central position. This movement necessitates corrective saccades, hence gaze-evoked nystagmus will ensue. Vertical nystagmus such as primary position upbeat or downbeat nystagmus is also seen only in the central vestibular syndromes. The detection and diagnosis of these characteristic nystagmus are essential for primary clinicians who care patients with acute vertigo.
Full Text of this Article in Japanese PDF (262K)

(臨床神経, 51：1086−1088, 2011)
key words：回転性めまい，非回転性めまい，注視眼振，上眼瞼向き眼振，下眼瞼向き眼振

（受付日：2011年5月20日）