フクシマ　ムネヒサ   Fukushima Munehisa   福嶋　宗久    所属   医学部 医学科（附属足立医療センター）    職種   講師
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Factors associated with spontaneous nystagmus changes in acute Ménière's disease.
掲載誌名	正式名：Journal of neurology 略　 称：J Neurol ISSNコード：14321459/03405354
掲載区分	国外
巻・号・頁	pp.11367
著者・共著者	Fukushima Munehisa†*, Waki Sadanori, Saho Makino, Akahani Shiro
担当区分	筆頭著者,責任著者
発行年月	2022/10
概要	BACKGROUND:Neuro-otological factors that influence changes in spontaneous nystagmus (SN) during vertigo attacks in Ménière's disease (MD) remain unclear.OBJECTIVE:To identify neuro-otological factors that might influence the initial direction of SN and the directional change of SN.METHODS:A prospective, observational study of 22 patients with definite MD to evaluate the initial direction and directional change of SN during vertigo attacks, endolymphatic hydrops (EH) volume, and the function of horizontal semicircular canal and hearing levels.RESULTS:SN consistently began as irritative in 17 of 22 cases, and 9 of 17 cases showed a definite change in direction after onset. SN consistently began as paralytic in 5 of 22 cases, and 3 of 5 cases showed a definite change in direction after onset. Subjects in the irritative initial SN group had less severe degrees of hearing loss, smaller cochlear and vestibular EH volume than the paralytic initial SN group (P = 0.017, < 0.001, and 0.009, respectively). Subjects in the SN direction change group had significantly smaller maximum slow phase velocity, percentage of caloric weakness and canal paresis than the no SN direction change group (P = 0.001, 0.006, and 0.001, respectively). Simple logistic regression analysis showed that smaller EH volume was significantly associated with initial irritative SN (OR = 0.867, 95% CI 0.762-0.988, P = 0.032) and that the degree of canal paresis was negatively associated with the presence of directional change of SN (OR = 0.022, 95% CI 0.002-0.289, P = 0.004).CONCLUSIONS:The morphology of EH and canal paresis may independently affect the characteristics of SN in patients with MD.
DOI	10.1007/s00415-022-11367-6
PMID	36180650