FUKUSHIMA Munehisa
   Department   School of Medicine(Tokyo Women's Medical University Adachi Medical Center), School of Medicine
   Position   Assistant Professor
Article types Original article
Language English
Peer review Peer reviewed
Title Factors associated with spontaneous nystagmus changes in acute Ménière's disease.
Journal Formal name：Journal of neurology
Abbreviation：J Neurol
ISSN code：14321459/03405354
Domestic / ForeginForegin
Volume, Issue, Page pp.11367
Author and coauthor Fukushima Munehisa†*, Waki Sadanori, Saho Makino, Akahani Shiro
Authorship Lead author,Corresponding author
Publication date 2022/10
Summary 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