Oku Ryota, Shigeno Kohichiro, Kumagami Hidetaka, Takahashi Haruo
Department of Otolaryngology, Head and Neck Surgery, University of Nagasaki, Nagasaki, Japan.
Acta Otolaryngol. 2003 Dec;123(9):1035-9. doi: 10.1080/00016480310000377.
Vertiginous attacks of Ménière's disease (MD) are characterized by various types of vertigo, namely rotatory vertigo, dizziness and drop attack. When a patient complains of dizziness without spontaneous nystagmus, otolith dysfunction cannot be ruled out. The purpose of this study was to evaluate otolith dysfunction during vertiginous attacks of MD or delayed endolymphatic hydrops.
Vestibular function tests were carried out daily for several days in 11 patients (MD, n = 9; delayed endolymphatic hydrops, n = 2) during vertiginous attacks. Otolith function was evaluated by means of the static torsional position of both eyes [static ocular torsion (OT)] whilst in an upright position. We defined otolith dysfunction as an abnormal change (range) in OT without spontaneous nystagmus or as an abnormal change in OT without a change in spontaneous nystagmus.
Four patients had an abnormal change (range) in OT without spontaneous nystagmus or an abnormal change in OT without a change in spontaneous nystagmus during vertiginous attacks of MD.
Otolith dysfunction occurs in patients during vertiginous attacks of MD. In cases of ataxia without spontaneous nystagmus, otolith dysfunction most likely causes atypical attacks of MD.
梅尼埃病（MD）的眩晕发作具有多种类型的眩晕特点，即旋转性眩晕、头晕和跌倒发作。当患者主诉头晕且无自发性眼球震颤时，不能排除耳石功能障碍。本研究的目的是评估MD眩晕发作期间或延迟性内淋巴积水时的耳石功能障碍。
对11例患者（MD患者9例，延迟性内淋巴积水患者2例）在眩晕发作期间连续数天每天进行前庭功能测试。通过双眼在直立位时的静态扭转位置[静态眼扭转（OT）]评估耳石功能。我们将耳石功能障碍定义为无自发性眼球震颤时OT的异常变化（范围），或无自发性眼球震颤变化时OT的异常变化。
4例MD患者在眩晕发作期间出现无自发性眼球震颤时OT的异常变化（范围）或无自发性眼球震颤变化时OT的异常变化。
MD患者在眩晕发作期间会出现耳石功能障碍。在无自发性眼球震颤的共济失调病例中，耳石功能障碍很可能导致MD的非典型发作。
