Noh Haemin, Lee Dong-Han, Shin Jung Eun, Kim Chang-Hee
Department of Otorhinolaryngology-Head and Neck Surgery, Research Institute of Medical Science, Konkuk University School of Medicine, Konkuk University Medical Center, Seoul 05029, Korea.
Audiol Res. 2021 Feb 6;11(1):55-62. doi: 10.3390/audiolres11010007.
There have been no reports regarding nystagmus observed immediately after the end of an acute vertiginous attack in patients with Meniere's disease. The aim of this study was to demonstrate positional direction-changing nystagmus in patients with Meniere's disease, and to discuss the mechanism that underlies this nystagmus. Video-nystagmography was recorded in two patients with definite Meniere's disease, who showed positional direction-changing nystagmus during the period immediately after a vertigo attack. In one patient, video-nystagmographic recording was conducted 5 h after an episode of vertigo attack, and it showed very weak, persistent positional geotropic direction-changing nystagmus. In the other patient, video-nystagmographic recording was conducted 23 h after an episode of vertigo attack, and it showed very weak, persistent positional apogeotropic direction-changing nystagmus. Our patients exhibited very weak, persistent positional direction-changing nystagmus, which was geotropic in one and apogeotropic in the other. This type of positional nystagmus has been reported in other inner ear disorders and it cannot be clearly explained by typical benign paroxysmal positional vertigo. The change in chemical composition and/or electrolyte concentration of the inner ear fluid, although still unclear, may underlie the production of this characteristic nystagmus in these patients.
关于梅尼埃病患者急性眩晕发作结束后立即观察到的眼球震颤，目前尚无相关报道。本研究的目的是证实梅尼埃病患者存在位置性变向眼球震颤，并探讨这种眼球震颤的发生机制。对两名确诊为梅尼埃病的患者进行了视频眼震图记录，这两名患者在眩晕发作后的即刻出现了位置性变向眼球震颤。其中一名患者在眩晕发作5小时后进行了视频眼震图记录，结果显示为非常微弱、持续的向地性位置性变向眼球震颤。另一名患者在眩晕发作23小时后进行了视频眼震图记录，结果显示为非常微弱、持续的背地性位置性变向眼球震颤。我们的患者表现出非常微弱、持续的位置性变向眼球震颤，其中一名患者为向地性，另一名患者为背地性。这种类型的位置性眼球震颤在其他内耳疾病中也有报道，并且不能用典型的良性阵发性位置性眩晕来清楚地解释。内耳液化学成分和/或电解质浓度的变化，尽管仍不清楚，但可能是这些患者产生这种特征性眼球震颤的基础。
