Omura A, Watanabe Y, Kobayashi H, Shojaku H, Mizukoshi K
Department of Otorhinolaryngology, Faculty of Medicine, Toyama Medical and Pharmaceutical University, Japan.
Acta Otolaryngol Suppl. 1993;504:125-9. doi: 10.3109/00016489309128137.
The case of a 60-year old male with prodromal common cold symptoms and progression of brain stem involvement with no cardiac or respiratory complications is described. This conformed to the criteria of Bickerstaff's encephalitis. Neurotological examinations, including the OKN test, the caloric test, and the GBST were performed from onset to recovery of the disease. The results of these tests closely reflected the central nervous system disorders each time, but there was a discrepancy in the results of the two test batteries of equilibrium function, the caloric test and the GBST. The caloric test showed bilateral canal paresis while the GBST showed normal responses. These results suggested that the involved area of the vestibular nucleus was localized to the superior portions. Form our clinical observations, we can conclude that neurotological examinations provide more vital information for localized diagnosis and follow-up of the brain stem lesion in Bickerstaff's encephalitis.
本文描述了一名60岁男性病例，该患者最初出现普通感冒症状，随后脑干受累且无心脏或呼吸并发症。这符合比克斯特费尔德脑炎的标准。从疾病发作到康复期间进行了包括视动性眼震试验（OKN试验）、冷热试验和姿势图（GBST）在内的神经耳科学检查。这些检查结果每次都能密切反映中枢神经系统紊乱情况，但在平衡功能的两项测试即冷热试验和姿势图的结果上存在差异。冷热试验显示双侧半规管麻痹，而姿势图显示正常反应。这些结果表明，前庭核的受累区域定位于上部。从我们的临床观察可以得出结论，神经耳科学检查为比克斯特费尔德脑炎脑干病变的定位诊断和随访提供了更重要的信息。
