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  • WHICH IS THE BEST VALUE TO ESTIMATE THE VESTIBULAR FUNCTION?
  • ゼンテイ ハンノウ ノ ハンテイ キジュン

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In spite of many investigations in the form such as the duration, frequency, number of beats, total amplitude or eye-speed in the slow phase of nystagmus for estimation of the vestibular function, no decisive conclusion has not been obtained up to the present day as to the best diagnostic method for this function.<br>This problem was investigated by the author with a number of statistical studies of the postrotatory and caloric responses in 50 normal subjects and 300 patients. In all tests the recording of nystagmus was performed by electronystagmography (ENG). Nystagmus was always recorded with the subjects' eyes shut. The technique of calorization was the same as that of Fitzgerald & Hallpike. The rotatory test was carried out with accelerations of 1.2°/sec2., up to a rate of 60°/sec, and followed by a period of rotation at a constant rate lasting 30sec. and suddenly brought to rest.<br>From the recorded curves, the duration frequency, number of beats and maximum eye-speed in the slow phase were calculated and the normal limits of these characteristics were discussed by statistical analysis. Results obtained are summarized as follows;<br>1) Duration is the most reliable factor for estimation of the vestibular function, and the reliable factor following this is the number of beats. The majority of pathological difference can be inspected from both observations. Pathological difference is rarely seen in maximum eye-speed in the slow phase.<br>2) The frequency pattern of caloric nystagmus is convenint in observing the whole period of the reaction, however, quantitative determination should be investigated by the duration, number of beats and eye-speed in the slow phase.<br>3) The rotatory test rarely gives any information of importance that cannot be obtained by caloric test, and selective asscsment of the function of the labyrinths is impossible. Therefore, the rotatory test is not always a vital examination of the vestibular function test.<br>4) Spontaneous- and positional nystagmus do not appear in normal persons, whereas these ware observed in more than 50% of patients with vestibular or neural diseases. Therefore, this observation is one of the most important test of the vestibular examination.

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