- 期刊
前庭病變的突發性跌倒－Tumarkin氏耳石性危象
Drop Attacks from Vestibular Lesion - Tumarkin Otolithic Crisis
摘要
突發性跌倒可源自末梢前庭的病變，如梅尼爾氏病，也可能是某些中樞病變的前兆。台大醫院耳鼻喉部自1987年10月至1992年9月的5年間共經歷13例突發性跌倒的患者，其中Tumarkin氏耳石性危象9例（梅尼爾氏病8例，遲發性內淋巴水腫1例），前庭神經炎1例，另3例經神經科與內科共同會診後診斷為特發性。源自末梢前庭病變的患者有6例因藥物治療效果不佳而接受手術治療，術後患者症狀均獲明顯改善。3例特發性患者則對內科療法均無反應，也未接受手術治療。
並列摘要
Drop attacks is an unusual but dangerous situation. They often occur suddenly without warning and may result in serious body injury, even to fatal head trauma. Peripheral vestibular diseases and some central neurological diseases are thought to be the main causes for drop attacks. Others such as cardiac arrhythmia, drug-induced motor control disturbance, and idiopathic origin are also mentioned. We experienced 13 cases of drop attacks from October 1987 to September 1992. Among them, 9 cases were Tumarkin otolithic crisis (8 Meniere's disease and 1 delayed endolymphatic hydrops), one case was vestibular neuritis, and 3 cases were of idiopathic origin. Six of the 10 patients with peripheral vestibular origin ultimately required surgery to relieve symptoms. Four patients were treated with cochleosacculotomy and 2 patients chose endolymphatic sac operation initially. Drop attacks disappeared in all patients except one who underwent sac operation first. After a second operation (cochleosacculotomy), he got complete relief. Three patients of idiopathic origin still suffer from drop attacks despite medication.