良性発作性頭位めまい症（BPPV）に関する質疑応答集
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1 Equilibrium Res Vol. (4) BPPV BPPV BPPV EBM BPPV Agency for Health Care Policy and Research, 1993 Abstract Table Pub Med Web ver. 4 Pub Med BPPV AND 1997: 2007 [dp] AND English[la] AND BPPV BPPV Web ver. 4 Meta-analysisCochrane Systematic ReviewRandomized control trials BPPV BPPV ( 226 )
2 Equilibrium Res Vol. (4) BPPV Equilibrium Res 39: , 1980 Equilibrium Res 41: 90 98, 1982 Karlberg M, Hall K, Quickert N, et al.: What inner ear diseases cause benign paroxysmal positional vertigo? Acta Otolaryngol 120: , 2000 Cohen HS, Kimball KT, Stewart MG: Benign paroxysmal positional vertigo and comorbid conditions. ORL J Otorhinolaryngol Relat Spec 66: 11 15, 2004 Del Rio M, Arriaga MA: Benign positional vertigo: prognostic factors. Otolaryngol Head Neck Surg 130: , 2004 Whitney SL, Marchetti GF, Morris LO: Usefulness of the dizziness handicap inventory in the screening for benign paroxysmal positional vertigo. Otol Neurotol 26: , 2005 von Brevern M, Radtke A, Lezius F, et al.: Epidemiology of benign paroxysmal positional vertigo: a population based study. J Neurol Neurosurg Psychiatry 78: , 2007 BPPV BPPV CCD BPPV CCD BPPV Norre ME: Diagnostic problems in patients with benign paroxysmal positional vertigo. Laryngoscope 104: , 1994 Ichijo H, Ichinohe M, Usami S, et al.: Observation of positional nystagmus with infrared CCD camera. Acta Otolaryngol Suppl 520: , 1995 Herdman SJ, Tusa RJ: Cpmplications of the repositioning procedure. Arch Otolaryngol Head Neck Surg 112: , 1996 Honrubia V, Baloh RW, Harris MR, et al.: Paroxysmal positional vertigo syndrome. Am J Otol 20: , 1999 Bertholon P, Bronstein AM, Davies RA, et al.: Positional down beating nystagmus in 50 patients: cerebellar disorders and possible anterior semicircular canalithiasis. J Neurol Neurosurg Psychiatry 72: , 2002 ( 227 )
3 Equilibrium Res Vol. (4) Equilibrium Res 65: , 2006 BPPV BPPV BPPV BPPV BPPV BPPV BPPV BPPV BPPV BPPV horizontal canal BPPV BPPV BPPV BPPV BPPV BPPV BPPV BPPV BPPV BPPV BPPV BPPV McClure JA: Horizontal canal BPV. J Otolaryngol 14: 30 35, 1985 Pagnini P, Nuti D, Vannucchi P: Benign paroxysmal vertigo of the horizontal canal. ORL J Otorhinolaryngol Relat Spec 51: , 1989 Baloh RW, Jacobson K, Honrubia V: Horizon- ( 228 )
4 Equilibrium Res Vol. (4) tal semicircular canal variant of benign positional vertigo. Neurology 43: , 1993 Herdman SJ, Tusa RJ: Complications of the repositioning procedure. Arch Otolaryngol Head Neck Surg 122: , 1996 Honrubia V, Baloh RW, Harris MR, et al.: Paroxysmal positional vertigo syndrome. Am J Otol 20: , 1999 Bertholon P, Bronstein AM, Davies RA, et al.: Positional down beating nystagmus in 50 patients: cerebellar disorders and possible anterior semicircular canalithiasis. J Neurol Neurosurg Psychiatry 72: , 2002 Korres S, Balatsouras DG, Kaberos A, et al.: Occurrence of semicircular canal involvement in benign paroxysmal positional vertigo. Otol Neurotol 23: , 2002 Lopez-Escamez JA, Molina MI, Gamiz M, et al.: Multiple positional nystagmus suggests multiple canal involvement in benign paroxysmal positional vertigo. Acta Otolaryngol 125: , 2005 Cakir BO, Ercan I, Cakir ZA, et al.: What is the true incidence of horizontal semicircular canal benign paroxysmal positional vertigo? Otolaryngol Head Neck Surg 134: , 2006 BPPV BPPV BPPV BPPV BPPV Brandt T, Daroff RB: Physical therapy for benign paroxysmal positional vertigo. Arch Otolaryngol 106: , 1980 Semont A, Freyss G, Vitte E: Curing the BPPV with a liberatory maneuver. Adv Otolaryngol 42: , 1988 Epley JM: The canalith repositioning procedure: for treatment of benign paroxysmal positional vertigo. Otolaryngol Head and Neck Surg 107: , 1992 Lempert T, Tiel-Wick K: A positional maneuver for treatment of horizontal-canal benign positional vertigo. Laryngoscope 106: , 1996 Fife TD: Recognition and management of horizontal canal benign positional vertigo. Am J Otol 19: , 1998 BPPV Equilibrium Res 63: 28 33, 2004 Gordon CR, Gadoth N: Repeated vs single physical maneuver in benign paroxysmal positional vertigo. Acta Neurol Scand 10 : , 2004 Cohen HS, Kimball KT : Effectiveness of ( 229 )
5 Equilibrium Res Vol. (4) treatments for benign paroxysmal positional vertigo of the posterior canal. Otol Neurotol 26: , 2005 BPPV BPPV Brandt-Daroff Semont Epley BPPV Lempert BPPV BPPV BPPV BPPV Brandt BPPV Epley BPPV Brandt-Droff Semont Brandt-Daroff Brandt-Daroff Semont Epley Epley Semont Lempert Brandt T, Daroff RB: Physical therapy for benign paroxysmal positional vertigo. Arch Otolaryngol 106: , 1980 Semont A, Freyss G, Vitte E: Curing the BPPV with a liberatory maneuver. Adv Otolaryngol 42: , 1988 Epley JM: The canalith repositioning procedure: for treatment of benign paroxysmal positional vertigo. Otolaryngol Head and Neck Surg 107: , 1992 Parnes LS, Price Jones RG: Particle repositioning maneuver for benign paroxysmal positional vertigo. Ann Otol Rhinol Laryngol 102: , 1993 Equilibrium Res Suppl 11: 72 79, 1995 Lempert T, Tiel-Wick K: A positional maneuver for treatment of horizontal canal benign positional vertigo. Laryngoscope 106: , 1996 Beynon GJ: A review of management of benign paroxysmal positional vertigo by exercise therapy and by repositioning manoeuvres. Br J Audiol 31: 11 26, 1997 Radtke A, Neuhauser H, von Brevern M, et al.: A modified Epley s procedure for selftreatment of benign paroxysmal positional vertigo. Neurology 53: , 1999 BPPV BPPV BPPV ( 230 )
6 Equilibrium Res Vol. (4) BPPV BPPV BPPV Asawavichianginda S, Isipradit P, Snidvongs K, et al.: Canalith repositioning for benign paroxysmal positional vertigo: a randomized, controlled trial. Ear Nose Throat J 79: , 2000 Nunez RA, Cass SP, Furman JM: Short- and long-term outcomes of canalith repositioning for benign paroxysmal positional vertigo. Otolaryngol Head Neck Surg 122: , 2000 Sherman D, Massoud EA: Treatment outcomes of benign paroxysmal positional vertigo. J Otolaryngol 30: , 2001 Soto Varela A, Bartual Magro J, Santos Pérez S, et al.: Benign paroxysmal vertigo: a comparative prospective study of the efficacy of Brandt and Daroff exercises, Semont and Epley maneuver. Rev Laryngol Otol Rhinol (Bord) 122: , 2001 Simhadri S, Panda N, Raghunathan M: Efficacy of particle repositioning maneuver in BPPV: a prospective study. Am J Otolaryngol 24: , 2003 Angeli SI, Hawley R, Gomez O: Systematic approach to benign paroxysmal positional vertigo in the elderly. Otolaryngol Head Neck Surg 128: , 2003 BPPV Equilibrium Res 63: 28 33, 2004 Woodworth BA, Gillespie MB, Lambert PR: The canalith repositioning procedure for benign positional vertigo: a meta-analysis. Laryngoscope 114: , 2004 Hilton M, Pinder D: The Epley (canalith repositioning) manoeuvre for benign paroxysmal positional vertigo. Cochrane Database Syst Rev. CD Review Del Rio M, Arriaga MA: Benign positional vertigo: prognostic factors. Otolaryngol Head Neck Surg 130: , 2004 Salvinelli F, Trivelli M, Casale M, et al.: Treatment of benign positional vertigo in the elderly : a randomized trial. Laryngoscope 114: , 2004 White J, Savvides P, Cherian N, et al.: Canalith repositioning for benign paroxysmal positional vertigo. Otol Neurotol 26: , 2005 Richard W, Bruintjes TD, Oostenbrink P, et al.: Efficacy of the Epley maneuver for posterior canal BPPV : a long-term, controlled study of 81 patients. Ear Nose Throat J 84: 22 25, 2005 Cohen HS, Kimball KT : Effectiveness of treatments for benign paroxysmal positional vertigo of the posterior canal. Otol Neurotol 26: , 2005 Sekine K, Imai T, Sato G, et al.: Natural history of benign paroxysmal positional vertigo and efficacy of Epley and Lempert maneuvers. Otolaryngol Head Neck Surg 135: , 2006 Von Brevern M, Seelig T, Radtke A, et al.: Short-term efficacy of Epley s manoeuvre: a double-blind randomized trial. J Neurol Neurosurg Psychiatry 77: , 2006 Brandt T, Huppert D, Hecht J, et al.: Benign paroxysmal positioning vertigo: a long-term follow-up (6 17 years) of 125 patients. Acta Otolaryngol 126: , 2006 ( 231 )
7 Equilibrium Res Vol. (4) BPPV Angeli SI, Hawley R, Gomez O: Systematic approach to benign paroxysmal positional vertigo in the elderly. Otolaryngol Head Neck Surg 128: , 2003 Hilton M, Pinder D: The Epley (canalith repositioning) manoeuvre for benign paroxysmal positional vertigo. Cochrane Database Syst Rev. CD Review Sridhar S, Panda N: Particle repositioning manoeuvre in benign paroxysmal positional vertigo: Is it really safe? J Otolaryngol 34: 41 45, 2005 BPPV BPPV BPPV BPPV BPPV BPPV Fujino A, Tokumasu K, Yosio S, et al.: Vestibular training for benign paroxysmal positional vertigo. Its efficacy in comparison with antivertigo drugs. Arch Otolaryngol Head Neck Surg 120: , 1994 BPPV Semont ATP Equilibrium Res 59: 425, 2000 Hain TC, Uddin M: Pharmacological treatment of vertigo. CNS Drugs 17: , 2003 Salvinelli F, Trivelli M, Casale M, et al.: Treatment of benign positional vertigo in the elderly : a randomized trial. Laryngoscope 114: , 2004 Imai T, Ito M, Takeda N, et al.: Natural course of the remission of vertigo in patients with benign paroxysmal positional vertigo. Neurology 64: , 2005 ( 232 )
8 Equilibrium Res Vol. (4) Patient Intervention Outcome Brandt Karlberg M BPPV BPPV secondary BPPV Cohen HS BPPV Del Rio M BPPV Epley Whitney SL Dizziness Handicap Inventory DHI BPPV BPPV Epley DHI getting out of bed rollinginbed BPPV von Brevern M criteria Vestibular vertigo ( 233 )
9 Equilibrium Res Vol. (4) Norre ME BPPV retrospective ENG Frenzel Dix- Hallpike Ichijo H BPPV VTR Herdman SJ BPPV canalith repositioning maneuver Frenzel Honrubia V BPPV Frenzel Bertholon P BPPV BPPV BPPV Frenzel BPPV BPPV BPPV BPPV BPPV Dix-Hallpike McClure JA BPPV Pagnini P BPPV BPPV Baloh RW BPPV BPPV ( 234 )
10 Equilibrium Res Vol. (4) Herdman SJ BPPV canalith repositioning maneuver Frenzel BPPV BPPV Honrubia V BPPV Frenzel Frenzel BPPV Frenzel BPPV BPPV BPPV BPPV BPPV BPPV BPPV BPPV BPPV Bertholon P BPPV idiopathic idiopathic habituation latency / Dix-Hallpike / idiopathic BPPV Korres S BPPV BPPV BPPV BPPV Lopez-Escamez JA BPPV VOG BPPV particle repositioning maneuver Epley Outcome measure positional test BPPV VOG Dix-Hallpike ( 235 )
11 Equilibrium Res Vol. (4) Cakir BO BPPV BPPV BPPV BPPV BPPV BPPV BPPV Dix-Hallpike Roll test BPPV Brandt T Brandt-Daroff Semont A Semont Epley JM BPPV CRP canalith repositioning procedure Lempert T BPPV atypical undermost ear BPPV dense particle Fife TD BPPV canalith repositioning treatment Epley ATP VitB 12 Lempert Epley ATP VitB 12 Epley ( 236 )
12 Equilibrium Res Vol. (4) Gordon CR BPPV Dix-Hallpike particle repositioning maneuver PRM PRM PRM neck collar Cohen HS BPPV modified canalith repositioning maneuver CRP modified liberatory maneuver LMsham maneuver Brandt and Daroff B-D habituation exercises Dix-Hallpike PRM CRP LM B-D sham habituation CRP LM B-D habituation CRP LM B-D BPPV Brandt T Brandt-Daroff Semont A Semont Epley JM BPPV CRP canalith repositioning procedure atypical Parnes LS Epley canalith repositioning procedure CRP vibration particle repositioning maneuver PRM BPPV ( 237 )
13 Equilibrium Res Vol. (4) Lempert T BPPV undermost ear BPPV dense particle Beynon GJ BPPV Brandt-Daroff Semont Epley Radtke A BPPV modified Epley Brandt-Daroff modified Epley Asawavichianginda S canalith repositioning procedure Dix-Hallpike Dix-Hallpike Nunez RA BPPV canalith repositioning procedure Sherman D BPPV PRM particle repositioning maneuversham PRM control Soto Varela A Brandt-Daroff habituation exercises Semont Epley BPPV Simhadri S particle repositioning maneuver PRM placebo treatment Dix-Hallpike BPPV Sham PRM control Dix-Hallpike PRM Sham PRM control Sham PRM PRM Semont Epley Brandt-Daroff PRM PRM / Dix-Hallpike / Dix-Hallpike ( 238 )
14 Equilibrium Res Vol. (4) BPPV Semont Parnes BPPV Lempert Angeli SI BPPV CRM modified Epley Dix-Hallpike vestibular rehabilitation Brandt- Daroff habituation exercises Epley ATP VitB 12 BPPV Parnes Semont Semont BPPV Lempert CRM Semont CRM Epley ATP VitB 12 Epley Woodworth BA Hilton M BPPV Epley Dix -Hallpike BPPV modified Epley Dix-Hallpike sham manoeuver Dix- Hallpike Dix- Hallpike modified Epley BPPV Epley Del Rio M BPPV Epley Salvinelli F BPPV Semont Flunarizine Epley Semont Flunarizine ( 239 )
15 Equilibrium Res Vol. (4) White J BPPV Semont Epley Dix-Hallpike Semont Epley / Richard W Epley Epley Frenzel Dix-Hallpike Epley Cohen HS BPPV modified canalith repositioning maneuver CRP modified liberatory maneuver LMsham maneuver Brandt and Daroff B-D habituation exercises Dix-Hallpike Sekine K BPPV BPPV von Brevern M Epley sham procedure Epley Brandt T Brandt-Daroff Semont Epley BPPV CRP LM B-D sham habituation CRP LM B-D habituation CRP LM B-D BPPV BPPV Epley sham procedure Epley BPPV / ( 240 )
16 Equilibrium Res Vol. (4) Angeli SI BPPV CRM modified Epley Dix-Hallpike vestibular rehabilitation Brandt- Daroff habituation exercises CRM Semont CRM Hilton M BPPV modified Epley Dix-Hallpike sham manoeuver modified Epley BPPV Epley Sridhar S BPPV Fujino A BPPV vestibular training betahistine mesylate vestibular training betahistine mesylate Semont ATP Semont ATP vestibular training Semont BPPV ATP BPPV Hain TC Salvinelli F BPPV Semont Flunarizine Semont Flunarizine ( 241 )
17 Equilibrium Res Vol. (4) Imai T BPPV BPPV BPPV BPPV BPPV BPPV ( 242 )
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Part 1 画像に頼らない, 明日から使えるめまい診察伝授 1 めまい診療が難しい理由は? MRI 感度は 50% 未満, さらには診断学が使えないから 症例 1 症例 1 めまい 50 歳女性 起床時からめまいがあり, 改善しないため救急要請 搬送後にストレッチャーへ移動したとたん嘔吐 症状が続き非常に辛そうで, 問診はほとんどできない 身体所見を取ることも難しい バイタルサインは安定している