Masato Kikukawa

Clinical Significance of Head Movement While Stepping

Head movement of normal subjects and patients with peripheral vestibular disorders while stepping was recorded using three accelerometers, a multi-channel telemeter and a microcomputer. The head movement registered from normal subjects was stable at a stepping speed of 1.2 or 1.4 steps/sec. Patients with peripheral vestibular disorders (except for BPPV) showed significantly greater head movement values in all three directions and smaller ratios of anteroposterior component to lateral component in the head movement, as compared with those of normal subjects.

Stepping Analysis in Patients with Spinocerebellar Degeneration and Parkinson's Disease

POLGON (Polarized light goniometer) was used to evaluate ataxia during stepping movements in patients with spinocerebellar degeneration (SCD) and Parkinsons disease. The measurements included mean angular change of shoulders (M.A.C.S.) and its coefficient of variation (C.V.). In patients with SCD, the values of M.A.C.S. were significantly larger at 1.0 step/s than those at other stepping rhythms. This results suggests that the stepping rhythm of 1.0 step/s is useful for the detection of cerebellar ataxia. The values of C.V. correlated with the degree of advancement of SCD. In patients with Parkinsons disease, the values of M.A.C.S. tended to decrease because of the restricted elevation of the knee, while those of C.V. were increased. The results showed that the stepping test using the POLGON was useful for estimation of the characteristic disequilibrium of SCD and Parkinsons disease.

Relationship Between Movements of the Head and the Center of Ora Vity of the Body In Ménière's Disease

The body sway of the patients with unilateral and bilateral Ménières disease was recorded by using a cephalograph and a stabilometer, and analyzed with a microcomputer. The results show that the locus type, locus area and locus length traced by the heads center and the bodys center of gravity are useful parameters of the body sway, representing the characteristics of peripheral vestibular disorders. The noteworthy characteristics are shown in the right-and-left type and forward-and-backward type in statokinesigram, in the significant differences of locus area and/or locus length between the head movement and the movement of the center of gravity, and the change of the averaged divisional frequencies of the body sway with eye-closing.

Clinical Significance of Head Movement while Stepping

A newly devised system was employed to measure head movement while stepping. The system consisted of three accelerometers, a multi-channel telemeter and a microcomputer.The data calculated by the computer were expressed in cm and plotted on the 3-dimensional coordinates.A total of ten normal adults and twenty-two patients with peripheral vestibular disorders were examined. The results obtained from the normal subjects were stable at the stepping speeds of 1.2 and 1.4 steps/sec. The patients with peripheral vestibular disorders, except those with benign paroxysmal positional vertigo, showed large values of head movement in all three dimensions. However, the most important clinical characteristic was confirmed to be the increased horizontal head movement with abnormal ratios of anteroposterior components to lateral components in the head movement.

Caloric Nystagmic Response of Patients with Ménière's Disease in Long-term Follow-up Observation

It is most difficult to evaluate the prognosis of patients with Menieres disease. We estimated the relationship between the activity of the disease and the caloric nystagmic response by reviewing long-term follow-up observation on these patients.Sixty-four patients aged 15 to 56 at the onset of the disease were investigated. The items for investigation were frequency of attack, spontaneous or positional nystagmus, caloric nystagmus, postrotatory nystagmus, hearing impairment, blood pressure (including the Schellongs test), treatment received and so on.The following conclusions were obtained.1. Estimation of the prognosis cannot be made at the first examination of the patient.2. The attacks occurred most frequently in the patients who tended to show DP in the caloric nystagmic response, over a long period of time.3. There were some in whom the caloric nystagmic response changed from DP to CP after a short time, or in whom there was no caloric difference between the left and right ears after a short period with caloric DP.