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Biomedical subjects

E Sakata

Publications and source records attributed to E Sakata.

At least 37 records · Page 2Linked to original sources
PubMed1986

[Treatment of Ménière's disease. Middle ear infusion with lidocaine and steroid solution].

Before considering the surgical treatment of patients with Ménière disease who would resist to various conservative therapies, including oral drug therapy, the author experimented the inner ear anesthetic therapy or the middle ear infusion therapy with a steroid solution, and each therapeutic result was compared. The results were as follows: 1) The effectiveness of the inner ear anesthetic therapy for vertigo was noted in 42 ears out of the total 47, while the effectiveness of the middle ear steroid infusion therapy for vertigo was found in all treated 21 ears. 2) Although both therapies proved non-effective for hearing disturbance, excluding special cases, the former therapy was found effective for it in 26 ears among 42. 3) For other concomitant symptoms such as the full sensation of ear obturation, head heaviness, and stiff shoulders, both therapies were considerably effective. It was concluded from these results that the first choice of therapy for patients with Ménière disease who should resist to all conservative therapies should be the middle ear steroid infusion therapy at the out-patient clinic, and the second choice would be the inner ear anesthetic therapy, and that both therapies were worth while experimenting before considering surgical treatment.

Dexamethasone↗
PubMed1986

[Classification of optokinetic after-nystagmus and its topographical-diagnostic significance in man].

The existence of optokinetic after-nystagmus (OKAN) has long been known, as far back as the age of Bárány. The term OKAN means nystagmus appearing after first inducing optokinetic nystagmus, and then the optokinetic stimulation is removed. It appears easily with the eyes open in a dark place. There have been various theories about the mechanism of the onset of OKAN. Sakata et al. previously classified the types of OKAN into the following 7 types: 1) The normal type, (2) the directional preponderance type, (3) the disinhibitory type, (4) the inversive type, (5) the inhibitory type, (6) the dysmetric type, (7) the clonic type. In the present study, the authors performed a vestibular equilibrium function inspection, including an OKAN inspection, on about 10,000 patients who visited the Department of Neuro-Otology with complaints of vertigo and equilibrium disturbance. The results of the inspection were classified in accordance with Sakata's method, and the diagnostic contribution of the OKAN inspection was examined. The diagnostic significance of the OKAN inspection is considered as follows: (1) This inspection can detect a very small difference between the left and right of nystagmus in the vestibular-optokinetic system, which difference cannot be detected with OKP inspection giving a rather strong stimulation or with the caloric test giving a non-physiological strong stimulation. (2) This can be a focal localization diagnostic method by the classification by type.

Humans↗
PubMed1986

Classification of non-nystagmic spontaneous pathological eye movements.

We attempted to classify the well-known spontaneous pathological eye movement (SPEM), to provide a unified nomenclature, to describe its pathophysiology, and to determine its significance in determining a differential diagnosis. Nomenclature was according to the first reporter. These phenomena are easy to confuse with artifact when recording ENGs. A careful analysis which considers history and general neurological findings can identify many of these as true clinical findings which may be as important as nystagmus in the establishing of a clinical diagnosis. Each SPEM, once confirmed, plays a decisive role in the localization of lesions within the central nervous system.

Brain Diseases↗
PubMed1985

Recent development of the study on clinical significance of abnormal eye movement.

As a general trend, the diagnosis in medical clinics often depends on laboratory test results. Neurotological diagnosis, however, requires detailed neurological examinations on a patient by a neurotologist. Therefore, there are differing diagnostic skills among physicians, and there is a kind of "man-made flavor" in neurotological diagnostic procedure. In the present study, current development in the knowledge on the clinical diagnostic significance of pathological eye movement during the last 2-3 years is summarized. Acquired pendular wondering eye-movement. Fixation jerks. Spontaneous and transitory eyeball burst or seizure. Vertical rebound nystagmus. Optokinetic vertical ocular dysmetria. Divergence nystagmus. Counterolling, pure rotatory positioning nystagmus. Inversion of optokinetic after-nystagmus (OKAN). Vertical congenital nystagmus and inversion of optokinetic nystagmus (OKN). Treatment of congenital nystagmus. Vertical spontaneous nystagmus to lower eyelid or so-called "downbeat nystagmus." Downbeat nystagmus seen in bilateral labyrinthine dysfunction. The significance of bilateral vestibular lesion, or symmetric lesion in other is emphasized in the present report for reader's reference and criticism. Our experience on the clinical significance of the abnormal eye movement was reported. It is our wish that accumulation of data on important cases along with the results of experimental studies directly connected with clinical medicine may contribute to the progress of our neurotology in the right direction as "neurology of the posterior fossa."

Cerebellar Diseases↗
PubMed1984

Pathophysiology of positional vertigo of the malignant paroxysmal type.

It is well known that paroxysmal positional vertigo is induced by change of head position and subsides immediately when the head is returned to the original position. There are two types of paroxysmal positional vertigo. One is what DIX and HALLPIKE (1952) call the benign type which is thought to be caused by otolith lesions. Another is a malignant type, in contrast to the former and is related to a lesion in the central nervous system. Otologists are usually familiar with the former, but the latter is not known among neurologists and neurosurgeons. We experienced 37 cases of the malignant type and found that this type of paroxysmal vertigo is induced by various diseases. Furthermore, we believe that the mechanism of this paroxysmal vertigo is the lack of inhibitory function of the vestibular cerebellum, and not abrupt malfunction of communication of the cerebrospinal fluid in the ventricular system. We also believe that this symptom is a very useful sign for diagnosing lesions of the cerebellar vermis.

Adult↗
PubMed1984

Sylvian aqueduct syndrome. Chronology of tumors in the pineal region in view of ocular movement.

We experienced 21 cases of tumors (13 of pinealoma of the two-cell pattern and eight of tumors originating from the posterior part of the third ventricle). We carefully observed the eye movements of these patients during their respective clinical courses and found changes in abnormal eye movements along with remission following cobalt irradiation therapy or ventriculo-peritoneal shunt as well as with relapse on recurrence of tumors. From the neurotological viewpoint, we divided the development of these abnormal eye movements into four chronological stages. We emphasized the importance of the early diagnosis of tumors manifesting Sylvian aqueduct syndrome. Careful observation and analysis of eye movement will be a great help in making diagnoses as well as decisions for further examination and treatment.

Adult↗
PubMed1984

Directional preponderance of optokinetic nystagmus. Study of 30 cases of unilateral cerebral lesions.

Analysis of the optokinetic nystagmus has been one of the most important means to examine the function of the vestibulo-oculomotor system. Especially in Japan, it has been used as a mean to analyze the function of the brain stem. We investigated directional preponderance of the optokinetic nystagmus in supratentorial lesions especially unilateral lesions, in the cerebral hemisphere which had been nearly neglected as an object for investigation of the vestibular system. We examined 30 cases of unilateral lesion in the cerebral hemisphere. In all cases CT-scan confirmed that these lesions have no mass effect which might affect the function of the surrounding brain. It was also confirmed that these cases had no spontaneous nystagmus. These cases consisted of 11 cerebral infarctions, 9 cerebral thrombosis, 6 cerebral hemorrhages and 4 cerebral contusions. In the result, 27 cases showed directional preponderance of the optokinetic nystagmus to the ipsilateral side, while there was none to the contralateral side. Three cases showed no directional preponderance. Some cases showed marked inhibition of optokinetic nystagmus of the contralateral side. These markedly inhibited cases are very similar to cases of pontine lesion which usually manifest marked inhibition of the optokinetic nystagmus to the ipsilateral side.

Aged↗
PubMed1984

[Therapy of tinnitus. Tympanic cavity infusion of lidocaine and steroid solution].

Tinnitus is an otological symptom which is often encountered and is yet difficult to treat. If tinnitus is of cochlear origin then it seems reasonable to assume that a total depression of the cochlear function will abolish cochlear tinnitus. To achieve this depression, transtympanic injections of a local anesthetic (4% Lidocaine) to anesthetize the inner ear and of Decadoron were conducted in a patient suffering from tinnitus. One hundred and sixty-eight patients (220 ears) who had suffered from relatively long-term tinnitus were included in this study. In almost all of the cases the clinical symptoms and the otological findings (i.e., the audiogram and caloric test) indicated that the probable lesion underlying the tinnitus was located within the end organ. In some cases this injection brought a transient (for few days), slight, neurosensorial deafness in the low-frequency range. This auditory disorder, however, was completely restored without sequelae. Our results are summarized as follows: in 76 ears, tinnitus was abolished completely, in 109 ears, tinnitus was considerably ameliorated, in 35 ears, tinnitus was slightly ameliorated or no effect. One hundred and nine patients (138 ears) who had suffered from tinnitus were included in this study. Decadoron was applied to the middle ear cavity by transtympanic injection. Our results are summarized as follows: in 87 ears, tinnitus was abolished, in 39 ears, tinnitus was considerably ameliorated, in 14 ears, tinnitus was slightly ameliorated or no effect.

Dexamethasone↗
PubMed1979

[A case of "ping-pong ball eye movement (author's transl)].

We experienced a rare and peculiar eye movement in a comatose patient with ruptured intracranial aneurysm. The patient's eyes moved quickly and irregulary from one extreme position to the other with whirling and bounding components. Such abnormal eye movement occasionally halted, but abruptly reappeared. We named this abnormal eye movement which had never been reported before, "ping-pong eye movement". Neuropathological study revealed a subarachnoid hemorrhage and the diffuse infarction in the right remporal lobe, and a smal clot in the fourth ventricle without specific findings in the brainstem and the cerebellum. Consideration was made that the hemorrhage in the fourth ventricle resulted in a hyper-irritable state in the fastigial nuclei, from which the abnormal discharges were driven to the reticular formation, the vestibular nuclei, the MLF, and the oculomotor complexes. We conclude that this "ping-pong" ball eye movement" might be the appearance of epilepsy in the eyes, due to the epileptogenic focus of the fastigial nuclei.

Eye Movements↗
PubMed1976

[Simple method of differential diagnosis of peripheral and central vertigo--development of diagnostic method and studies of 178 cases].

In patients who complain of vertigo or who have equilibrium disorders, it is often difficult to determine the etiology of the disorder, that is to determine whether it is dependent on a peripheral or central vestibular disorder. To attempt to determine the etiology in these cases, we divised a new method, the caloric eye tracking pattern test (CETP-Test). Seventeen normal subjects and 161 patients were tested. The latter group included 33 with peripheral disorders such as Meniere's disease, benign paroxysmal positional nystagmus, and others, and 128 with central disorders such as vertebral basilar artery insufficiency, cervical vertigo, and others, were tested. The cases of central disorders were limited to those patients whose eye tracking pattern before the caloric stimulation was normal. In normal subjects and in patients with peripheral disorders, it is well known that caloric nystagmus has little influence on the eye tracking pattern. In contrast, in patients with central vestibular disorders, caloric nystagmus evokes abnormalities on the eye tracking pattern, either superimposed or saccades, despite the fact that the eye tracking pattern before the caloric stimulation is normal. First we administer the eye tracking stimulation test using a target which moves horizontally at 0.3 cycle per second. Next, we perform the caloric test on the right ear, using 20 c.c. of ice water for 10 seconds. During the evoked caloric nystagmus we administer the eye tracking test once again. The eye tracking pattern is recorded for 20 seconds beginning 50 seconds after the start of the ice water injection. The procedure repeated on the left ear. The results on each case are presented as three patterns of ENG-recording. We may stat that in normal subjects and in patients with peripheral vestibular disorders, visual suppression of caloric nystagmus remains functional. Caloric induced nystagmus does not affect the CETP. In patients with central vestibular disorders, visual suppression of caloric nystagmus does not function properly because of defects in the visual suppression mechanism. Therefore, caloric nystagmus greatly influences the CETP. Consequently, the CETP may not be smooth when CETP test is administered to patients with central vestibular disorders. We may say also that the visual suppression to the vestibular nystagmus is evoked more strongly by pursuing a moving visual stimulus than by gazing a stational target. These results allow for a differential diagnosis between peripheral and central disorders.

Adult↗