JP4124157B2 - An nystagmus that can be used to treat dizziness - Google Patents

Description

  The present invention relates to an nystagmus that can be used for the treatment of benign paroxysmal positional vertigo, and is an nystagmus that can easily carry out the Ipley method, which conventionally required a high level of specialized knowledge and experience. It is about the total.

  There is no clear definition of “vertigo”, but in general, it felt uncomfortable and felt that the mutual relationship and positional relationship between one's own body and the surrounding space were disturbed when resting or exercising A symptom that sometimes occurs. There are psychogenic types, but it is mainly divided into inner ear (semicircular canal and vestibular) type and central type with abnormalities such as brain. In this inner ear vertigo and central vertigo, abnormal eye movement called nystagmus is observed. Therefore, in vertigo diagnosis, eye movements when a specific image is viewed or the head is moved are measured.

  In the measurement of such eye movement, a large screen was previously required, and an image was projected onto the screen to show to the subject. However, since it can be measured only in a limited place, the technique described in Patent Document 1 detects eye movement using a helmet equipped with a reflector for projecting an image and an eye movement detection device. Thus, the balance function is evaluated.

  Patent Document 2 discloses a balanced function inspection apparatus in which a light source, an image sensor, and image processing means are provided on a wearing tool to be worn on the face of a subject, and a pseudo-semicircular canal may be provided. Has been.

  However, these devices only determine the presence or absence of abnormal eye movements (nystagmus) by measuring eye movements in response to external stimuli such as video and head position changes. Device. For example, in the technique of Patent Document 2, by providing a pseudo-semicircular canal on the wearing tool, it is possible to recognize the relationship between the subject's head position and eye movement and the pseudo-semicircular canal, and which part of the semicircular canal inside the head actually It is said that it can be easily grasped whether it is being stimulated. However, even if it can be understood that nystagmus occurs when any part of the semicircular canal is stimulated, these conventional techniques for diagnosis are completely different from the actual treatment.

  By the way, in Japan, over 70% of vertigo is occupied by inner ear vertigo, the most typical of which is benign paroxysmal positional vertigo (BPPV). The main cause of this BPPV is that a part of the vestibule of the inner ear (see Fig. 1) is broken and released due to bruise or aging of the head, and drifts in the lymph filled in the semicircular canal, and the semicircular canal to external stimuli The response is disturbed. This floating substance is called canalis, and causes a very intense dizziness when it is moved when the head position changes. Therefore, if this canary can be returned to the correct position, dizziness can be suppressed.

The Ipley method is an excellent treatment method for BPPV found from this viewpoint. Although it may have to be performed several times in 4 to 5 days, the effect of treatment can be quickly achieved only by 15 to 30 minutes. There is no pain. The specific method is to first determine whether the cause of BPPV is in the right ear or the left ear by the Dix-Hall Pike method (a method of changing the head position and observing the presence of nystagmus) or the like. By moving the canalis by changing the orientation of the head and body, etc., and guiding it to the correct position. However, this Ipley method is extremely difficult technically and requires high specialized knowledge and experience, and not everyone can do it.
Japanese Patent No. 3074825 (claims, FIG. 1 etc.) JP-A-9-285468 (claims, paragraphs [0023] and [0067])

  As described above, conventionally, an apparatus (an nystagmus) for diagnosing dizziness by measuring eye movement with respect to an external stimulus such as an image has been known. However, the conventional apparatus is only for diagnosis and cannot be applied to treatment. In addition, although the Ipley method is known as an excellent treatment method for benign paroxysmal positional vertigo, this method is not easily performed because it requires highly specialized knowledge and experience.

  Therefore, the problem to be solved by the present invention is that it can be used for the treatment of benign paroxysmal positional vertigo, and that the simple method that requires advanced specialized knowledge and experience is simply performed. It is to provide an nystagmus that can be used.

  In order to solve the above-mentioned problems, the present inventors have advanced various studies on nystagmus used for vertigo diagnosis. As a result, by comparing the eye movements that occur in response to head movements against the database, it is possible to grasp the position of canalis, which is the main cause of benign paroxysmal positional vertigo, and to correct canalis The present invention was completed by finding that the posture that the subject should take in order to lead to the position can be easily determined.

That is, the nystagmus according to the present invention is an nystagmus that can be used for dizziness treatment, from a head position detection unit for detecting the head position of a subject and data obtained by the head position detection unit. A head position analysis unit for analyzing the movement of the head, an eyeball imaging unit for imaging the movement of the eyeball, and an eyeball image analysis unit for analyzing eye movements from the eyeball images obtained by the eyeball imaging unit A calculation unit for calculating the posture to be taken by the subject from the analysis result of the head position and the analysis result of the eyeball image, and a presentation unit for presenting the posture to be taken by the subject calculated by the calculation unit; comprising a, the calculation unit, and calculates the posture to be subject taken according to a predetermined database the relationship between the analysis results and the subjects to be taken the posture of the head position of the analysis result and eye video. Although the conventional nystagmus can only detect the presence or absence of nystagmus, etc., according to the nystagmus of the present invention, it is easy to obtain extremely useful information for the treatment of benign paroxysmal positional vertigo can do.

  Preferably, the nystagmus further includes a presentation unit for presenting a posture to be taken by the subject calculated by the calculation unit. As a result, it is possible to easily carry out the explain method, which conventionally required highly specialized knowledge and experience.

  The head position detection unit is preferably one that can be worn by the subject or one that detects the position of the marker attached to the subject. This is in accordance with an actual embodiment, and enables downsizing of the apparatus.

  The presenting unit is preferably one that presents the posture to be taken by the subject as character information, symbol information, or moving image information. These can easily indicate to the doctor the posture that the subject should take to treat benign paroxysmal positional vertigo.

  According to the nystagmus according to the present invention, it is possible to simply carry out the Ippley method, which has conventionally required a high level of specialized knowledge and experience and has limited the number of people who can perform it. Therefore, the nystagmus of the present invention is extremely useful in the industry as it can easily treat benign paroxysmal positional vertigo that sometimes causes extremely severe vertigo that interferes with daily life.

  Hereinafter, embodiments of the present invention and effects thereof will be described.

  The nystagmus of the present invention includes at least a “head position detection unit”, a “head position analysis unit”, an “eyeball imaging unit”, an “eyeball image analysis unit”, and a “calculation unit”. Below, each part is demonstrated.

(1) Head Position Detection Unit The head position detection unit of the present invention is for detecting the head position of the subject, but does not simply shoot the head, but mainly determines the movement direction and movement angle of the head. It is for detection. Therefore, examples of the head position detecting unit include a gyro and a three-dimensional acceleration sensor built in goggles worn by the subject. Alternatively, it may be a combination of a marker attached to the subject and an imaging device for the marker, a position sensor or angle sensor that is attached to the subject's head and uses magnetism, and a detection device for these sensors. .

(2) Head position analysis section The head position analysis section is for analyzing the movement of the head from the data obtained by the head position detection section. For example, when the head is moved, the head position analysis section This is for detecting the moving direction, moving speed, moving acceleration, moving angle, moving angular velocity, and the like. That is, the movement of the head is analyzed by the combination of the head position detection unit and the head position analysis unit, and as a result, it is grasped what kind of stimulation the inner ear that controls the sense of balance receives. Accordingly, the head analysis unit uses one corresponding to the head position detection unit. For example, a gyroscope or various sensors incorporated in goggles or the like worn on the subject as a head analysis unit can analyze information emitted from them. Moreover, what is necessary is just to use what can determine a head position, an angle, etc. by processing the image as information, when image | photographing the marker position with which the test subject was mounted | worn.

(3) Eyeball imaging unit The eyeball imaging unit images the eyeball of the subject. The type of equipment to be used is not particularly limited, but since the nystagmus of the present invention needs to determine the presence or absence of nystagmus by moving the head of the subject, the eyeball imaging unit even if the head moves A CCD camera or a CMOS camera built in goggles or the like fixed to the subject's head is preferable so that the camera does not move relatively.

(4) Eyeball image analysis unit The eyeball image analysis unit is for determining the presence or absence of nystagmus due to movement of the head by analyzing eye movements from the eyeball images obtained by the eyeball imaging unit. Specifically, it is only necessary to analyze at least one of the horizontal position, the vertical direction, and the rotation component of the eyeball position or eyeball velocity due to eye movement using a pattern such as a pupil, iris, or capillary.

(5) Calculation Unit The calculation unit calculates the posture to be taken by the subject based on the analysis result of the eyeball image with respect to the analysis result of the head position. More specifically, the presence or absence of nystagmus (abnormal eye movements) when the subject's head is moved in a specific direction or speed is measured in the inner ear by comparing the information with the accumulated data. The location of the abnormally stimulated part, the canalis (the otolith liberated from the vestibule, which directly causes benign paroxysmal positional vertigo) is identified. Then, in order to move the canalis in the lymph fluid of the semicircular canal and guide it to the correct position, the posture to be taken by the subject and the time to take each posture are calculated.

  The specific method used here is not particularly limited. For example, a table lookup method based on the analysis result of the head position and the analysis result of the eyeball image, a method of referring to the next posture from the database, a neural network, etc. The method of calculating the posture to be taken by artificial intelligence of the above can be mentioned.

(6) Presenting unit The presenting unit is for presenting the posture to be taken by the subject calculated by the calculation unit to a doctor, a laboratory technician, or the subject himself as a measurer. The specific presentation method is not particularly limited, but for example, it is displayed as character information or symbol information on a display device such as a CRT or LCD panel, or a moving image such as animation using CG or the like for easier understanding. Display as information. In addition, for cases in which it is not possible to keep an eye on the subject during the examination, the pre-sampled guide voice is played back, or the posture to be taken by the subject is guided by voice output such as by voice synthesis. These voices and character information can be used in combination.

  Next, the usage method of the nystagmus according to the present invention will be exemplified.

  First, in order to determine whether the benign paroxysmal positional vertigo (BPPV) of the subject to be treated is caused by the inner ear of the right ear or the left ear, the Dix-Hallpike method (Dix-Hallpike method) To do. Specifically, as shown in FIG. 2, the presence or absence of nystagmus is detected when the body is turned sideways while tilting the face of the subject wearing the nysmograph of the present invention. Determine if it is otic. At this time, the movement of the body to be taken by the subject and points to be particularly careful (for example, the speed of lying down and the direction of the face) may be displayed on the presentation unit as animation, character information, or the like. In the Dix-Hall Pike method, it is necessary to cause the subject to cause nystagmus (vertigo). Therefore, if the method is repeated many times, an excessive burden is imposed on the subject. However, if the presentation unit of the present invention can check the point of caution while checking it, the burden on the patient can be suppressed even when a doctor who is not familiar with the method performs the test. can do.

  Next, in order to identify the position of the canary that caused BPPV, the presence or absence of nystagmus is measured while changing the posture of the subject. The data flow in the following procedure is shown in FIG.

  In order to specify the position of canarys, the subject's head or body itself (whether it is supine or scoliosis, etc.) is moved in the same manner as in the method of specifying whether the right ear is BPPV or the left ear. The eyeball imaging unit and the eyeball image analysis unit measure the presence or absence of nystagmus while measuring the acceleration, direction, etc., of the head moving by the detection unit and the head position analysis unit. At this time, it is preferable to display the body movement and the like to be taken by the subject on the presentation unit.

  Data on the presence or absence of nystagmus with respect to the movement of the head is accumulated, and the position of the canalis is specified by comparing these data and past data in the database by the calculation unit. In this way, by measuring the presence or absence of nystagmus while moving the subject's head according to the instructions displayed on the presentation unit, the position of the canarys can be specified with a minimum operation, which is given to the subject. The burden can be reduced. The position of the obtained canalis is preferably displayed on the presentation unit.

  Then, based on the information on the obtained canalis position, in order to prevent the abnormal response (vertigo) from being caused by external stimuli such as a sudden movement of the head, it is specified to guide the canalis to an appropriate position. Let the subject take a certain amount of time (such as face or body orientation). At this time, the posture to be taken by the subject, the time for which the posture should be continued, and the like are calculated by the calculation unit according to the position of the canalis specified above and displayed on the presentation unit. The display method is not particularly limited such as moving image information, and points to be particularly noted may be presented by character information, symbol information, audio information, or the like. By such display, the doctor or the like causes the subject to take the posture to be taken for a specific time. Alternatively, the subject himself / herself may look at the presentation unit and change his / her posture by himself / herself.

  The display shown on the presentation unit should display at least the posture that the subject should take and the time for which the posture should be continued. However, as shown in FIG. 4, if the position of the canalis in the semicircular canal is displayed, a doctor or the like Therefore, it is easy to imagine the state of the subject's inner ear.

  As described above, according to the nystagmus of the present invention, the right ear BPPV or the left ear BPPV or the canary that directly causes BPPV can be suppressed while minimizing the burden on the subject. It becomes possible to specify the position. Further, the nystagmus of the present invention can display the posture and the like that the subject should take for the BPPV treatment based on the obtained information and the information in the database. It is possible to easily carry out the Ipley method, which required advanced specialized knowledge and experience.

It is a schematic diagram which simplifies and shows the structure of an inner ear. It is a figure for showing the posture which should be taken in the case of the Dicks-Hole Pike method which is a method of determining whether BPPV is right ear or left ear. It is the schematic which shows the flow of data at the time of use of this invention apparatus. It is a schematic diagram which shows an example of the presentation part of the nystagmus concerning this invention.

Claims (5)

An nystagmus that can be used to treat dizziness,
A head position detector for detecting the head position of the subject;
From the data obtained by the head position detector, the head position analyzer for analyzing the movement of the head,
An eyeball imaging unit for imaging eyeball movement;
An eyeball image analysis unit for analyzing eye movements from the eyeball image obtained by the eyeball imaging unit ;
An arithmetic unit for calculating the posture to be taken by the subject from the analysis result of the head position and the analysis result of the eyeball image ,
A presentation unit for presenting a posture to be taken by the subject calculated by the calculation unit ,
The nystagmus is characterized in that the calculation unit calculates a posture to be taken by the subject according to a database in which a relationship between the analysis result of the head position, the analysis result of the eyeball image, and the posture to be taken by the subject is determined in advance . The nystagmus according to claim 1 , wherein the head position detection unit is attachable to a subject. The nystagmus according to claim 1 , wherein the head position detector detects a position of a marker attached to the subject. The presentation unit, electronystagmography according to any one of claims 1 to 3, intended to present the posture to be taken by the subject as character information or symbolic information. The presentation unit, electronystagmography according to any one of claims 1 to 3, intended to present the posture to be taken by the subject as a moving picture information.

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