Investigation of vestibular damage by antituberculous drugs.

Vestibular function testing was performed regularly on patients who were administered streptomycin, kanamycin, or enviomycin, and vestibular damage was detected at an early stage, and quantitatively. We investigated the point in time at which the therapy should be discontinued. Subjects consisted of 204 cases of tuberculosis treated with streptomycin, kanamycin, enviomycin. They were admitted to the hospital between December 1984 and August 1989. Twenty-eight cases of vestibular dysfunction due to streptomycin, kanamycin, and enviomycin could easily be detected at an early stage by performing Meyer zum Gottesberge's head-shaking test for the evaluation of jumbling, together with Romberg's test and the stepping test. All cases who had vestibular dysfunction completely recovered because of early detection. In addition, 7 cases recovered afterwards from temporary vestibular damage shown only in Meyer zum Gottesberge's head-shaking test (abnormality of vestibulo-ocular reflex was only detected and vestibulo-spinal reflex remained intact), despite continuation of streptomycin injection. When the results of the head-shaking test are less than 50% and when a sway and/or rotation in the stepping test occurs, the injections should be discontinued.

Clinical investigation of vestibular damage by antituberculous drugs.

Vestibular function testing was done regularly on the cases given streptomycin, kanamycin, or enviomycin and a method to detect the cases of vestibular dysfunction at an early stage was discussed, as well as the time these drugs should be discontinued. Subjects were 85 cases of tuberculosis treated with streptomycin, kanamycin, or enviomycin who were admitted to our hospital from December 1984 to May 1986. The method of equilibrium examination performed at regular intervals is as follows: standing test (Romberg test), stepping test, and Meyer zum Gottesberge's head-shaking test were done once a week for a month after starting antituberculous injections and they were re-examined once every 2 weeks for at least 3 months after beginning the injections. After the 3 months these tests were done once a month. Eight cases of vestibular damage due to streptomycin or enviomycin could be easily detected at an early stage by performing Meyer zum Gottesberge's head-shaking test, together with the standing test and the stepping test. Vestibular dysfunction is apt to occur after about 1 month or within a month from the start of daily injections especially with streptomycin. Therefore, the method of equilibrium examination, we suggest, is that the Meyer zum Gottesberge's head-shaking test, the standing test (Romberg test), and the stepping test should be performed once a week during the first month after the start of this drug. When the result of the Meyer zum Gottesberge's head-shaking test is less than 50% and swaying and/or rotation occur in the stepping test, the drugs being given should be discontinued.