The Effect of Streptomycin Medication on the Galvanic Reaction

Abstract

ie toxic effect of streptomycin medication has aroused much interest, and 1ial)le to arise after various periods of treatment with this drug are available.Only isolated cases of impairment of hearing have been reported. A dosage of 1-2 grams daily will apparently have no effect on hearing. On the other hand a dosage of 2-3 grams daily is in most cases sufficient to lead to a dysfunction of the vestibular system if medication is continued for inore than two weelcs. In four cases treated for morbus MhiCre I I a m b e r g e r , I L y c l C~i Pr K o ch reported an abolition of the vestibular reaction following treatment with streptomycin given 3 grams per day for a period of three weeks. Mof f i t & N o r m a n found a dosage of 2 grams daily to be follo~\-ed in the fourth to sixth week by a labyrinthine dysfunction in approximately 90 per cent of their material. A dosage of I gram daily gave serious consequences in 4 per cent of the cases, and slight, in 23 per cent. H a m b e r g e r et a1 stressed the great risk involved in the streptomycin medication of a patient with renal insufficiency, because in such cases the concentration of the drug in the blood will be high. These authors, however, found that a total dosage of more than 60 grams of the drug was liable to have an adverse effect on the restibular nerve even in patients with normal renal function.In some cases the vestibular dysfunction seems to be re\~ersible. 1 : o w 1 e r & S e l i g m a n found a caloric response in a case in which the labyrinth did not respond previously to irrigation with ice water for 5 minutes. S i r o t a 8:J o n e s found the caloric response to return in 6 cases of 15 in which tlie response was absent after 120 days' streptomycin treatment with 1.8 grams per day. W i n s t o n examined the response to rotation and caloric stimulation and found that tlie duration of post-rotatoric nystagmus diminished first and then disappeared together with the caloric response, but about I 5 days after discontinuation of treatment with the drug, the vestibular function began to recover. B a r r , F l o h e r g , H a m b e r g e r Pr K o c h also claim that in cases that have received small doses for a short time and in which the response is apparently lost, the ear may nevertheless recover.The vestibular function is generally tested by rotation and caloric stimulation and liomberg's test. Some authors have also reported use of the tipping test. American authors have discussed the localization of the vestil)ular injury on the basis of clinical findings. G l o r i g & F o w l e r conclude that the injury must certainly be located in the labyrinth. illore recent investigations 1)y 1; 1 o 1) e r g, H a m 1) e I-g e r and H y d 6 11 have however revealed microspetrographically that the injury shows a predilection for the vestibular ganglion and T many exhaustive descriptions of the subjective and objective symptoms Acta Otolaryngol Downloaded from informahealthcare.com by ThULB Jena on 11/18/14For personal use only.