Leigh R J, Tomsak R L, Grant M P, Remler B F, Yaniglos S S, Lystad L, Dell'Osso L F
Department of Neurology, Case Western Reserve University, University Hospital, Cleveland, OH 44106.
Ann Neurol. 1992 Nov;32(5):633-42. doi: 10.1002/ana.410320506.
We injected botulinum toxin into the horizontal rectus muscles of the right eyes of 2 patients who had acquired pendular nystagmus with horizontal, vertical, and torsional components. This treatment successfully abolished the horizontal component of the nystagmus in the injected eye in both patients for approximately 2 months. Both patients showed a small but measurable improvement of vision in the injected eye that may have been limited by coexistent disease of the visual pathways. The vertical and torsional components of the nystagmus persisted in both patients. In 1 patient, the horizontal component of nystagmus in the noninjected eye increased; we ascribe this finding to plastic-adaptive changes in response to paresis caused by the botulinum toxin. Such plastic-adaptive changes and direct side effects of the injections--such as diplopia and ptosis--may limit the effectiveness of botulinum toxin in the treatment of acquired nystagmus. Neither patient elected to repeat the botulinum treatment.
我们向2例患有伴有水平、垂直和扭转成分的后天性摆动性眼球震颤的患者右眼的水平直肌注射了肉毒杆菌毒素。该治疗成功消除了两名患者注射眼眼球震颤的水平成分，持续约2个月。两名患者注射眼的视力均有小幅但可测量的改善，这可能受到视觉通路并存疾病的限制。两名患者的眼球震颤垂直和扭转成分均持续存在。在1例患者中，未注射眼的眼球震颤水平成分增加；我们将这一发现归因于对肉毒杆菌毒素引起的轻瘫的适应性可塑性变化。这种适应性可塑性变化以及注射的直接副作用，如复视和上睑下垂，可能会限制肉毒杆菌毒素治疗后天性眼球震颤的有效性。两名患者均未选择重复肉毒杆菌毒素治疗。
