Sugiura Y, Hoshi A, Matsuura Y, Yamamoto T, Ugawa Y
Department of Neurology, School of Medicine, Fukushima Medical University, Fukushima, Japan.
Acta Neurol Scand. 2008 Aug;118(2):132-5. doi: 10.1111/j.1600-0404.2008.00993.x. Epub 2008 Feb 25.
Animal experiments demonstrated that there are vestibular cortical areas at the parietal cortex. Moreover, in humans, recent functional neuroimaging studies revealed that caloric stimulation activated the parietoinsular vestibular cortex and optokinetic stimulation activated the parieto-occipital cortex. These activations indicate that the parietal vestibular areas play some role in nystagmus generation or in spatial information processing in the eye movement tasks.
The aim of this communication was to present a patient giving some information about parietal cortical function in nystagmus production and vertigo.
We report a 51-year-old, heavy alcoholic man with Bálint syndrome, constructional disability, limb-kinetic apraxia and ideo-motor apraxia. Brain magnetic resonance imaging demonstrated bilateral parietal cortical laminar necrosis anterior to the parieto-occipital sulci without any involvement of the primary sensory and parietoinsular cortices. Optokinetic nystagmus (OKN) was not elicited whereas cold caloric stimulation fully evoked nystagmus toward the opposite side with oscillopsia when eyes opened. However, he did not feel vertiginous sensation when the eyes were closed.
These findings suggest that the parietal cortices are indispensable for OKN production and vertiginous sensation.
动物实验表明，顶叶皮质存在前庭皮质区域。此外，在人类中，近期的功能神经影像学研究显示，冷热刺激激活了顶叶岛盖前庭皮质，视动刺激激活了顶枕叶皮质。这些激活表明，顶叶前庭区域在眼球震颤的产生或眼动任务中的空间信息处理中发挥了一定作用。
本交流的目的是介绍一名患者，其提供了一些关于顶叶皮质在眼球震颤产生和眩晕方面功能的信息。
我们报告一名51岁的重度酗酒男性，患有巴林特综合征、结构障碍、肢体运动性失用症和观念运动性失用症。脑磁共振成像显示，顶枕沟前方的双侧顶叶皮质层状坏死，初级感觉皮质和顶叶岛盖皮质未受任何累及。视动性眼球震颤（OKN）未引出，而冷热水刺激在睁眼时可完全诱发向对侧的眼球震颤并伴有视振荡。然而，闭眼时他并未感到眩晕。
这些发现表明，顶叶皮质对于OKN的产生和眩晕感是不可或缺的。
