Murdin Louisa, Bronstein Adolfo M
Neuro-Otology Department, The National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Trust, London, UK.
J Neurol. 2009 Jul;256(7):1143-5. doi: 10.1007/s00415-009-5090-x. Epub 2009 Mar 12.
It is unclear how the torticollis occasionally observed in patients with progressive supranuclear palsy (PSP) relates to vestibulo-collic reflex mechanisms. We report here the results of vestibular evoked myogenic potentials (VEMPs) in a PSP patient with forced head deviation in the opposite direction of turning, leading to torticollis for a few seconds. As VEMPs were normal bilaterally we conclude that an enhanced vestibulo-collic reflex per se is not the cause of the torticollis in our patient. The abnormal head deviation induced by turning in some PSP patients is best explained by damage to reticular nuclei responsible for resetting eye and head saccades. When such mechanisms are defective, unopposed vestibulo-collic reflexes can lead to eye and head deviations in the opposite direction of body turns.
目前尚不清楚进行性核上性麻痹（PSP）患者偶尔出现的斜颈与前庭-颈反射机制有何关联。我们在此报告一名PSP患者的前庭诱发肌源性电位（VEMP）结果，该患者在转身时头部会向相反方向强制偏斜，导致斜颈持续数秒。由于双侧VEMP均正常，我们得出结论，增强的前庭-颈反射本身并非我们这位患者斜颈的原因。部分PSP患者转身时诱发的异常头部偏斜，最好的解释是负责重置眼球和头部扫视的网状核受损。当这些机制出现缺陷时，未受抑制的前庭-颈反射会导致眼球和头部向身体转动的相反方向偏斜。
