Lueck C J, Hamlyn P, Crawford T J, Levy I S, Brindley G S, Watkins E S, Kennard C
Department of Neurology, London Hospital, UK.
Brain. 1991 Oct;114 ( Pt 5):2069-79. doi: 10.1093/brain/114.5.2069.
A case is presented of a patient who underwent insertion of a periaqueductal grey electrode for the relief of chronic pain. Shortly after insertion, the patient developed a left-sided ocular tilt reaction (OTR). The electrode tip, initially to the right of the midline, was then withdrawn slightly so that it was now on the left side. Stimulation at this point gave rise to a worsening of the tilt reaction, in addition to bilateral counter-clockwise torsional nystagmus. Computerized tomography and stereotactic coordinates indicated that the tip of the electrode was finally situated in the region of the left interstitial nucleus of Cajal (INC). The production of an OTR by stimulation in this region is similar to the phenomenon previously reported in monkeys and cats. The side of the OTR is consistent with previous evidence, suggesting that the utricular pathways cross between medulla and midbrain.
本文介绍了一例患者，该患者接受了导水管周围灰质电极植入术以缓解慢性疼痛。植入后不久，患者出现了左侧眼倾斜反应（OTR）。电极尖端最初位于中线右侧，随后稍微回撤，使其位于左侧。此时进行刺激，除了引起双侧逆时针扭转性眼球震颤外，还导致倾斜反应加重。计算机断层扫描和立体定向坐标显示，电极尖端最终位于左侧 Cajal 间质核（INC）区域。该区域刺激产生 OTR 的现象与先前在猴子和猫中报道的现象相似。OTR 的侧别与先前的证据一致，提示椭圆囊通路在延髓和中脑之间交叉。
