Thurtell Matthew J, Leigh R John
Departments of Neurology and Daroff-Dell'Osso Laboratory, Veterans Affairs Medical Center and University Hospitals, Case Western Reserve University, Cleveland, OH 44106, USA.
Handb Clin Neurol. 2011;102:333-78. doi: 10.1016/B978-0-444-52903-9.00019-4.
We review current concepts of nystagmus and saccadic oscillations, applying a pathophysiological approach. We begin by discussing how nystagmus may arise when the mechanisms that normally hold gaze steady are impaired. We then describe the clinical and laboratory evaluation of patients with ocular oscillations. Next, we systematically review the features of nystagmus arising from peripheral and central vestibular disorders, nystagmus due to an abnormal gaze-holding mechanism (neural integrator), and nystagmus occurring when vision is compromised. We then discuss forms of nystagmus for which the pathogenesis is not well understood, including acquired pendular nystagmus and congenital forms of nystagmus. We then summarize the spectrum of saccadic disorders that disrupt steady gaze, from intrusions to flutter and opsoclonus. Finally, we review current treatment options for nystagmus and saccadic oscillations, including drugs, surgery, and optical methods. Examples of each type of nystagmus are provided in the form of figures.
我们采用病理生理学方法，回顾了当前关于眼球震颤和扫视振荡的概念。我们首先讨论当正常保持注视稳定的机制受损时，眼球震颤是如何产生的。然后，我们描述了眼部振荡患者的临床和实验室评估。接下来，我们系统地回顾了外周和中枢前庭疾病引起的眼球震颤的特征、由于异常注视保持机制（神经整合器）导致的眼球震颤，以及视力受损时出现的眼球震颤。然后，我们讨论了发病机制尚不完全清楚的眼球震颤形式，包括获得性钟摆型眼球震颤和先天性眼球震颤形式。然后，我们总结了从侵入性到扑动和视阵挛等扰乱稳定注视的扫视障碍谱。最后，我们回顾了当前针对眼球震颤和扫视振荡的治疗选择，包括药物、手术和光学方法。每种类型的眼球震颤示例均以图表形式给出。
