Matsuzono Kosuke, Manabe Yasuhiro, Takahashi Yoshiaki, Narai Hisashi, Omori Nobuhiko, Abe Koji
Department of Neurology, National Hospital Organization Okayama Medical Center, Okayama, Japan.
Department of Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, Okayama, Japan.
Case Rep Neurol. 2014 Apr 30;6(1):134-8. doi: 10.1159/000362120. eCollection 2014 Jan.
We report a patient with acute cerebral infarction of the left paramedian thalamus, upper mesencephalon and cerebellum who exhibited ipsilateral oculomotor nerve palsy and contralateral downbeat nystagmus. The site of the infarction was considered to be the paramedian thalamopeduncular and cerebellar regions, which are supplied by the superior cerebellar artery containing direct perforating branches or both the superior cerebellar artery and the superior mesencephalic and posterior thalamosubthalamic arteries. Contralateral and monocular downbeat nystagmus is very rare. Our case suggests that the present downbeat nystagmus was due to dysfunction of cerebellar-modulated crossed oculovestibular fibers of the superior cerebellar peduncle or bilateral downbeat nystagmus with one-sided oculomotor nerve palsy.
我们报告了一名左侧中脑旁正中丘脑、中脑上部和小脑发生急性脑梗死的患者，该患者出现同侧动眼神经麻痹和对侧下跳性眼球震颤。梗死部位被认为是中脑旁正中丘脑脚和小脑区域，这些区域由含有直接穿支的小脑上动脉或小脑上动脉以及中脑上部和丘脑底后动脉供血。对侧和单眼性下跳性眼球震颤非常罕见。我们的病例表明，目前的下跳性眼球震颤是由于小脑上脚的小脑调节交叉性眼前庭纤维功能障碍或伴有单侧动眼神经麻痹的双侧下跳性眼球震颤所致。
