Amari Kazumitsu, Kudo Yosuke, Watanabe Kosuke, Yamamoto Masahiro, Takahashi Koji, Tanaka Osamu, Johkura Ken
Department of Neuroendovascular Therapy, Yokohama Brain and Spine Center, Yokohama, Japan.
Department of Neurology, Yokohama Brain and Spine Center, Yokohama, Japan.
J Neurol Sci. 2016 Sep 15;368:249-53. doi: 10.1016/j.jns.2016.07.019. Epub 2016 Jul 15.
Lateral medullary infarction (LMI) sometimes causes long-lasting dizziness. However, the characteristics of nystagmus in patients with post-LMI dizziness are unknown. We undertook a prospective, comparative study of nystagmus in patients with and without post-LMI dizziness to determine the characteristic pattern of nystagmus of chronic post-LMI dizziness.
We evaluated and compared nystagmus under spontaneous, head-shaking, and positional testing conditions in 12 patients with post-LMI dizziness and in 6 patients without post-LMI dizziness.
In the dizziness group, contralateral spontaneous nystagmus, ipsilateral head-shaking nystagmus, and horizontal direction-changing geotropic positional nystagmus were observed in patients in whom the LMI had occurred <60days previously (subacute period). In patients with dizziness in whom the LMI had occurred >90days previously (chronic period), the nystagmus was ipsilateral under all conditions. In the non-dizziness group, ipsilateral nystagmus was observed in 1 of the 2 subacute patients only after head-shaking and in 1 of the 4 chronic patients only during positional testing.
Ipsilateral nystagmus observed under all spontaneous, head-shaking, and positional testing conditions characterizes chronic post-LMI dizziness.
延髓外侧梗死（LMI）有时会导致长期头晕。然而，LMI后头晕患者的眼球震颤特征尚不清楚。我们对有和没有LMI后头晕的患者进行了一项前瞻性比较研究，以确定慢性LMI后头晕患者眼球震颤的特征模式。
我们评估并比较了12例LMI后头晕患者和6例无LMI后头晕患者在自发、摇头和位置测试条件下的眼球震颤情况。
在头晕组中，LMI发生时间<60天（亚急性期）的患者出现对侧自发性眼球震颤、同侧摇头性眼球震颤和水平方向改变的地向性位置性眼球震颤。在LMI发生时间>90天（慢性期）的头晕患者中，所有条件下的眼球震颤均为同侧性。在非头晕组中，仅在摇头后，2例亚急性期患者中的1例出现同侧眼球震颤；仅在位置测试期间，4例慢性期患者中的1例出现同侧眼球震颤。
在所有自发、摇头和位置测试条件下观察到的同侧眼球震颤是慢性LMI后头晕的特征。
