Furman J M, Becker J T
Department of Otolaryngology, University of Pittsburgh School of Medicine, PA.
Ann Neurol. 1989 Nov;26(5):669-74. doi: 10.1002/ana.410260513.
Two patients with Wernicke's encephalopathy were evaluated with quantitative vestibulo-ocular reflex and ocular motor testing. Vestibulo-ocular reflex testing included caloric irrigation, earth vertical axis rotational sinusoids, and rotational impulses. Both patients demonstrated hypoactive vestibular responses to both caloric and rotational stimuli at the time of presentation. One patient had unbeating nystagmus that diminished with upgaze, downgaze, or convergence. Following treatment with thiamine, both patients' vestibular responses improved but remained abnormal, with a short vestibulo-ocular reflex time constant and increased low-frequency rotational phase lead. Impairment of the velocity storage element attributable to damage to the vestibular nucleus and nucleus prepositus hypoglossi may account for this permanent effect on the vestibulo-ocular reflex.
对两名韦尼克脑病患者进行了定量前庭眼反射和眼球运动测试。前庭眼反射测试包括冷热灌注、地垂直轴旋转正弦波和旋转脉冲。两名患者在就诊时对冷热和旋转刺激均表现出前庭反应减弱。一名患者有不跳动的眼球震颤，在向上注视、向下注视或集合时减弱。经硫胺素治疗后，两名患者的前庭反应均有改善，但仍异常，前庭眼反射时间常数短，低频旋转相位超前增加。前庭核和舌下前置核受损导致的速度存储元件损伤可能是对前庭眼反射产生这种永久性影响的原因。
