Wójcik-Pędziwiatr Magdalena, Mirek Elżbieta, Rudzińska-Bar Monika, Szczudlik Andrzej
Department of Neurology, The John Paul II Hospital, Kraków, Poland.
Department of Neurology, The John Paul II Hospital, Kraków, Poland; Department of Clinical Rehabilitation, University of Physical Education, Kraków, Poland.
Neurol Neurochir Pol. 2017 Jul-Aug;51(4):299-303. doi: 10.1016/j.pjnns.2017.05.001. Epub 2017 May 17.
Apart from intention tremor essential tremor (ET) patients may display other cerebellar signs, like dysmetria or tandem gait disturbances as well as parkinsonian signs like resting tremor, cogwheel sign, subtle bradykinesia. Previous reports claimed the occurrence of the eye movement abnormalities characteristic for dysfunction of cerebellar dorsal vermis in ET patients with concomitant cerebellar signs. There are no previous reports evaluating the eye movement abnormalities in ET patients with concomitant parkinsonian signs. The objective of this study was to determine the relationship between the occurrence of parkinsonian and cerebellar signs and the oculomotor abnormalities in ET patients.
Fifty ET patients including 6 (12.0%) patients with concomitant parkinsonian signs (ET-P), 20 (40.0%) patients with cerebellar signs (ET-C), 7 (14.0%) with mixed parkinsonian and cerebellar signs (ET-M), 17 (34.0%) patients with the only tremor (ET-T) together with 42 healthy controls were included to the study. Reflexive, pace-induced and cued saccades were recorded using Saccadometer Advanced. Smooth pursuit and fixation were tested using EOG.
Latency of pace-induced saccades was significantly longer in ET-C and ET-M patients compared to ET-T and ET-P patients. Latency of cued saccades was significantly longer in ET-M patients compared to ET-T. There were no significant differences of the eye movement parameters between ET-P patients compared to ET-T patients.
In ET patient with concomitant cerebellar signs prolonged volitional saccades latency was detected. There are no particular differences in the eye movements in ET patients with concomitant parkinsonian signs compared to ET patients without concomitant signs.
除意向性震颤外,特发性震颤(ET)患者可能还会表现出其他小脑体征,如辨距不良或串联步态障碍,以及帕金森氏体征,如静止性震颤、齿轮样强直、轻微运动迟缓。既往报道称,伴有小脑体征的ET患者出现了小脑蚓部背侧功能障碍所特有的眼球运动异常。此前尚无评估伴有帕金森氏体征的ET患者眼球运动异常的报道。本研究的目的是确定ET患者中帕金森氏体征和小脑体征的出现与动眼神经异常之间的关系。
本研究纳入了50例ET患者,包括6例(12.0%)伴有帕金森氏体征的患者(ET-P)、20例(40.0%)伴有小脑体征的患者(ET-C)、7例(14.0%)伴有帕金森氏和小脑体征的患者(ET-M)、17例(34.0%)仅有震颤的患者(ET-T),以及42名健康对照者。使用高级眼跳计记录反射性、步速诱导性和提示性眼跳。使用眼电图测试平稳跟踪和注视。
与ET-T和ET-P患者相比,ET-C和ET-M患者的步速诱导性眼跳潜伏期明显更长。与ET-T患者相比,ET-M患者的提示性眼跳潜伏期明显更长。与ET-T患者相比,ET-P患者的眼球运动参数没有显著差异。
在伴有小脑体征的ET患者中检测到意志性眼跳潜伏期延长。与不伴有体征的ET患者相比,伴有帕金森氏体征的ET患者在眼球运动方面没有特别差异。