Department of Neurology (S-HL), Chonnam National University Medical School, Gwangju, Korea; Research Administration Team (H-JK), Seoul National University Bundang Hospital, Seoul, Korea; and Department of Neurology (H-JK, J-SK), Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seoul, Korea.
J Neuroophthalmol. 2018 Sep;38(3):393-412. doi: 10.1097/WNO.0000000000000583.
The brainstem contains numerous structures including afferent and efferent fibers that are involved in generation and control of eye movements.
These structures give rise to distinct patterns of abnormal eye movements when damaged. Defining these ocular motor abnormalities allows a topographic diagnosis of a lesion within the brainstem.
Although diverse patterns of impaired eye movements may be observed in lesions of the brainstem, medullary lesions primarily cause various patterns of nystagmus and impaired vestibular eye movements without obvious ophthalmoplegia. By contrast, pontine ophthalmoplegia is characterized by abnormal eye movements in the horizontal plane, while midbrain lesions typically show vertical ophthalmoplegia in addition to pupillary and eyelid abnormalities.
Recognition of the patterns and characteristics of abnormal eye movements observed in brainstem lesions is important in understanding the roles of each neural structure and circuit in ocular motor control as well as in localizing the offending lesion.
脑干包含众多结构，包括传入和传出纤维，这些结构参与眼球运动的产生和控制。
这些结构在受损时会产生不同模式的异常眼球运动。定义这些眼运动异常可以对脑干内的病变进行定位诊断。
尽管脑干病变可观察到多种不同的眼球运动障碍模式，但延髓病变主要引起各种类型的眼球震颤和前庭眼运动障碍，而无明显的眼外肌麻痹。相比之下，桥脑病变的特征是水平方向的眼球运动异常，而中脑病变除了瞳孔和眼睑异常外，通常还表现为垂直性眼球运动障碍。
认识到脑干病变中观察到的异常眼球运动模式和特征对于理解每个神经结构和回路在眼球运动控制中的作用以及定位病变部位非常重要。
