Strominger M B, Mincy E J, Strominger A I, Strominger N L
J Clin Neuroophthalmol. 1986 Mar;6(1):57-65.
A case of bilateral internuclear ophthalmoplegia of long duration with autopsy confirmation is reported. The main features of the syndrome included paresis of ocular adduction upon attempted lateral gaze, horizontal nystagmus in the abducting eye, and an absence of converging eye movements. Examination of Weil-stained sections revealed multiple plaques of demyelination. The medial longitudinal fasciculus was demyelinated bilaterally in the upper pons-caudal midbrain. The oculomotor, trochlear, and abducens nuclei appeared relatively well preserved. The internal capsule was severely damaged. Large cyst-like structures were centered in the anterior limb bilaterally and extended caudally to the level of the genu. Plaques of demyelination were present bilaterally in the posterior limb. The left side of the internal capsule was more severely affected than the right. It is thought that convergence in this case may have been eliminated by interruption of fibers from the frontal eye fields and/or other cortical areas in their descent through the internal capsule.
报告了一例经尸检证实的长期双侧核间性眼肌麻痹病例。该综合征的主要特征包括试图向外侧注视时眼球内收麻痹、外展眼的水平眼球震颤以及眼球集合运动缺失。对魏尔染色切片的检查发现多处脱髓鞘斑块。脑桥上段至中脑尾部的内侧纵束双侧脱髓鞘。动眼神经核、滑车神经核和展神经核相对保存完好。内囊严重受损。大的囊肿样结构以双侧内囊前肢为中心，并向后延伸至膝部水平。双侧内囊后肢存在脱髓鞘斑块。左侧内囊比右侧受影响更严重。据认为，该病例中的集合运动可能是由于额叶眼区和/或其他皮质区域的纤维在通过内囊下行时中断而消失。
