Yetiser Sertac, Ince Dilay, Yetiser Berkay
1 Department of ORL & HNS, Anadolu Medical Center, Kocaeli, Turkey.
2 School of Engineering, Koc University, Sarıyer, Istanbul, Turkey.
Ear Nose Throat J. 2019 Aug;98(7):420-424. doi: 10.1177/0145561319840902. Epub 2019 Apr 8.
Gaze-evoked nystagmus is not rare among those who have acute balance problem and may indicate a cerebellar dysfunction that is associated with a broad spectrum of disorders. The aim of this study is to analyze optokinetic response in those patients. Eleven males and 7 females (age range: 25-60, 42.5 [9.75]) with gaze-evoked nystagmus were analyzed with optokinetic test (Micromed Inc). Nystagmus was elicited by a stimulator light spot moving across the patient's visual field at a target speed of 30 degree/second. Ten age-matched healthy participants served as controls. The gain and slow-phase velocity difference in oculomotor response from left and right stimulus was compared in patients and the control participants. One-way analysis of variance test was used for multiple variance analysis of the groups. Statistical significance was set at < .05. Slow-phase velocity of gaze-evoked nystagmus was ranging between 6 and 19 degree/second. The mean slow-phase velocity of gaze-evoked nystagmus to the right and left was 8.1 (3.81) and 6.8 (4.67) degree/second, respectively. Optokinetic gain was out of normal limits in 10 (55.5%) patients. Comparison of mean gain difference between the patients and the normal participants was statistically significant ( = .025). No statistical difference was found in mean slow-phase velocity difference in optokinetic nystagmus between control participants and patients ( > .05 [.099]). An acute-onset balance problem may be associated with dysfunction of separate populations of neurons in the brainstem and cerebellum even if there is no radiological neuropathy since gaze-evoked nystagmus is a sign of neural integrator dysfunction. Patients with gaze-evoked nystagmus and optokinetic abnormalities may have disruption of cerebellar pathways and should be followed closely.
在患有急性平衡问题的人群中，凝视诱发性眼球震颤并不罕见，它可能表明存在与多种疾病相关的小脑功能障碍。本研究的目的是分析这些患者的视动反应。对11名男性和7名女性（年龄范围：25 - 60岁，平均年龄42.5岁[9.75]）患有凝视诱发性眼球震颤的患者进行了视动测试（Micromed公司）。通过刺激光点以30度/秒的目标速度在患者视野中移动来诱发眼球震颤。10名年龄匹配的健康参与者作为对照。比较了患者和对照参与者左右刺激下眼动反应的增益和慢相速度差异。采用单因素方差分析对各组进行多变量分析。设定统计学显著性为<0.05。凝视诱发性眼球震颤的慢相速度在6至19度/秒之间。凝视诱发性眼球震颤向右和向左的平均慢相速度分别为8.1（3.81）度/秒和6.8（4.67）度/秒。10名（55.5%）患者的视动增益超出正常范围。患者与正常参与者之间平均增益差异的比较具有统计学显著性（P = 0.025）。对照参与者和患者之间视动性眼球震颤的平均慢相速度差异未发现统计学差异（P>0.05[0.099]）。即使没有放射性神经病变，急性发作的平衡问题也可能与脑干和小脑中不同神经元群的功能障碍有关，因为凝视诱发性眼球震颤是神经整合功能障碍的一个迹象。患有凝视诱发性眼球震颤和视动异常的患者可能存在小脑通路的破坏，应密切随访。
