Morrow M J, Sharpe J A
Neuro-ophthalmology Unit, Toronto Hospital, Ontario, Canada.
Ann Neurol. 1988 Sep;24(3):390-8. doi: 10.1002/ana.410240307.
Torsional nystagmus was recorded in 3 patients with the lateral medullary syndrome. Magnetic search coil oculography demonstrated slow phases of nystagmus of increasing, decreasing, and constant velocity. Neural integration of torsional eye velocity commands to position commands is impaired by lateral medullary infarction. Torsional pulsion of saccades, consisting of torsional fast eye movements induced during saccades downward or away from the side of infarction, was recorded in 2 patients. All patients had skew deviation with hypotropia on the side of brainstem damage. The torsional nystagmus beat away from the side of infarction in each patient, but in one it alternated direction as the eyes drifted about a neutral position of torsion. We attribute the torsional nystagmus to an imbalance of central projections from the anterior and posterior semicircular canals and the otolith receptors that mediate ocular counterroll.
在3例延髓外侧综合征患者中记录到了扭转性眼球震颤。磁性搜索线圈眼震电图显示眼球震颤的慢相速度有增加、减少和恒定三种情况。延髓外侧梗死会损害扭转性眼速度指令到位置指令的神经整合。在2例患者中记录到了扫视扭转冲动，表现为向下或远离梗死侧扫视时诱发的扭转性快速眼球运动。所有患者在脑干损伤侧均有斜视角伴下斜视。每位患者的扭转性眼球震颤均向远离梗死侧跳动，但其中1例患者的眼球在扭转中立位置附近漂移时，眼球震颤方向会交替变化。我们将扭转性眼球震颤归因于介导眼反向转动的前、后半规管及耳石感受器的中枢投射失衡。
