Zee D S, Hain T C, Carl J R
Ann Neurol. 1987 Apr;21(4):383-8. doi: 10.1002/ana.410210411.
We tested the hypothesis that abnormalities of the abducting eye in internuclear ophthalmoplegia reflect an adaptive process that helps overcome the adduction weakness of the opposite eye. This response operates under the constraints of Hering's law of equal innervation: any attempt to increase the innervation to a weak muscle in one eye must be accompanied by a commensurate increase in innervation to the yoke muscle in the other eye. In 4 patients with internuclear ophthalmoplegia, we patched one eye for 1 to 5 days to allow time for the central nervous system to optimize innervation for the habitually viewing eye. We predicted that there would be a conjugate adjustment of innervation that would diminish the abduction overshoot and backward postsaccadic drift made by the habitually viewing eye. This was the case in 3 of our 4 patients. Our findings show that the abduction nystagmus is a manifestation of a normal adaptive response in some patients with INO.
核间性眼肌麻痹中外展眼的异常反映了一种适应性过程，该过程有助于克服对侧眼内收无力的问题。这种反应在赫林等神经支配定律的限制下发挥作用：任何试图增加对一只眼弱肌的神经支配的尝试，都必须伴随着对另一只眼配偶肌神经支配的相应增加。在4例核间性眼肌麻痹患者中，我们将一只眼遮盖1至5天，以便中枢神经系统有时间为习惯注视眼优化神经支配。我们预测，神经支配会有共轭调整，从而减少习惯注视眼的外展过冲和扫视后向后漂移。我们的4例患者中有3例出现了这种情况。我们的研究结果表明，外展性眼球震颤是一些核间性眼肌麻痹患者正常适应性反应的一种表现。
