Optom Vis Sci. 2023 Jun 1;100(6):419-421. doi: 10.1097/OPX.0000000000002027. Epub 2023 May 19.
Unilateral gaze-evoked nystagmus is a rare neurologic finding that is largely diagnosed in connection with ischemic stroke. Gazed-evoked nystagmus is also a rare initial presentation of multiple sclerosis.
This study aimed to report a rare presentation of gaze-evoked nystagmus in a patient with multiple sclerosis and review the mechanism underlying the gaze-evoked nystagmus.
A 32-year-old man presented with a 1-week history of diplopia. Neurologic examination revealed right-sided gaze-evoked nystagmus and right-sided ataxia. Laboratory test revealed a positive result for oligoclonal bands. Contrast brain MRI revealed multiple hyperintense T2 lesions including a hyperintense patch at the right inferior cerebellar peduncle. A diagnosis of multiple sclerosis was made. The patient received methylprednisolone 500 mg intravenously for 14 days. The diplopia and gaze-evoked nystagmus resolved and remained stable 2 months later.
Our case demonstrates that damage to the inferior cerebellar peduncle may result in ipsilesional gaze-evoked nystagmus and ipsilesional ataxia, in contrast to ipsilesional gaze-evoked nystagmus and contralesional ataxia.
单侧凝视诱发的眼球震颤是一种罕见的神经系统发现，主要与缺血性中风有关。凝视诱发的眼球震颤也是多发性硬化症的一种罕见首发症状。
本研究旨在报告一例多发性硬化症患者中罕见的凝视诱发眼球震颤表现，并回顾凝视诱发眼球震颤的发生机制。
一名 32 岁男性，因复视 1 周就诊。神经系统检查显示右侧凝视诱发眼球震颤和右侧共济失调。实验室检查显示寡克隆带阳性。对比脑 MRI 显示多个高信号 T2 病灶，包括右侧小脑下脚的高信号斑块。诊断为多发性硬化症。患者接受甲基强的松龙 500mg 静脉注射治疗 14 天。复视和凝视诱发眼球震颤消失，2 个月后仍稳定。
我们的病例表明，小脑下脚损伤可能导致同侧凝视诱发眼球震颤和同侧共济失调，与同侧凝视诱发眼球震颤和对侧共济失调相反。
