Department of Neurology.
Department of Ophthalmology, New York University Grossman School of Medicine, New York, New York, USA.
Curr Opin Ophthalmol. 2023 Nov 1;34(6):465-469. doi: 10.1097/ICU.0000000000000998. Epub 2023 Aug 21.
Opsoclonus and ocular flutter are saccadic intrusions characterized by spontaneous, back-to-back, fast eye movements (saccades) that oscillate about the midline of central visual fixation without intervening inter-saccadic intervals. When this type of movement occurs exclusively in the horizontal plane, it is called ocular flutter. When it occurs in multiple planes (i.e. horizontal, vertical, and torsional) it is called opsoclonus. The most common etiologic categories are parainfectious and paraneoplastic diseases. Less common are toxic-metabolic, traumatic, or idiopathic origins. The mechanism of these movements relates to dysfunction of brainstem and cerebellar machinery involved in the generation of saccades. In this review, we discuss the characteristics of opsoclonus and ocular flutter, describe approaches to clinical evaluation and management of the patient with opsoclonus and ocular flutter, and review approaches to therapeutic intervention.
Recent publications demonstrated eye position-dependent opsoclonus present only in left gaze, which may be related to dysfunction of frontal eye fields or structures in the cerebellar vermis.
Opsoclonus and ocular flutter originate from a broad array of neuropathologies and have value from both a neuroanatomic and etiologic perspective.
目的综述：眼球震颤和眼阵挛是一种眼球跳动，特点是自发性、连续、快速的眼球运动（跳动），在中央视觉固定的中线附近摆动，没有中间的跳动间隔。当这种运动仅发生在水平面上时，称为眼阵挛；当它发生在多个平面（即水平、垂直和扭转）时，称为眼球震颤。最常见的病因类别是感染后和肿瘤相关疾病。较少见的是中毒性代谢、创伤性或特发性起源。这些运动的机制与涉及眼球跳动产生的脑干和小脑机械功能障碍有关。在这篇综述中，我们讨论了眼球震颤和眼阵挛的特征，描述了眼球震颤和眼阵挛患者的临床评估和管理方法，并回顾了治疗干预措施。
最新发现：最近的出版物表明，仅在左眼注视时出现与眼位相关的眼球震颤，这可能与额眼区或小脑蚓部结构的功能障碍有关。
总结：眼球震颤和眼阵挛起源于广泛的神经病理学，从神经解剖学和病因学的角度都具有价值。
