Comacchio Francesco, Talenti Giacomo, Manara Renzo, Briani Chiara
Otolaryngology Unit, University Hospital Sant'Antonio Padova, Via Facciolati 71, 35127, Padova, Italy.
Neuroradiology Unit, University Hospital Padova, Via Giustiniani 2, 35128, Padova, Italy.
J Otol. 2023 Oct;18(4):246-249. doi: 10.1016/j.joto.2023.09.001. Epub 2023 Sep 22.
The role of intercalatus nucleus of Staderini (INS), the most caudal of the perihypoglossal nuclei, is much debated. Last research seems to suggest that this nucleus plays a role as a vertical eyes movements integrator. The few clinical reports present in the literature that describe isolated lesions of the INS have described patients presenting in acute with up-beating vertical spontaneous nystagmus. Isolated acute lesion of INS is, in fact, much rare, and, without other neurological signs, is exceptional. We present a case of acute isolated vertigo with no other neurological signs or symptoms, due to INS ischemia provoked by vertebral artery stenosis. The patient presented with spontaneous vertical up-beating nystagmus that showed at videonystagmographic recording, a clear exponential decay of angular slow-phase velocity, that is considered a typical sign of neural integrator impairment. This case seems to represent a further confirm that INS is part, as a vertical-to-position neural integrator, of the neural circuit controlling the vertical eyes movements.
斯塔代里尼间插核（INS）是舌下神经周核中最靠尾端的核团，其作用存在诸多争议。最新研究似乎表明该核团作为垂直眼动整合器发挥作用。文献中少数描述INS孤立性病变的临床报告称，患者急性起病，伴有向上跳动的垂直性自发性眼球震颤。事实上，INS的孤立性急性病变非常罕见，若无其他神经体征，则更是罕见。我们报告一例因椎动脉狭窄引发INS缺血导致的急性孤立性眩晕病例，患者无其他神经体征或症状。患者出现自发性垂直向上跳动性眼球震颤，在视频眼震图记录中显示，角慢相速度呈明显指数衰减，这被认为是神经整合器受损的典型征象。该病例似乎进一步证实，INS作为垂直位置神经整合器，是控制垂直眼动神经回路的一部分。
