Isago H, Tsuboya R, Kataura A
Auris Nasus Larynx. 1985;12(1):15-21. doi: 10.1016/s0385-8146(85)80074-2.
A case of periodic alternating nystagmus (PAN), probably of congenital type, was reported. A 25-year-old woman, who has been suffering from cerebral palsy, was referred to our clinic for the consultation of a peculiar nystagmus and intermittent oscillopsia. Electronystagmographic examination revealed that the horizontal nystagmus on straight ahead gaze in the light continuously changed its direction alternately about 110 sec in right direction and about 90 sec in left direction with about 5 sec of an interlude, during which no nystagmus was observed, between each span. Electronystagmographic recording also illustrated that the amplitude and slow phase eye velocity of PAN first increase and then decrease in each span. Since other various kind of examination including neuroradiological examination revealed no special abnormality except for the signs of cerebral palsy, congenital PAN was suspected in this case. Although previous report indicated that baclofen dose not control congenital PAN in contrast to that of acquired type, we tried baclofen in this case. Baclofen reduced the strength of the nystagmus remarkably and patient also recognized the considerable improvement of her oscillopsia. We are of the opinion that the baclofen may improve the strength of congenital PAN and oscillopsia as well as those of acquired type PAN.
报告了一例可能为先天性的周期性交替性眼球震颤（PAN）病例。一名25岁患有脑瘫的女性因特殊眼球震颤和间歇性视振荡前来我院门诊咨询。眼震电图检查显示，在光照下向前直视时，水平眼球震颤持续交替改变方向，向右约110秒，向左约90秒，每个周期之间有大约5秒的间歇期，在此期间未观察到眼球震颤。眼震电图记录还表明，PAN的振幅和慢相眼速度在每个周期中先增加后降低。由于包括神经放射学检查在内的其他各种检查除了脑瘫体征外未发现特殊异常，因此该病例怀疑为先天性PAN。尽管先前的报告表明，与后天性类型相比，巴氯芬不能控制先天性PAN，但我们仍在该病例中试用了巴氯芬。巴氯芬显著降低了眼球震颤的强度，患者也意识到视振荡有了明显改善。我们认为，巴氯芬可能改善先天性PAN和视振荡的强度，以及后天性PAN的强度。
