Rousseaux M, Petit H, Hache J C, Devos P, Dubois F, Warot P
Rev Neurol (Paris). 1985;141(5):391-403.
Oculomotor disorders in 22 infarctions in the thalamic region are recorded. Clinical examination and electro-oculography (17 cases) showed that paramedian thalamo-subthalamic lesions were responsible for clear deficits: upgaze paralysis and in some cases downgaze paralysis, partial paresis of the oculomotor nerve, deficits of lateral eye movements, myosis, paralysis of head flexion combined with downgaze paralysis. Postero-median choroid artery infarction was associated with upgaze paresis, slight deficit of lateral eye movements and myosis. Postero-lateral choroid artery infarction resulted in a partial visual field defect and in some cases, a contralateral hypometria; myosis was slight and inconstant. Infarctions of the internal capsule (anterior choroid artery, deep branches of the middle cerebral artery) were associated with a deficit of contralateral saccades. Ocular pursuit, when possible, was often saccadic, whatever the site of the infarction. This prevailed with gaze towards the lesion side.
记录了22例丘脑区域梗死中的动眼神经障碍。临床检查和眼电图检查(17例)显示,丘脑旁正中-底丘脑病变导致明显的功能缺损:上视麻痹,部分病例伴有下视麻痹、动眼神经部分麻痹、眼球外展运动功能缺损、瞳孔缩小、头部前屈麻痹合并下视麻痹。脉络膜后正中动脉梗死与上视麻痹、眼球外展运动轻度功能缺损和瞳孔缩小有关。脉络膜后外侧动脉梗死导致部分视野缺损,部分病例伴有对侧运动功能减退;瞳孔缩小轻微且不恒定。内囊梗死(脉络膜前动脉、大脑中动脉深支)与对侧扫视功能缺损有关。无论梗死部位如何,只要可能,眼球跟踪通常为扫视运动。这种情况在注视病变侧时更为常见。