Gresty M
J Neurol Neurosurg Psychiatry. 1977 Oct;40(10):992-1002. doi: 10.1136/jnnp.40.10.992.
The effect of head position on conjugate horizontal gaze was studied in healthy adults, in patients with multiple sclerosis without eye movement signs, and in patients with downbeat nystagmus indicative of low brain stem lesions. Displacements of gaze from primary position to 30 degrees left and right were recorded using the electro-oculogram, with the head in the primary position, and turned voluntarily to the left and right (in yaw). The quality of eye movements was noted and peak velocities of saccades were measured. The head turning test trebled the incidence of abnormal eye movements found in the multiple sclerosis patients and increased it by tenfold in the patients with downbeat nystagmus. Disorders of eye movement were also found in approximately 20--30% of healthy subjects tested. Weakness of abduction was the most common eye movement defect and appeared to be posterior internuclear ophthalmoplegia. A hypothesis is made which unifies the theoretical explanations of anterior and posterior internuclear ophthalmoplegia. The most likely cause of the disorders of eye movement observed is vertebrobasilar ischaemia induced by stretching and compression of the vertebral arteries during eccentric head posture.
研究了头部位置对健康成年人、无眼球运动体征的多发性硬化症患者以及提示低位脑干病变的下跳性眼球震颤患者共轭水平注视的影响。使用眼电图记录从初始位置向左和向右30度的注视位移，头部处于初始位置，并分别向左和向右转（偏航）。记录眼球运动的质量并测量扫视的峰值速度。头部转动测试使多发性硬化症患者中异常眼球运动的发生率增加了两倍，使下跳性眼球震颤患者中异常眼球运动的发生率增加了十倍。在大约20%-30%接受测试的健康受试者中也发现了眼球运动障碍。外展无力是最常见的眼球运动缺陷，似乎是核间性眼肌麻痹。提出了一个统一核间性眼肌麻痹前后理论解释的假说。观察到的眼球运动障碍最可能的原因是在偏心头部姿势期间椎动脉的拉伸和压迫导致的椎基底动脉缺血。
