Leigh R J, Hanley D F, Munschauer F E, Lasker A G
Ann Neurol. 1984 May;15(5):465-73. doi: 10.1002/ana.410150511.
Eye movements induced by head rotation were studied in 6 patients in acute coma, 4 patients in a persistent vegetative state, and 6 healthy, alert control subjects. Results from control subjects suggest that the oculocephalic response in the supine position is principally a vestibulo-ocular reflex. A position-step rotation of the head produced an initial oppositely directed eye movement, followed by a drift of the eyes back toward midline with a negative exponential time course. The time constant of this drift was greater than or equal to 10 seconds in control subjects but less than or equal to 1.5 seconds in unconscious patients and less than or equal to 0.5 seconds in vegetative patients. The rapid drift back of the eyes in unresponsive patients implies dysfunction of reticular and, possibly, cerebellar connections; the rate of this drift may indicate the severity and extent of brain injury. Sinusoidal head rotation produced slow and quick phases of nystagmus in normal subjects. Quick phases were absent in patients in acute coma; although present in vegetative patients, the quick phases did not keep the eyes close to primary position, as was the case in control subjects.
对6例急性昏迷患者、4例持续性植物状态患者和6名健康清醒的对照受试者进行了头部旋转引起的眼球运动研究。对照受试者的结果表明，仰卧位时的眼前庭反射主要是前庭眼反射。头部的位置阶跃旋转会产生最初方向相反的眼球运动，随后眼球以负指数时间进程向中线漂移。在对照受试者中，这种漂移的时间常数大于或等于10秒，而在无意识患者中小于或等于1.5秒，在植物状态患者中小于或等于0.5秒。无反应患者眼球的快速回漂意味着网状结构以及可能的小脑连接功能障碍；这种漂移的速率可能表明脑损伤的严重程度和范围。在正常受试者中，正弦头部旋转会产生眼球震颤的慢相和快相。急性昏迷患者没有快相；虽然植物状态患者有快相，但快相并不能像对照受试者那样使眼球保持在接近初始位置。
