Esteban A, De Andrés C, Giménez-Roldán S
J Neurol Neurosurg Psychiatry. 1978 Aug;41(8):690-8. doi: 10.1136/jnnp.41.8.690.
A clinical and electromyographic study of oculomotor function was carried out in a series of 24 patients with amyotrophic lateral sclerosis (ALS). In 15 cases an alteration of Bell's phenomenon was found. In addition, three patients showed some impairment of conjugate ocular motility in the form of upward gaze paly. All cases had preserved oculocephalic reflexes in the vertical and horizontal planes. On clinical and electromyographic grounds, three degrees of altered Bell's phenomenon are suggested: attenuated (short and unsustained upward displacement of the eyeballs after forced closure of the eyelids), abolished (no upward displacement), and inverted (downward instead of upward displacement of the eyes). These oculomotor alterations were not directly related to the type of ALS at onset of the illness, nor with its duration. However they were correlated with the relative degree of the clinical bilateral pyramidal tract signs at the supraspinal level. The common involvement of the corticogeniculate tract in ALS could explain the unexpectedly high incidence of alteration of Bell's phenomenon found in this disease, but is is non-specific and similar lesions from different causes may also produce it.
对24例肌萎缩侧索硬化症（ALS）患者进行了动眼功能的临床和肌电图研究。15例患者发现贝尔现象改变。此外，3例患者出现了以向上凝视麻痹形式的共轭眼球运动障碍。所有病例在垂直和水平平面上的眼头反射均保留。基于临床和肌电图结果，提出了贝尔现象改变的三个程度：减弱（强迫闭眼后眼球向上移位短且不能持续）、消失（无向上移位）和倒置（眼球向下而非向上移位）。这些动眼改变与疾病发作时ALS的类型无关，也与其病程无关。然而，它们与脊髓上水平临床双侧锥体束征的相对程度相关。ALS中皮质膝状体束的常见受累可以解释该疾病中贝尔现象改变的意外高发生率，但这是非特异性的，不同原因引起的类似病变也可能导致这种情况。
