Kommerell G
Invest Ophthalmol Vis Sci. 1981 Oct;21(4):592-9.
Inability to adduct the left eye beyond the midline was found in a patient after brain stem infarction. Pursuit movements, refixation saccades, and the vestibulo-ocular reflex were restricted to the temporal hemifield. Only near convergence led to an adduction of 15 degrees in the left eye. Nasally directed saccades were slow, and temporally directed saccades showed glissadic back-drift. Electromyography revealed a lack of burst activity in the left medial rectus; however, inhibition of the left (homolateral) and the right (contralateral) medial rectus muscles during off-saccades and in off-positions of gaze was normal. These observations suggest that inhibition for medial rectus motor neurons is not mediated by the medial longitudinal fasciculus. The findings are compatible with the neurophysiological data, which show that reductions of activity in the medial rectus motoneurons are largely caused by disfacilitation via internuclear neurons rather than by inhibition.
在一名脑干梗死患者中发现左眼不能内收超过中线。跟踪运动、重新注视扫视和前庭眼反射仅限于颞侧半视野。仅近距集合可使左眼内收15度。鼻侧方向的扫视缓慢，颞侧方向的扫视出现滑回漂移。肌电图显示左内直肌缺乏爆发性活动；然而，在扫视停止时和注视偏离位置时，左（同侧）和右（对侧）内直肌的抑制是正常的。这些观察结果表明，内直肌运动神经元的抑制不是由内侧纵束介导的。这些发现与神经生理学数据相符，该数据表明内直肌运动神经元活动的减少主要是由通过核间神经元的去易化作用而非抑制作用引起的。
