Troost B T, Martinez J, Abel L A, Heros R C
Arch Neurol. 1980 Jul;37(7):453-6. doi: 10.1001/archneur.1980.00500560083015.
We describe the unusual association of two ocular motor abnormalities: upbeat nystagmus and internuclear ophthalmoplegia in a young woman originally believed to have demyelinating disease. Quantitative eye movement recordings documented a unidirectional defect in upward visual pursuit with preservation of the vertical vestibulo-ocular reflexes. The ocular oscillation was characterized as a type of "pursuit defect" nystagmus. An enhancing lesion of the upper brainstem seen on computerized tomography was primarily localized to the midbrain on pneumoencephalography. Biosy of the lesion disclosed a malignant glial tumor. The patient's course initally progressed but became stable following radiotherapy and chemotherapy during the next eight months. We believe the association of upbeat nystagmus and internuclear ophthalmoglegia should prompt a detailed search for a structural lesion.
上视性眼球震颤和核间性眼肌麻痹，该女性最初被认为患有脱髓鞘疾病。定量眼动记录显示向上视跟踪存在单向缺陷，而垂直前庭眼反射保留。眼部振荡被特征化为一种“跟踪缺陷”性眼球震颤。计算机断层扫描上所见的上脑干强化病变在气脑造影中主要定位于中脑。病变活检显示为恶性胶质瘤。患者病程最初进展，但在接下来的八个月接受放疗和化疗后病情稳定。我们认为上视性眼球震颤和核间性眼肌麻痹的关联应促使对结构性病变进行详细检查。
