Barton J J, Jama A, Sharpe J A
Neuro-ophthalmology Unit, Toronto Hospital Neurological Center, ON, Canada.
Neurology. 1995 Nov;45(11):2065-72. doi: 10.1212/wnl.45.11.2065.
We measured the duration and amplitude of saccades in three normal subjects, eight patients with myasthenia gravis, and eight patients with nonmyasthenic ocular palsies. Saccades were examined at the start of a repetitive saccade task, after 3 minutes of activity, and 1 minute after administration of edrophonium. The duration of saccades was prolonged initially in both myasthenic and nonmyasthenic palsies. Activity did not produce significant differences among the three groups in either the slope of the duration-amplitude relationship or the predicted durations of saccades of 5 degrees, 10 degrees, or 15 degrees. However, durations decreased in myasthenia but increased in nonmyasthenic palsies after edrophonium. Much of this decrease in myasthenic saccadic duration was due to reduction in deceleration time, indicating resolution of intrasaccadic fatigue after edrophonium administration. However, the relation of deceleration fraction (deceleration time divided by total duration) to total duration remained constant in all subject groups. Analysis of saccadic duration is a useful means of interpreting responses to edrophonium because it incorporates data from saccades of a wide range of amplitudes into a linear relation between duration and amplitude.
我们测量了3名正常受试者、8名重症肌无力患者和8名非重症肌无力性眼肌麻痹患者的扫视持续时间和幅度。在重复扫视任务开始时、活动3分钟后以及注射依酚氯铵1分钟后对扫视进行检查。重症肌无力和非重症肌无力性麻痹患者的扫视持续时间最初均延长。活动在三组中均未在持续时间-幅度关系的斜率或5度、10度或15度扫视的预测持续时间方面产生显著差异。然而,注射依酚氯铵后,重症肌无力患者的扫视持续时间缩短,而非重症肌无力性麻痹患者的扫视持续时间延长。重症肌无力患者扫视持续时间的这种缩短很大程度上是由于减速时间的减少,这表明注射依酚氯铵后眼内扫视疲劳得到缓解。然而,减速分数(减速时间除以总持续时间)与总持续时间的关系在所有受试者组中保持不变。分析扫视持续时间是解释对依酚氯铵反应的一种有用方法,因为它将来自各种幅度扫视的数据纳入了持续时间和幅度之间的线性关系中。