Kommerell G
Universitäts-Augenklinik Freiburg, Abteilung Neuroophthalmologie und Schielbehandlung, Germany.
Ger J Ophthalmol. 1994 May;3(3):186-8.
The "dynamic head-tilt test" introduced in this article examines the influence of the vestibular semicircular canals on the eye muscles during the head tilt. Normally, a rotatory nystagmus results. If under certain pathological circumstances, the vestibulo-ocular reflex is transmitted only to the rectus muscles and not to the obliques, the cyclorotatory nystagmus is converted into a vertical nystagmus. We have found this condition in five cases; in two it was very pronounced. During head tilt to the right, the slow phases of the nystagmus were directed upward in the right eye and downward in the left eye. During head tilt to the left, the nystagmus directions were reversed. Since other signs of oblique muscle palsy such as incomitance and cyclotropia were lacking or inappropriately slight, the author suggests the presence of a supranuclear lesion eliminating the vestibular input to the trochlear nucleus and to the subnucleus of the inferior oblique muscle while leaving the input for voluntary and visual gaze signals intact.
本文介绍的“动态头部倾斜试验”研究了头部倾斜过程中前庭半规管对眼肌的影响。正常情况下，会产生旋转性眼球震颤。如果在某些病理情况下，前庭眼反射仅传导至直肌而不传导至斜肌，旋转性眼球震颤就会转变为垂直性眼球震颤。我们在5例病例中发现了这种情况；其中2例非常明显。向右侧头部倾斜时，眼球震颤的慢相在右眼向上，在左眼向下。向左侧头部倾斜时，眼球震颤方向相反。由于缺乏斜肌麻痹的其他体征，如斜视和旋转斜视，或这些体征不明显，作者认为存在一种核上病变，该病变消除了前庭向滑车神经核和下斜肌亚核的输入，而保留了对随意和视觉注视信号的输入。
