Takahashi M, Kaneko M, Hattori T, Hirayama K, Komatsuzaki A
Department of Neurology, Chiba University School of Medicine.
Rinsho Shinkeigaku. 1993 Jun;33(6):652-6.
Slow eye movements or slow saccades are relatively rare conditions in Wilson's disease where selective impairments of saccades are observed. The authors have a case of Wilson's disease showing a defect of saccades in all directions, with the complete preservation of smooth pursuit eye movements. T2-weighted images revealed abnormalities of signal intensity in bilateral pontine tegmentum, besides putaminal and thalamic lesions commonly seen in the previous reports. A rather selective disturbance of saccade eye movements due to the pontine tegmentum is consistent with the concept, as yet mainly based on experimental work on animals, of an anatomical segregation of the brainstem pathways for smooth pursuit eye movements, saccades, and vestibular and optokinetic patterns. Whereas the basal brainstem, especially basal pons, subserves smooth pursuit eye movements, saccades and reflex-like eye movements are mediated by the pontine tegmentum. The authors' case offers a support that dissociating eye movement disorders are due to the restricted lesions mentioned above.
缓慢眼动或缓慢扫视在威尔逊病中相对少见，在该病中可观察到选择性扫视障碍。作者有一例威尔逊病患者，其所有方向的扫视均存在缺陷，而平稳跟踪眼动则完全保留。T2加权图像显示，除了先前报告中常见的壳核和丘脑病变外，双侧脑桥被盖部信号强度也有异常。脑桥被盖部导致的相当选择性的扫视眼动障碍与以下概念相符，该概念目前主要基于动物实验研究，即脑干中平稳跟踪眼动、扫视以及前庭和视动模式的通路在解剖学上是分离的。虽然脑桥基底部，尤其是脑桥基底部，负责平稳跟踪眼动，但扫视和类似反射的眼动由脑桥被盖部介导。作者的病例支持了这样一种观点，即分离性眼动障碍是由上述局限性病变所致。
