Sakuma A, Kato I, Ogino S, Okada T, Takeyama I
Department of Otorhinolaryngology, St. Marianna University School of Medicine, Kawasaki, Japan.
Acta Otolaryngol Suppl. 1996;522:43-6.
A 24-year-old man was admitted to the University Hospital showing severe dehydration that might have been the result of medicine-induced gastritis. Wernicke's encephalopathy was suspected in this patient. On admission, primary position upbeat nystagmus (PPUN) was found. The patient showed tongue fasciculation and loss of gag reflex, which, however, soon returned to normal. Electronystagmographic (ENG) findings were suggestive of lesions in the brainstem. Based on neurological signs and symptoms, we concluded caudal brainstem lesions might be a possible site responsible for the upbeat nystagmus. This nystagmus, however, was later found to be reversed to downbeat nystagmus. This is considered to have been due to predominant differences in vertical velocity which are induced by gravity.
一名24岁男性因严重脱水入住大学医院，严重脱水可能是药物性胃炎所致。怀疑该患者患有韦尼克脑病。入院时，发现有原发性位置性上跳性眼球震颤（PPUN）。患者出现舌肌束颤和咽反射消失，但很快恢复正常。眼震电图（ENG）结果提示脑干病变。根据神经体征和症状，我们得出结论，脑干尾部病变可能是导致上跳性眼球震颤的一个可能部位。然而，这种眼球震颤后来被发现转变为下跳性眼球震颤。这被认为是由于重力引起的垂直速度的主要差异所致。
