Beversdorf D Q, Jenkyn L R, Petrowski J T, Cromwell L D, Nordgren R E
Section of Neurology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire 03756, USA.
J Neuroophthalmol. 1995 Dec;15(4):230-5.
A patient with paralysis of upward gaze and downward gaze, absent oculocephalic reflexes, and absent vertical saccades also demonstrated intermittent stupor over the first 9 days of presentation. Magnetic resonance imaging (MRI) demonstrated an infarct in the tegmentum of the mesencephalon including the right red nucleus and the periaqueductal area, superior to the oculomotor nucleus, and contiguous through the left thalamus. The infarct included the area around the rostral interstitial nucleus of the medial longitudinal fasciculus (riMLF), as well as the midbrain reticular formation. Mechanisms are proposed for the unusual concurrent sign of intermittent unresponsiveness in this case.
一名向上凝视和向下凝视麻痹、眼前庭反射消失且垂直扫视消失的患者，在就诊的前9天还表现出间歇性昏迷。磁共振成像（MRI）显示中脑被盖部梗死，包括右侧红核和导水管周围区域，位于动眼神经核上方，并通过左侧丘脑相连。梗死区域包括内侧纵束吻侧间质核（riMLF）周围区域以及中脑网状结构。本文提出了该病例中出现间歇性无反应这一异常并发症状的机制。
