Endres M, Heide W, Kömpf D
Neurologische Klinik, Medizinische Universität zu Lübeck.
Nervenarzt. 1996 Jun;67(6):484-9.
See-saw nystagmus is an uncommon but characteristic kind of nystagmus. Typically there is intorsion and elevation of one eye and simultaneous extorsion and depression of the other eye. The nystagmus can be of pendular-waveform or jerk-waveform. The pendular-waveform see-saw nystagmus is commonly due to a midline meso-diencephalic, bilaterally compressing mass. The jerk-waveform see-saw nystagmus is mostly due to a unilateral lesion in the meso-diencephalic junction. For explanation, a current theory assumes a unilateral lesion of the interstitial nucleus of Cajal sparing the rostral interstitial nucleus of the medial longitudinal fascicle. Another concept suggests a lesion of the vertical vestibulo-ocular-reflex. We report two patients with jerk-waveform see-saw nystagmus. In both patients an internuclear ophthalmoplegia was found additionally. The origin was a unilateral brainstem infarction in both cases. We explain the symptomatology of see-saw nystagmus and discuss the actual theories of its origin.
跷跷板样眼球震颤是一种罕见但具有特征性的眼球震颤。通常，一只眼睛会发生眼球内旋和上抬，同时另一只眼睛会发生眼球外旋和下转。这种眼球震颤可以是摆动型波形或急跳型波形。摆动型波形的跷跷板样眼球震颤通常是由于中线中脑间脑处有双侧压迫性肿块。急跳型波形的跷跷板样眼球震颤主要是由于中脑间脑交界处的单侧病变。一种当前的理论认为， Cajal间质核的单侧病变未累及内侧纵束的嘴侧间质核来解释这种现象。另一种观点认为是垂直前庭眼反射受损。我们报告了两名患有急跳型波形跷跷板样眼球震颤的患者。在这两名患者中还发现了核间性眼肌麻痹。两例的病因均为单侧脑干梗死。我们解释了跷跷板样眼球震颤的症状，并讨论了其起源的现有理论。
