Nakaso K, Awaki E, Isoe K
Department of neurology, Tottoriken Saiseikai Sakaiminato General Hospital.
Rinsho Shinkeigaku. 1996 May;36(5):692-5.
We reported a 72-year-old man with left supranuclear hypoglossal nerve palsy and right Avellis' syndrome due to a medullary small infarction. On admission, he showed slight disturbance of consciousness, ocular lateropulsion to the right side, rotatory nystagmus, dysarthria, absent right gag reflex, curtain sign, absent right palatal reflex, deviation of the uvula toward the left side, raise of only the left palate when the patient attempted to utter, paralysis of the right vocal cord and deviation of the tongue toward the left side. Neither atrophy nor fasciculation was observed on the tongue. 124 days after the onset, he had only the left supranuclear hypoglossal nerve palsy and right Avellis' syndrome. MRI showed a small lesion in the medulla, so lateral area of the medulla and a part of the reticular formation medial to the nucleus ambiguous presumed to be involved. These findings suggest that supranuclear pathway to the hypoglossal nucleus of the opposite side exists in the reticular formation near nucleus ambiguous.
我们报告了一名72岁男性，因延髓小梗死出现左侧核上性舌下神经麻痹和右侧阿韦利斯综合征。入院时，他表现出轻度意识障碍、眼球向右侧偏斜、旋转性眼球震颤、构音障碍、右侧咽反射消失、幕布征、右侧腭反射消失、悬雍垂偏向左侧、患者试图发声时仅左侧腭部抬高、右侧声带麻痹以及舌头偏向左侧。舌部未观察到萎缩和肌束震颤。发病124天后，他仅遗留左侧核上性舌下神经麻痹和右侧阿韦利斯综合征。MRI显示延髓有一个小病变，推测病变累及延髓外侧区以及疑核内侧的部分网状结构。这些发现提示，在疑核附近的网状结构中存在至对侧舌下神经核的核上通路。
