Horiuchi I, Yoshimura T, Furuya H, Satake M, Kobayashi T
Department of Neurology, Faculty of Medicine, Kyushu University, Fukuoka.
Rinsho Shinkeigaku. 1997 Apr;37(4):334-7.
A case of alternating abducens hemiplegia was reported. A 16-year-old girl developed alternating hemiplegia characterized by the left abducens nerve palsy and right hemiparesis. In addition, she had right supranuclear facial nerve palsy. A brain MRI showed left mid to lower pontine lesion and vertebral angiography revealed medullary venous malformation in the left pons. SEP with right posterior tibial nerve stimulation showed a delayed central conduction time, suggesting that the lesion involved left medial lemniscus. We previously reported a 39-year-old man who developed pure alternating abducens hemiplegia. He did not show supranuclear facial nerve palsy or SEP abnormality. These findings support the idea that the supranuclear facial nerve fiber leaves the pyramidal tract at the upper to middle pons and descends in the area of the pontine tegmentum around the medial lemniscus.
报告了一例交替性展神经偏瘫病例。一名16岁女孩出现交替性偏瘫，其特征为左侧展神经麻痹和右侧偏瘫。此外，她还有右侧核上性面神经麻痹。脑部磁共振成像（MRI）显示左侧脑桥中下部病变，椎动脉血管造影显示左侧脑桥有延髓静脉畸形。右侧胫后神经刺激的体感诱发电位（SEP）显示中枢传导时间延迟，提示病变累及左侧内侧丘系。我们之前报告过一名39岁男性，他出现了单纯性交替性展神经偏瘫。他未表现出核上性面神经麻痹或SEP异常。这些发现支持了核上性面神经纤维在脑桥上中部离开锥体束并在内侧丘系周围的脑桥被盖区域下行的观点。
