Hirose G, Ogasawara T, Shirakawa T, Kawada J, Kataoka S, Yoshioka A, Halmagyi G M
Department of Neurology, Kanazawa Medical University, Ishikawa, Japan.
Ann Neurol. 1998 Mar;43(3):403-6. doi: 10.1002/ana.410430323.
We report on a patient who developed primary position upbeat nystagmus (ppUBN) due to a unilateral medial medullary infarction. On oculography, the slow phases of the nystagmus sometimes had an exponentially decreasing velocity waveform, indicating that the nystagmus was due to impairment of the vertical position-to-velocity neural integrator. On magnetic resonance imaging, the lesion was caudal to the vestibular nuclei and to the most rostral of the perihypoglossal nuclei, the nucleus intercalatus, a structure that was also involved in a previously reported case of ppUBN due to a unilateral medullary lesion. On the basis of these imaging and oculographic observations, we propose that a unilateral lesion of the nucleus intercalatus is sufficient to cause ppUBN and that the nucleus intercalatus is a part of the vertical position-to-velocity neural integrator in the human ocular-motor system.
我们报告了一名因单侧内侧延髓梗死而出现原发性位置性上跳性眼球震颤（ppUBN）的患者。在眼动描记术中，眼球震颤的慢相有时具有指数递减速度波形，表明该眼球震颤是由于垂直位置到速度神经积分器受损所致。在磁共振成像中，病变位于前庭核的尾侧以及舌下神经周围核最靠头端的中间核，该结构在先前报道的一例因单侧延髓病变导致的ppUBN病例中也有涉及。基于这些影像学和眼动描记术观察结果，我们提出中间核的单侧病变足以导致ppUBN，并且中间核是人类眼球运动系统中垂直位置到速度神经积分器的一部分。
