Odaka M, Yuki N, Yamazaki K, Hirata K
Department of Neurology, Dokkyo University School of Medicine, Tochigi, Japan.
Rinsho Shinkeigaku. 1998 Apr;38(4):319-22.
A 29-year-old man developed drowsiness, ophthalmoplegia and cerebellar ataxia following upper respiratory tract infection. We diagnosed the patient as having a Bickerstaff's brainstem encephalitis. There was upbeating nystagmus which appeared with upward gaze, and bilateral horizontal gaze-evoked nystagmus in both directions. On electronystagmography, eye-tracking test showed saccadic pattern with impaired smooth pursuit eye movement. The horizontal optokinetic nystagmus test showed diminution of response. These results suggested that brainstem and cerebellum were widely involved. Presence of nystagmus may help to speculate the lesion of Bickerstaff's brainstem encephalitis.
一名29岁男性在上呼吸道感染后出现嗜睡、眼肌麻痹和小脑共济失调。我们诊断该患者患有比克斯特法夫脑干脑炎。向上注视时出现上跳性眼球震颤，双眼向双侧水平凝视均可诱发水平性眼球震颤。眼震电图检查中，眼跟踪测试显示扫视模式，平滑追踪眼球运动受损。水平视动性眼球震颤测试显示反应减弱。这些结果提示脑干和小脑广泛受累。眼球震颤的存在可能有助于推测比克斯特法夫脑干脑炎的病变部位。
