Johkura K, Komiyama A, Hasegawa O, Kuroiwa Y
Department of Neurology, Urafune Hospital, Yokohama City University, Yokohama, Japan.
J Neurol Sci. 1998 Dec 11;161(2):176-9. doi: 10.1016/s0022-510x(98)00280-9.
An unusual combination of downgaze palsy and bilateral ptosis occurred in a patient with central nervous system lymphoma involving bilateral thalamus and midbrain tegmentum. Following treatment with corticosteroids, the transition from total paralysis of downgaze to the supranuclear form was noted, along with alleviation of ptosis, followed by complete resolution of both. The results of serial magnetic resonance images were consistent with our interpretation that his initial eye signs were caused by the combined involvement of the bilateral rostral interstitial nucleus of the medial longitudinal fasciculus (supranuclear downgaze palsy) and the oculomotor subnuclei (nuclear palsy of the inferior recti and levator palpebrae muscles).
一名患有累及双侧丘脑和中脑被盖的中枢神经系统淋巴瘤的患者出现了下视麻痹和双侧上睑下垂的不寻常组合。在用皮质类固醇治疗后，观察到从完全性下视麻痹转变为核上型，同时上睑下垂有所减轻，随后两者完全消失。系列磁共振成像结果与我们的解释一致，即其最初的眼部体征是由双侧内侧纵束吻侧间质核（核上性下视麻痹）和动眼神经亚核（下直肌和提上睑肌的核性麻痹）共同受累所致。
