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首页> 外文期刊>Otology and neurotology: official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology >Periodic alternating nystagmus caused by a medullary lesion in acute disseminated encephalomyelitis
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Periodic alternating nystagmus caused by a medullary lesion in acute disseminated encephalomyelitis

机译：急性弥漫性脑脊髓炎由髓样病变引起的周期性交替性眼球震颤

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OBJECTIVE: To document a patient with periodic alternating nystagmus (PAN) caused by acute disseminated encephalomyelitis (ADEM) and suggest a mechanism to explain her PAN. PATIENT: A 34-year-old woman with PAN caused by ADEM. INTERVENTION: Diagnostic. RESULTS: The patient complained of severe disequilibrium from the disease onset. Four years after onset, when she visited us, the patient exhibited prominent PAN consisting of alternating rightward and leftward components, which cycled about every 90 seconds and were accompanied by a 5-second translating phase with downbeating nystagmus. Eye movement analysis that separated the horizontal and vertical components revealed the presence of downbeating movements throughout all phases of the PAN. ENG recordings revealed slightly saccadic pursuit, slightly impaired optokinetic eye movement and an absence of visual suppression of the caloric response. MRI recorded at the onset of the disease revealed lesions in the medulla, the spinal cord at the C2 level, and the frontal horn of the left lateral ventricle, but not the cerebellum. CONCLUSION: We attribute this patient's PAN to impairment of the nucleus prepositus hypoglossi in the medulla, which plays a role in the velocity storage system. In addition, cerebellar dysfunction is indicated by the occurrence of PAN while fixating.
机译：目的：记录由急性弥漫性脑脊髓炎（ADEM）引起的周期性交替性眼球震颤（PAN）患者，并提出解释其PAN的机制。患者：一名34岁由ADEM引起的PAN患者。干预：诊断。结果：该患者主诉疾病发作时严重不平衡。发病四年后，当她拜访我们时，患者表现出突出的PAN，该PAN由左右成分交替组成，大约每90秒循环一次，并伴有5秒的翻译阶段，伴有震颤的眼球震颤。将水平和垂直分量分开的眼动分析表明，在PAN的所有阶段中都存在拍打运动。 ENG的录音显示出轻微的跳动，轻微的视动眼运动以及视觉上没有抑制热量反应。疾病发作时记录的MRI显示了髓质，C2水平的脊髓和左心室的额角而不是小脑的病变。结论：我们将此患者的PAN归因于延髓的髓前垂核的受损，这在速度存储系统中起作用。另外，小脑功能障碍由固定时PAN的出现指示。

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