橋梗塞症例よりみた完全注視方向性眼振

概要

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Complete gaze directional nystagmus was observed transiently in a 59-year-old woman with left pontine infarction. She had had a sudden attack of headache, rotatory vertigo and double vision. Neurological examination showed incomplete left abducent nerve palsy, incomplete left facial nerve palsy, and sensory disturbance of the left arm and foot. The oto-neurological findings were complete gaze directional nystagmus and positional nystagmus towards the upper part of the ear. However, as her vertigo subsided, complete gaze directional nystagmus also subsided. We speculated that a small lesion of the midbrain, especially of the pons, could cause complete gaze directional nystagmus. We advocate the use of the Square Drawing Test (SDT) in patients with infarction of the midbrain.