Wallenberg症候群の眼振について

概要

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The origin of nystagmus, and the neurological symptoms and signs in 5 patients with Wallenbergs syndrome were related to the site and extension of lesions revealed by MRI. The relationship between nystagmus and a lesion in the neural structure, especially in the vestibular nucleus, was studied. 1. Pure rotatory nystagmus was observed in 3 of the 5 patients, rotatory nystagmus with dissociated vertical movements like a see-saw in one, and no nystagmus in one. 2. Nystagmus towards the side of the lesion was observed in one patient and nystagmus towards the contralateral side in 3. 3. MRI did not reveal any lesions at the level of the lateral vestibular nucleus in any of the patients. 4. Two patients, who had lesions in the medial and or inferior vestibular nucleus, did not complain of vertigo. On the contrary, 3, who had no lesions in the vestibular nuclei, complained of vertigo or dizziness. Therefore, it was supposed that a lesion adjacent to the vestibular nuclei associated with preservation of the vestibular nuclei might cause vertigo. 5. Both skew deviation of the eyes and head tilt phenomenon were observed only in patients with no preservation of the medial and or inferior vestibular nucleus. 6. Recording of eye movements with a CCD camera was very helpful in the analysis of nystagmus and in the follow-up studies of these patients.