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Paroxysmal ocular tilt reactions after mesodiencephalic lesions: report of two cases and review of the literature

Cited 4 time in Web of Science Cited 5 time in Scopus
Authors
Oh, Sun-Young; Choi, Kwang-Dong; Shin, Byoung-Soo; Seo, Man-Wook; Kim, Young Hyun; Kim, Ji Soo
Issue Date
2008-11-29
Publisher
Elsevier
Citation
J Neurol Sci. 2009;277(1-2):98-102
Keywords
AgedCerebral Hemorrhage/*complications/pathology/physiopathologyFemaleHumansIntracranial Aneurysm/*complications/pathology/physiopathologyMagnetic Resonance ImagingMaleMiddle AgedNystagmus, Pathologic/etiology/pathology/physiopathologyOcular Motility Disorders/*complications/pathology/physiopathologyThalamic Diseases/*complications/pathology/physiopathologyTomography, X-Ray Computed
Abstract
BACKGROUND: To elucidate the mechanisms of paroxysmal ocular tilt reaction (OTR) from mesodiencephalic lesions by analyzing the associated ocular motor findings. METHODS: Two patients with paroxysmal ipsiversive OTR due to mesodiencephalic lesions underwent evaluation of associated ocular motor abnormalities and one of them had three-dimensional recording of eye motion. We also reviewed previously reported six patients with paroxysmal OTR. RESULTS: One patient showed contraversive torsional nystagmus during the paroxysms in association with vertical gaze limitation and vertical gaze-evoked nystagmus, which are consistent with baseline dysfunction and paroxysmal irritation of the interstitial nucleus of Cajal (INC) during the attacks. The other patient exhibited ipsiversive torsional nystagmus during the attacks, along with slowed vertical saccades and decreased amplitude of ipsitorsional nystagmus during the torsional vestibulo-ocular reflex between the attacks. These findings are best explained by underlying dysfunction and paroxysmal irritation of the rostral interstitial nucleus of the medial longitudinal fasciculus (riMLF). CONCLUSIONS: The associated ocular motor findings in our patients indicate that paroxysmal ipsiversive OTR in mesodiencephalic lesions is caused by intermittent hyperactivity of partially damaged ipsilesional riMLF or INC.
ISSN
0022-510X (Print)
Language
English
URI
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19038407

http://www.sciencedirect.com/science?_ob=MImg&_imagekey=B6T06-4V11MB6-2-C&_cdi=4854&_user=168665&_orig=search&_coverDate=02%2F15%2F2009&_sk=997229998&view=c&wchp=dGLzVlz-zSkWb&md5=4af1de5199181f9dcbda54b3cd44436c&ie=/sdarticle.pdf

http://hdl.handle.net/10371/68453
DOI
https://doi.org/10.1016/j.jns.2008.10.023
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College of Medicine/School of Medicine (의과대학/대학원)Dept. of Neurology (신경과학교실)Journal Papers (저널논문_신경과학교실)
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