脑干病变引起眼球运动障碍、眼球震颤的临床分析

Clinical Analysis of Ocular Dayscinesia Nystagmus Caused by Lesions in the Brain Stem

目的 :探讨眼球运动障碍、眼球震颤对脑干病变定位的临床意义。方法 :对 39例经 CT、MRI证实为脑干病变的患者行眼球运动障碍、眼球震颤分析。结果 :眼球垂直注视麻痹、会聚麻痹对中脑病变有定位意义 ;核间性眼肌麻痹对中脑、脑桥病变有定位意义 ;眼球水平运动障碍对脑桥病变有定位意义 ;延髓病变无眼球运动障碍 ;眼球震颤可发生在脑干各种部位病变。结论 :眼球运动障碍对脑干病变定位有临床意义 ;眼球震颤尤其是垂直性、旋转性、摆动性震颤对诊断脑干病变有一定临床意义 ;MRI对脑干病变定位、定性有价值 ,CT对脑干病变诊断有局限性。

Objective:To investigate the clinical significane of ocular dyscinesia nystagmus caused lesions in the brain stem.Methods:Analyse the ocular dyscinesia and nystagmus in 39 patiens who have lesions in the brain stem confirmed by CT and MRI.Results:Paralysis of vertical gaze and paralysis of convergence aer both of significance in locating lesions in the midbrain; internuclear ophthalmoplegia,inlocating lesion in midbrain and pons;horizontal dyscinesia,in locatings lesions in pons,No ocular dyscinesia is found when lesions occur in the medulla oblongata.Lesions in any part of the brain stem may cause nystagmus.Conclusion:Ocular dyscinesia is of significonce in locating lesions in the brain stem and so is nystagmus;especially vertical,rotatory and pendular nystagmus.MRI is valuable for the location of lesions in the brain stem and for their qualitative evaluation as well.CT has its limitation in locating the lesions in the brain stem.