十六个半综合征合并垂直方向凝视性眼震的临床特点(附1例报告)

Clinical features of sixteen-and-a-half syndrome combined with verticalg aze-evoked nystagmus(report of onecase)

目的本文旨在进一步认识十六个半综合征中前庭功能受损的临床表现,以及脑桥病变所导致不同眼震形式,以便提高临床诊疗能力。方法结合病例报告中的病史、临床症状、体征、辅助检查,综合分析十六个半综合征的眼动特征及相关的神经传导通路,以定位脑桥病变部位。结果本患者第Ⅷ颅神经(前庭蜗神经)单纯累及左侧前庭,临床可见左旋上跳自发眼震和左侧球囊通路功能减低。脑桥部位病变可见垂直方向凝视性眼震。结论十六个半综合征中前庭蜗神经受累,可单纯累及前庭部分,而无听力受损表现。脑桥部位病变除可致十六个半综合征,也可同时导致垂直方向凝视性眼震。

Objective The purpose of this paper is to further understand the clinical manifestations of impaired vestibular function in the sixteen-and-a-half syndrome and the different forms of nystagmus caused by pontine lesions,so as to improve the clinical diagnosis and treatment ability.Methods Combined with the medical history,clinical symptoms,signs and auxiliary examination in the case report,the eye movement characteristics and related nerve pathways of the sixteen-and-a-half syndromes were comprehensively analyzed to locate the pons lesions.Results In this patient,the VIl cranial nerve(vestibulo-cochlear)simply involved the left vestibule,and there were clinical evidences of spontaneous nystagmus with left torsional upbeat and reduced function of the left saccule pathway.The lesions at the pontine showed vertical gaze-evoked nystagmus.Conclusions In the sixteen-and-a-half syndrome,the vestibular cochlear nerve is involved and may involve only the vestibular part without hearing impairment.The lesion of pons may result in sixteen and a half syndromes,and may also result in vertical gaze-evoked nystagmus.