以核間眼肌麻痺為表徵之腦幹中風—病例報告

Brain Stem Stroke Manifested as Internuclear Ophthalmoplegia-Case Report

許惇彥(Tun-Yen Hsu) ； 楊怡和(Yi-Ho Young)

《中華民國耳鼻喉科醫學雜誌》 37卷6期 (2002/10) Pp. 456-459

https://doi.org/10.6286/2002.37.6.456

摘要

生理性的眼球運動，兩眼動作共軛，一旦眼球運動不共軛時，即所謂「共軛偏視」。臨床上可由眼球運動時的眼位變化，定位病變所在。最近我們經驗一例70歲男性，以急性眩暈、視力模糊、及複視為主訴，眼球運動檢查時，發現向左注視時右眼無法內轉，而外展的左眼出現向左眼振，即所謂的核間眼肌麻痺，屬右側內側縱束症候群。經一系列電生理檢查及核磁共振掃描證實為腦幹中風。保守治療2個月後，眩暈、共軛偏視、及複視等症狀均消失。

關鍵字

眩暈 ； 共軛偏視 ； 核間眼肌麻痺 ； 內側走束

並列摘要

Conjugate deviation of the eyes is of help in determining the locus of lesion in brain stem. Herein, we report a 70-year-old male with acute vertigo, blurred vision, and diplopia, accompanied by right internuclear ophthalmoplegia for two days. A battery of electrophysiological examinations including auditory brain stem response, vestibular evoked myogenic potentials and electronystagmography revealed the lesion located on the right medial longitudinal fasciculus including both upper and lower brain stem. Magnetic resonance imaging disclosed a high intensity area in the right pontine area indicating brain stem hemorrhage. All of the symptoms subsided after two months conservative treatment.

並列關鍵字

vertigo ； conjugate deviation ； internuclear ophthalmoplegia ； medial longitudinal fasciculus