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中樞神經系統病灶與垂直眼球運動麻痺的神經解剖學相關性
Neuroanatomical Correlation between Central Nervous System Lesions and Impaired Vertical Eye Movement
摘要
眼球運動的控制中樞目前已知在腦幹，而其中水平運動的控制中心為中線旁橋腦網狀系統(PPRF, paramedian pontine reticular formation)，其傳導路徑目前也已明瞭。而眼球垂直運動的控制中樞就目前所知是在中腦的核，確切位置及路徑仍不清楚。本篇提出三個臨床上所見的垂直眼球運動障礙病患，病例一為一眼球往上及往下運動均有障礙者，病灶位於頂蓋前區域出血。病例二為眼球往下運動障礙，病灶為腦部兩側多處血栓塞，最大者在左側丘腦。病例三為眼球往上及往下運動障礙且疑併有核間眼球運動麻痺(INO, internuclear ophthalmoplegia)，病灶為兩側丘腦栓塞。綜觀此三病例，其腦部病灶位置與目前學者所知之致病病灶，如紅核內側、Cajal核及Darschewitsch核等構造大致相符合，惟其傳導路徑仍有持繼續研究探討。
關鍵字
無資料並列摘要
The center of eyeball conjugating movement is located in midbrain. The horizontal gaze center is located in paramedian pontine reticular formation (PPRF). But the exact location and pathway of vertical gaze movement are still not well understood. We present 3 clinical cases with vertical gaze problems, their symptoms and signs are compatible with their brain image findings. The most common lesions in brain CT scan or MRI in these 3 cases are thalamus and pre-tectal area. Up to now, the vertical gaze center is known located around medial aspects of red nucleus, pretectal area, Cajal nucleus, Darchewitsch nucleus. In this study, the lesions in these 3 cases is compatible with the so-called vertical gaze center, but the pathway require further research.
延伸閱讀
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