一側大脳血管障害における眼球運動について

抄録

Neurotological examinations were performed on patients with unilateral cerebral vascular deficits, with special regard to oculomotor function.
Materials and method: Twenty-six patients with hemiplegia due to vascular disturbances in the territory of the middle cerebral artery were examined and analysed neurotologically. Audiometry, equilibrium test, nystagmus test, oculomotor function tests (OKN, pursuit and saccadic eye movement), caloric test and visual suppression test were carried out. Eye movements were recorded electronystagmographically, and horizontal eye movements were correlated with the side of the lesion.
Patients were classified as deep form and cortical form according to the location of the lesion, and also to acute and chronic groups according to the course of the disease.
Results : Gaze nystagmus to the side of the lesion was observed in three patients with cortical lesions, in the acute group. Some kind of nystagmus (gaze, positional and positioning nystagmus) was seen in 16 patients. Optokinetic nystagmus towards the side opposite to the lesion was much more deranged in 22 patients. Saccadic eye movement was also disturbed towards the side opposite in 9 patients, 6 of whom had cortical lesion. Smooth pursuit, on the contrary, showed little difference between the two directions, and only 4 patients showed saccadic pursuit towards the side of the lesion. The quick phase of caloric nystagmus was not disturbed even in patients with disturbed voluntary saccade.