The clinical symptoms and signs of two patients with convergence nystagmus are described, clinicalsymptoms and signs, and the mechanism of convergence nystagmus is discussed from the viewpoint of the results of otoneurological studies
The first case was a 20-year-old male whose chief complaints were indistinct consciousness and visual disturbance. Radiographic examinations and neurological tests revealed cerebral atrophy, dilatation of the lateral ventricles, a low density area in the right occipital region and marked narrowing of the right posterior cerebral artery. Neurological signs were left homonymous hemianopia, paralysis of upward gaze, convergence nystagmus, cerebellar symptoms and left hemiplegia. The diagnosis was cerebral vescular lesions with multiple thromboses.
The second case was a 37-year-old female, who had developed motor disturbances, dysarthria and dysphagia.
There were marked cerebellar signs, atrophy and fasciculation of the tongue, muscle atrophy and pathological reflexes. Oculomotor signs were paralysis of upward gaze and convergence nystagmus.
The diagnosis was Marie's cerebellar degenerative disease. In these two cases convergence nystagmus seemed to indicate that the responsible lesions were located in the periaqeuductal region of the midbrain, quardrigeminal plate and oculomotor nuclei.
The mechanism of convergence nystagmus appears to be an overflow of impulses to the medial recti centers.
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