Opsoclonus in three dimensions: oculographic, neuropathologic and modelling correlates
Opsoclonus in three dimensions: oculographic, neuropathologic and modelling correlates
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DOI：
10.1016/s0022-510x(01)00564-0
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发表时间：
2001-08-15
影响因子：
4.4
通讯作者：
Sharpe, JA
中科院分区：
文献类型：
--
作者：
Wong, AMF;Musallam, S;Sharpe, JA
眼阵挛是一种运动障碍，由不自主的、无意识的、混乱的、多方向的扫视组成，没有扫视间隔。我们使用磁性巩膜探测线圈技术来研究两个肺癌并发症患者的眼阵挛。眼动记录提供的证据表明，眼阵挛是一个三维振荡，包括扭转，水平和垂直分量。扭转性眼球震颤也存在于一名患者。抗神经元抗体研究显示，抗Ta（Ma2癌神经元抗原）抗体的存在下，在一个病人，这以前只与副肿瘤性边缘脑炎和脑干功能障碍，但没有眼阵挛，只有在睾丸癌或乳腺癌患者。神经病理检查显示轻度副肿瘤性脑炎。中缝间位核（rip）中的正常神经元不支持视阵挛发病机制中全间歇细胞功能障碍的假设。计算机模拟的扫视系统的模型表明，在小脑的顶核（FOR）的眼区去抑制可以产生眼阵挛。组织学检查发现小脑顶核有炎症和胶质增生。这种形态学的发现是一致的，但没有必要确认，传入投射到FOR的损害，由模型确定。浦肯野细胞在背蚓部，抑制FOR，托盘功能障碍引起眼阵挛解除抑制。（C）2001爱思唯尔科学B.V.保留所有权利。
Opsoclonus is a dyskinesia consisting of involuntary, arrhythmic, chaotic, multidirectional saccades, without intersaccadic intervals. We used a magnetic scleral search coil technique to study opsoclonus in two patients with paraneoplastic complications of lung carcinoma. Eye movement recordings provided evidence that opsoclonus is a three-dimensional oscillation, consisting of torsional, horizontal, and vertical components. Torsional nystagmus was also present in one patient. Antineuronal antibody study revealed the presence of anti-Ta (Ma2 onco-neuronal antigen) antibodies in one patient, which had previously been associated only with paraneoplastic limbic encephalitis and brainstem dysfunction, but not opsoclonus, and only in patients with testicular or breast cancer. Neuropathologic examination revealed mild paraneoplastic encephalitis. Normal neurons identified in the nucleus raphe interpositus (rip) do not support postulated dysfunction of omnipause cells in the pathogenesis of opsoclonus. Computer simulation of a model of the saccadic system indicated that disinhibition of the oculomotor region of the fastigial nucleus (FOR) in the cerebellum can generate opsoclonus. Histopathological examination revealed inflammation and gliosis in the fastigial nucleus. This morphological finding is consistent with, but not necessary to confirm, damage to afferent projections to the FOR, as determined by the model. Malfunction of Purkinje cells in the dorsal vermis, which inhibit the FOR, tray cause opsoclonus by disinhibiting it. (C) 2001 Elsevier Science B.V. All rights reserved.