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Internuclear Ophthalmoplegia: II. Pursuit, Optokinetic Nystagmus, and Vestibulo-Ocular Reflex

Internuclear Ophthalmoplegia: II. Pursuit, Optokinetic Nystagmus, and Vestibulo-Ocular Reflex Abstract • Smooth pursuit, optokinetic nystagmus (OKN) and the vestibulo-ocular reflex (VOR) were studied in four patients with internuclear ophthalmoplegia (two with bilateral and two with unilateral lesions). Horizontal smooth pursuit by an adducting eye on the side of a medial longitudinal fasciculus (MLF) lesion was normal in three of four patients; vertical pursuit was abnormal in all four. The horizontal VOR gain of slow components made by an adducting eye on the side of an MLF lesion was normal in all four patients. The vertical VOR gain was decreased in the two patients tested. It is concluded that either there are pathways independent of the MLF for horizontal pursuit and vestibular signals that are not available to vertical signals, or vertical pursuit and vestibular eye movements require a higher rate of oculomotor neuron firing than equal-velocity horizontal eye movements. References 1. Smith JL, David MJ: Internuclear ophthalmoplegia: Two new clinical signs . Neurology 14:307-309, 1964.Crossref 2. Stroud MH, Thalmann R, Gay A: Vestibular influences on internuclear ophthalmoplegia . Ann Otol Rhinol Laryngol 80:42-45, 1971. 3. Siroky A, Krejcova H, Vymazal J: The early diagnosis of multiple sclerosis by monocular registration of evoked nystagmus . Acta Neurol Scand 49:205-214, 1973.Crossref 4. Dell'Osso LF, Robinson DA, Daroff RB: Optokinetic asymmetry in internuclear ophthalmoplegia . Arch Neurol 31:138-139, 1974.Crossref 5. Pola J, Robinson DA: An explanation of eye movements seen in internuclear ophthalmoplegia . Arch Neurol 33:447-452, 1976.Crossref 6. Pola J, Robinson DA: Oculomotor signals in the medial longitudinal fasciculus of the monkey . J Neurophysiol , to be published. 7. Evinger LC, Fuchs AF, Baker R: Bilateral lesions of the medial longitudinal fasciculus in monkeys: Effects on the horizontal and vertical components of voluntary and vestibular induced eye movements . Exp Brain Res 28:1-20, 1977. 8. Baloh RW, Kumley W, Honrubia V, et al: Quantitative measurement of smooth pursuit eye movements . Ann Otol Rhinol Laryngol 85:111-119, 1976. 9. Sills A, Honrubia V, Konrad HR, et al: A rapid optokinetic nystagmus test: Comparison with standard testing . Trans Am Acad Ophthalmol Otolaryngol 82:223-231, 1976. 10. Sills A, Honrubia V, Kumley V: Algorithm for the multiparameter analyses of nystagmus using a digital computer . Aviat Space Environ Med 46:934-942, 1975. 11. Lorente de No R: Vestibulo-ocular reflex arc . Arch Neurol Psychiatry 30:245-291, 1933.Crossref 12. Stark L: The control system for versional eye movements , in Bach-Y-Rita P, Collins CC, Hyde JE (eds): The Control of Eye Movements . New York, Academic Press Inc, 1971, pp 363-428. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Neurology American Medical Association

Internuclear Ophthalmoplegia: II. Pursuit, Optokinetic Nystagmus, and Vestibulo-Ocular Reflex

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References (15)

Publisher
American Medical Association
Copyright
Copyright © 1978 American Medical Association. All Rights Reserved.
ISSN
0003-9942
eISSN
1538-3687
DOI
10.1001/archneur.1978.00500320010003
Publisher site
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Abstract

Abstract • Smooth pursuit, optokinetic nystagmus (OKN) and the vestibulo-ocular reflex (VOR) were studied in four patients with internuclear ophthalmoplegia (two with bilateral and two with unilateral lesions). Horizontal smooth pursuit by an adducting eye on the side of a medial longitudinal fasciculus (MLF) lesion was normal in three of four patients; vertical pursuit was abnormal in all four. The horizontal VOR gain of slow components made by an adducting eye on the side of an MLF lesion was normal in all four patients. The vertical VOR gain was decreased in the two patients tested. It is concluded that either there are pathways independent of the MLF for horizontal pursuit and vestibular signals that are not available to vertical signals, or vertical pursuit and vestibular eye movements require a higher rate of oculomotor neuron firing than equal-velocity horizontal eye movements. References 1. Smith JL, David MJ: Internuclear ophthalmoplegia: Two new clinical signs . Neurology 14:307-309, 1964.Crossref 2. Stroud MH, Thalmann R, Gay A: Vestibular influences on internuclear ophthalmoplegia . Ann Otol Rhinol Laryngol 80:42-45, 1971. 3. Siroky A, Krejcova H, Vymazal J: The early diagnosis of multiple sclerosis by monocular registration of evoked nystagmus . Acta Neurol Scand 49:205-214, 1973.Crossref 4. Dell'Osso LF, Robinson DA, Daroff RB: Optokinetic asymmetry in internuclear ophthalmoplegia . Arch Neurol 31:138-139, 1974.Crossref 5. Pola J, Robinson DA: An explanation of eye movements seen in internuclear ophthalmoplegia . Arch Neurol 33:447-452, 1976.Crossref 6. Pola J, Robinson DA: Oculomotor signals in the medial longitudinal fasciculus of the monkey . J Neurophysiol , to be published. 7. Evinger LC, Fuchs AF, Baker R: Bilateral lesions of the medial longitudinal fasciculus in monkeys: Effects on the horizontal and vertical components of voluntary and vestibular induced eye movements . Exp Brain Res 28:1-20, 1977. 8. Baloh RW, Kumley W, Honrubia V, et al: Quantitative measurement of smooth pursuit eye movements . Ann Otol Rhinol Laryngol 85:111-119, 1976. 9. Sills A, Honrubia V, Konrad HR, et al: A rapid optokinetic nystagmus test: Comparison with standard testing . Trans Am Acad Ophthalmol Otolaryngol 82:223-231, 1976. 10. Sills A, Honrubia V, Kumley V: Algorithm for the multiparameter analyses of nystagmus using a digital computer . Aviat Space Environ Med 46:934-942, 1975. 11. Lorente de No R: Vestibulo-ocular reflex arc . Arch Neurol Psychiatry 30:245-291, 1933.Crossref 12. Stark L: The control system for versional eye movements , in Bach-Y-Rita P, Collins CC, Hyde JE (eds): The Control of Eye Movements . New York, Academic Press Inc, 1971, pp 363-428.

Journal

Archives of Neurology – American Medical Association

Published: Aug 1, 1978

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