Hostname: page-component-78c5997874-s2hrs Total loading time: 0 Render date: 2024-11-09T13:13:27.308Z Has data issue: false hasContentIssue false

Task Dependent Variations of Ocular Lateropulsion in Wallenberg’s Syndrome

Published online by Cambridge University Press:  18 September 2015

T.H. Kirkham*
Affiliation:
McGill University Departments of Neurology. Neurosurgery and Ophthalmology and Montreal Neurological Hospital and Institute, Montreal, Québec, Canada
D. Guitton
Affiliation:
McGill University Departments of Neurology. Neurosurgery and Ophthalmology and Montreal Neurological Hospital and Institute, Montreal, Québec, Canada
M. Gans
Affiliation:
McGill University Departments of Neurology. Neurosurgery and Ophthalmology and Montreal Neurological Hospital and Institute, Montreal, Québec, Canada
*
Neuro-Ophthalmology Department, Room 201. Montreal Neurological Hospital, 3801 University St., Montreal, Québec, Canada H3A 2B4
Rights & Permissions [Opens in a new window]

Summary

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

The eye movements of a patient with a left lateral medullary infarct (Wallenberg’s syndrome) were recorded using the scleral search coil in magnetic field technique. When asked to look at spontaneously appearing targets, saccades to the left were generally accurate hut those to the right reached the target by multiple step refixation saccades. Large amplitude rightward saccades were possible between two continuously visible targets or when making voluntary saccades in the dark.

Vertical saccades, up or down, between spontaneously appearing targets were always associated with a leftward eye movement (lateropulsion). Voluntary vertical saccades between continuously visible targets showed that upward movements had left lateropulsion but downward movements were normal. Vertical voluntary saccades in the dark were oblique, upward saccades showing left lateropulsion and downward saccades showing rightward deviation. The aberrant horizontal components of vertical saccades had amplitude and velocity characteristics for components of normal oblique saccades. Possibly impaired assessment of vertically with incorrect eye position information produced by the infarct accounts for the lateropulsion of saccades in Wallenberg’s syndrome.

Type
Research Article
Copyright
Copyright © Canadian Neurological Sciences Federation 1981

References

Bahill, A.T. and Stark, L. (1977). Oblique saccadic eye movements. Independence of horizontal and vertical channels. Arch. Ophthalmol., 95: 12581261.CrossRefGoogle ScholarPubMed
Bahill, AT. and Troost, B.T. (1979). Types of saccadic eye movements. Neurology (Minn.), 29: 11501152.CrossRefGoogle ScholarPubMed
Baloh, R.W., Sills, A.W.Kumley, W.E. and Honrubia, V. (1975). Quantitative measurement of saccadic amplitude, duration and velocity. Neurology (Minn.), 25: 10651070.CrossRefGoogle ScholarPubMed
Barre, W. and Jones, G.M. (1965). Influence of eye lid movement upon electro-oculographic recordings of vertical eye movements. Aerospace Med., 36: 855858.Google Scholar
Bjerver, D. and Silfverskiold, B.P. (1968). Lateropulsion and imbalance in Wallenberg’s syndrome. Acta. Neurol. (Scand.), 44: 91100.CrossRefGoogle ScholarPubMed
Collard, M., Eber, A.M., Coquillat, C., Philippott, J. and Rohmer, F. (1975). Laterogyrie spasmodique du regard au cours d’un syndrome de Wallenberg. Rev. Otoneuroophtal., 47: 195198.Google ScholarPubMed
Collewijn, H., Van Der, Mark. F. and Jansen, T.C. (1975). Precise recording of human eye movements. Vision Res., 15: 447450.CrossRefGoogle ScholarPubMed
Currier, R.D. (1969). Syndromes of the medulla oblongata. In: Handbook of clinical neurology. Amsterdam, North Holland Publishing Company. (Vinken, P.J. and Bruyn, G.W., eds.) 2. pp 217237.Google Scholar
Daroff, R.B., Hoyt, W.F., Sanders, M.D. and Nelson, E.R. (1968). Gaze evoked eyelid and ocular nystagmus inhibited by the near reflex: unusual ocular motor phenomena in a lateral medullary syndrome. J. Neurol. Neurosurg. Psychiat., 31: 362367.CrossRefGoogle Scholar
Fisher, C.M., Karnes, W.E. and Kubik, C.S. (1961). Lateral medullary infarction – the pattern of vascular occlusion. J. Neuropath. Exp. Neurol., 20: 323379.CrossRefGoogle ScholarPubMed
Gillilan, L.A. (1964). The correlation of the blood supply to the human brain stem with clinical brain stem lesions. J. Neuropath. Exp. Neurcl., 23: 78108.Google Scholar
Hagstrom, L., Hornsten, G. and Silfverskiold, B.P. (1969). Ocuiostatic and visual phenomena occurring in association with Wallenberg’s syndrome. Acta Neurol. (Scand.). 45: 568582.CrossRefGoogle ScholarPubMed
Halmagyi, C.M., Gresty, M.A., Gibson, W.P.R. (1979). Ocular tilt reaction with peripheral vestibular lesion. Ann. Neurol., 6: 8083.CrossRefGoogle ScholarPubMed
Hamann, K.U. (1979). Systematisch Abweichung sakkadischer Augenbewegungen beim Wallenberg-Syndrom. Ophthalmologica (Basel), 178: 373380.CrossRefGoogle Scholar
Hornsten, C. (1974a). Wallenberg’s syndrome. Part I. General symptomatology with special reference to visual disturbances and imbalance. Acta Neurol. (Scand.), 50: 434446.Google Scholar
Hornsten, G. (1974b). Wallenberg’s syndrome. Part II. Oculomotor and oculostatic disturbances. Acta Neurol. (Scand.), 50: 447468.CrossRefGoogle Scholar
Hoyt, W.F. and Frisen, L. (1975). Supranuclear ocular motor control. Some clinical considerations 1974. In: Basic mechanisms of ocular motility and their clinical implications. Oxford, England. Pergamon Press. (Bach-Y-Rita, P., Lennerstrand, C. eds.) pp 379392.Google Scholar
Kommerell, G. and Hoyt, W.F. (1973). Lateropulsion of saccadic eye movements. Electrooculographic studies in a patient with Wallenberg’s syndrome. Arch. Neurol., 28: 313318.CrossRefGoogle Scholar
Moberg, A., Preber, L.Silfverskiold, B.P. and Vallbo, J. (1962). Imbalance, nystagmus and diplopia in Wallenberg’s syndrome. Clinical analysis of a case and post-mortem examination. Acta Otolaryngol., (Scand.). 55: 269282.CrossRefGoogle Scholar
Rabinovitch, H.E., Sharpe, J.A. and Sylvester, T.O. (1977). The ocular tilt reaction. A paroxysmal dyskinesia associated with elliptical nystagmus. Arch. Ophthalmol., 95: 13951398.Google ScholarPubMed
Robinson, D.A. (1963). A method of measuring eye movement using a scleral search coil in a magnetic field. I.E.E.E. Trans. Biomed. Electron., B.M.E., 10: 137145.Google Scholar
Robinson., D.A. (1975). Oculomotor control signals. In: Basic mechanisms of ocular motility and their clinical implications. Oxford, England. Pergamon Press. (Bach-Y-Rita, P., Lennerstrand, C. eds.) pp 337374.Google Scholar
Schmidt, D., Abel, L.A., Dell’Osso, L.F. and Daroff, R.B. (1979). Saccadic velocity characteristics: Intrinsic variability and fatigue. Aviat. Space Environ. Med., 50: 393395.Google ScholarPubMed
Silfverskiold, B.P. (1965). Skew deviation in Wallenberg’s syndrome. Acta. Neurol. (Scand.), 41: 381386.CrossRefGoogle Scholar
Zee, D.S. and Robinson, D.A. (1979). A hypothetical explanation of saccadic oscillations. Ann. Neurol., 5: 405414.CrossRefGoogle ScholarPubMed
Zee, D.S., Yee, R.D., Cogan, D.G., Robinson, D.A. and Engel, W.K. (1976). Ocular motor abnormalities in hereditary cerebellar ataxia. Brain, 99: 207234.CrossRefGoogle ScholarPubMed