한빛사논문
분당서울대학교병원
Abstract
Seung-Han Lee MD1,†, Seong-Ho Park MD, PhD2,†, Ji-Soo Kim MD, PhD2,*, Hyo-Jung Kim Msc3, Farkhod Yunusov MD2,4, David S. Zee MD5
1 Department of Neurology, Chonnam National University Medical School, Gwangju, Korea
2 Department of Neurology, Seoul National University College Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
3 Biomedical Research Institute, Seoul National University Bundang Hospital, Seongnam, Korea
4 Department of Neurology, Tashkent Medical Academy, Tashkent, Uzbekistan
5 Department of Neurology, Otolaryngology-Head and Neck Surgery, Neuroscienceand Ophthalmology, The Johns Hopkins University School of Medicine, Baltimore, USA
†Both authors equally contributed to this study.
*Corresponding author and reprints: Ji-Soo Kim, MD, PhD, Department of Neurology, College of Medicine, Seoul National University, Seoul National University Bundang Hospital, 173-82 Gumi-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-707, Korea
Abstract
The oculomotor abnormalities with isolated infarction of the cerebellar tonsil are unknown. In a patient with acute infarction of the right tonsil, we found 1) nearly completely abolished ipsilateral smooth pursuit and impaired contralateral pursuit, 2) a low-amplitude ipsilesional right-beating nystagmus without fixation, 3) gaze-holding deficits, and 4) normal vestibulo-ocular reflex. These findings contrast with striking vestibular abnormalities reported with unilateral flocculus and anterior tonsil infarction. Taken together these findings allow more diagnostic certainty in cerebellar patients, help resolve controversies about interpretation of experimental findings in monkeys, and clarify homologies between the monkey and human cerebellum. ANN NEUROL 2013. ⓒ 2013 American Neurological Association
Keywords: Vertigo; Tonsil; Paraflocculus; Cerebellum; Infarction; Smooth pursuit; Vestibulo-ocular reflex
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