Sung-Hee Kim1, David S Zee1, Sascha du Lac1, Hyo Jung Kim1, Ji-Soo Kim2. 1. From the Department of Neurology (S.-H.K.), Kyungpook National University School of Medicine, Daegu, Korea; Departments of Neurology, Ophthalmology, Otolaryngology-Head and Neck Surgery, and Neuroscience (D.S.Z., S.d.L.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Biomedical Laboratory Science (H.J.K.), Kyungdong University, Goseong-Gun, Gangwon-do; and Department of Neurology (J.-S.K.), Seoul National University College of Medicine, Seoul National University Bundang Hospital, Korea. 2. From the Department of Neurology (S.-H.K.), Kyungpook National University School of Medicine, Daegu, Korea; Departments of Neurology, Ophthalmology, Otolaryngology-Head and Neck Surgery, and Neuroscience (D.S.Z., S.d.L.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Biomedical Laboratory Science (H.J.K.), Kyungdong University, Goseong-Gun, Gangwon-do; and Department of Neurology (J.-S.K.), Seoul National University College of Medicine, Seoul National University Bundang Hospital, Korea. jisookim@snu.ac.kr.
Abstract
OBJECTIVE: To describe the ocular motor abnormalities in 9 patients with a lesion involving the nucleus prepositus hypoglossi (NPH), a key constituent of a vestibular-cerebellar-brainstem neural network that ensures that the eyes are held steady in all positions of gaze. METHODS: We recorded eye movements, including the vestibulo-ocular reflex during head impulses, in patients with vertigo and a lesion involving the NPH. RESULTS: Our patients showed an ipsilesional-beating spontaneous nystagmus, horizontal gaze-evoked nystagmus more intense on looking toward the ipsilesional side, impaired pursuit more to the ipsilesional side, central patterns of head-shaking nystagmus, contralateral eye deviation, and decreased vestibulo-ocular reflex gain during contralesionally directed head impulses. CONCLUSIONS: We attribute these findings to an imbalance in the NPH-inferior olive-flocculus-vestibular nucleus loop, and the ocular motor abnormalities provide a new brainstem localization for patients with acute vertigo.
OBJECTIVE: To describe the ocular motor abnormalities in 9 patients with a lesion involving the nucleus prepositus hypoglossi (NPH), a key constituent of a vestibular-cerebellar-brainstem neural network that ensures that the eyes are held steady in all positions of gaze. METHODS: We recorded eye movements, including the vestibulo-ocular reflex during head impulses, in patients with vertigo and a lesion involving the NPH. RESULTS: Our patients showed an ipsilesional-beating spontaneous nystagmus, horizontal gaze-evoked nystagmus more intense on looking toward the ipsilesional side, impaired pursuit more to the ipsilesional side, central patterns of head-shaking nystagmus, contralateral eye deviation, and decreased vestibulo-ocular reflex gain during contralesionally directed head impulses. CONCLUSIONS: We attribute these findings to an imbalance in the NPH-inferior olive-flocculus-vestibular nucleus loop, and the ocular motor abnormalities provide a new brainstem localization for patients with acute vertigo.
Authors: Ji-Soo Kim; David E Newman-Toker; Kevin A Kerber; Klaus Jahn; Pierre Bertholon; John Waterston; Hyung Lee; Alexandre Bisdorff; Michael Strupp Journal: J Vestib Res Date: 2022 Impact factor: 2.354
Authors: G M Halmagyi; Luke Chen; Hamish G MacDougall; Konrad P Weber; Leigh A McGarvie; Ian S Curthoys Journal: Front Neurol Date: 2017-06-09 Impact factor: 4.003