Vertical eye movement disorder

Introduction Radiation reflex disorder is a symptom of progressive supranuclear palsy. Nuclear ocular dyskinesia: mainly manifested as symmetrical vertical dyskinesia. The earliest is the downward gaze obstacle, followed by the upper eye movement difficulty, and finally can not horizontally move, the eyeball is set in the middle position, the pupil is more reduced, and the light reflection exists. Convergence reflex barrier is a doll eye phenomenon.

Cause

The cause of vertical movement disorders of the eyeball:

The nerve fibers are distorted (Hirano sphere), the particles are vacuolar degeneration, and the Purkinje cell axons are occasionally damaged. The basal ganglia, brainstem, and cerebellar nerve cells disappeared, nerve fiber gliosis and nerve cells disappeared, and fiber distribution was disordered. Detunation of each nerve conduction bundle was demyelinated, substantia nigra and hypothalamic nucleus were formed, and peripheral blood vessels were reflexed. .

May be caused by degenerative diseases or viral infections, which may overlap with cortical degeneration of Lhermitte syndrome, Creutzfeldt-Jakob syndrome, Hirano tremor-dementia syndrome, and neurogenic hypopigmentation syndrome to a certain extent, and cannot They are differentiated according to their clinical manifestations or anatomical changes, and these syndromes are currently classified as the same type of syndrome.

an examination

Related inspection

Eye movement to check the ultrasound of the eyeball and eyelid

Examination and diagnosis of vertical movement disorders of the eyeball:

The diagnostic criteria for PSP are: onset after middle or middle age, and progressive non-familial supranuclear ophthalmoplegia has at least two of the following five items: 1 unstable posture, falling backwards; 2 pseudobulbar paralysis (Muscle dysfunction and difficulty swallowing); 3 less movement and rigidity; 4 frontal lobe syndrome (intellectual retardation, strong grip and mimic action); 5 axonal muscle tone abnormalities and rigidity.

Differential diagnosis

Symptoms of eye movement vertical dyskinesia:

Eyeball floating phenomenon: The colorless and transparent gel-like body in the 4/5 cavity filled with the eyeball, mainly composed of collagen fiber filament and 98.5%-99.7% water. The vitreous itself has no blood vessels and its metabolism is very low. Its nutrition comes from the choroid and aqueous humor. The vitreous is susceptible to various physical, chemical, traumatic, inflammatory, degenerative, decomposing, and liquefaction phenomena. It is characterized by a variety of floating objects such as a bit shape, a line shape, and a spider web shape, and floats up and down with the movement of the eyeball.

The eyeball regulation function is reduced or disappeared: the eyeball, like the brain, is an organ rich in nerves and blood vessels, and bears extremely complex physiological functions. In order to see the close range of the target, the intraocular lens-ciliary muscle contraction increases the curvature of the intraocular lens, thereby enhancing the refractive power of the eye, so that close objects can form a clear image on the retina. The function of changing the refractive power of the eye while seeing the near object is called the eye's adjustment function. Decreased or disappeared eyeball function will reduce vision.

Eyeball convergence function paralysis or paralysis: eyeball convergence function paralysis or paralysis is more common in the pineal somatic tumor eye, in addition to the eye can not be seen, but also accompanied by changes in pupillary photoreaction, eyeball convergence function paralysis or paralysis, nystagmus. The damage around the aqueduct (including the front of the aqueduct and the posterior part of the third ventricle) is impaired.

The diagnostic criteria for PSP are: onset after middle or middle age, and progressive non-familial supranuclear ophthalmoplegia has at least two of the following five items: 1 unstable posture, falling backwards; 2 pseudobulbar paralysis (Muscle dysfunction and difficulty swallowing); 3 less movement and rigidity; 4 frontal lobe syndrome (intellectual retardation, strong grip and mimic action); 5 axonal muscle tone abnormalities and rigidity.

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