본문 바로가기
KERD
논문KCI 등재

안진검사에서 단속운동검사, 시추적검사, 시운동성 안진검사의 임상적 의의

Clinical significance of saccade test, smooth pursuit test, and optokinetic nystagmus test in nystagmography

0

조회

0

다운로드

2

인용

0

참고문헌

키워드

주제분류의학일반

초록

Background: Saccade test, smooth pursuit test, and optokinetic nystagmus test are clinically useful tests to accurately diagnose vertigo. However, there have only been a few studies regarding a correlation between the anatomical site of the lesion and the abnormality of eyeball movement in patients with vertigo. Methods: The medical records of 97 patients with vertigo between January 2006 and June 2008 were reviewed retrospectively. We classified many kinds of abnormalities regarding the saccade test, smooth pursuit test and optokinetic nystagmus test into several categories and analyzed the localizing lesion of vertigo. Results: According to the saccade test, both total saccade abnormality (S-total) and slow velocity of saccade (S-type 3) were shown to be significantly higher in the central lesion of vertigo. According to the smooth pursuit test, symmetrical unidirectional smooth pursuit abnormality (SP-type 2) was observed to be significantly higher in the peripheral lesion over vertigo. Moreover, according to the optokinetic nystagmus test, total optokinetic nystagmus abnormalities (OKN-total) were shown to be significantly useful findings in the diagnosis of the central lesion of vertigo. The coexisting abnormalities of all three tests (S+SP+OKN abnormalities) were shown to be significantly higher in the central lesion of vertigo. Conclusion: These results suggest that all these tests, saccade test, smooth pursuit test, and optokinetic nystagmus test, are very useful to distinguish between the central lesion and the peripheral lesion of vertigo. However, these tests are not beneficial in localizing the central lesion of vertigo.

Abstract

Background: Saccade test, smooth pursuit test, and optokinetic nystagmus test are clinically useful tests to accurately diagnose vertigo. However, there have only been a few studies regarding a correlation between the anatomical site of the lesion and the abnormality of eyeball movement in patients with vertigo. Methods: The medical records of 97 patients with vertigo between January 2006 and June 2008 were reviewed retrospectively. We classified many kinds of abnormalities regarding the saccade test, smooth pursuit test and optokinetic nystagmus test into several categories and analyzed the localizing lesion of vertigo. Results: According to the saccade test, both total saccade abnormality (S-total) and slow velocity of saccade (S-type 3) were shown to be significantly higher in the central lesion of vertigo. According to the smooth pursuit test, symmetrical unidirectional smooth pursuit abnormality (SP-type 2) was observed to be significantly higher in the peripheral lesion over vertigo. Moreover, according to the optokinetic nystagmus test, total optokinetic nystagmus abnormalities (OKN-total) were shown to be significantly useful findings in the diagnosis of the central lesion of vertigo. The coexisting abnormalities of all three tests (S+SP+OKN abnormalities) were shown to be significantly higher in the central lesion of vertigo. Conclusion: These results suggest that all these tests, saccade test, smooth pursuit test, and optokinetic nystagmus test, are very useful to distinguish between the central lesion and the peripheral lesion of vertigo. However, these tests are not beneficial in localizing the central lesion of vertigo.

참고문헌 (19)

  1. Cook G, "The human eye-movement mechanism. Experiments, modeling, and model testing", Arch Ophthalmol, 79, pp.428~436 (1968)
  2. 허영은, "Bedside Evaluation of Dizzy Patients", Journal of Clinical Neurology, 9(4), pp.203~213 (2013), 대한신경과학회[DOI]
  3. Seferlis F, "Age related changes in ocular motor testing in healthy subjects", J Vestib Res, 25, pp.57~66 (2015)
  4. Chung WK, "Clinical significance of the optokinetic nystagmus abnormality", Korean J Otolaryngol-Head Neck Surg, 40, pp.331~339 (1997)
  5. Kim ES, "Age specificity in normative data of visual evoked eye movement in healthy subjects", Korean J Otolaryngol-Head Neck Surg, 36, pp.1170~1180 (1993)
  6. Chung WK, "Clinical significance of saccade abnormalities", Korean J Otolaryngol-Head Neck Surg, 43, pp.143~148 (2000)
  7. Kim JI, "Saccade, smooth pursuit and optokinetic system", J Korean Bal Soc, 2, pp.17~25 (2003)
  8. Termsarasab P, "The diagnostic value of saccades in movement disorder patients:a practical guide and review", J Clin Mov Disord, 2, pp.14~ (2015)
  9. Noda H, "Cerebellar control of saccadic eye movements: its neural mechanisms and pathways", Jpn J Physiol, 41, pp.351~368 (1991)
  10. Takemori S, "Visual suppression of vestibular nystagmus in rhesus monkeys", Brain Res, 72, pp.203~212 (1974)
  11. Becker W, "The control of eye movements in the saccadic system", Bibl Ophthalmol, 82, pp.233~243 (1972)
  12. 배창훈, "말초성 현기증의 감별진단", Yeungnam University Journal of Medicine, 31(1), pp.1~8 (2014), 영남대학교 의과대학[DOI]
  13. Lee H, "Smooth pursuit and optokinetic system", J Korean Bal Soc, 3, pp.281~288 (2004)
  14. Bogousslavsky J, "Pursuit gaze defects in acute and chronic unilateral parieto-occipital lesions", Eur Neurol, 25, pp.10~18 (1986)
  15. Szirmai A, "Electronystagmographic analysis of caloric test parameters in vestibular disorders", Eur Arch Otorhinolaryngol, 270, pp.87~91 (2013)
  16. Zee DS, "Effects of ablation of flocculus and paraflocculus of eye movements in primate", J Neurophysiol, 46, pp.878~899 (1981)
  17. Knapp CM, "OKN asymmetry in human subjects: a literature review", Strabismus, 21, pp.37~49 (2013)
  18. Magnusson M, "Velocity and asymmetry of optokinetic nystagmus in the evaluation of vestibular lesions", Acta Otolaryngol, 102, pp.65~74 (1986)
  19. Takemori S, "Loss of visual suppression of vestibular nystagmus after flocculus lesions", Brain Res, 72, pp.213~224 (1974)

관련 논문AI추천

이 간행물의 다른 논문 (25건)