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중뇌경색에서 발생한 단독 하직근 마비

Isolated Inferior Rectus Palsy from Midbrain Infarction

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주제분류신경과학

초록

We describe a patient with isolated inferior rectus palsy due to midbrain infarction. A 68-year-old-man developed vertical diplopia of sudden onset which was maximal with a right lower side gaze. Neurological examination revealed weakness of the right inferior rectus muscle. Magnetic resonance imaging of the brain showed a focal infarction in the dorsomedial portion of the right midbrain tegmentum. The sole involvement of fascicular fi bers of the inferior rectus muscle in the midbrain was accountable as the cause of this isolated inferior rectus palsy. We think that this is a case supporting the three-dimensional model of somatotopic fascicular arrangement of oculomotor nerve in the midbrain. (Korean J Stroke 2011;13:96-98)

Abstract

We describe a patient with isolated inferior rectus palsy due to midbrain infarction. A 68-year-old-man developed vertical diplopia of sudden onset which was maximal with a right lower side gaze. Neurological examination revealed weakness of the right inferior rectus muscle. Magnetic resonance imaging of the brain showed a focal infarction in the dorsomedial portion of the right midbrain tegmentum. The sole involvement of fascicular fi bers of the inferior rectus muscle in the midbrain was accountable as the cause of this isolated inferior rectus palsy. We think that this is a case supporting the three-dimensional model of somatotopic fascicular arrangement of oculomotor nerve in the midbrain. (Korean J Stroke 2011;13:96-98)

참고문헌 (11)

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  6. 김정은, "Isolated Medial Rectus Palsy in Midbrain Microbleed", 대한뇌졸중학회지, 11(2), pp.103~104 (2009), 대한뇌졸중학회
  7. Bogousslavsky J, "Pure midbrain infarction: clinical syndromes, MRI, and etiologic pattern", Neurology, 44, pp.2032~2040 (1994)
  8. Kim JS, "Pure midbrain infarction Clinical, radiologic, and pathophysiologic fi ndings", Neurology, 64, pp.1227~1232 (2005)
  9. Castro O, "Isolated inferior oblique paresis from brain-stem infarction. Perspective on oculomotor fascicular organization in the ventral midbrain tegmentum", Arch Neurol, 47, pp.235~237 (1990)
  10. Ksiazek SM, "Fascicular arrangement in partial oculomotor paresis", Am J Ophthalmol, 118, pp.97~103 (1994)
  11. Saeki N, "Partial oculomotor nerve palsy due to midbrain lesion-case report and discussion on its characteristics", No To Shinkei, 40, pp.335~339 (1988)

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