Vestibulo-ocular reflex deficits with medial longitudinal fasciculus lesions

2017 ◽  
Vol 264 (10) ◽  
pp. 2119-2129 ◽  
Author(s):  
Swee T. Aw ◽  
Luke Chen ◽  
Michael J. Todd ◽  
Michael H. Barnett ◽  
G. Michael Halmagyi
Neurology ◽  
2017 ◽  
Vol 89 (24) ◽  
pp. 2476-2480 ◽  
Author(s):  
Seo-Young Choi ◽  
Hyo-Jung Kim ◽  
Ji-Soo Kim

Objective:To determine the role of the medial longitudinal fasciculus (MLF) in conveying vestibular signals.Methods:In 10 patients with isolated acute unilateral internuclear ophthalmoplegia (INO) due to an acute stroke, we performed comprehensive vestibular evaluation using video-oculography, head impulse tests with a magnetic search coil technique, bithermal caloric tests, tests for the ocular tilt reaction, and measurements of subjective visual vertical and cervical and ocular vestibular evoked myogenic potentials (VEMPs).Results:The head impulse gain of the vestibulo-ocular reflex (VOR) was decreased invariably for the contralesional posterior canal (PC) (n = 9; 90%) and usually for the ipsilesional horizontal canal (n = 5; 50%). At least one component of contraversive ocular tilt reaction (n = 9) or contraversive tilt of the subjective visual vertical (n = 7) were common along with ipsitorsional nystagmus (n = 5). Cervical or ocular VEMPs were abnormal in 5 patients.Conclusions:The MLF serves as the main passage for the high-acceleration VOR from the contralateral PC. The associations and dissociations of the vestibular dysfunction in our patients indicate variable combinations of damage to the vestibular fibers ascending or descending in the MLF even in strokes causing isolated unilateral INO.


Author(s):  
Shirley H. Wray

covers deviations and disorders of horizontal gaze, which are so significantly linked to lesions of the pons that an emphasis on pontine signs is an important focus of this chapter. The pontine syndromes presented include a congenital case of horizontal gaze palsy and progressive scoliosis, and syndromes associated with adjacent tegmental structures, especially the paramedian reticular formation, the facial nerve, and the medial longitudinal fasciculus. A lesion of the medial longitudinal fasciculus causes internuclear ophthalmoplegia Examples are provided of internuclear ophthalmoplegia in childhood, combined unilateral conjugate gaze palsy and internuclear ophthalmoplegia, the one-and-a-half syndrome, and other variants. A case of bilateral horizontal gaze palsy permits discussion of the caloric test, one of the most widely used clinical test of the vestibulo-ocular reflex.


2013 ◽  
Vol 72 (3) ◽  
pp. 156-162
Author(s):  
Yumiko O. Kato ◽  
Koshi Mikami ◽  
Yasuhiro Miyamoto ◽  
Shoji Watanabe ◽  
Izumi Koizuka

2020 ◽  
Vol 21 ◽  
pp. 100488
Author(s):  
Adam Pantanowitz ◽  
Kimoon Kim ◽  
Chelsey Chewins ◽  
Isabel N.K. Tollman ◽  
David M. Rubin

Author(s):  
Raymond van de Berg ◽  
Nils Guinand ◽  
T. A. Khoa Nguyen ◽  
Maurizio Ranieri ◽  
Samuel Cavuscens ◽  
...  

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