Ping-pong ball eye movementを示した1例

A CASE OF "PING-PONG BALL EYE MOVEMENT"

I．はじめに

　眼運動症状は，後頭蓋窩疾患の病巣局在や予後に関して，しばしば貴重な情報を提供してくれる。このたび著者らは，脳血管障害で眼球が左右交互に跳びはね，あたかもピンポン球のような動きを呈した症例を経験した。この異常な眼球運動を"ping-pong ball eye movement"と名付けるとともに，その責任部位，メカニズムについて若干の考察を加えたい。

We experienced a rare and peculiar eye movement in a comatose patient with ruptured intracranial aneurysm. The patient's eyes moved quickly and irregulary from one extreme position to the other with whirling and bounding components. Such abnormal eye movement occasionally halted, but abruptly reappeared. We named this abnormal eye movement which had never been reported before, "ping-pong ball eye movement ".

Neuropathological study revealed a subarachnoid hemorrhage and the diffuse infarction in the right remporal lobe, and a smal clot in the fourth ven-tricle without specific findings in the brainstem and the cerebellum.

Consideration was made that the hemorrhage in the fourth ventricle resulted in a hyper-irritable state in the fastigial nuclei, from which the ab-normal discharges were driven to the reticular formation, the vestibular nuclei, the MLF, and the oculomotor complexes.

We conclude that this " ping-pong ball eye movement" might be the appearance of epilepsy in the eyes, due to the epileptogenic focus of the fastigial nuclei.