Non-paralytic pontine exotropiaを呈した脳幹部梗塞の1例

A Case of Non-Paralytic Pontine Exotropia due to Brainstem Infarction

　急性期にnon-paralytic pontine exotropia（NPPE）を呈した橋梗塞の1例を報告した。症例は58歳男性。突然の複視で発症し，右MLF症候群に加え，正面視において健側眼の左が外転位をとる眼球運動障害を認めた。第3病日には他覚的所見は消失し，第7病日には自覚症状も消失した。第24病日に行ったMRIでは，橋中部被蓋傍正中部に梗塞巣を認めた。NPPEは脳幹梗塞の局在診断として有用であり，超急性期の眼球運動障害を注意深く観察することが重要と考えられる。

A case with non-paralytic pontine exotropia due to brainstem infarction is reported. A 58-year-old male developed sudden onset diplopia. Ocular motor findings were as follows; in forward gaze, the left eye was in abduction position. Leftward gaze, the right eye did not adduct with left beating nystagmus of left eye. Rightward gaze, both eyes could make full excursion and upward, downward gaze were possible. These findings was noted at only acute phase, 7 days later NPPE was disappeared. MRI revealed spotty lesion in the paramedian portion of the mid pontine tegmentum.