Horizontal eye movement disorders in thalamic hemorrhage Satoshi Hasebe 1 , Hiroshi Ohtsuki 1 , Hideki Okayama 1 , Yoshimasa Watanabe 1 , Takumi Koyama 2 1Dept of Ophthalmol, Okayama Univ Med Sch 2Okayama Rousai Hosp pp.1243-1247
Published Date 1988/11/15
DOI https://doi.org/10.11477/mf.1410210544
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We evaluated the horizontal eye movements in 3 cases with small to moderate sized hemorrhage in the thalamus due to systemic hypertension. One case manifested upper gaze palsy, convergence palsy, skew deviation and convergence-retraction nystagmus. The second case showed vertical gaze palsy and convergence palsy. The third case showed normal findings on routine ophthal-mological examination. Computed tomography showed enhanced lesions in the left thalamus exten-ding toward the dorsal midbrain in the first two cases. A localized lesion in the right thalamus was detected in the third case.

Infrared electrooculography (pEOG) recorded disturbed horizontal eye movements in all the 3 cases. Hypometric saccades were elicited when directed away from the side of the thalamic lesion. Saccadic pursuit appeared when directed toward the side of the lesion. The vestibulo-ocular reflex was intact.

The findings indicate that horizontal eye move-ment disorders may develop, beside vertical gaze palsy, in thalamic hemorrhages. While vertical gaze palsy is consequent to dorsal midbrain lesion, the disturbed horizontal saccadic and pursuit eye movements would be due either to interrupted efferent pathway of horizontal eye movement, which is mediated through the thalamus, or by the failure in gaze control mechanism in the thalamus.

Rinsho Ganka (Jpn J Clin Ophthalmol) 42(11) : 1243-1247, 1988

Copyright © 1988, Igaku-Shoin Ltd. All rights reserved.


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