片側性眼瞼眼振を生じた小脳海綿状血管腫の1例

A case of cerebellar cavernous hemangioma with unilateral lid nystagmus.

　片側性Popper型の眼瞼眼振と考えられる異常眼瞼挙上運動を示した58歳男性例を報告した．症例は右側の外転神経麻痺，顔面神経麻痺，小脳症状，難聴がみられ，左方視で注視眼振に連動して左上眼瞼の律動的な挙上運動がみられた．CTスキャンで右小脳に造影効果のある高吸収域が発見され，後頭窩開頭による腫瘍摘出術の結果，小脳海綿状血管腫と判明した．このような片側性の眼瞼眼振の報告はこれまでみられず，極めて稀な症例と考えられた．

We observed an unusual instance of unilateral Popper-type lid nystagmus in a 58-year-old right -handed male. He sought medical advice on account of lagophthalmic corneal ulcer in his right eye. He had a history over the past 30 years of slowly progressive abducens nerve palsy, facial palsy, hearing loss and cerebellar symptoms on his right side. Computed tomography revealed high-density areas in his right cerebellar hemisphere. Cavernous hemangioma was diagnosed by neurosurgical intervention.

We evaluated the eye and eyelid movements with EOG and EMG before surgery. We observed righ-tward gaze-evoked ocular nystagmus and synchro-nous lid nystagmus of the left eyelid. EMG showed rhythmically increasing discharges of the superior levator palpebrae muscle and reciprocal ones of the orbicularis oculi muscle.

Rinsho Ganka (Jpn J Clin Ophthalmol) 42(11) : 1265-1268, 1988