7.異常眼球運動

「緒言」異常眼球運動は, 一般に病的眼振を除く, 中枢神経系障害に基づく自発性の異常な眼球運動 (眼振様運動や意識障害下の自発性眼球運動) の総称とされる. 本稿では, 意識下でみられる代表的な眼振様運動 (Ocular flutter, Opsoclonus, Square wave jerks ; SWJks) と, 周期性交代性眼振 (Periodic alternating nystagmus ; PAN) について述べる. 「Opsoclonus/Ocular flutter」1. Opsoclonus/Ocular flutterの定義と歴史的背景Ocular flutterは,...

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Published inEquilibrium Research Vol. 82; no. 3; pp. 163 - 172
Main Author 内藤, 理恵
Format Journal Article
LanguageJapanese
Published 一般社団法人 日本めまい平衡医学会 30.06.2023
日本めまい平衡医学会
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ISSN0385-5716
1882-577X
DOI10.3757/jser.82.163

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Abstract 「緒言」異常眼球運動は, 一般に病的眼振を除く, 中枢神経系障害に基づく自発性の異常な眼球運動 (眼振様運動や意識障害下の自発性眼球運動) の総称とされる. 本稿では, 意識下でみられる代表的な眼振様運動 (Ocular flutter, Opsoclonus, Square wave jerks ; SWJks) と, 周期性交代性眼振 (Periodic alternating nystagmus ; PAN) について述べる. 「Opsoclonus/Ocular flutter」1. Opsoclonus/Ocular flutterの定義と歴史的背景Ocular flutterは, 水平性の急速衝動性眼球運動で, かつては, flutter-like oscillationと呼ばれていた. 振幅は4～5°と小さく, 頻度8～10Hz, 急激に左右に振動し, 2～5秒間持続する. 多くは固視や注視で誘発され, 閉眼時も持続する.
AbstractList 「緒言」異常眼球運動は, 一般に病的眼振を除く, 中枢神経系障害に基づく自発性の異常な眼球運動 (眼振様運動や意識障害下の自発性眼球運動) の総称とされる. 本稿では, 意識下でみられる代表的な眼振様運動 (Ocular flutter, Opsoclonus, Square wave jerks ; SWJks) と, 周期性交代性眼振 (Periodic alternating nystagmus ; PAN) について述べる. 「Opsoclonus/Ocular flutter」1. Opsoclonus/Ocular flutterの定義と歴史的背景Ocular flutterは, 水平性の急速衝動性眼球運動で, かつては, flutter-like oscillationと呼ばれていた. 振幅は4～5°と小さく, 頻度8～10Hz, 急激に左右に振動し, 2～5秒間持続する. 多くは固視や注視で誘発され, 閉眼時も持続する.
Author 内藤, 理恵
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References 7) 工藤洋祐, 城倉　健: Ocular flutterとOpsoclonus. 神経眼科　32: 19-22, 2015
28) 小宮山　純: Macrosaccadic oscillations. Equilibrium Res 60: 443-449, 2001
31) Sibony PA, Evinger C, Manning KA: The effects of tobacco smoking on smooth pursuit eye movements. Ann Neurol 23: 238-241, 1988
12) Eggers SDZ, Bisdorff A, von Brevern M, et al.: Classification of vestibular signs and examination techniques: Nystagmus and nystagmus-like movements. J Vestibular Res 29: 57-87, 2019
16) Helmchen C, Rambold H, Sprenger C, et al.: Cerebellar activation in opsoclonus: an fMRI study. Neurology 61: 412-415, 2003
55) Karp J, Porke LB: Periodic alternating nystagmus. Arch Neurol 32: 422-423, 1975
14) Blain PG, Nightingale S, Stoddart JC, et al.: Strychinine poisoning: abnormal eye movements. J Toxicol Clin Toxicol 19: 215-217, 1982
45) Otero-Millan J, Serra A, Leigh RJ, et al.: Distinctive features of saccadic intrusions and microsaccades in progressive supuranuclear palsy. J Neurosci 23: 4379-4387, 2011
33) Fahey MC, Cremer PD, Aw ST, et al.: Vestibular, saccadic and fixation abnormalities in genetically confirmed Friedreich ataxia. Brain 131: 1035-1045, 2008
19) Shaikh AG, Ramat S, Optican LM, et al.: Saccadic burst cell membrane dysfunction is responsible for saccadic oscillations. J Neuro-ophthalmol 28: 329-336, 2008
34) Swartz BE, Li S, Bespalova I, et al.: Pathogenesis of clinical signs in recessive ataxia with saccadic intrusions. Ann Neurol 54: 824-828, 2003
36) Rascol O, Sabatini U, Simonetta-Moreau M, et al.: Square wave jerks in parkinsonian syndromes. J Neurol Neurosurg Psychiatry 54: 599-602, 1991
49) Miller NR, Newman NJ: Nystagmus and related ocular motility disorders. In ed Miller NR, Newman NJ. The essentials: Walsh and Hoyt's Clinical Neuro-ophthalmology 5th ed. pp614-646, Williams & Wilkins, Philadelphia, 1999
59) 江本博文, 清澤源弘, 藤野　貞: 眼振と眼振様運動. 神経眼科―臨床のために第3版. 285-316頁, 医学書院, 東京, 2013
4) Dyken P, Kolár O: Dancing eyes, dancing feet: infantile polymyoclonia. Brain 91: 305-320, 1968
37) Troost BT, Daroff RB: The ocular motor defects in progressive supranuclear palsy. Ann Neurol 2: 397, 1977
38) Sharpe JA, Harishanu YO, White OB: Cerebral square wave jerk. Neurology 32: 57-62, 1982
26) Jung R, Kornhuber HH: Results of electronystagmography in man: The value of optokinetic, vestibular and spontaneous nystagmus for neurologic diagnosis and research. In ed Bender MB. The Oculomotor System. pp428-488, Harper&Row, New York, 1964.
50) 三村　治: 眼振 ・ 異常眼球運動. 神経眼科学を学ぶ人のために第3版. 265-267頁, 医学書院, 東京, 2014
35) Otero-Millan J, Serra A, Leigh RJ, et al.: Distinctive features of saccadic intrusions and microsaccades in progressive supranuclear palsy. J Neurosci 31: 4379-4387, 2011
56) Waespe W, Cohen B, Paphan T: Dynamic modification of the vestibuloocular reflex by the nodulus and uvula. Science 228: 199-202, 1985
10) Shaikh AG, Miura K, Optican LM, et al.: A new familial disease of saccadic oscillations and limb tremor provides clues to mechanisms of common tremor disorders. Brain 130: 3020-3031, 2007
29) Fukazawa T, Tashiro K, Hamada T, et al.: Multisystem degeneration: drugs and square wave jerks. Neurology 36: 1230-1233, 1986
42) Martines-Conde S, Macknik SL, Hubel DH: The role of fixational eye movements in visual perception. Nat Rev Neurosci 5: 229-240, 2004
9) Morad Y, Benyamini OG, Avni I: Benign opsoclonus in preterm infants. Pediatr Neurol 31: 275-278, 2004
53) 小松崎　篤: 各疾患における ENG 記録所見. ENG アトラス―めまい・平衡機能障害診断のために. 111-434頁, 医学書院, 東京, 2017
22) Furman JM, Eidelman BH, Fromm GH: Spontaneous remission of paraneoplastic ocular flutter and saccadic intrusions. Neurology 38: 499-501, 1988
17) Oguro K, Kobayashi J, Aiba H, et al.: Opsoclonus-myoclonus syndrome with abnormal single photon emission computed tomography imaging. Pediatr Neurol 16: 334-336, 1997
46) Janet CR: Nystagmus and saccadic intrusions. Neuro-Ophthalmol 25: 1376-1400, 2019
57) Leigh RJ, Robinson DA, Zee DS: A hypothetical explanation for periodic alternation nystagmus: instability in the optokinetic-vestibular system. Ann NY Acad Sci 374: 619-635, 1981
1) 徳増厚二, 大久保　仁, 加藤　功　他: 平衡機能検査法基準化のための資料. ―1987年平衡機能検査法基準化委員会答申書, および英文項目―. めまい平衡障害の診断・治療のための臨床指針資料. Equilibrium Res (Suppl): 1-26, 1995
23) 中馬越清隆, 岩本義輝, 吉田　薫: 脳幹におけるサッケードと注視の制御. 脳と眼球運動　脳の科学　25: 653-661,2003
13) Shinoda Y, Sugiuchi Y, Izawa Y, et al.: Neural circuits for triggering saccades in the brainstem. Prog Brain Res 171: 79-85, 2008
40) Zee DS, Yamazaki A, Sutler PH, et al.: Effects of ablation of flocculus and paraflocculus on eye movements in primate. J Neurophysiol 46: 878-899, 1981
8) Koide R, Sakamoto M, Tanaka K, et al.: Opsoclonus-myoclonus syndrome during pregnancy. J Neuroopthalmol 24: 273, 2004
25) Ohm J: Zur Augenzitternkunde. Graefe Arch Opthalmol 134: 27-37, 1935
3) Leigh RJ, Zee DS: Diagnosis of nystagmus and saccadic intrusions. In The neurology of eye movements 5th ed. pp657-768, Oxford Univ Press, New York, 2015
21) Kudo Y, Sugawara E, Takahashi K, et al.: An attempt to treat ocular flutter and opsoclonus by cerebellar magnetic stimulation. J Neurol Sci 395: 119-120, 2018
11) Kaski D, Bronstein AM: Functional eye movement disorders. In ed Hallett M, Stone J, Carson A. Handbook of Clinical Neurology Vol. 139 (3rd series), pp343-351, Elsevier, Amsterdam, 2016
27) Dell'Osso LR, Troost BT, Daroff RB: Macrosquare wave jerks. Neurology 25: 975-979, 1975
20) Titulaer MJ, Soffietti R, Dalmau J, et al.: Screening for tumors in paraneoplastic syndromes: Report of an EFNS task force. Eur Neurol 18: 19-e3, 2011
39) Averbuch-Heller L, Stahl JS, Hlavin ML, et al.: Square-wave jerks induced pallidotomy in parkinsonian patients. Neurology 52: 185-188, 1999
43) MaCamy MB, Otelo-Millan J, Macknik SL, et al.: Microsaccadic efficacy and contribution to foveal and peripheral vision. J Neurosci 32: 9194-9204, 2012
48) Shallo-Hoffman J, Petersen J, Mühlendyck H: How normal are “normal” square wave jerks. Invest Opthalmol Vis Sci 30: 1009-1011, 1989
51) Guyer DR, Lessell S: Periodic alternating nystagmus associated with albinism. J Clin Neuroophthalmol 6: 82-85, 1986
15) Zee DS, Robinson DA: A hypothetical explanation of saccadic oscillations. Ann Neurol 5: 405-414, 1979
2) Orzechowski K: De L'ataxie dysmétrique des yeux. Remarques sur L'ataxie des yeux dite myoclonique (opsoclonie, opsochorie). J Psycchol Neurol 35: 1-18, 1927
6) Bataller L, Graus F, Saiz A, et al.: Clinical outcome in adult onset idiopathic or paraneoplastic opsoclonus-myoclonus. Brain 124: 437-443, 2001
41) Feldon SE, Langston JW: Square-wave jerks: a disorder of microsaccades? Neurology 27: 278-281, 1977
47) Salman MS, JA Sharpe, L Lillakas, et al.: Square wave jerks in children and adolescents. Pediatr Neurol 38: 16-19, 2008
52) Murofushi T, Chihara Y, Ushio M, et al.: Periodic alternating nystagmus in Meniere's disease: the peripheral type? Acta Otolaryngol 128: 824-827, 2008
58) Furman JM, Wall C 3rd, Pang DL: Vestibular function in periodic alternating nystagmus. Brain 113: 1425-1439, 1990
24) Shaikh AG: Saccadic oscillations - membrane, model, and medicine. Expert Rev Ophthalmol 7: 481-486, 2012
60) Halmagyi GM, Rudga P, Gresty MA, et al.: Treatment of periodic alternating nystagmus. Ann Neurol 8: 609-611, 1980
18) Wong AM, Musallam S, Tomlinson RD, et al.: Opsoclonus in three dimensions: oculographic, neuropathologic and modeling correlates. J Neurol Sci 189: 71-81, 2001
32) Shallo-Hoffmann J, Sendler B, Mu: hlendyck H: Normal square wave jerks in differing age groups. Invest Opthalmol Vis Sci 31: 1649-1652, 1990
61) Mimura O, Ishikawa H, Kimura N, et al.: Retrospective study of recession of four horizontal rectus muscle in periodic alternating nystagmus. Clin Ophthalmol 8: 2523-2528, 2014
30) Herishanu YO, Sharpe JA: Normal square wave jerks. Invest Ophthalmol Vis Sci 20: 268-272, 1981
54) Keane JR: periodic alternationg nystagmus. Am J Opthalmol 72: 757, 1971
5) Brunklaus A, Pohl K, Zuberi SM, et al.: Investigating neuroblastoma in childhood opsoclonus-myoclonus syndrome. Arch Dis Child 97: 461-463, 2012
44) Gorges M, Pinkhardt EH, Kassubek J: Alterations of eye movement control in neurodegenerative movement disorders. J Ophthalmol ID 658243, 2014
References_xml – reference: 27) Dell'Osso LR, Troost BT, Daroff RB: Macrosquare wave jerks. Neurology 25: 975-979, 1975
– reference: 38) Sharpe JA, Harishanu YO, White OB: Cerebral square wave jerk. Neurology 32: 57-62, 1982
– reference: 28) 小宮山　純: Macrosaccadic oscillations. Equilibrium Res 60: 443-449, 2001
– reference: 45) Otero-Millan J, Serra A, Leigh RJ, et al.: Distinctive features of saccadic intrusions and microsaccades in progressive supuranuclear palsy. J Neurosci 23: 4379-4387, 2011
– reference: 1) 徳増厚二, 大久保　仁, 加藤　功　他: 平衡機能検査法基準化のための資料. ―1987年平衡機能検査法基準化委員会答申書, および英文項目―. めまい平衡障害の診断・治療のための臨床指針資料. Equilibrium Res (Suppl): 1-26, 1995
– reference: 33) Fahey MC, Cremer PD, Aw ST, et al.: Vestibular, saccadic and fixation abnormalities in genetically confirmed Friedreich ataxia. Brain 131: 1035-1045, 2008
– reference: 22) Furman JM, Eidelman BH, Fromm GH: Spontaneous remission of paraneoplastic ocular flutter and saccadic intrusions. Neurology 38: 499-501, 1988
– reference: 30) Herishanu YO, Sharpe JA: Normal square wave jerks. Invest Ophthalmol Vis Sci 20: 268-272, 1981
– reference: 34) Swartz BE, Li S, Bespalova I, et al.: Pathogenesis of clinical signs in recessive ataxia with saccadic intrusions. Ann Neurol 54: 824-828, 2003
– reference: 12) Eggers SDZ, Bisdorff A, von Brevern M, et al.: Classification of vestibular signs and examination techniques: Nystagmus and nystagmus-like movements. J Vestibular Res 29: 57-87, 2019
– reference: 52) Murofushi T, Chihara Y, Ushio M, et al.: Periodic alternating nystagmus in Meniere's disease: the peripheral type? Acta Otolaryngol 128: 824-827, 2008
– reference: 5) Brunklaus A, Pohl K, Zuberi SM, et al.: Investigating neuroblastoma in childhood opsoclonus-myoclonus syndrome. Arch Dis Child 97: 461-463, 2012
– reference: 26) Jung R, Kornhuber HH: Results of electronystagmography in man: The value of optokinetic, vestibular and spontaneous nystagmus for neurologic diagnosis and research. In ed Bender MB. The Oculomotor System. pp428-488, Harper&Row, New York, 1964.
– reference: 47) Salman MS, JA Sharpe, L Lillakas, et al.: Square wave jerks in children and adolescents. Pediatr Neurol 38: 16-19, 2008
– reference: 54) Keane JR: periodic alternationg nystagmus. Am J Opthalmol 72: 757, 1971
– reference: 61) Mimura O, Ishikawa H, Kimura N, et al.: Retrospective study of recession of four horizontal rectus muscle in periodic alternating nystagmus. Clin Ophthalmol 8: 2523-2528, 2014
– reference: 57) Leigh RJ, Robinson DA, Zee DS: A hypothetical explanation for periodic alternation nystagmus: instability in the optokinetic-vestibular system. Ann NY Acad Sci 374: 619-635, 1981
– reference: 35) Otero-Millan J, Serra A, Leigh RJ, et al.: Distinctive features of saccadic intrusions and microsaccades in progressive supranuclear palsy. J Neurosci 31: 4379-4387, 2011
– reference: 37) Troost BT, Daroff RB: The ocular motor defects in progressive supranuclear palsy. Ann Neurol 2: 397, 1977
– reference: 39) Averbuch-Heller L, Stahl JS, Hlavin ML, et al.: Square-wave jerks induced pallidotomy in parkinsonian patients. Neurology 52: 185-188, 1999
– reference: 31) Sibony PA, Evinger C, Manning KA: The effects of tobacco smoking on smooth pursuit eye movements. Ann Neurol 23: 238-241, 1988
– reference: 13) Shinoda Y, Sugiuchi Y, Izawa Y, et al.: Neural circuits for triggering saccades in the brainstem. Prog Brain Res 171: 79-85, 2008
– reference: 24) Shaikh AG: Saccadic oscillations - membrane, model, and medicine. Expert Rev Ophthalmol 7: 481-486, 2012
– reference: 29) Fukazawa T, Tashiro K, Hamada T, et al.: Multisystem degeneration: drugs and square wave jerks. Neurology 36: 1230-1233, 1986
– reference: 14) Blain PG, Nightingale S, Stoddart JC, et al.: Strychinine poisoning: abnormal eye movements. J Toxicol Clin Toxicol 19: 215-217, 1982
– reference: 55) Karp J, Porke LB: Periodic alternating nystagmus. Arch Neurol 32: 422-423, 1975
– reference: 15) Zee DS, Robinson DA: A hypothetical explanation of saccadic oscillations. Ann Neurol 5: 405-414, 1979
– reference: 2) Orzechowski K: De L'ataxie dysmétrique des yeux. Remarques sur L'ataxie des yeux dite myoclonique (opsoclonie, opsochorie). J Psycchol Neurol 35: 1-18, 1927
– reference: 41) Feldon SE, Langston JW: Square-wave jerks: a disorder of microsaccades? Neurology 27: 278-281, 1977
– reference: 21) Kudo Y, Sugawara E, Takahashi K, et al.: An attempt to treat ocular flutter and opsoclonus by cerebellar magnetic stimulation. J Neurol Sci 395: 119-120, 2018
– reference: 48) Shallo-Hoffman J, Petersen J, Mühlendyck H: How normal are “normal” square wave jerks. Invest Opthalmol Vis Sci 30: 1009-1011, 1989
– reference: 42) Martines-Conde S, Macknik SL, Hubel DH: The role of fixational eye movements in visual perception. Nat Rev Neurosci 5: 229-240, 2004
– reference: 56) Waespe W, Cohen B, Paphan T: Dynamic modification of the vestibuloocular reflex by the nodulus and uvula. Science 228: 199-202, 1985
– reference: 60) Halmagyi GM, Rudga P, Gresty MA, et al.: Treatment of periodic alternating nystagmus. Ann Neurol 8: 609-611, 1980
– reference: 11) Kaski D, Bronstein AM: Functional eye movement disorders. In ed Hallett M, Stone J, Carson A. Handbook of Clinical Neurology Vol. 139 (3rd series), pp343-351, Elsevier, Amsterdam, 2016
– reference: 25) Ohm J: Zur Augenzitternkunde. Graefe Arch Opthalmol 134: 27-37, 1935
– reference: 8) Koide R, Sakamoto M, Tanaka K, et al.: Opsoclonus-myoclonus syndrome during pregnancy. J Neuroopthalmol 24: 273, 2004
– reference: 49) Miller NR, Newman NJ: Nystagmus and related ocular motility disorders. In ed Miller NR, Newman NJ. The essentials: Walsh and Hoyt's Clinical Neuro-ophthalmology 5th ed. pp614-646, Williams & Wilkins, Philadelphia, 1999
– reference: 20) Titulaer MJ, Soffietti R, Dalmau J, et al.: Screening for tumors in paraneoplastic syndromes: Report of an EFNS task force. Eur Neurol 18: 19-e3, 2011
– reference: 53) 小松崎　篤: 各疾患における ENG 記録所見. ENG アトラス―めまい・平衡機能障害診断のために. 111-434頁, 医学書院, 東京, 2017
– reference: 10) Shaikh AG, Miura K, Optican LM, et al.: A new familial disease of saccadic oscillations and limb tremor provides clues to mechanisms of common tremor disorders. Brain 130: 3020-3031, 2007
– reference: 44) Gorges M, Pinkhardt EH, Kassubek J: Alterations of eye movement control in neurodegenerative movement disorders. J Ophthalmol ID 658243, 2014
– reference: 58) Furman JM, Wall C 3rd, Pang DL: Vestibular function in periodic alternating nystagmus. Brain 113: 1425-1439, 1990
– reference: 3) Leigh RJ, Zee DS: Diagnosis of nystagmus and saccadic intrusions. In The neurology of eye movements 5th ed. pp657-768, Oxford Univ Press, New York, 2015
– reference: 7) 工藤洋祐, 城倉　健: Ocular flutterとOpsoclonus. 神経眼科　32: 19-22, 2015
– reference: 59) 江本博文, 清澤源弘, 藤野　貞: 眼振と眼振様運動. 神経眼科―臨床のために第3版. 285-316頁, 医学書院, 東京, 2013
– reference: 18) Wong AM, Musallam S, Tomlinson RD, et al.: Opsoclonus in three dimensions: oculographic, neuropathologic and modeling correlates. J Neurol Sci 189: 71-81, 2001
– reference: 6) Bataller L, Graus F, Saiz A, et al.: Clinical outcome in adult onset idiopathic or paraneoplastic opsoclonus-myoclonus. Brain 124: 437-443, 2001
– reference: 32) Shallo-Hoffmann J, Sendler B, Mu: hlendyck H: Normal square wave jerks in differing age groups. Invest Opthalmol Vis Sci 31: 1649-1652, 1990
– reference: 50) 三村　治: 眼振 ・ 異常眼球運動. 神経眼科学を学ぶ人のために第3版. 265-267頁, 医学書院, 東京, 2014
– reference: 16) Helmchen C, Rambold H, Sprenger C, et al.: Cerebellar activation in opsoclonus: an fMRI study. Neurology 61: 412-415, 2003
– reference: 51) Guyer DR, Lessell S: Periodic alternating nystagmus associated with albinism. J Clin Neuroophthalmol 6: 82-85, 1986
– reference: 4) Dyken P, Kolár O: Dancing eyes, dancing feet: infantile polymyoclonia. Brain 91: 305-320, 1968
– reference: 46) Janet CR: Nystagmus and saccadic intrusions. Neuro-Ophthalmol 25: 1376-1400, 2019
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Snippet 「緒言」異常眼球運動は, 一般に病的眼振を除く, 中枢神経系障害に基づく自発性の異常な眼球運動 (眼振様運動や意識障害下の自発性眼球運動) の総称とされる. 本稿では, 意...
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Title 7.異常眼球運動
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