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Ocular contrapulsion in multiple sclerosis: clinical features and pathophysiological mechanisms.
E M Frohman1, T C Frohman, J Fleckenstein
1Department of Neurology, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, Texas 75235, USA. efrohm@mednet.swmed.edu
Journal of Neurology, Neurosurgery, and Psychiatry
|April 20, 2001
Summary
Ocular contrapulsion, a specific eye movement disorder, can occur in multiple sclerosis due to lesions in the superior cerebellar peduncle. This condition involves abnormal saccadic eye movements and is linked to the uncinate fasciculus.
Area of Science:
- Neuroscience
- Ophthalmology
- Neurology
Background:
- Multiple sclerosis (MS) is an autoimmune disease causing demyelination in the central nervous system.
- Cerebellar eye movement disorders can arise from lesions affecting specific white matter tracts.
Observation:
- This study describes ocular contrapulsion, a syndrome characterized by directional saccadic abnormalities.
- Contrapulsion involves hypermetric saccades away from a lesion and hypometric saccades towards it.
- Oblique saccades during vertical gaze were also noted, directed away from the lesion side.
Findings:
- Two multiple sclerosis patients exhibited ocular contrapulsion.
- Brain MRI confirmed lesions in the superior cerebellar peduncle (SCP) and uncinate fasciculus.
- Oculography revealed saccadic hypermetria away from the lesion and stepwise hypometric saccades towards the lesion.
Implications:
- Ocular contrapulsion is a recognizable sign of MS-related lesions in the SCP region.
- Understanding this syndrome aids in diagnosing and localizing neurological deficits in MS patients.
- This highlights the specific role of the uncinate fasciculus in coordinating eye movements.