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Eye movements in amyotrophic lateral sclerosis.

B Cohen, J Caroscio

    Journal of Neural Transmission. Supplementum
    |January 1, 1983
    PubMed
    Summary

    Oculomotor abnormalities are present in amyotrophic lateral sclerosis (ALS) patients, contrary to previous assumptions. These involve issues with voluntary saccades, convergence, pursuit eye movements, and potentially ophthalmoplegia, suggesting motor system involvement.

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    Area of Science:

    • Neurology
    • Ophthalmology

    Background:

    • Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease primarily affecting motor neurons.
    • The oculomotor system's involvement in ALS has been historically underestimated or overlooked.

    Observation:

    • Recent clinical observations and literature suggest oculomotor abnormalities in a subset of ALS patients.
    • These abnormalities manifest in two primary categories: deficits in voluntary saccades, convergence, and pursuit eye movements due to cortico-oculomotor pathway damage, and a rarer, more global ophthalmoplegia likely from ocular motor nuclei involvement.

    Findings:

    • Patients may exhibit impaired voluntary saccades, convergence, and pursuit eye movements.
    • Deficits in visual suppression of the vestibulo-ocular reflex (VOR) and optokinetic nystagmus (OKN) can corroborate ocular pursuit impairments.
    • A less common presentation involves global ophthalmoplegia, suggesting neuronal loss near ocular motor nuclei.

    Implications:

    • Oculomotor testing, particularly involving the vestibulo-ocular reflex (VOR), can aid in identifying specific oculomotor deficits in ALS.
    • Further research is needed to determine the incidence of various oculomotor deficits and correlate them with broader somatic motor system impairments in ALS.
    • These findings highlight the potential for oculomotor system evaluation as part of a comprehensive assessment for amyotrophic lateral sclerosis patients.

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