Research in Vestibular Science

Case Report

Vertical One-and-a-Half Syndrome Accompanying Contralateral Abduction and Incomplete Depression Palsy Due to Thalamo-Mesencephalic Infarction: Won Gu Lee, Meyung Kug Kim, Bong Goo Yoo; Res Vestib Sci. 2017;16(4):151-155. Published online December 15, 2017; DOI: https://doi.org/10.21790/rvs.2017.16.4.151

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Abstract PDF: Vertical gaze palsy is usually associated with lesions of the rostral midbrain and thalamo-mesencephalic junction. The rostral interstitial nucleus of the medial longitudinal fasciculus (riMLF), the interstitial nucleus of Cajal, and the posterior commissure located in the midbrain are the critical area in supranuclear control of vertical eye movements. We describe a case of vertical one-and-a-half syndrome accompanying contralateral abduction and incomplete depression palsy due to thalamo-mesencephalic infarction. These vertical eye movement abnormalities are presumed to be caused by damage to the ipsilateral riMLF, interstitial nucleus of Cajal, and oculomotor fascicles.

Original Article

3-D Model of The Oculomotor Fascicular Arrangement Within The Midbrain Using Brain MRI: Jeong Ho Park, Du Shin Jeong, Sun Ah Park, Tae Kyeong Lee, Ki Bum Sung; J Korean Bal Soc. 2008;7(1):22-32.

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Abstract PDF: Background and Purpose: The oculomotor nerve fascicles arise along its entire length and sweep ventrally to exit the midbrain at the medial edge of the crus cerebri. A rostro-caudal topography among the fascicular fibers is relatively well established. There are, however, some controversies whether medio-lateral topography also exists. Methods: We retrospectively reviewed the clinical records and MRI of the 8 patients showing isolated oculomotor nerve palsy due to midbrain infarction. Brain MRI was performed using a 1.5-T magnet with 2mm thickness and 0.1 mm slice interval. The anterior-posterior axis(X) was defined as the midline crossing the center of the cerebral aqueduct and the medio-lateral axis(Y) as the line crossing the same point. For rostro-caudal measurement, the intercommissural line was used as base line of the Z axis. The location of the lesions was defined by measuring actual distance of the margins of the lesions in millimeter from each axis; anterior, right, and caudal direction was defined as positive values in X, Y and Z coordinates, respectively. Results: The mean values and range of the X, Y and Z are as follows: X=7.56±4.34, 1≤X≤15; Y=3.43±1.37, 0≤Y≤6; Z=6.51±3.91, 0≤Z≤12.5. Conclusions: The distribution of all the MRI lesions was 0≤|Y|≤6 (mm), 0≤|Z|≤12.5 (mm) in mediolateral and rostrocaudal direction respectively, which is almost the same as the previously reported divergent range of the oculomotor fascicles in midbrain tegmentum. We suggest that our method of three dimensional measurements of the MRI lesion in midbrain tegmentum could be a useful tool for the study of oculomotor fascicular arrangement.

Case Report

Partial Oculomotor Nerve Palsy due to Different Fascicular Involvements in Recurrent Midbrain Infarctions: Jeong Ho Park, Won Hee Chung, Tae Kyeong Lee, Ki Bum Sung; J Korean Bal Soc. 2006;5(2):292-295.

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Abstract PDF: We experienced a patient with partial oculomotor palsy who had initially manifested pupillary mydriasis and inferior rectus palsy which were attributed to an ipsilateral fascicular lesion in midbrain. She developed ipsilateral ptosis and monocular elevation palsy due to a new lesion on MRI one month later. This case could be the first neuroimaging evidence which support the hypothesis that fascicles of the oculomotor nerve for inferior oblique, superior rectus, and levator palphebrae muscle fibers are located more laterally and caudally than fascicles for pupil and inferior rectus muscle within midbrain tegmentum. Key Words : Oculomotor nerve, Infarction, Midbrain

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