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Medial vestibulospinal tract lesions impair sacculo-collic reflexes

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Abstract

The medial vestibulospinal tract (VST) is known to mediate the vestibular-evoked myogenic potential (VEMP) in the contracting sternocleidomastoid muscle (SCM). To determine whether disruption of the medial VST in the medulla impairs formation of VEMP, we measured VEMP in 14 patients with medial medullary infarction (MMI). VEMP was induced by a short tone burst and was recorded in contracting SCM while patients turned their heads forcefully to the contralateral side against resistance. Normative data were obtained from 47 healthy volunteers. Seven patients (50%) had abnormal VEMP in the side of the MMI lesion, absent in two, decreased in four, and delayed in two. One patient showed both decreased and delayed response. Of the seven patients with abnormal VEMP, five had the lesions that extended to the dorsal tegmentum while five of the seven patients with normal VEMP showed restricted anteromedial lesions mainly involving the pyramids. Spontaneous nystagmus (4/7, 57%), gaze-evoked nystagmus (6/7, 86%), and ocular tilt reaction/tilt of the subjective visual vertical (4/7, 57%) were frequently observed in the patients with abnormal VEMP. The abnormal VEMP in patients with infarctions involving the medullary tegmentum supports that VEMP is mediated by the medial VST descending within the medial longitudinal fasciculus.

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Acknowledgments

The authors thank Jong-Hee Lee for experimental assistance. This study was supported by a grant of the Korea Health 21 R&D Project, Ministry of Health & Welfare, Republic of Korea (A080750).

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Authors and Affiliations

  1. Department of Neurology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang, Seongnam, Gyeonggi, 463-707, South Korea

    Seonhye Kim & Ji Soo Kim

  2. Department of Neurology, Wonkwang University School of Medicine, Iksan, South Korea

    Hak-Seung Lee

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  1. Seonhye Kim
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  2. Hak-Seung Lee
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Correspondence to Ji Soo Kim.

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Kim, S., Lee, HS. & Kim, J.S. Medial vestibulospinal tract lesions impair sacculo-collic reflexes. J Neurol 257, 825–832 (2010). https://doi.org/10.1007/s00415-009-5427-5

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  • DOI: https://doi.org/10.1007/s00415-009-5427-5

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