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aDepartment of Neurology and Center of Sensorimotor Research, Klinikum Grosshadern, Ludwig-Maximilians University, Munich, Germany bDepartment of Neurology, Johannes Gutenberg-University, Mainz, Germany
Address for correspondence: Prof. Dr. Marianne Dieterich, Department of Neurology, Johannes Gutenberg-University, Langenbeckstrasse 1, D-55131 Mainz, Germany. Voice: + 49-6131-17-2510; fax: + 49-6131-17-5697. dieterich{at}neurologie.klinik.uni-mainz.de Ann. N.Y. Acad. Sci. 1004: 50-60 (2003).
Clinical ocular motor syndromes were compared with ocular motor syndromes simulated by a mathematical model of the vestibuloocular reflex. The mathematical sensorimotor feedforward model of otolith control of three-dimensional binocular eye position is based on relevant anatomical connections of the vestibuloocular reflex from the utricles to extraocular eye muscles. This is the first attempt to simulate static ocular motor syndromes for unilateral utricular or vestibular nerve failure, lesions of the vestibular nucleus, and lesions of the ascending vestibuloocular reflex pathways. Comparison of the predicted syndromes with those found in patients with unilateral disorders of the vestibular nerve (herpes zoster neuritis), the vestibular nucleus (medullary infarction), and the medial longitudinal fasciculus (pontine infarction) showed good agreement as regards the direction of horizontal, vertical, and torsional eye deviations. The ability of the model to simulate complete or incomplete failures of single elements or entire pathways allows us to pose direct clinical questions about as yet unknown ocular motor syndromes or about the localization of the damage as well as the mechanism involved in syndromes already known.
Key Words: mathematical model • vestibuloocular reflex • otolith • ocular motor syndrome • skew deviation • ocular torsion • patients
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