{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T08:32:55Z","timestamp":1740126775630,"version":"3.37.3"},"reference-count":35,"publisher":"Georg Thieme Verlag KG","issue":"06","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Laryngorhinootologie"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title><jats:p>Der Diagnose von Augenbewegungsst\u00f6rungen und der Nystagmusformen beruht auf einer systematischen klinischen Untersuchung aller Arten von Augenbewegungen. Diese Untersuchung umfasst: Augenposition, Untersuchung auf einen Spontannystagmus, Motilit\u00e4t, Blickfolge, Blickhaltefunktion, Sakkaden, Vergenzreaktion, optokinetischer Nystagmus, Funktion des vestibulookul\u00e4ren Reflexes (VOR) sowie die Fixationssuppression des VOR. Anatomisch relevante Strukturen sind Mesenzephalon, Pons, Medulla oblongata, Zerebellum und Kortex. Topografisch anatomisch gelten die einfachen klinischen Regeln: Vertikale und torsionale Augenbewegungen werden vorwiegend im Mesenzephalon und horizontale Augenbewegungen in dem Pons generiert. Typische Zeichen einer Mittelhirnl\u00e4sion sind vertikale Sakkaden- oder Blickparese, ein isolierter vertikaler Blickrichtungsnystagmus und einer Ponsl\u00e4sion entsprechende horizontale St\u00f6rungen. Das Zerebellum spielt eine Rolle bei praktisch allen Augenbewegungen; typische klinische Zeichen sind eine allseitige Blickfolgesakkadierung, Blickrichtungsnystagmus oder dysmetrische Sakkaden. Unter einem Nystagmus versteht man rhythmische Augenbewegungen, die in der Regel aus einem langsamen (urs\u00e4chlichen bzw. pathologischen) Augendrift und einer schnellen kompensatorischen R\u00fcckstellbewegung (R\u00fcckstellsakkade) bestehen. Es lassen sich 3 einfache Kategorien unterscheiden: Spontannystagmus, d. h. ein Nystagmus, der bei Fixation in Geradeaus-Blickposition auftritt, Nystagmusformen, die nur in Abh\u00e4ngigkeit von der Blickrichtung auftreten und Nystagmen, die nur durch bestimmte Man\u00f6ver ausgel\u00f6st werden: Kopfsch\u00fctteln, Lagerung, Hyperventilation oder physikalischen Druck (z. B. Pressen). Letztere sind oft durch peripher-vestibul\u00e4re L\u00e4sionen ausgel\u00f6st, k\u00f6nnen aber auch zentralen Ursprungs sein. Viele zentrale Nystagmusformen erlauben eine genaue anatomische Lokalisation, z. B. der Downbeat-Nystagmus (DBN), der meistens auf einer Flocculus-L\u00e4sion beruht oder der Upbeat-Nystagmus (UBN) auf einer L\u00e4sion im Mesencephalon oder der Medulla oblongata. Beispiele einer Pharmakotherapie sind die Gabe von 4-Aminopyridin beim DBN und UBN, Memantin oder Gabapentin beim Fixationspendelnystagmus oder Baclofen beim periodisch-alternierenden Nystagmus.<\/jats:p>","DOI":"10.1055\/a-2192-7319","type":"journal-article","created":{"date-parts":[[2024,1,10]],"date-time":"2024-01-10T03:36:05Z","timestamp":1704857765000},"page":"413-421","source":"Crossref","is-referenced-by-count":0,"title":["Okulomotorikst\u00f6rungen und Nystagmus"],"prefix":"10.1055","volume":"103","author":[{"given":"Christoph","family":"Helmchen","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Neurologie, Universit\u00e4tsklinikum Schleswig-Holstein, L\u00fcbeck"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wolfgang","family":"Heide","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Neurologie, Allgemeines Krankenhaus Celle, Celle, 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