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February 1958

Electromyography—A Tool in Ocular and Neurologic Diagnosis: III. Supranuclear Mechanisms

AMA Arch Ophthalmol. 1958;59(2):177-187. doi:10.1001/archopht.1958.00940030043003

Study of a diverse group of supranuclear muscle affections has revealed certain unusual and, in some instances, characteristic phenomena. The technique has been described in previous publications.1,2 Frequently noted has been a spindle pattern of innervation in the extraocular muscles in which the discharge builds up to a peak and then declines in a rhythmic fashion. This pattern is similar to that seen in the electroencephalogram during sleep and barbiturate hypnosis. Motor spindles were also observed in sleep (Fig. 1) and have been encountered in gaze palsies or deviations. The presence of such spindles suggests the existence of a supranuclear disturbance of motility. The location and nature of the generator for such potentials is of course unknown. It may be suggested that the reticular formation is involved in their genesis. Pendular nystagmus shows a similar pattern. Saccadic movements and innervation are also characteristic of gaze disturbances.

A. Conjugate