BackgroundLittle is known about ping-pong gaze (PPG) outside of individual case reports. We aimed to describe PPG through an observational study and literature review.MethodsConsecutive patients with PPG at Shanghai General Hospital (SGH) from February 2016 to March 2018 were enrolled. A literature review through March 2018 was conducted.ResultsOf the 14 patients with PPG in SGH, the median age was 60years and 12 were males. The median Glasgow coma scale score was 7.5. The cycle of the PPG ranged from 1.5 to 6.5s. The leading three etiologies were acute ischemic stroke in five patients, post-seizure state in three patients, and hypoxic-ischemic encephalopathy in two patients. A total of 88.9% (8/9) of the patients with consistent whole-field PPG had similar bilateral hemispheric damage, whereas 80.0% (4/5) of the patients with PPG in the hemifield had unilateral or extremely asymmetric bilateral hemispheric damage. The hemifiled side was the same side as the sole/dominant hemispheric lesion. The final clinical outcomes were neurologic remission for seven patients, vegetative state for one patient, and death for six patients.ConclusionsPPG is a sign with localizing value that suggests hemispheric damage and asymmetric PPG might help to predict lateralization of the lesions. Acute ischemic stroke is the most common cause of PPG. Etiology and initial outcome are likely important prognostic factors of PPG.
[1]Fudan Univ, Huashan Hosp, Dept Neurol, 12 Wulumuqi Rd M, Shanghai 200040, Peoples R China;
[2]Shanghai Jiao Tong Univ, Sch Med, Shanghai Peoples Hosp 1, Dept Neurol,Shanghai Gen Hosp, 100 Haining Rd, Shanghai 200080, Peoples R China
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