Combined pharmacologic and surgical approach to acquired nystagmus due to multiple sclerosis.

Abstract

PURPOSE:

To describe a combined pharmacological and surgical approach to treating acquired nystagmus in a patient with multiple sclerosis.

DESIGN:

Interventional case report.

METHODS:

A 40-year-old patient with acquired horizontal and vertical nystagmus and severe oscillopsia secondary to multiple sclerosis had combined treatment with gabapentin and a vertical Kestenbaum-type procedure.

RESULTS:

After gabapentin treatment (3,000 mg orally daily) the horizontal nystagmus was significantly reduced, and the patient developed a marked chin-up position. The vertical nystagmus remained unchanged, dampening on downgaze. A recession of both inferior rectus muscles reduced the nystagmus significantly in primary position, the abnormal head position disappeared, and oscillopsia completely resolved. Treatment increased visual acuity from 6/24 in the right eye and 6/60 in the left eye to 6/9 in both eyes.

CONCLUSIONS:

Acquired nystagmus in multiple sclerosis can be significantly improved by using a combined pharmacological and surgical approach.

• Authors: Sunila Jain, Frank Proudlock, Cris S Constantinescu, Irene Gottlob
• Journal: American journal of ophthalmology (Am J Ophthalmol) Vol. 134 Issue 5 Pg. 780-2 (Nov 2002) ISSN: 0002-9394 [Print] United States
• PMID: 12429265 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Acetates
• Amines
• Cyclohexanecarboxylic Acids
• Excitatory Amino Acid Antagonists
• gamma-Aminobutyric Acid
• Gabapentin

Topics

• Acetates (therapeutic use)
• Adult
• Amines
• Combined Modality Therapy
• Cyclohexanecarboxylic Acids
• Diplopia (etiology, therapy)
• Excitatory Amino Acid Antagonists (therapeutic use)
• Gabapentin
• Head Movements
• Humans
• Male
• Multiple Sclerosis (complications)
• Nystagmus, Pathologic (etiology, therapy)
• Oculomotor Muscles (surgery)
• Ophthalmologic Surgical Procedures
• Posture
• Visual Acuity
• gamma-Aminobutyric Acid