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

AbstractPURPOSE:
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.
AuthorsSunila Jain, Frank Proudlock, Cris S Constantinescu, Irene Gottlob
JournalAmerican journal of ophthalmology (Am J Ophthalmol) Vol. 134 Issue 5 Pg. 780-2 (Nov 2002) ISSN: 0002-9394 [Print] United States
PMID12429265 (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)
  • Head Movements
  • Humans
  • Male
  • Multiple Sclerosis (complications)
  • Nystagmus, Pathologic (etiology, therapy)
  • Oculomotor Muscles (surgery)
  • Ophthalmologic Surgical Procedures
  • Posture
  • Visual Acuity
  • gamma-Aminobutyric Acid

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