Combined pharmacologic and surgical approach to acquired nystagmus due to multiple sclerosis.
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.[1]References
- Combined pharmacologic and surgical approach to acquired nystagmus due to multiple sclerosis. Jain, S., Proudlock, F., Constantinescu, C.S., Gottlob, I. Am. J. Ophthalmol. (2002) [Pubmed]
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