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Treatment of nystagmus.
Curr Treat Options Neurol. 2012 Feb; 14(1):60-72.CT

Abstract

OPINION STATEMENT

Patients with congenital and acquired forms of nystagmus are commonly encountered in clinical practice. Many report visual symptoms, such as oscillopsia and blurred vision, which can be alleviated if the nystagmus can be suppressed. Pharmacologic, optical, and surgical treatments are available, with the choice of treatment depending on the characteristics of the nystagmus and the severity of the associated visual symptoms. Downbeat nystagmus can be treated with 4-aminopyridine, 3,4-diaminopyridine, or clonazepam. Upbeat nystagmus can be reduced with memantine, 4-aminopyridine, or baclofen. Torsional nystagmus may respond to gabapentin. Acquired pendular nystagmus in patients with multiple sclerosis is often partially suppressed by gabapentin or memantine. Acquired pendular nystagmus in patients with oculopalatal tremor can respond to gabapentin, memantine, or trihexyphenidyl. Although acquired periodic alternating nystagmus is often completely suppressed by baclofen, memantine can be effective in refractory cases. Seesaw nystagmus can be reduced with alcohol, clonazepam, or memantine. Infantile nystagmus may not cause significant visual symptoms if "foveation periods" are well developed, but the nystagmus can be treated in symptomatic patients with gabapentin, memantine, acetazolamide, topical brinzolamide, contact lenses, or base-out prisms to induce convergence. Several surgical therapies have also been reported to improve infantile nystagmus syndrome (INS), but selection of the appropriate therapy requires preoperative evaluation of visual acuity and nystagmus intensity in different gaze positions. Other treatment options for nystagmus include botulinum toxin injections into the extraocular muscles or retrobulbar space. Electro-optical devices are currently being developed, in order to noninvasively negate the visual consequences of nystagmus.

Authors+Show Affiliations

Department of Ophthalmology & Visual Sciences, University of Iowa, 200 Hawkins Dr PFP, Iowa City, IA, 52242, USA, mj.thurtell@gmail.com.No affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

22072056

Citation

Thurtell, Matthew J., and R John Leigh. "Treatment of Nystagmus." Current Treatment Options in Neurology, vol. 14, no. 1, 2012, pp. 60-72.
Thurtell MJ, Leigh RJ. Treatment of nystagmus. Curr Treat Options Neurol. 2012;14(1):60-72.
Thurtell, M. J., & Leigh, R. J. (2012). Treatment of nystagmus. Current Treatment Options in Neurology, 14(1), 60-72. https://doi.org/10.1007/s11940-011-0154-5
Thurtell MJ, Leigh RJ. Treatment of Nystagmus. Curr Treat Options Neurol. 2012;14(1):60-72. PubMed PMID: 22072056.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Treatment of nystagmus. AU - Thurtell,Matthew J, AU - Leigh,R John, PY - 2011/11/11/entrez PY - 2011/11/11/pubmed PY - 2011/11/11/medline SP - 60 EP - 72 JF - Current treatment options in neurology JO - Curr Treat Options Neurol VL - 14 IS - 1 N2 - OPINION STATEMENT: Patients with congenital and acquired forms of nystagmus are commonly encountered in clinical practice. Many report visual symptoms, such as oscillopsia and blurred vision, which can be alleviated if the nystagmus can be suppressed. Pharmacologic, optical, and surgical treatments are available, with the choice of treatment depending on the characteristics of the nystagmus and the severity of the associated visual symptoms. Downbeat nystagmus can be treated with 4-aminopyridine, 3,4-diaminopyridine, or clonazepam. Upbeat nystagmus can be reduced with memantine, 4-aminopyridine, or baclofen. Torsional nystagmus may respond to gabapentin. Acquired pendular nystagmus in patients with multiple sclerosis is often partially suppressed by gabapentin or memantine. Acquired pendular nystagmus in patients with oculopalatal tremor can respond to gabapentin, memantine, or trihexyphenidyl. Although acquired periodic alternating nystagmus is often completely suppressed by baclofen, memantine can be effective in refractory cases. Seesaw nystagmus can be reduced with alcohol, clonazepam, or memantine. Infantile nystagmus may not cause significant visual symptoms if "foveation periods" are well developed, but the nystagmus can be treated in symptomatic patients with gabapentin, memantine, acetazolamide, topical brinzolamide, contact lenses, or base-out prisms to induce convergence. Several surgical therapies have also been reported to improve infantile nystagmus syndrome (INS), but selection of the appropriate therapy requires preoperative evaluation of visual acuity and nystagmus intensity in different gaze positions. Other treatment options for nystagmus include botulinum toxin injections into the extraocular muscles or retrobulbar space. Electro-optical devices are currently being developed, in order to noninvasively negate the visual consequences of nystagmus. SN - 1534-3138 UR - https://www.unboundmedicine.com/medline/citation/22072056/Treatment_of_nystagmus_ L2 - https://dx.doi.org/10.1007/s11940-011-0154-5 DB - PRIME DP - Unbound Medicine ER -
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