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S. Thomas, R.J. McLean, F.A. Proudlock, N. Sarvananthan, I. Gottlob; Pharmacological Treatment of Nystagmus . Invest. Ophthalmol. Vis. Sci. 2005;46(13):2400.
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Purpose: Various drugs have been tried in the management of acquired nystagmus of varying aetiology. We would like to present our results with gabapentin and memantine in the treatment of acquired and congenital nystagmus. Methods: Twelve patients with nystagmus secondary to multiple sclerosis and other neurological causes were treated with gabapentin. Two patients who did not improve on gabapentin were prescribed memantine. Two patients with congenital nystagmus, one associated with rod monochromatism and the other with corneal dystrophy were treated with gabapentin. Eye movement recordings were done using Eye–link infrared pupil tracker 250Hz, before and after treatment, and the intensity of nystagmus was calculated. Results: Of the nine patients with multiple sclerosis, three patients showed at least 2–line improvement on Snellen chart. Another four patients reported symptomatic relief from oscillopsia. The two patients who did not improve with gabapentin were tried on memantine and both the patients showed objective and subjective improvement. Eye movement recordings demonstrated the improvement in nystagmus. The three patients with nystagmus secondary to brain atrophy, cerebrovascular accident and spinocerebellar ataxia did not show any improvement on gabapentin. In two of these patients, the drug was discontinued due to untoward effects. The two patients with congenital nystagmus, improved subjectively and objectively with gabapentin. Conclusions: In our experience, both gabapentin and memantine appear useful not only in the management of acquired nystagmus, but also in the treatment of congenital nystagmus. A placebo controlled, randomised, double blind trial is being carried out to establish the efficacy of these drugs.
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