• Ophthalmology · Jan 2004

    Case Reports

    Surgical treatment of trauma-induced periodic alternating nystagmus.

    • Ivan G Castillo, Robert D Reinecke, Robert C Sergott, and Sheryl Wizov.
    • Neuro-Ophthalmology Service, Wills Eye Hospital, Thomas Jefferson Medical College, Philadelphia, Pennsylvania 19107-5598, USA.
    • Ophthalmology. 2004 Jan 1;111(1):180-3.

    PurposeTo report a new treatment for acquired periodic alternating nystagmus in which medical therapy with baclofen was not tolerated.DesignInterventional case report and literature review.InterventionSimultaneous adjustable bilateral retroequatorial horizontal rectus muscle recessions.Main Outcome MeasuresOcular alignment and ocular motility recordings.ResultsA 30-year-old man had blurred vision after an emergency left temporal craniotomy for gunshot wounds. Ophthalmologic examination revealed periodic alternating nystagmus that was documented by an infrared electronystagmogram. Baclofen was started but was not tolerated. Bilateral lateral and medial retroequatorial rectus muscle recessions were performed and were successful in the treatment of this patient.ConclusionSimultaneous bilateral retroequatorial horizontal rectus recessions may be an effective treatment for intractable acquired periodic alternating nystagmus.

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