• J. Neurol. Neurosurg. Psychiatr. · Mar 2005

    Case Reports

    4-aminopyridine restores visual ocular motor function in upbeat nystagmus.

    • S Glasauer, R Kalla, U Büttner, M Strupp, and T Brandt.
    • Department of Neurology, Klinikum Grosshadern, Marchioninistrasse 23, 81377 Munich, Germany. sglasauer@nefo.med.uni-muenchen.de
    • J. Neurol. Neurosurg. Psychiatr. 2005 Mar 1; 76 (3): 451-3.

    AbstractThe effect of the potassium channel blocker 4-aminopyridine (4-AP) on spontaneous upbeat nystagmus (UBN) was investigated with the search coil technique during fixation in different gaze positions and smooth pursuit in a patient before and after ingestion of 10 mg 4-AP. UBN was reduced from 8.6 deg/s to 2.0 deg/s by 4-AP causing subjective relief from distressing oscillopsia, and impaired upward smooth pursuit was restored (gains: before medication 0.38; after medication 0.86). In the dark, UBN was slightly stronger and not affected by 4-AP. We propose that 4-AP improved the function of cerebellar pathways that mediate gaze holding and smooth pursuit by intensifying the excitability of cerebellar Purkinje cells.

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