Effectiveness of botulinum toxin administered to abolish acquired nystagmus
Corresponding Author
Dr. R. John Leigh MD
Department of Neurology, Case Western Reserve University, University Hospitals, and Department of Veterans Affairs Medical Center, Cleveland, OH
Department of Neuroscience, Case Western Reserve University, University Hospitals, and Department of Veterans Affairs Medical Center, Cleveland, OH
Department of Neurology, University Hospitals, 2074 Abington Rd, Cleveland, OH 44106Search for more papers by this authorRobert L Tomsak MD, PhD
Department of Neurology, Case Western Reserve University, University Hospitals, and Department of Veterans Affairs Medical Center, Cleveland, OH
Department of Ophthalmology, Case Western Reserve University, University Hospitals, and Department of Veterans Affairs Medical Center, Case Western Reserve University, University Hospitals, and Department of Veterans Affairs Medical Center, Cleveland, OH
Search for more papers by this authorMichael P. Grant PhD
Department of Neuroscience, Case Western Reserve University, University Hospitals, and Department of Veterans Affairs Medical Center, Cleveland, OH
Search for more papers by this authorBernd F. Remler MD
Department of Neurology, Case Western Reserve University, University Hospitals, and Department of Veterans Affairs Medical Center, Cleveland, OH
Department of Ophthalmology, Case Western Reserve University, University Hospitals, and Department of Veterans Affairs Medical Center, Case Western Reserve University, University Hospitals, and Department of Veterans Affairs Medical Center, Cleveland, OH
Search for more papers by this authorStacy S. Yaniglos OD
Department of Optometry, Case Western Reserve University, University Hospitals, and Department of Veterans Affairs Medical Center, Cleveland, OH
Search for more papers by this authorLisa Lystad MD
Department of Neurology, Case Western Reserve University, University Hospitals, and Department of Veterans Affairs Medical Center, Cleveland, OH
Search for more papers by this authorLouis F. Dell'Osso PhD
Department of Neurology, Case Western Reserve University, University Hospitals, and Department of Veterans Affairs Medical Center, Cleveland, OH
Search for more papers by this authorCorresponding Author
Dr. R. John Leigh MD
Department of Neurology, Case Western Reserve University, University Hospitals, and Department of Veterans Affairs Medical Center, Cleveland, OH
Department of Neuroscience, Case Western Reserve University, University Hospitals, and Department of Veterans Affairs Medical Center, Cleveland, OH
Department of Neurology, University Hospitals, 2074 Abington Rd, Cleveland, OH 44106Search for more papers by this authorRobert L Tomsak MD, PhD
Department of Neurology, Case Western Reserve University, University Hospitals, and Department of Veterans Affairs Medical Center, Cleveland, OH
Department of Ophthalmology, Case Western Reserve University, University Hospitals, and Department of Veterans Affairs Medical Center, Case Western Reserve University, University Hospitals, and Department of Veterans Affairs Medical Center, Cleveland, OH
Search for more papers by this authorMichael P. Grant PhD
Department of Neuroscience, Case Western Reserve University, University Hospitals, and Department of Veterans Affairs Medical Center, Cleveland, OH
Search for more papers by this authorBernd F. Remler MD
Department of Neurology, Case Western Reserve University, University Hospitals, and Department of Veterans Affairs Medical Center, Cleveland, OH
Department of Ophthalmology, Case Western Reserve University, University Hospitals, and Department of Veterans Affairs Medical Center, Case Western Reserve University, University Hospitals, and Department of Veterans Affairs Medical Center, Cleveland, OH
Search for more papers by this authorStacy S. Yaniglos OD
Department of Optometry, Case Western Reserve University, University Hospitals, and Department of Veterans Affairs Medical Center, Cleveland, OH
Search for more papers by this authorLisa Lystad MD
Department of Neurology, Case Western Reserve University, University Hospitals, and Department of Veterans Affairs Medical Center, Cleveland, OH
Search for more papers by this authorLouis F. Dell'Osso PhD
Department of Neurology, Case Western Reserve University, University Hospitals, and Department of Veterans Affairs Medical Center, Cleveland, OH
Search for more papers by this authorAbstract
We injected botulinum toxin into the horizontal rectus muscles of the right eyes of 2 patients who had acquired pendular nystagmus with horizontal, vertical, and torsional components. This treatment successfully abolished the horizontal component of the nystagmus in the injected eye in both patients for approximately 2 months. Both patients showed a small but measurable improvement of vision in the injected eye that may have been limited by coexistent disease of the visual pathways. The vertical and torsional components of the nystagmus persisted in both patients. In 1 patient, the horizontal component of nystagmus in the noninjected eye increased; we ascribe this finding to plastic-adaptive changes in response to paresis caused by the botulinum toxin. Such plastic-adaptive changes and direct side effects of the injections—such as diplopia and ptosis—may limit the effectiveness of botulinum toxin in the treatment of acquired nystagmus. Neither patient elected to repeat the botulinum treatment.
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Helveston EM,
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Large recession of the horizontal recti for treatment of nystagmus.
Ophthalmology
1991;
98:
130
2–1305
10.1016/S0161-6420(91)32139-0 Google Scholar
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