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Our study confirmed that both memantine and gabapentin decrease pendular nystagmus amplitude, velocity, and intensity with no change in nystagmus frequency. This study was designed to examine treatment effects on the visual consequences of nystagmus. Treatment with clonazepam, gabapentin, or memantine could be considered in patients with visual symptoms from persistent seesaw nystagmus (see Table 2 for recommended dosing). Seesaw Nystagmus | alternative Seesaw Nystagmus Pharmacologic treatment has been used in acquired nystagmus with mixed success. Treatments have included baclofen, sodium valproate, gabapentin, and memantine.1,2 However, in congenital nystagmus, little is known about the effect of drugs. We describe a patient with congenital nystagmus and corneal Only 6.7% of patients discontinued gabapentin. Baseline near oscillopsia was greater among those with higher nystagmus amplitude and velocity. Conclusions: This study demonstrated that both memantine and gabapentin reduce APN, improving functional visual outcomes. Gabapentin showed a better tolerability, suggesting that this agent should be Patients in both treatment groups reported vision improvement more often than patients in the placebo group (p=0.03). McLean et al concluded that memantine and gabapentin can improve visual acuity, reduce nystagmus intensity, and improve foveation inIN. 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. We conducted a double-blind crossover trial comparing gabapentin (up to 900 mg/day) to baclofen (up to 30 mg/day) as therapy for acquired nystagmus in 21 patients. We measured visual acuity and the nystagmus before, and at the end of, 2 weeks on each medication. We conducted a masked, cross-over, therapeutic trial of gabapentin (1200mg/day) versus memantine (40mg/day) for acquired nystagmus in 10 patients (28–61 years; 7 female; MS: 3, post-stroke: 6, post-traumatic: 1). Treatment with 3,4-diaminopyridine and 4-aminopyridine recently have been shown to be effective for downbeat nystagmus. Gabapentin, baclofen, and clonazepam also are useful in some patients with downbeat nystagmus. Baclofen is the therapy of choice for periodic alternating nystagmus. Gabapentin often is effective for acquired pendular nystagmus. The most success has been found with gabapentin in the treatment of acquired pendular nystagmus and baclofen in the treatment for acquired periodic alternating nystagmus. “Used off label, gabapentin can be highly effective in decreasing oscillopsia and nystagmus amplitude,” said Dr. Rucker. Optical or mechanical. In some patients, the use of prisms can stimulate convergence mechanisms, which can quiet the nystagmus pattern. 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 Red traces depict the right eye and grey traces the left. IN this example binocular jerk nystagmus superimposes upon monocular acquired pendular nystagmus in the right eye. There is a reduction in the amplitude of both types of nystagmus during treatment with gabapentin (1200 mg per day) (B) and memantine (10 mg per day) (C). Gabapentin and memantine are helpful in reducing acquired pendular nystagmus due to multiple sclerosis. Ocular oscillations in oculopalatal tremor may also improve following treatment with memantine or gabapentin. Treatment with gabapentin reduced both pendular and jerk nystagmus; however, patient 8 with jerk waveform superimposed over pendular nystagmus showed a predominant reduction in the pendular nystagmus (55.3%), while the jerk nystagmus was reduced by 12.6%. Unilateral vestibular failure within 3 days after symptom onset and after 12 months. Vestibular function was determined by caloric irrigation, using the ‘vestibular paresis formula’ (which allows a direct comparison of the function of both labyrinths) for each patient in the placebo (upper left), methylprednisolone (upper right), valacyclovir (lower right), and methylprednisolone plus A double-blind controlled study of gabapentin and baclofen as treatment for acquired nystagmus. Ann Neurol. 1997;41:818–825. doi: 10.1002/ana.410410620. [Google Scholar] 86. Strupp M, Schuler O, Krafczyk S, et al. Treatment of downbeat nystagmus with 3, 4-diaminopyridine: a placebo-controlled study. The effects of the anticonvulsant gabapentin were measured on vision and eve movements in three patients with acquired pendular nystagmus. In two patients, the nystagmus was associated with multiple sclerosis and, in the other, it followed brainstem stroke. A single oral 600 mg dose of gabapentin pr We conducted a masked, crossover, therapeutic trial of gabapentin (1,200mg/day) versus memantine (40 mg/day) for acquired nystagmus in 10 patients (aged 28-61 years; 7 female; 3 multiple sclerosis [MS]; 6 post-stroke; 1 post-traumatic). gabapentin treatment noticed a decrease in illusory motion after medication. Further case reports confirmed the viability of gabapentin as a treatment for APN [30,31]. Gabapentin was also shown to be effective in APN when compared in a cross over trial with vigabatrin, another GABAergic drug . ..
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