Gabapentine for periodic alternating nystagmus
Abstract
The variety of suggested treatments of nystagmus probably reflect its multiple pathogenetic mechanisms. Basic studies have shown that several neurotransmitters are involved in the ocular motor control, including gamma-aminobutyrric acid (GABA), acetylcholine and glycine.
Recently, Stahl et al. (1995 ) investigated the effects of gabapentine on acquired pendular nystagmus in two patients with multiple sclerosis. Gabapentine is an antiepileptic drug known to specifically interact with GABA-mediated neurotransmission.
We administered Gabapentine to a patient with acquired periodic alternating nystagmus nystagmus (PAN).
S. F., female, 16 years old, suffering from an eredodegenerative ataxia had periodic alternating nystagmus. Each period lasted 40 secs. and there was no free period between phases. Her ny was not modified by darkness but was reduced with eyes closed. She was treated with Gabapentine 400 mg. twice a day for 1 month. She reported an immediate improvement of visual and oculomotor ability and she could resume activities such as reading and writing on a personal computer. After 1 month ny was still absent with eyes closed and reduced in darkness.