A double‐blind controlled study of gabapentin and baclofen as treatment for acquired nystagmus

Averbuch‐Heller, Lea; Tusa, Ronald J.; Fuhry, L.; Rottach, Klaus G.; Ganser, GL; Heide, Wolfgang; Büttner, U.; Leigh, R. John

doi:10.1002/ana.410410620

Cited by 183 publications

(29 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The most rigorous treatment trials in acquired pendular nystagmus (due to MS or OPT) led to the proposal of gabapentin or memantine as valuable drugs (26, 100–104). Only one study specifically tested gabapentin, memantine, and baclofen in a group of six patients with acquired pendular nystagmus in OPT with a significant effect of gabapentin and memantine on reduction of nystagmus amplitude and frequency irregularity (102).…”

Section: Treatmentmentioning

confidence: 99%

Hypertrophic Olivary Degeneration and Palatal or Oculopalatal Tremor

2017

View full text Add to dashboard Cite

Hypertrophic degeneration of the inferior olive is mainly observed in patients developing palatal tremor (PT) or oculopalatal tremor (OPT). This syndrome manifests as a synchronous tremor of the palate (PT) and/or eyes (OPT) that may also involve other muscles from the branchial arches. It is associated with hypertrophic inferior olivary degeneration that is characterized by enlarged and vacuolated neurons, increased number and size of astrocytes, severe fibrillary gliosis, and demyelination. It appears on MRI as an increased T2/FLAIR signal intensity and enlargement of the inferior olive. There are two main conditions in which hypertrophic degeneration of the inferior olive occurs. The most frequent, studied, and reported condition is the development of PT/OPT and hypertrophic degeneration of the inferior olive in the weeks or months following a structural brainstem or cerebellar lesion. This “symptomatic” condition requires a destructive lesion in the Guillain–Mollaret pathway, which spans from the contralateral dentate nucleus via the brachium conjunctivum and the ipsilateral central tegmental tract innervating the inferior olive. The most frequent etiologies of destructive lesion are stroke (hemorrhagic more often than ischemic), brain trauma, brainstem tumors, and surgical or gamma knife treatment of brainstem cavernoma. The most accepted explanation for this symptomatic PT/OPT is that denervated olivary neurons released from inhibitory inputs enlarge and develop sustained synchronized oscillations. The cerebellum then modulates/accentuates this signal resulting in abnormal motor output in the branchial arches. In a second condition, PT/OPT and progressive cerebellar ataxia occurs in patients without structural brainstem or cerebellar lesion, other than cerebellar atrophy. This syndrome of progressive ataxia and palatal tremor may be sporadic or familial. In the familial form, where hypertrophic degeneration of the inferior olive may not occur (or not reported), the main reported etiologies are Alexander disease, polymerase gamma mutation, and spinocerebellar ataxia type 20. Whether or not these are associated with specific degeneration of the dentato–olivary pathway remain to be determined. The most symptomatic consequence of OPT is eye oscillations. Therapeutic trials suggest gabapentin or memantine as valuable drugs to treat eye oscillations in OPT.

show abstract

Section: Treatmentmentioning

confidence: 99%

Hypertrophic Olivary Degeneration and Palatal or Oculopalatal Tremor

2017

View full text Add to dashboard Cite

show abstract

“…For drug treatment of pendular nystagmus gabapentin (900–1,200 mg/day, class II evidence [217], class III evidence [218]) or memantine (40–60 mg/day, class III evidence [219]) should be used. Scopolamine adhesives, vigabatrin or baclofen are not effective.…”

Section: Oculomotor Symptomsmentioning

confidence: 99%

Symptomatic Treatment of Multiple Sclerosis

2006

View full text Add to dashboard Cite

Besides immunomodulation and immunosuppression, the specific treatment of symptoms is an essential component of the overall management of multiple sclerosis (MS). Symptomatic treatment is aimed at the elimination or reduction of symptoms impairing the functional abilities and quality of life of the affected patients. Moreover, with symptomatic treatment the development of a secondary physical impairment due to an existing one may be avoided. Many therapeutic techniques as well as different drugs are used for the treatment of MS symptoms, but only a few of them have been investigated, especially in MS patients, and are approved by the national health authorities. Despite an overwhelming number of publications, only a few evidence-based studies exist and consensus reports are very rare, too. Therefore, it seemed necessary to develop a consensus statement on symptomatic treatment of MS comprising existing evidence-based literature as well as therapeutic experience of neurologists who have dealt with these problems over a long time. This consensus paper contains proposals for the treatment of the most common MS symptoms: disorders of motor function and coordination, of cranial nerve function, of autonomic, cognitive, and psychological functions as well as MS-related pain syndromes and epileptic seizures.

show abstract

“…nystagmus [73][74][75]. Recent studies have shown the efficacy of the aminopyridines in the treatment of cerebellar nystagmus [75][76][77][78][79].…”

Section: Mechanicsmentioning

confidence: 99%

Eye Movement Research in the Twenty-First Century—a Window to the Brain, Mind, and More

Shaikh

Zee

2017

Cerebellum

View full text Add to dashboard Cite

The study of eye movements not only addresses debilitating neuro-ophthalmological problems but has become an essential tool of basic neuroscience research. Eye movements are a classic way to evaluate brain function-traditionally in disorders affecting the brainstem and cerebellum. Abnormalities of eye movements have localizing value and help narrow the differential diagnosis of complex neurological problems. More recently, using sophisticated behavioral paradigms, measurement of eye movements has also been applied to disorders of the thalamus, basal ganglia, and cerebral cortex. Moreover, in contemporary neuroscience, eye movements play a key role in understanding cognition, behavior, and disorders of the mind. Examples include applications to higher-level decision-making processes as in neuroeconomics and psychiatric and cognitive disorders such as schizophrenia and autism. Eye movements have become valued as objective biomarkers to monitor the natural progression of disease and the effects of therapies. As specific genetic defects are identified for many neurological disorders, ocular motor function often becomes the cornerstone of phenotypic classification and differential diagnosis. Here, we introduce other important applications of eye movement research, including understanding movement disorders affecting the head and limbs. We also emphasize the need to develop standardized test batteries for eye movements of all types including the vestibulo-ocular responses. The evaluation and treatment of patients with cerebellar ataxia are particularly amenable to such an approach.Keywords Saccade . Vestibulo-ocular reflex . Pursuit Eye movements are critical for the survival of any animal that sees. Promptly bringing an image to the fovea of an object that suddenly intrudes into one's periphery, and then keeping the image stable on the fovea, allows the cognitive brain to analyze the visual scene in a tenth of a second. In this way, it can generate an immediate, and sometimes life or death, decision whether to flee, fight, embrace, or just do nothing. Neural correlates of eye movements are found in almost every corner of the brain, helping to provide the most reliable information from our visual systems for all aspects of behavior.Using eye movements to understand human disease extends back to at least the mid-nineteenth century when early reports of strabismus [1][2][3][4][5] and nystagmus [4,[6][7][8][9][10][11][12][13] appeared. Nevertheless, in the years following, for almost another century, the literature on eye movements was meager. In the mid1940s, however, the number of publications on nystagmus and strabismus began to grow (https://www.ncbi.nlm.nih. gov/pubmed/?term = nystagmus, https://www.ncbi.nlm.nih. gov/pubmed/?term = strabismus), and in the mid-1960s, there was another growth spurt with more studies reporting various types of dysfunction of eye movements in conditions affecting the brainstem or cerebellum. Topics such as adaptive control of eye movements and the central role of normal and

show abstract

A double‐blind controlled study of gabapentin and baclofen as treatment for acquired nystagmus

Cited by 183 publications

References 28 publications

Hypertrophic Olivary Degeneration and Palatal or Oculopalatal Tremor

Hypertrophic Olivary Degeneration and Palatal or Oculopalatal Tremor

Symptomatic Treatment of Multiple Sclerosis

Eye Movement Research in the Twenty-First Century—a Window to the Brain, Mind, and More

Contact Info

Product

Resources

About