Congenital Nystagmus (Infantile Nystagmus) Medication

Updated: Jun 28, 2017
  • Author: Mark Ventocilla, OD, FAAO; Chief Editor: Edsel Ing, MD, MPH, FRCSC  more...
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Medication

Medication Summary

The only drugs used in the management of nystagmus are not useful in infants but are useful in adults with persistent nystagmus in which the motility disturbance itself is believed to cause visual impairment or other undesirable symptoms.

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Anticonvulsants

Class Summary

Agents acting through gabapentin binding sites that may activate voltage-gated calcium channels may be useful in treating nystagmus.

Gabapentin (Neurontin)

Has been shown to be useful in some adults with congenital nystagmus in improving symptoms. No studies have been done in children to date. Exact mechanism of action is unknown but thought to be due to its antiglutamatergic activity. Has been used successfully to treat adult acquired nystagmus in multiple sclerosis.

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Skeletal muscle relaxants

Class Summary

Agents used to treat reversible or intractable spasticity are helpful.

Baclofen (Lioresal)

May be effective in reducing nystagmus in adult patients with a history of idiopathic infantile nystagmus. Exact therapeutic mechanism unknown but may relate to inhibition of glutamate release rather than augmentation of GABA-ergic pathways as originally believed. It has been used to treat several types of nystagmus, most commonly PAN.

Improvements in nystagmus intensity appear within minutes and regress after several hours. Medication should not be taken at bedtime or other times when use of eyes is not anticipated.

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Neuromuscular Blocking Agents, Toxin

Class Summary

Agents that produce a state of muscle denervation are helpful.

OnabotulinumtoxinA (BOTOX®)

Used in treatment of nystagmus by injection into specific extraocular muscles and retrobulbar placement within the muscle cone.

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