Surgical treatment of trauma-induced periodic alternating nystagmus.
OBJECTIVE
To report a new treatment for acquired periodic alternating nystagmus in which medical therapy with baclofen was not tolerated.


METHODS
Interventional case report and literature review.


METHODS
Simultaneous adjustable bilateral retroequatorial horizontal rectus muscle recessions.


METHODS
Ocular alignment and ocular motility recordings.


RESULTS
A 30-year-old man had blurred vision after an emergency left temporal craniotomy for gunshot wounds. Ophthalmologic examination revealed periodic alternating nystagmus that was documented by an infrared electronystagmogram. Baclofen was started but was not tolerated. Bilateral lateral and medial retroequatorial rectus muscle recessions were performed and were successful in the treatment of this patient.


CONCLUSIONS
Simultaneous bilateral retroequatorial horizontal rectus recessions may be an effective treatment for intractable acquired periodic alternating nystagmus.
Castillo
Ivan G
IG
Neuro-Ophthalmology Service, Wills Eye Hospital, Thomas Jefferson Medical College, Philadelphia, Pennsylvania 19107-5598, USA.
Reinecke
Robert D
RD
Sergott
Robert C
RC
Wizov
Sheryl
S
D000328:Adult; D003399:Craniotomy; D004584:Electronystagmography; D020197:Head Injuries, Penetrating / Q000150:complications* / Q000601:surgery; D006801:Humans; D008297:Male; D009759:Nystagmus, Pathologic / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery*; D009801:Oculomotor Muscles / Q000601:surgery*; D013508:Ophthalmologic Surgical Procedures; D014948:Wounds, Gunshot / Q000150:complications* / Q000601:surgery