title: Surgical treatment of trauma-induced periodic alternating nystagmus.
abstract: 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.
authors.affiliation: Neuro-Ophthalmology Service, Wills Eye Hospital, Thomas Jefferson Medical College, Philadelphia, Pennsylvania 19107-5598, USA.
authors.forename: Ivan G
authors.initials: IG
authors.lastname: Castillo
authors.forename: Robert D
authors.initials: RD
authors.lastname: Reinecke
authors.forename: Robert C
authors.initials: RC
authors.lastname: Sergott
authors.forename: Sheryl
authors.initials: S
authors.lastname: Wizov
mesh_terms: 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