title: "Ping-pong gaze" secondary to monoamine oxidase inhibitor overdose.
abstract: An infrequent manifestation of monoamine oxidase inhibitor (MAOI) toxicity is "ping-pong gaze" (PPG). We describe the case of a 26-year-old female who was found unresponsive after taking 40 tablets of phenelzine. On presentation to the hospital, her eyes were moving in characteristic "ping pong" fashion. After 6 hours her gaze terminated. The following day her neurologic exam was benign and she had no long-term sequelae. While the etiology of PPG is unknown, it is most often seen with irreversible structural brain damage. However, a detailed literature review revealed that previous cases of MAOI toxicity where the patient survived have all had complete neurologic recovery.
authors.affiliation: Department of Pulmonary Critical Care, University Hospitals, Case Western Reserve University, Cleveland, Ohio, USA.
authors.forename: Amy
authors.initials: A
authors.lastname: Attaway
authors.affiliation: Department of Pulmonary Critical Care, MetroHealth Medical Center, Cleveland, Ohio, USA.
authors.forename: Laila
authors.initials: L
authors.lastname: Sroujieh
authors.affiliation: Department of Pharmacy, Ferris State University, Borgess Hospital, Kalamazoo, Michigan, USA.
authors.forename: Tracey L
authors.initials: TL
authors.lastname: Mersfelder
authors.affiliation: Pulmonary Critical Care, Henry Ford Health System, Detroit, Michigan, USA.
authors.forename: Christopher
authors.initials: C
authors.lastname: Butler
authors.affiliation: Pulmonary Critical Care, Henry Ford Health System, Detroit, Michigan, USA.
authors.forename: Daniel
authors.initials: D
authors.lastname: Ouellette
keywords: Monoamine oxidase inhibitor toxicity; phenelzine; ping pong gaze; short-cycle periodic alternating gaze