Drug-Related Eyelid Nystagmus

Abstract

Carbamazepine and derivatives may induce eyelid nystagmus in the setting of acute intoxication. To the best of our knowledge, these are the first cases of drug-related eyelid nystagmus.

Reversible downbeat nystagmus induced by carbamazepine in a three‐year‐old child

“…& gaze-evoked nystagmus, saccade abnormalities (slowing, inaccuracy, prolonged latency), smooth pursuit impairment, total ophthalmoplegia, oculogyric crisis and eyelid nystagmus [2,[4][5][6][7][8]. The peculiarity of our patient is that this is the first paediatric case to be reported, yet combination therapy is widely used in infants and children with drug-resistant epilepsies.…”

Isolated Eyelid Nystagmus: Case Report and Nosological Considerations

“…Eyelid nystagmus was first recognized in 1916 by Pick 1 . Very few other cases have been reported, whose features are summed in Table 1 1–13 . Although the phenomenology shows resemblances in all cases, there are differential features that raise pathophysiological questions.…”

“…1 Very few other cases have been reported, whose features are summed in Table 1. [1][2][3][4][5][6][7][8][9][10][11][12][13] Although the phenomenology shows resemblances in all cases, there are differential features that raise pathophysiological questions. Some cases are coupled with the fast phase of ocular vertical nystagmus, which may point to an aberrant activation of the otherwise normally coordinated movement of the lids and eyes, reported in lesions possibly involving the ventral tegmental tract.…”

Unilateral Benign Gaze–Evoked and Convergence-Evoked Eyelid Nystagmus

“…Eyelid nystagmus has been associated with numerous pathological conditions, including midbrain tumors, pontine or mesencephalic hemorrhage, Wallenberg syndrome, pontomesencephalic stroke, cerebellar tumor and trauma, brainstem angioma, Miller-Fisher syndrome, and chronic alcohol abuse. Eyelid nystagmus was also described as a sign of drug intoxication (3).…”

“…The authors hypothesized that the abnormal lid movements somehow resulted from an abnormal innervational milieu created by the dorsal midbrain lesion involving cell bodies of neurons that bilaterally innervate the levator muscle in the central caudal nucleus (1). Matarazzo et al (3) presented 2 cases of ocular nystagmus and eyelid nystagmus in primary position exacerbated in the lateral gaze, induced by carbamazepine and oxcarbazepine intoxication. They suggested that impairment of pretectal pathways may be the cause.…”