Abstract
We report two cases of non periodic alternating nystagmus, one of vascular origin (ischemia of the vertebrobasilar territory) and a second of traumatic origin (whiplash injury) with otoneurological signs, typical of lesions in posterior cranial fossa and in particular of vestibulum-cerebellum and brainstem: gaze paretic nystagmus, rebound nystagmus, saccadic dysmetria, vestibular hyperreflexia and impaired visual suppression test.
In one case it was possible to give baclofen therapy, which yielded positive results. Suspension of drug administration resulted in the worsening of clinical signs. The mechanism of action of the drug will be discussed.
Sommario
Gli autori riportano 2 casi di nistagmo alternante non periodico, uno di origine vascolare (ischemia nel territorio dell'arteria vertebro-basilare) ed il secondo di origine traumatica (colpo di frusta) con segni otoneurologici tipici di lesione della fossa cranica posteriore ed in particolare del vestibulum-cerebellum e del tronco (presenza di gaze paretic nystagmus, nistagmo di rimbalzo, dismetria saccadica, iperreflessia vestibolare ed alterazione del test di soppressione visuale.
In un caso è stato possibile somministrare baclofene che ha determinato un miglioramento della sintomatologia clinica e strumentale. La temporanea sospensione del farmaco è risultata in un peggioramento sia clinico che strumentale. È discusso il meccanismo di azione di tale farmaco.
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Nuti, D., Ciacci, G., Giannini, F. et al. Aperiodic alternating nystagmus: report of two cases and treatment by baclofen. Ital J Neuro Sci 7, 453–459 (1986). https://doi.org/10.1007/BF02283025
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DOI: https://doi.org/10.1007/BF02283025