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Oral gabapentin treatment for symptomatic Heimann-Bielschowsky phenomenon
Waheeda Rahman1, Frank Proudlock, Irene Gottlob
1Department of Ophthalmology, University Hospitals of Leicester, Leicester, United Kingdom.
Purpose:
To describe a patient with symptomatic Heimann-Bielschowsky phenomenon (HBP) treated successfully with oral gabapentin.
Design:
Interventional case report.
Methods:
A 57-year-old patient with retinitis pigmentosa had a 12-month history of vertical oscillopsia. The right visual acuity was 20/200 and the left visual acuity was 20/60 with glasses. He had a coarse, slow, pendular, vertical movement of the right eye consistent with Heimann-Bielschowsky phenomenon. His treatment commenced with oral gabapentin with gradual increase in dose to 2400 mg/d. Eye movement recordings were performed before and after treatment.
Results:
He became considerably less symptomatic on gabapentin. The right visual acuity improved to 20/80 with glasses. Eye movement recordings confirmed markedly reduced vertical oscillations of the right eye. The patient continues on gabapentin with no side effects and sustained effect.
Conclusions:
The vertical nystagmoid movement in HBP can be considerably reduced and symptoms remarkably improved when treated with oral gabapentin.
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