Jove
Visualize
Contact Us
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

Related Experiment Videos

Amitriptyline-induced ophthalmoplegia

R H Spector, R Schnapper

    Neurology
    |September 1, 1981
    PubMed
    Summary
    This summary is machine-generated.

    Amitriptyline overdose can cause severe eye movement paralysis. Physostigmine salicylate (PS) revived consciousness but not eye movement in a high-dose case, suggesting a dose-dependent effect.

    Related Concept Videos

    You might also read

    Related Articles

    Articles linked to this work by shared authors, journal, and citation graph.

    Sort by
    Same author

    Vertical diplopia.

    Survey of ophthalmology·1993
    Same author

    Echographic diagnosis of dural carotid-cavernous sinus fistulas.

    American journal of ophthalmology·1991
    Same author

    Diplopia due to 4th nerve palsy and enlargement of the right medial rectus muscle.

    The Journal of rheumatology·1989
    Same author

    Minimal thyroid ophthalmopathy.

    Neurology·1987
    Same author

    Unilateral septic cavernous sinus thrombosis. A case report with digital orbital venographic documentation.

    Journal of clinical neuro-ophthalmology·1986
    Same author

    The "sinister" Tolosa-Hunt syndrome.

    Neurology·1986

    Area of Science:

    • Toxicology
    • Neuroscience
    • Pharmacology

    Background:

    • Amitriptyline is a tricyclic antidepressant with anticholinergic properties.
    • Anticholinergic toxicity can manifest with various neurological and physiological symptoms.
    • Ophthalmoplegia, or paralysis of eye muscles, is a rare but serious side effect.

    Observation:

    • A pregnant woman ingested a large dose (1.0-1.5 gm) of amitriptyline, developing total external ophthalmoplegia unresponsive to caloric stimulation.
    • Intravenous administration of 4.0 mg physostigmine salicylate (PS) resulted in improved consciousness and reflex activity.
    • However, physostigmine salicylate had no significant effect on the patient's ocular motility.

    Findings:

    • A previous case report of lower-dose amitriptyline ingestion showed immediate restoration of eye movement with 2 mg of PS.

    Related Experiment Videos

  • This suggests that the dose of amitriptyline may influence the efficacy of physostigmine salicylate in reversing ophthalmoplegia.
  • Amitriptyline's effect on the vestibuloocular reflex appears to involve cholinergic pathways.

    • Implications:

    • High-dose amitriptyline toxicity may present with profound ophthalmoplegia resistant to standard physostigmine salicylate treatment.
    • The dose-dependent nature of this effect warrants further investigation into the mechanisms of amitriptyline-induced anticholinergic toxicity.
    • Clinical management of severe amitriptyline overdose should consider the potential for persistent ocular motility dysfunction.