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Pendular nystagmus in patients with peroxisomal assembly disorder
A A Kori1, N H Robin, J B Jacobs
1Department of Neurology, University Hospitals of Cleveland, Ohio 44106, USA.
Background:
Pendular nystagmus commonly occurs in congenital and acquired disorders of myelin.
Objective:
To characterize the nystagmus in 3 siblings with an infantile form of an autosomal recessive peroxisomal assembly disorder causing leukodystrophy.
Design:
We examined visual function and measured eye movements using infrared oculography. We noted changes in eye speed and frequency before and after the administration of gabapentin to 1 patient.
Results:
All 3 siblings showed optic atrophy and pendular nystagmus that was predominantly horizontal, at a frequency of 3 to 6 Hz, with phase shifts of 45 degrees to 80 degrees between the oscillations of each eye. Gabapentin administered to 1 child caused a modest improvement of vision and the reduction of the velocity and frequency of oscillations in the eye with worse nystagmus.
Conclusion:
The pendular nystagmus in these patients was due to their leukodystrophy and may have a similar pathogenesis to the oscillations seen in other disorders affecting central myelin.