@article{ref1,
title="External ophthalmoplegia caused by amitriptyline poisoning",
journal="Nervenarzt",
year="2002",
author="von Stuckrad-Barre, S. and Wekerle, G. and Pfefferkorn, T. and Strupp, M.",
volume="73",
number="2",
pages="174-176",
abstract="Drug-induced ocular motor disorders occurring during coma may be difficult to distinguish from structural cerebral lesions. We recently encountered a case of reversible amitriptyline-induced external ophthalmoplegia, which was first described by Mladinich and Carlow in 1977. We suggest that the mechanism for gaze paresis and loss of vestibulo-ocular reflex due to amitriptyline overdose involves the modulation of neurons of the pontine paramedian reticular formation, the rostral fasciculus longitudinalis medialis, and the vestibulo-ocular reflex. Clinical features that might be useful when distinguishing amitriptyline-induced ophthalmoplegia from structural brain lesions--such as basilar thrombosis--include the preservation of corneal response, purposeful withdrawal from noxious stimuli, rapid recovery within 24 hours, and the reversal of symptoms by physostigmine.<p /><p>Language: de</p>",
language="de",
issn="0028-2804",
doi="",
url="http://dx.doi.org/"
}