TY  - JOUR
PY  - 2002//
TI  - External ophthalmoplegia caused by amitriptyline poisoning
JO  - Nervenarzt
A1  - von Stuckrad-Barre, S.
A1  - Wekerle, G.
A1  - Pfefferkorn, T.
A1  - Strupp, M.
SP  - 174
EP  - 176
VL  - 73
IS  - 2
N2  - 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>
LA  - de
SN  - 0028-2804
UR  - http://dx.doi.org/
ID  - ref1
ER  -