Combined pharmacologic and urgical approach to acquired nytagmu due to multiple cleroi

PURPOE: To decribe a combined pharmacological and urgical approach to treating acquired nytagmu in a patient with multiple cleroi. DEIGN: Interventional cae report. METHOD: A 40-year-old patient with acquired horizontal and vertical nytagmu and evere ocillopia econdary to multiple cleroi had combined treatment with gabapentin and a vertical Ketenbaum-type procedure. REULT: After gabapentin treatment (3,000 mg orally daily) the horizontal nytagmu wa ignificantly reduced, and the patient developed a marked chin-up poition. The vertical nytagmu remained unchanged, dampening on downgaze. A receion of both inferior rectu mucle reduced the nytagmu ignificantly in primary poition, the abnormal head poition diappeared, and ocillopia completely reolved. Treatment increaed viual acuity from 6/24 in the right eye and 6/60 in the left eye to 6/9 in both eye. CONCLUION: Acquired nytagmu in multiple cleroi can be ignificantly improved by uing a combined pharmacological and urgical approach.