Oral gabapentin treatment for symptomatic Heimann-Bielschowsky phenomenon.

Abstract

To describe a patient with symptomatic Heimann-Bielschowsky phenomenon (HBP) treated successfully with oral gabapentin. Interventional case report. A 57-year-old patient with retinitis pigmentosa had a 12-month history of vertical oscillopsia. The right visual acuity was 20/200 and the left visual acuity was 20/60 with glasses. He had a coarse, slow, pendular, vertical movement of the right eye consistent with Heimann-Bielschowsky phenomenon. His treatment commenced with oral gabapentin with gradual increase in dose to 2400 mg/d. Eye movement recordings were performed before and after treatment. He became considerably less symptomatic on gabapentin. The right visual acuity improved to 20/80 with glasses. Eye movement recordings confirmed markedly reduced vertical oscillations of the right eye. The patient continues on gabapentin with no side effects and sustained effect. The vertical nystagmoid movement in HBP can be considerably reduced and symptoms remarkably improved when treated with oral gabapentin.