A 6-month trial of memantine for nystagmus and associated phenomena in oculopalatal tremor

• Type: Article in International Scientific Journal
• Date: 2022

Authors

Martins, AI (Author) Other; Ricardo Soares dos Reis (Author) FMUP; Jorge, A (Author) Other; Duque, C (Author) Other; Pereira, DJ (Author) Other; Ribeiro, CF (Author) Other; Sargento Freitas, J (Author) Other; Matos, A (Author) Other; Negrao, L (Author) Other; Lemos, J (Author) Other

Journal

Title: Frontiers in Neurology

Vol. 13

ISSN: 1664-2295

Publisher: Frontiers Media

Indexing

ISI Web of Knowledge - 0 Citations

Scopus

Other information

Authenticus ID: P-00X-4DX

DOI: 10.3389/fneur.2022.921341

Abstract (EN): IntroductionOculopalatal tremor (OPT) is a late manifestation of a Guillain-Mollaret triangle lesion. Memantine has been shown to improve nystagmus in OPT, but its long-term efficacy and putative distinct effects on each plane of nystagmus and on associated phenomena (e.g., gravity perception) are largely unknown. MethodsWe conducted a 6-month open-label study to evaluate the effect of memantine in OPT patients. Baseline (visit 1), 2 (visit 2), and 6 months (visit 3) assessments included video-oculography, best corrected visual acuity (BCVA), visual function questionnaire (VFQ25), palatal tremor frequency, and subjective visual vertical (SVV). Memantine was titrated to 20 mg per day and stopped after 6 months. ResultsWe included six patients (5 females; mean age 68.5+/-9.7). At visit 2, nystagmus improved >50% only along the horizontal plane in two patients, while worsening >50% along the vertical and horizontal planes in 4 and 1 patients, respectively. At visit 3, previous improvement of nystagmus along the horizontal plane in two patients was not sustained, and it further worsened >50% along the vertical plane in 4. The mean vertical velocity and amplitude of nystagmus in the left eye significantly worsened from visit 2 to visit 3 (p = 0.028). Throughout the study, nystagmus frequency remained unchanged (p = 0.074), BCVA improved in both eyes (p = 0.047, p = 0.017), SVV progression was unpredictable (p = 0.513), and the mean VFQ-25 score (p = 0.223) and mean palatal frequency remained unchanged. ConclusionThe long-term use of memantine 20 mg per day in OPT produced a modest and only transient improvement in nystagmus, predominantly along the horizontal plane. Visual acuity improved, albeit without relevant changes in vision-related quality of life.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 10