Botox is of very limited use for nystagmus
A lot of people ask the Nystagmus Network about botulinum toxin as a possible treatment for nystagmus. So I talked to John Lee, a consultant ophthalmologist at Moorfields Eye Hospital in London who treats a small number of patients with botox. Why only a small number? Simple - botox only helps a subset of people who have Acquired Nystagmus (AN). It does not have any benefits for people with congenital nystagmus (CN).
Here's what Mr Lee said: "The only type of nystagmus for which it (botox) is an indication at all is acquired nystagmus due to neurological disease in adults. It has nothing to do with CN or with other kinds of benign nystagmus. Essentially it is only for nystagmus related to brain damage. The commonest causes of that are multiple sclerosis -- where they have fairly advanced MS – and some situations where there has been either a trauma or a brain stem haemorrhage or something of that nature. Then you can also get AN.
In this situation the individual is aware of the world wobbling around – they get the symptom called oscillopsia – and that is what you are trying to treat. It has no application anywhere else whatsoever."
This is an extract from a longer article in the summer 2009 issue of NN’s Focus newsletter. The article looks at how exactly botox works, where the injection goes, how often you need a repeat dose, what the disadvantages are and exactly who is most likely to benefit.
© John Sanders, 2009
Email: John Sanders
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