Dayanand Medical College, Ludhiana, India.
Sri Guru Ramdas Institute of Medical Sciences & Research, Amritsar, India.
J Clin Pharmacol. 2023 Dec;63(12):1324-1329. doi: 10.1002/jcph.2330. Epub 2023 Sep 2.
Amiodarone is an antiarrhythmic drug with a significant adverse effect profile, including neurotoxicity. While ataxia, neuropathy, and tremors are more commonly seen forms of amiodarone neurotoxicity, very few cases of nystagmus are reported. We report the case of an 86-year-old man who presented with abrupt-onset ataxia, dizziness, and inability to ambulate, 10 days after initiating amiodarone for atrial fibrillation. His examination revealed gaze-evoked nystagmus along with features of cerebellar dysfunction. After excluding other etiologies, amiodarone was stopped. His nystagmus resolved, and his ataxia improved within 48 h of stopping amiodarone. Due to the rarity of this drug-induced adverse effect, we performed a systematic review of available case reports in the literature (PubMed and Scopus) using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and presented our findings. Nystagmus is a rarely reported adverse effect of amiodarone, which can occur within days to months of starting the medication. Treatment includes stopping the drug and monitoring for resolution of nystagmus.
胺碘酮是一种抗心律失常药物，具有显著的不良反应谱，包括神经毒性。虽然眼球震颤是胺碘酮神经毒性更常见的形式，但很少有报道。我们报告了一例 86 岁男性的病例，他在开始胺碘酮治疗心房颤动 10 天后出现急性发作的共济失调、头晕和无法行走。他的检查显示眼球诱发的眼球震颤，伴有小脑功能障碍的特征。排除其他病因后，停止使用胺碘酮。在停止胺碘酮 48 小时内，他的眼球震颤消失，共济失调改善。由于这种药物引起的不良反应非常罕见，我们根据系统评价和荟萃分析的首选报告项目，在文献（PubMed 和 Scopus）中对可用的病例报告进行了系统回顾，并展示了我们的发现。眼球震颤是胺碘酮的一种罕见不良反应，可在开始用药后数天至数月内发生。治疗包括停止药物治疗和监测眼球震颤的消退。
