Spector R H, Schnapper R
Neurology. 1981 Sep;31(9):1188-90. doi: 10.1212/wnl.31.9.1188.
Total external ophthalmoplegia, unresponsive to caloric stimulation, was observed in a gravid woman who had ingested approximately 1.0 to 1.5 gm of amitriptyline. The intravenous administration of 4.0 mg physostigmine salicylate (PS) produced a revival of consciousness and reflex activity but had no appreciable effect on ocular motility. A prior case report of amitriptyline-induced ophthalmoplegia in a patient who took lesser amounts of the medication described immediate restoration of eye movement with only 2 mg of intravenous PS. The action of the amitriptyline on the vestibuloocular reflex seems to involve cholinergic transmission and the effect of the drug may be dose related.
在一名摄入约1.0至1.5克阿米替林的孕妇中观察到完全性眼外肌麻痹，对冷热刺激无反应。静脉注射4.0毫克水杨酸毒扁豆碱（PS）后，患者意识和反射活动恢复，但对眼球运动无明显影响。先前有一例服用较少剂量阿米替林导致眼肌麻痹的病例报告，该患者静脉注射仅2毫克PS后眼动立即恢复。阿米替林对前庭眼反射的作用似乎涉及胆碱能传递，且药物作用可能与剂量有关。
