Table 1

Summary of current drug treatments for nystagmus*

*For details see refs 2 and 3.
Vestibular forms of nystagmus
    Peripheral imbalanceDiphenhydramine, promethazine, prochlorperazine, ondansetron for relief of attendant vertigo and nausea; resume activities as soon as able
Central imbalance

  • Downbeat nystagmus

Clonazepam, baclofen, trihexyphenidyl; acetazolamide (for nystagmus associated with episodic ataxia type II)

  • Upbeat nystagmus

Baclofen
Central instability

  • Periodic alternating nystagmus

Baclofen
Nystagmus associated with visual system disorder

  • Seesaw nystagmus

Baclofen, clonazepam, alcohol, gabapentin
Nystagmus from disorders of the gaze holding mechanism

  • Acquired pendular nystagmus

In association with disease of central myelin: gabapentin, memantine, clonazepam, trihexyphenidyl, scopolamine; cannabis, alcohol
As part of the syndrome of oculopalatal tremor (“myoclonus”): gabapentin, valproate trihexyphenidyl
Saccadic intrusions and oscillations

  • Square wave jerks

Methylphenidate

  • Opsoclonus and ocular flutter

Clonazepam, popranolol, gabapentin, corticosteroids, intravenous immunoglobulin, plasma exchange
Miscellaneous abnormal movements

  • Superior oblique myokymia

Gabapentin, carbamazepine, popranolol

  • Ocular neuromyotonia

Carbamazepine