@article {Dieterich627, author = {M Dieterich and A Straube and T Brandt and W Paulus and U B{\"u}ttner}, title = {The effects of baclofen and cholinergic drugs on upbeat and downbeat nystagmus.}, volume = {54}, number = {7}, pages = {627--632}, year = {1991}, doi = {10.1136/jnnp.54.7.627}, publisher = {BMJ Publishing Group Ltd}, abstract = {The GABAergic drug baclofen and the cholinergic drug physostigmine were administered to patients with upbeat and downbeat nystagmus. Baclofen (orally, 5 mg three times daily) reduced nystagmus slow phase velocity and distressing oscillopsia by 25-75\% in four out of five patients (two upbeat nystagmus; two downbeat nystagmus). Physostigmine (1 mg single intravenous injection) increased nystagmus in five additional patients with downbeat (1) or positional downbeat nystagmus (4) for a duration of 15-20 minutes. The different interactions of baclofen and physostigmine on neurotransmission subserving vertical vestibulo-ocular reflex could account for these effects. The response to baclofen appears to be a GABA-B-ergic effect with augmentation of the physiological inhibitory influence of the vestibulo-cerebellum on the vestibular nuclei. Similarly baclofen has an inhibitory effect on the velocity storage mechanism. Cholinergic action may cause the increment of nystagmus by physostigmine.}, issn = {0022-3050}, URL = {https://jnnp.bmj.com/content/54/7/627}, eprint = {https://jnnp.bmj.com/content/54/7/627.full.pdf}, journal = {Journal of Neurology, Neurosurgery \& Psychiatry} }