Acute Pain
Volume 10, Issue 2 , Pages 93-95, June 2008

Downbeat nystagmus related with epidural opioid side effect

  • Gema Ruíz

      Affiliations

    • Department of Anaesthesiology, Hospital Universitario Doce de Octubre, Madrid, Spain
    • Corresponding Author InformationCorresponding author at: Hospital Universitario Doce de Octubre, Department of Anaesthesiology, Avda. Andalucía s/n, Km:5.4, CP: 28041 Madrid, Spain. Tel.: +34 91 390 82 43; fax: +34 91 390 80 18.
    • ,
  • Alejandro Orts

      Affiliations

    • Department of Anaesthesiology, Hospital Universitario Doce de Octubre, Madrid, Spain
    • ,
  • Juan Monsalve

      Affiliations

    • Department of Ophthalmology, Hospital Virgen de la Concha, Zamora, Spain
    • ,
  • Pilar Aliste

      Affiliations

    • Department of Anaesthesiology, Hospital Universitario Doce de Octubre, Madrid, Spain
    • ,
  • Adam Ross

      Affiliations

    • Bristol Eye Hospital, Bristol, UK
    • ,
  • Blanca Monsalve

      Affiliations

    • Bristol Eye Hospital, Bristol, UK

Received 17 October 2007; received in revised form 27 February 2008; accepted 7 March 2008.

Summary 

Background

Downbeat nystagmus is a vertical downlook nystagmus associated with craniocervical injury or pharmacological intoxications.

Case report

We describe a clinical case of a patient who presented with a downbeat nystagmus as the only side effect associated with the use of epidural morphine. The vertical oscillopsia resolved when epidural morphine was withdrawn.

Conclusions

Downbeat nystagmus is an unfrequent complication but should be considered when utilising perineural morphine anaesthesia. A thorough differential diagnosis should be done previously too.

Keywords: Nystagmus, Epidural morphine, Epidural complication, Vertical oscillopsia

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PII: S1366-0071(08)00046-6

doi:10.1016/j.acpain.2008.03.001

Acute Pain
Volume 10, Issue 2 , Pages 93-95, June 2008

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