The Use of Botulinum Toxin in a Case of Acquired Periodic Alternating Nystagmus.

Botulinum toxin has an important role in the nystagmus and strabismus clinics. Depending on the circumstances, it may be used as either long term treatment, or for surgical planning to simulate the effects of surgery. In this case, the effects were equivalent to high dose of baclofen and four horizontal rectus muscles recessions, which she underwent when the effects of the botulinum toxin had worn off. Botulinum toxin could be considered as a treatment option in acquired PAN, particularly in women of childbearing age and/or if intolerant or refractory to medical treatment, but ideally not as a long-term treatment option.