Amitriptyline Ophthalmoplegia

Excerpt

To the editor: Oculovestibular (caloric) testing is a useful procedure to determine the integrity of the ocular motor system in a comatose patient. Absence of an oculovestibular response is considered to occur only in deep metabolic coma or in the near terminal stages of rostral-caudal deterioration from structural lesions. Mladinich and Carlow (1) have reported a case of total gaze paralysis in light coma due to amitriptyline poisoning. We report here a second such case with prompt resolution of the paralysis after physostigmine administration.

A 52-year-old woman telephoned for an ambulance after taking an overdose of drugs. She was comatose