Peribulbar Botulinum Toxin As A Treatment For Symptomatic Opsoclonus In Oculopalatal Myoclonus

Oculopalatal myoclonus is the result of a lesion of the dento-rubro-olivary tract in the brainstem and is characterized by rhymical movements of the soft palate and pendular vertical nystagmus.1 The acquired nystagmus results in debilitating oscillopsia. Various pharmacologic agents and surgical techniques have been employed to alleviate these symptoms with limited success. There have been very few reports of treatment with retrobulbar botulinum injection in the literature. 1,2 We describe a case of oculopalatal myoclonus in which peribulbar botulinum toxin injection was extremely successful in alleviating nystagmus and improving visual acuity.