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Slow saccades and hypometria in anticonvulsant toxicity

From the Department of Neurology, University Hospitals of Cleveland, Case Western Reserve University, and the Ocular Motor Neurophysiology Laboratory, Veterans Administration Medical Center, Cleveland, OH.

We report a patient with abnormal saccades in association with anticonvulsant toxicity (phenytoin 27.5 µg/ml, phenobarbital 18.8 µg/ml). The patient looked toward visual targets either with multiple, small, hypometric saccades or with single slow saccades. These abnormalities resolved when anticonvulsant levels returned to therapeutic range. Thus, slow saccades may be clinical evidence of anticonvulsant toxicity.

Address correspondence and reprint requests to Dr. Leigh, Ocular Motor Neurophysiology Lab (127A), Veterans Administration Medical Center, Cleveland, OH 44106.

Supported in part by the Veterans Administration and the John P. Blair Research Fellowship (SET).

Accepted for publication March 26, 1984.