Oscillopsia and pseudonystagmus in kidney transplant patients

PURPOSE: Modern immunosuppressants have improved the success of kidney tran splantation for renal failure patients. They also may induce neurotoxic eff ects including tremor. We report two cases of pseudonystagmus and oscillops ia in transplant patients caused by immunosuppressant-induced head tremor a nd gentamicin-induced vestibulotoxicity. METHODS: Case reports. Head tremor, static visual acuity, and dynamic visua l acuity were measured. Vestibular function was evaluated with ice water ca lorics. RESULTS: Both patients had significant head tremor and pseudonystagmus. Hea d stabilization improved static visual acuity, Dynamic visual acuity reveal ed a dr line and 10-line loss of visual acuity, respectively. CONCLUSIONS: These findings of pseudonystagmus and oscillopsia are likely t o become more prevalent as more renal failure patients receive transplants. Improvement may be seen with reduction of immunosuppressant, reduction of stimulant intake, use of medications to reduce head tremor, and vestibular rehabilitation, (C) 1999 by Elsevier Science Inc. All rights reserved.