Article · Volume 7, Issue 1 · pp. 34–37
“Ping‑pong gaze” secondary to monoamine oxidase inhibitor overdose
Amy Attaway1, Laila Sroujieh2, Tracey L. Mersfelder3, Christopher Butler4, Daniel Ouellette4
- 1Department of Pulmonary Critical Care, University Hospitals, Case Western Reserve University, Cleveland, Ohio, USA.
- 2Department of Pulmonary Critical Care, MetroHealth Medical Center, Cleveland, Ohio, University Hospitals, Case Western Reserve University, Cleveland, Ohio, USA.
- 3Department of Pharmacy, Ferris State University, Borgess Hospital, Kalamazoo, Michigan, USA.
- 4Pulmonary Critical Care, Henry Ford Health System, Detroit, USA.
Abstract
An infrequent manifestation of monoamine oxidase inhibitor (MAOI) toxicity is “ping-pong gaze” (PPG). We describe the case of a 26-year-old female who was found unresponsive after taking 40 tablets of phenelzine. On presentation to the hospital, her eyes were moving in characteristic “ping pong” fashion. After 6 hours her gaze terminated. The following day her neurologic exam was benign and she had no long-term sequelae. While the etiology of PPG is unknown, it is most often seen with irreversible structural brain damage. However, a detailed literature review revealed that previous cases of MAOI toxicity where the patient survived have all had complete neurologic recovery.
Keywords: Monoamine oxidase inhibitor toxicity; phenelzine; ping pong gaze; short‑cycle periodic alternating gaze
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