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Suggest Treatment For Oculogyric Crisis

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Posted on Wed, 7 Dec 2016
Question: My autistic son who 16 and is non verbal is having an issue. His eyes look upward for long periods of time in the afternoon to evening. When it is happening it is like he is fighting to look straight. He can look straight during this but it is a struggle. This seems to happen for a few hours for a few days and then goes away for months. He is fully conscience, can follow all instructions. He can eat, walk, follow any instruction while this is happening. What could cause this and how do we deal with it.


Oh and he is on 15 MG a day of Abilify.
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Answered by Dr. Dariush Saghafi (2 hours later)
Brief Answer:
Oculoyric crisis

Detailed Answer:
Good afternoon. Your son's eye movement problem is consistent with a condition known as OCULOGYRIC CRISIS and is seen primarily with certain types of medications used for psychiatric issues. It occurs as the manifestation of a phenomenon known as DYSTONIA and in this case for some reason some patients are particularly susceptible to medication effects of their eyes. It could involve other parts of their bodies as well but is most uncomfortable and noticeable in the eyes.

When the medication begins to wear down in terms of serum concentration the problem relaxes....after the next dose...within 30-120 min. it starts back up again. His episodes are likely linked to when he started Abilify or within a time period from that time unless there are other medications he's on which you've not mentioned.

The treatment is preferably withdrawal of the medication and search for a reasonable substitute. Or the use of something on the order of either promethazine or benadryl. If your doctor who prescribed this medication is unaware of this type of effect then, he can look at this particle article that was written about a patient suffering the same sort of thing. The difference in this patient is that they were suffering from schizophrenia....but the particular problem the patient has doesn't matter.....it's the medication that is doing what it's doing.

J Pharmacol Pharmacother. 2012 Jul;3(3):279-81. doi: 10.4103/0976-500X.99446.
Aripiprazole-induced oculogyric crisis (acute dystonia).
Bhachech JT1.

This is not as uncommon as you may think and in my patients I've always seen quick and definitive resolution in short order after the medication has been stopped. I would prefer to see patients such as your son with autism treated with alternative means of personal intervention as opposed to using drugs...unless of course, the Abilify really makes a world of difference to his behavior or learning processes.....in the patients I typically see....it's generally very little to nothing....but I'm actually a bit of a fan of Abilify compared to other things.....except when it causes OCULOGYRIC CRISIS! :)

Cheers!

If I've adequately answered your questions could you do me a huge favor by CLOSING THE QUERY and being sure to include some fine words of feedback along with a 5 STAR rating if you feel my suggestions have helped? Again, many thanks for posing your questions and please let me know how things turn out.

Do not forget to contact me in the future at: www.bit.ly/drdariushsaghafi for additional questions, comments, or concerns having to do with this topic or others.

This query has utilized a total of 15 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Dariush Saghafi

Neurologist

Practicing since :1988

Answered : 2473 Questions

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Suggest Treatment For Oculogyric Crisis

Brief Answer: Oculoyric crisis Detailed Answer: Good afternoon. Your son's eye movement problem is consistent with a condition known as OCULOGYRIC CRISIS and is seen primarily with certain types of medications used for psychiatric issues. It occurs as the manifestation of a phenomenon known as DYSTONIA and in this case for some reason some patients are particularly susceptible to medication effects of their eyes. It could involve other parts of their bodies as well but is most uncomfortable and noticeable in the eyes. When the medication begins to wear down in terms of serum concentration the problem relaxes....after the next dose...within 30-120 min. it starts back up again. His episodes are likely linked to when he started Abilify or within a time period from that time unless there are other medications he's on which you've not mentioned. The treatment is preferably withdrawal of the medication and search for a reasonable substitute. Or the use of something on the order of either promethazine or benadryl. If your doctor who prescribed this medication is unaware of this type of effect then, he can look at this particle article that was written about a patient suffering the same sort of thing. The difference in this patient is that they were suffering from schizophrenia....but the particular problem the patient has doesn't matter.....it's the medication that is doing what it's doing. J Pharmacol Pharmacother. 2012 Jul;3(3):279-81. doi: 10.4103/0976-500X.99446. Aripiprazole-induced oculogyric crisis (acute dystonia). Bhachech JT1. This is not as uncommon as you may think and in my patients I've always seen quick and definitive resolution in short order after the medication has been stopped. I would prefer to see patients such as your son with autism treated with alternative means of personal intervention as opposed to using drugs...unless of course, the Abilify really makes a world of difference to his behavior or learning processes.....in the patients I typically see....it's generally very little to nothing....but I'm actually a bit of a fan of Abilify compared to other things.....except when it causes OCULOGYRIC CRISIS! :) Cheers! If I've adequately answered your questions could you do me a huge favor by CLOSING THE QUERY and being sure to include some fine words of feedback along with a 5 STAR rating if you feel my suggestions have helped? Again, many thanks for posing your questions and please let me know how things turn out. Do not forget to contact me in the future at: www.bit.ly/drdariushsaghafi for additional questions, comments, or concerns having to do with this topic or others. This query has utilized a total of 15 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.