Year : 2016  |  Volume : 7  |  Issue : 1  |  Page : 34-37

”Ping-pong gaze” secondary to monoamine oxidase inhibitor overdose

1 Department of Pulmonary Critical Care, University Hospitals, Case Western Reserve University, Cleveland, Ohio, USA
2 Department of Pulmonary Critical Care, MetroHealth Medical Center, Cleveland, Ohio, USA
3 Department of Pharmacy, Ferris State University, Borgess Hospital, Kalamazoo, Michigan, USA
4 Pulmonary Critical Care, Henry Ford Health System, Detroit, Michigan, USA

Correspondence Address:
Amy Attaway
University Hospitals, Case Western Reserve University, 11100 Euclid Avenue, Cleveland, Ohio
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0976-500X.179360

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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.

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