Key result
A 26-year-old female who developed ping-pong gaze after a phenelzine overdose experienced spontaneous termination of the gaze and complete neurologic recovery following supportive care.
Case Report (n=1)
No
Ping-pong gaze secondary to MAOI toxicity can present with complete neurologic recovery, unlike when caused by irreversible structural brain damage.
May indicate reversible ping-pong gaze in MAOI overdose; leaves open distinction from structural causes.
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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Attaway et al. (2016) conducted a case report in Monoamine oxidase inhibitor (MAOI) overdose (n=1). Phenelzine overdose was evaluated on Neurologic recovery and resolution of ping-pong gaze. A 26-year-old female who developed ping-pong gaze after a phenelzine overdose experienced spontaneous termination of the gaze and complete neurologic recovery following supportive care.
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