Saccadic oscillations as a possible indicator of dizziness due to choline esterase inhibitors: an observational study with video-oculography

Introduction: Cholinesterase inhibitors (ChEIs) are widely used to treat mild to moderate Alzheimer disease and vascular dementia. Even though dizziness due to medication of ChEIs has been ascribed to adverse effects on the cardiovascular or central nervous system, the mechanisms remain unclear and objective indicators are not available. Methods: We recorded the eye movements using video-oculography in three patients who developed dizziness and unsteadiness after initiation or increment of ChEI, donepezil (Aricept). Results: The patients showed frequent saccadic oscillations that improved after discontinuation of ChEI. Conclusions: Frequent saccadic oscillations may be an indicator of dizziness in patients taking ChEIs.