Other patients have nystagmus, vertigo, tinnitus, diplopia or seizures. Patients with orbital issues of diplopia, eye proptosis, and visual loss will require ophthalmologic treatment. Side effects include dry mouth, cognitive disturbance, drowsiness, diplopia, glaucoma and urinary retention. Other symptoms may include increased irritability, vomiting, diplopia, seizures, twitching and myoclonus of the limbs. Ptosis and diplopia can also occur postoperatively, but this usually self-corrects. During attacks, they also have vertigo, nausea, vomiting, tinnitus and diplopia. People with exotropia often experience crossed diplopia. These include recurrent headache, lethargy, diplopia, and blurred vision, particularly with exercise or fasting. He never complained of headaches, transient visual obscurations, diplopia, pulsatile tinnitus or other visual changes. It can cause painless facial asymmetry, diplopia and enophthalmos. Onset is typically sudden with symptoms of horizontal diplopia. Thus, tumor growth can impinge nerve function and result in vision loss and diplopia. Temporary diplopia can also be caused by tired or strained eye muscles. Injection of the drug has been found to cause transient diplopia and brain stem dysfunction. Neurotoxic symptoms are however rare and have only included diplopia and dyspnoea.