Superior oblique myokymia
From Wikipedia, the free encyclopedia
| Superior oblique myokymia Classification and external resources |
|
 |
|
|---|---|
| 6 = Superior oblique muscle |
Superior oblique myokymia is a neurological disorder affecting vision and was termed by Hoyt and Keane in 1970.[1]
It is a condition that presents as repeated, brief episodes of movement, shimmering or shaking of the vision of one eye, a feeling of the eye trembling, or vertical/tilted vision. It can present as one or more of these symptoms. Diagnosis is most often made by the elimination of other conditions, disorders or diseases.
Onset usually occurs in adulthood, and the course is benign and is not commonly associated with other disorders.
Contents |
[edit] Causes
In 1983, Bringewald postulated that superior oblique myokymia resulted from vascular compression of the trochlear nerve (fourth cranial nerve), which controls the action of the superior oblique muscle in the eye.[2] By 1998, there had been only one reported case of compression of the trochlear nerve by vessels.[3][4] More recently, magnetic resonance imaging experiments have shown that neurovascular compression at the root exit zone of the trochlear nerve can result in superior oblique myokymia.[5]
[edit] Treatment
Treatment can include pharmaceutical or surgical means. The drug Oral carbamazepine (Tegretol) has been used successfully. Other drugs used with variable success include gabapentin and, recently, memantine. Successful surgery options include superior oblique tenectomy accompanied by inferior oblique myectomy.[6]
Samii et al[7] and Scharwey and Samii[8] described a patient who had superior oblique myokymia for 17 years. The interposition of a Teflon pad between the trochlear nerve and a compressing artery and vein at the nerve's exit from the midbrain led to a remission lasting for a follow-up of 22 months.
[edit] References
- ^ Hoyt WF, Keane JR. (1970). "Superior oblique myokymia: report and discussion on five case of benign intermittent uniocular microtremor.". Arch Ophthalmol 84: 461–7.
- ^ Bringewald PR (1983). "Superior oblique myokymia". Arch Neurol 40: 526.
- ^ Samii M, Rosahl SK, Carvalho GA, Krzizok T (1998). "Microvascular decompression for superior oblique myokymia: first experience. Case report". J. Neurosurg. 89 (6): 1020–4. PMID 9833830.
- ^ Scharwey K, Krzizok T, Samii M, Rosahl SK, Kaufmann H (2000). "Remission of superior oblique myokymia after microvascular decompression". Ophthalmologica 214 (6): 426–8. PMID 11054004.
- ^ Superior oblique myokymia: magnetic resonance imaging support for the neurovascular compression hypothesis PMID: 11891831. Retrieved on 2007-06-26.
- ^ Superior Oblique Myokymia 379.58. Retrieved on 2007-06-25.
- ^ Samii M, Rosahl SK, Carvalho GA, Krzizok T (1998). "Microvascular decompression for superior oblique myokymia: first experience. Case report". J. Neurosurg. 89 (6): 1020–4. PMID 9833830.
- ^ Scharwey K, Krzizok T, Samii M, Rosahl SK, Kaufmann H (2000). "Remission of superior oblique myokymia after microvascular decompression". Ophthalmologica 214 (6): 426–8. PMID 11054004.
