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Neurologic Diagnosis
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
Become familiar (through YouTube videos) with other uncommon movements intruding on steady fixation, including square wave jerks, macrosaccadic oscillations, ocular flutter, opsoclonus, and superior oblique myokymia.
How to master MCQs
Published in Chung Nen Chua, Li Wern Voon, Siddhartha Goel, Ophthalmology Fact Fixer, 2017
Superior oblique myokymia is a rare disorder characterised by repetitive small amplitude oscillation of the globe. This oscillation may be vertical or oblique. The patient usually complains of diplopia, blurred vision or oscillopsia. The oscillation is best observed with a slit-lamp and can be heard with a stethoscope. It is often precipitated by reading. The condition is benign and a central nervous disorder is uncommon. Carbamazepine can reduce the oscillation.
Ocular Neuromyotonia: an update
Published in Expert Review of Ophthalmology, 2021
Subahari Raviskanthan, Peter W Mortensen, Andrew Lee
Superior oblique myokymia is a monocular disorder, manifesting as intermittent brief, high frequency, low amplitude torsional eye movements, thought to be because of altered membrane thresholds in the trochlear nerve [41]. Episodes are typically shorter, and the underlying pathophysiology is thought to be nerve injury or compression/irritation of the trochlear nerve from vascular compression [41]. Superior oblique myokymia is a phasic condition, compared to ONM which is a tonic condition [30]. Management can also include membrane stabilizing agents like carbamazepine, topical beta blocker eye drops, or surgical management for refractory cases [41].
Neuro-Ophthalmic Literature Review
Published in Neuro-Ophthalmology, 2022
David A. Bellows, Noel C.Y. Chan, John J. Chen, Hui-Chen Cheng, Peter W MacIntosh, Jenny A. Nij Bijvank, Michael S. Vaphiades, Xiaojun Zhang
Superior oblique myokymia (SOM) can cause monocular oscillopsia and vague symptoms of dizziness. It is characterised by monocular episodic contraction of the superior oblique muscle. Diagnosis is challenging, and sometimes binocular video-oculography or fundoscopic examination may better capture the high-frequency, low-amplitude movement. Possible treatment options include carbamazepine, gabapentin, baclofen and other medications, extraocular surgery, or microvascular decompression.
Neuro-Ophthalmic Literature Review
Published in Neuro-Ophthalmology, 2018
David Bellows, Noel Chan, John Chen, Hui-Chen Cheng, Panitha Jindahra, Peter MacIntosh, Axel Petzold, Michael Vaphiades, Konrad P. Weber
This is a well written and succinct review of the pathogenesis, manifestations, differential diagnosis, management and prognosis for superior oblique myokymia (SOM). The authors conducted a meta-analysis of all 116 published cases of SOM since the entity was first described by Duane in 1906.