Superior oblique myokymia: Difference between revisions
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| caption = 6 = [[Superior oblique muscle]] |
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'''Superior oblique myokymia''' is a [[neurological]] disorder affecting [[vision]] and was |
'''Superior oblique myokymia''' is a [[neurological]] disorder affecting [[Visual perception|vision]] and was named by Hoyt and Keane in 1970.<ref>{{cite journal| vauthors = Hoyt WF, Keane JR| title = Superior oblique myokymia. Report and discussion on five cases of benign intermittent uniocular microtremor| journal = Arch. Ophthalmol.| volume = 84| issue = 4| pages = 461–7|date=October 1970| pmid = 5492451| doi=10.1001/archopht.1970.00990040463011}}</ref> |
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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. |
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. |
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[[File:Vision alterada por SOM diurno.jpg|thumb|Altered vision by SOM during daylight driving.]] |
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[[File:Vision alterada por SOM nocturno.jpg|thumb|Altered vision by SOM during night driving.]] |
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==Causes== |
==Causes== |
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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.<ref>{{cite journal |
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.<ref>{{cite journal| author = Bringewald PR| title = Superior oblique myokymia| journal = Arch. Neurol.| volume = 40| issue = 8| page = 526|date=August 1983| pmid = 6870617| doi=10.1001/archneur.1983.04210070066021}}</ref> By 1998, there had been only one reported case of compression of the trochlear nerve by vessels.<ref name="Sam">{{cite journal |vauthors=Samii M, Rosahl SK, Carvalho GA, Krzizok T |title=Microvascular decompression for superior oblique myokymia: first experience. Case report |journal=J. Neurosurg. |volume=89 |issue=6 |pages=1020–24 |year=1998 |pmid=9833830 |doi=10.3171/jns.1998.89.6.1020}}</ref><ref name="Rem">{{cite journal |vauthors=Scharwey K, Krzizok T, Samii M, Rosahl SK, Kaufmann H |title=Remission of superior oblique myokymia after microvascular decompression |journal=Ophthalmologica |volume=214 |issue=6 |pages=426–28 |year=2000 |pmid=11054004 |doi=10.1159/000027537|s2cid=35862822 }}</ref> |
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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.<ref>{{cite |
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.<ref>{{cite journal| vauthors = Yousry I, Dieterich M, Naidich TP, Schmid UD, Yousry TA| title = Superior oblique myokymia: magnetic resonance imaging support for the neurovascular compression hypothesis| journal = Ann. Neurol.| volume = 51| issue = 3| pages = 361–68|date=March 2002| pmid = 11891831| doi = 10.1002/ana.10118| s2cid = 23905926| doi-access = free}}</ref> |
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==Diagnosis== |
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{{Empty section|date=October 2017}} |
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==Treatment== |
==Treatment== |
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Treatment can include pharmaceutical or surgical means. The drug |
Treatment can include pharmaceutical or surgical means. The drug [[carbamazepine]] (Tegretol) has been used successfully. Other drugs with variable success include [[gabapentin]] and, recently,{{when?|date=April 2020}} [[memantine]]. Successful surgery options include superior oblique tenectomy accompanied by inferior oblique myectomy.<ref>{{cite web |url=http://telemedicine.orbis.org/bins/volume_page.asp?cid=735-954-1328-1350&lang=1 |title=Superior Oblique Myokymia 379.58 |accessdate=2007-06-25 |format= |website=}}</ref> However, "[o]verall, the bulk of the ophthalmic literature would agree with the viewpoint that invasive craniotomy surgical procedures should be justified only by the presence of intractable and absolutely unbearable symptoms."<ref>''J Optom.'' 2014; 7:68–74 Vol. 7 Num. 2 {{doi|10.1016/j.optom.2013.06.004}}</ref> |
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Samii et al<ref |
Samii et al.<ref name="Sam"/> and Scharwey and Samii<ref name="Rem"/> 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. |
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==References== |
==References== |
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{{Reflist |
{{Reflist}} |
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== External links == |
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{{Medical resources |
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==Other Resources== |
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* [http://groups.msn.com/Superiorobliquemyokymia/somqapage1.msnw SOMPeople™ FAQ page] |
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| ICD10 = {{ICD10|G|51|4|g|50}} |
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{{PNS diseases of the nervous system}} |
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[[Category:Eye diseases]] |
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{{disease-stub}} |
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[[Category: |
[[Category:Neuro-ophthalmology]] |
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Latest revision as of 16:57, 10 November 2023
| Superior oblique myokymia | |
|---|---|
 | |
| 6 = Superior oblique muscle | |
| Specialty | Neurology  |
Superior oblique myokymia is a neurological disorder affecting vision and was named 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 cause is benign and is not commonly associated with other disorders.
Causes[edit]
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]
Diagnosis[edit]
![[icon]](/wiki/File:Wiki_letter_w_cropped.svg){kind=small} | This section is empty. You can help by adding to it. (October 2017) |
Treatment[edit]
Treatment can include pharmaceutical or surgical means. The drug carbamazepine (Tegretol) has been used successfully. Other drugs with variable success include gabapentin and, recently,[when?] memantine. Successful surgery options include superior oblique tenectomy accompanied by inferior oblique myectomy.[6] However, "[o]verall, the bulk of the ophthalmic literature would agree with the viewpoint that invasive craniotomy surgical procedures should be justified only by the presence of intractable and absolutely unbearable symptoms."[7]
Samii et al.[3] and Scharwey and Samii[4] 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.
References[edit]
- ^ Hoyt WF, Keane JR (October 1970). "Superior oblique myokymia. Report and discussion on five cases of benign intermittent uniocular microtremor". Arch. Ophthalmol. 84 (4): 461–7. doi:10.1001/archopht.1970.00990040463011. PMID 5492451.
- ^ Bringewald PR (August 1983). "Superior oblique myokymia". Arch. Neurol. 40 (8): 526. doi:10.1001/archneur.1983.04210070066021. PMID 6870617.
- ^ a b Samii M, Rosahl SK, Carvalho GA, Krzizok T (1998). "Microvascular decompression for superior oblique myokymia: first experience. Case report". J. Neurosurg. 89 (6): 1020–24. doi:10.3171/jns.1998.89.6.1020. PMID 9833830.
- ^ a b Scharwey K, Krzizok T, Samii M, Rosahl SK, Kaufmann H (2000). "Remission of superior oblique myokymia after microvascular decompression". Ophthalmologica. 214 (6): 426–28. doi:10.1159/000027537. PMID 11054004. S2CID 35862822.
- ^ Yousry I, Dieterich M, Naidich TP, Schmid UD, Yousry TA (March 2002). "Superior oblique myokymia: magnetic resonance imaging support for the neurovascular compression hypothesis". Ann. Neurol. 51 (3): 361–68. doi:10.1002/ana.10118. PMID 11891831. S2CID 23905926.
- ^ "Superior Oblique Myokymia 379.58". Retrieved 2007-06-25.
- ^ J Optom. 2014; 7:68–74 Vol. 7 Num. 2 doi:10.1016/j.optom.2013.06.004