Ocular neuromyotonia

Practical Neurology
Ricardo Soares-Dos-ReisJoão Lemos

Abstract

Ocular neuromyotonia is a rare, albeit treatable, ocular motor disorder, characterised by recurrent brief episodes of diplopia due to tonic extraocular muscle contraction. Ephaptic transmission in a chronically damaged ocular motor nerve is the possible underlying mechanism. It usually improves with carbamazepine. A 53-year-old woman presented with a 4-month history of recurrent episodes of binocular vertical diplopia (up to 40/day), either spontaneously or after sustained downward gaze. Between episodes she had a mild left fourth nerve palsy. Sustained downward gaze consistently triggered downward left eye tonic deviation, lasting around 1 min. MR scan of the brain was normal. She improved on starting carbamazepine but developed a rash that necessitated stopping the drug. Switching to lacosamide controlled her symptoms.

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Jan 27, 2015·Epilepsy Research·Michael A RogawskiChristian Wolff
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Citations

Sep 16, 2018·Practical Neurology·Mark Lawden
May 3, 2019·JAMA Ophthalmology·Alexander GrosingerM Tariq Bhatti
Aug 17, 2020·Journal of Neuro-ophthalmology : the Official Journal of the North American Neuro-Ophthalmology Society·Nailyn Rasool, Creig S Hoyt
May 18, 2021·Journal of Neuro-ophthalmology : the Official Journal of the North American Neuro-Ophthalmology Society·Lanning B KlineMehdi Tavakoli
Jun 5, 2021·Surgical Neurology International·Yuto ShingaiTeiji Tominaga
Jun 16, 2021·Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology·J BashfordC E Shaw

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