Superior oblique myokymia (SOM) is a rare monocular motor disorder usually treated with carbamazepine.1 We describe a patient with SOM who failed to respond to carbamazepine but did achieve symptomatic control with a low dose of propranolol hydrochloride. To our knowledge, there has been no previously reported usage of propranolol in the treatment of SOM.
Report of a Case.
—A 22-year-old, healthy woman presented with a 2-year history of an intermittent "shaking up and down" of the left eye and occasional vertical diplopia. The diplopia resolved when the left eye was covered. The patient's medical history was unremarkable, and she took no regular medication other than an oral contraceptive. Complete ocular examination revealed no irregularities, except for an intermittent rotary nystagmus of the left eye observed with the slit lamp. Subsequent orthoptic examination, including saccadic velocity testing, confirmed a diagnosis of SOM.After obtaining satisfactory hepatic and blood study
Tyler TD, Ruiz RS. Propranolol in the Treatment of Superior Oblique Myokymia. Arch Ophthalmol. 1990;108(2):175-176. doi:10.1001/archopht.1990.01070040027015