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October 1970

Superior Oblique Myokymia: Report and Discussion on Five Cases of Benign Intermittent Uniocular Microtremor

Author Affiliations

San Francisco
From the Neuro-ophthalmology Service, departments of ophthalmology, neurology, and neurological surgery, University of California, San Francisco. Dr. Keane is now with the Department of Neurology, University of Southern California, Los Angeles.

Arch Ophthalmol. 1970;84(4):461-467. doi:10.1001/archopht.1970.00990040463011

Unique symptoms of brief (one to four second) recurring episodes of torsional diplopia with tremorous sensations in one eye, shimmering oscillopsia, or both, and uniocular signs of a high frequency (12 to 15 per second), pendular, low amplitude (1 to 20) vertical and rotary microtremor began spontaneously and persisted as a stereotyped ocular stabilization defect in five healthy adults (ages 23 to 45). Periodic intorsion of the affected eye and rapid phasic electromyographic activity in a superior oblique, and the absence of reciprocal phasic inhibition in its antagonist, suggested a nuclear (brain stem) disorder. The report describes the phenomenology and natural history of this symptomatically obtrusive, but previously undefined, benign myokymia-like syndrome of the superior oblique muscle.

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