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Clinical and Oculographic Analysis of Inferior Oblique Myokymia
Ji-Yeong Jang1, Hyeshin Jeon, Seo-Young Choi
1Department of Neurology (J-YJ, S-YC, K-DC) and Ophthalmology (HJ), Pusan National University Hospital, Pusan National University School of Medicine and Biomedical Research Institute, Busan, Korea; and Department of Neurology (J-HC), Pusan National University School of Medicine, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea.
Abstract:
A 63-year-old man experienced transient vertical oscillopsia lasting several seconds for 2 months. Examination disclosed paroxysmal excyclotorsion of the right eye, spontaneously or triggered by adduction. Eye movements using 3D video-oculography showed intermittent, monocular phasic movements which consisted of excyclotorsion of the right eye mixed with a small amount of supraduction and abduction, and a tonic movement with excyclotorsion and slight elevation. Orbital and brain MRI was unremarkable. Administration of oxcarbazepine markedly decreased the severity and frequency of the episodes. The oculographic characteristics in our patient may indicate that inferior oblique myokymia may be attributed to aberrant, spontaneous discharges in the inferior oblique motor unit.
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