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Ocular neuromyotonia.

Ricardo Soares-Dos-Reis1,2, Ana Inês Martins3, Ana Brás3

  • 1Neurology Department, São João Hospital Centre, Porto, Portugal.

Practical Neurology
|February 23, 2018
PubMed
Summary
This summary is machine-generated.

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Ocular neuromyotonia causes brief, recurrent double vision due to eye muscle spasms. This rare disorder, possibly due to nerve damage, improved with lacosamide when carbamazepine caused a rash.

Area of Science:

  • Ophthalmology
  • Neurology

Background:

  • Ocular neuromyotonia is a rare disorder causing intermittent double vision.
  • It results from tonic extraocular muscle contraction, potentially due to ephaptic transmission in damaged nerves.

Observation:

  • A 53-year-old woman experienced recurrent vertical double vision and a left fourth nerve palsy.
  • Sustained downward gaze triggered a consistent downward deviation of the left eye.

Findings:

  • The patient's symptoms improved with carbamazepine but a rash necessitated discontinuation.
  • Lacosamide effectively controlled the ocular neuromyotonia symptoms.

Implications:

  • Carbamazepine is a common treatment for ocular neuromyotonia.
  • Lacosamide presents a viable alternative treatment option for patients intolerant to carbamazepine.
Keywords:
diplopialacosamideocular neuromyotoniatrochear nerve

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