Superior oblique myokymia, a review

Area of Science:

• Ophthalmology
• Neuro-ophthalmology

Background:

• Superior oblique myokymia (SOM) is a rare, monocular condition affecting healthy adults.
• Characterized by involuntary, rapid, jerky movements of the superior oblique muscle.

Purpose of the Study:

• To review the proposed pathophysiology of SOM.
• To describe the typical clinical presentation and diagnostic findings.
• To discuss current workup and treatment strategies for SOM.

Main Methods:

• Literature review of proposed pathophysiology.
• Clinical case reviews for typical presentation.
• Analysis of diagnostic criteria and examination findings.
• Review of established and emerging treatment options.

Main Results:

• Treatment spectrum includes observation, reassurance, topical/systemic medications.
• Strabismus surgery and neurosurgery are reserved for refractory cases or medication intolerance.
• Diagnostic key features involve clinical history and specific examination findings.

Conclusions:

• The episodic nature of SOM contributes to under-diagnosis.
• Early recognition of key clinical features is crucial for timely diagnosis.
• A range of therapeutic interventions are available, tailored to patient response and tolerance.