Pain-only decompression sickness affecting the orbicularis oculi

A case is reported of a diver who experienced the onset of pain in the left orbicularis oculi muscle approximately 20 min after surfacing from an experimental dive. A careful neurologic examination disclosed no abnormality. The response of the orbicularis oculi muscle to stimulation of the facial nerve and the blink reflex were both normal as recorded with a clinical neurophysiologic recording system (Nicolet CA 1000). The pain resolved quickly with recompression, supporting a diagnosis of pain-only decompression sickness in this small facial muscle.