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Related Experiment Videos

Gaze-induced strabismus

S A Newman1

  • 1Department of Ophthalmology, University of Virginia School of Medicine, Charlottesville.

Survey of Ophthalmology
|November 1, 1993
PubMed
Summary
This summary is machine-generated.

Ocular neuromyotonia, a rare condition affecting cranial nerves, can occur after radiation therapy. This case highlights its manifestation in the sixth cranial nerve (abducens nerve) and potential treatment with Carbamazepine.

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Area of Science:

  • Neuro-ophthalmology
  • Radiation Oncology

Background:

  • Sinonasal undifferentiated carcinoma (SNUC) is a rare malignancy.
  • Skull base and cavernous sinus involvement necessitates complex treatment, often involving surgery and radiation therapy.
  • Radiation therapy, while effective, can lead to long-term neurological sequelae.

Observation:

  • A 20-year-old woman with a history of treated SNUC presented with intermittent horizontal diplopia.
  • The diplopia was induced by rightward gaze, affecting the right lateral rectus muscle and causing exodeviation.
  • Clinical findings suggested ocular neuromyotonia of the right VI cranial nerve (abducens nerve).

Findings:

  • Ocular neuromyotonia was suspected to be a secondary effect of prior radiation therapy for SNUC.
  • The condition involved abnormal, sustained contraction of the affected extraocular muscle (right lateral rectus).

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  • Literature review indicates that cranial nerve palsies, including those of the III, IV, and VI nerves, can be radiation-induced.

    • Implications:

    • Ocular neuromyotonia is a potential, albeit rare, complication of radiation therapy in the head and neck region.
    • Early recognition and diagnosis are crucial for appropriate management.
    • Carbamazepine is a potential therapeutic option for managing symptoms of ocular neuromyotonia.