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Bilateral ocular neuromyotonia: oculographic correlations
M J Morrow1, G W Kao, A C Arnold
1Department of Neurology, UCLA School of Medicine, Sylmar, CA, USA.
Neurology
|January 1, 1996
Summary
Bilateral ocular neuromyotonia, a rare eye movement disorder, was observed in a patient with a history of pituitary adenoma. This condition causes episodic double vision due to abnormal muscle function affecting both eyes.
Area of Science:
- Ophthalmology
- Neuroscience
- Neurology
Background:
- Ocular neuromyotonia is a rare disorder characterized by abnormal eye movements.
- Previous treatment for a pituitary adenoma can be a relevant medical history.
Observation:
- A 45-year-old woman presented with episodic diplopia (double vision).
- The patient had a history of pituitary adenoma treatment.
- Ocular neuromyotonia affected muscles innervated by both oculomotor nerves bilaterally.
Findings:
- Oculography revealed episodes of tonic adduction.
- Saccades showed slowing and restriction in all directions.
- No oscillatory movements were observed, differentiating it from nystagmus.
Implications:
- The findings suggest a mechanism involving impaired phasic firing of agonist muscles and tonic contraction of antagonist muscles.
- This explains the paroxysmal limitation of eye movements seen in ocular neuromyotonia.
- Understanding this pathophysiology is crucial for diagnosing and managing patients with similar neurological presentations.
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