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Survey of Ophthalmology 2018Superior oblique myokymia (SOM) is a rare condition of unclear etiology. We discuss the history, etiology, clinical features, differential diagnoses, management, and... (Meta-Analysis)
Meta-Analysis Review
Superior oblique myokymia (SOM) is a rare condition of unclear etiology. We discuss the history, etiology, clinical features, differential diagnoses, management, and prognosis of SOM. We conducted a meta-analysis of all 116 cases published since SOM was first described in 1906. The age at examination was 17-72 years (mean: 42 years.) There was a right-sided preponderance in 61% of cases (P < 0.02) that was statistically significant in females (63%, P < 0.04) but not in males (59%, P = 0.18). The pathophysiology of SOM may be neurovascular compression and/or ephaptic transmission. Although various pharmacological and surgical approaches to SOM treatment have been proposed, the rarity of the condition has made it impossible to conduct clinical trials evaluating the safety and efficacy of these approaches. Recently, topical beta blockers have managed SOM symptoms in a number of cases, including the first case treated with levobunolol. Systemic medications, strabismus surgery, and neurosurgery have been used to control symptoms, with strabismus surgery carrying a moderate risk of postoperative diplopia in downgaze. Although there is no established treatment for SOM, we encourage clinicians to attempt topical levobunolol therapy before considering systemic therapy or surgery.
Topics: Adrenergic beta-Antagonists; Diagnosis, Differential; Humans; Myokymia; Oculomotor Muscles; Risk Factors; Trochlear Nerve Diseases
PubMed: 29056504
DOI: 10.1016/j.survophthal.2017.10.005 -
Nihon Rinsho. Japanese Journal of... Nov 1993Myokymia is one of the involuntary movements, which is characterized by undulatory muscle spasm, similar to the worm's crawl. Sometimes muscle pain, itchy sensation,... (Review)
Review
Myokymia is one of the involuntary movements, which is characterized by undulatory muscle spasm, similar to the worm's crawl. Sometimes muscle pain, itchy sensation, dysautonomia and other symptoms are associated with it. Cases showing normal neurological findings are rare. Myokymia is caused by various diseases, such as, multiple sclerosis, hypothyroidism, Guillan-Barre syndrome and so on. Generally myokymia is classified into two types, i.e. limb myokymia and facial myokymia according to the site. On the other hand, myokymia with hyperhidrosis is known as Issacs syndrome. There are many opinions about the pathogenesis and mechanism in the myoneural junction, peripheral nerve or spinal cord, however these are not established. Further investigation of myokymia is expected.
Topics: Adult; Diagnosis, Differential; Electromyography; Fasciculation; Female; Humans; Hypothyroidism; Male; Middle Aged; Multiple Sclerosis
PubMed: 8277563
DOI: No ID Found -
Current Opinion in Ophthalmology Nov 2019Superior oblique myokymia is a rare, monocular condition that typically presents in healthy adults. In this article, we review the proposed pathophysiology, describe the... (Review)
Review
PURPOSE OR REVIEW
Superior oblique myokymia is a rare, monocular condition that typically presents in healthy adults. In this article, we review the proposed pathophysiology, describe the typical clinical presentation, and discuss the recommended work up and various treatment options.
RECENT FINDINGS
Treatment for this condition ranges from observation and reassurance to various topical and systemic medications. Both strabismus surgery and neurosurgery are reserved for patients who fail medical therapy or are intolerant to medication secondary to side effects.
SUMMARY
Due to its episodic nature, SOM is often under-diagnosed. We highlight key features in a patient's clinical history and the examination findings that suggest and support the diagnosis, with review of available treatment options.
Topics: Humans; Oculomotor Muscles; Trochlear Nerve Diseases
PubMed: 31503076
DOI: 10.1097/ICU.0000000000000619 -
Practical Neurology Oct 2018
PubMed: 30061333
DOI: 10.1136/practneurol-2018-001967 -
Journal of Neurology Feb 2004
Review
Topics: Action Potentials; Axons; Humans; Isaacs Syndrome; Motor Neuron Disease; Motor Neurons; Muscle, Skeletal; Myokymia; Potassium Channels, Voltage-Gated
PubMed: 14991346
DOI: 10.1007/s00415-004-0331-5 -
SN Comprehensive Clinical Medicine 2022The purpose of this study is to report eyelid myokymia in patients recently recovered from COVID-19 disease. A cohort of 15 patients who developed eyelid myokymia during...
The purpose of this study is to report eyelid myokymia in patients recently recovered from COVID-19 disease. A cohort of 15 patients who developed eyelid myokymia during or immediate post-recovery of systemic disease were evaluated. Demographic, clinical characteristics, effect of age, and hospitalization on the disease course were studied. The disease course was evaluated every month for 3 months period. All, except 2, patients had complete resolution of lid myokymia within 3 months of onset. Median [IQR] myokymia recovery time was 42 [31,60] days. Age and duration of hospitalization had a significant linear relationship with myokymia recovery time. Recovery was delayed by 2.64 days with every 1-year increment in age and by 6.19 days with every additional day of hospital stay. Recovery time was independent of severity of systemic disease ( = .055) and gender ( = 0.2). Eyelid myokymia can be a possible manifestation of COVID-19 recovery phase. While myokymia recovers gradually in all these patients, older age and a longer duration of hospitalization are associated with slower recovery.
PubMed: 35036848
DOI: 10.1007/s42399-021-01094-w -
Archives of Neurology Feb 1977
Topics: Humans; Myoclonus; Peripheral Nerve Injuries
PubMed: 836186
DOI: 10.1001/archneur.1977.00500140087027 -
Survey of Ophthalmology 2011
Topics: Blepharospasm; Eyelid Diseases; Facial Muscles; Facial Nerve; Humans; Myokymia; Nerve Regeneration
PubMed: 21501741
DOI: 10.1016/j.survophthal.2011.02.005