How do you treat superior oblique Myokymia?
There is no single best treatment for superior oblique myokymia (SOM), but all of the following therapies were reported to be a least somewhat effective: carbamazepine, phenytoin, propranolol, topical timolol, memantine, gabapentin, prism lenses, and microvascular decompression of the trochlear nerve (SOR: C, case …
Is superior oblique myokymia serious?
CONCLUSIONS: Superior oblique myokymia is a very disturbing and alarming condition for a patient. This condition can resolve on its own without treatment, but the use of Neurontin, Tegretol, and Baclofen can be beneficial.
Can superior oblique Myokymia triggers?
Superior oblique myokymia was first described by Duane in 1906[1] as “unilateral rotary nystagmus.” Stress, fatigue, alcohol, caffeine, nicotine, and fluorescent lighting and trauma have been suggested as trigger factors.
What is oblique Myokymia?
Superior Oblique Myokymia (SOM) is a rare condition, characterized by episodes of sudden, rhythmic, monocular contractions of the superior oblique muscle. As a result, patients experience oscillopsia and diplopia, particularly when vision is directed downwards.
How do you cure Myokymia?
TREATMENT for Eye Lid Twitching (Myokymia)
- Quinine sulfate tablets (by prescription only) 130 mg. (half of a 230 mg tablet) at bedtime for one to two days.
- Drink quinine water. Unfortunately, it only has 50-75 mg of quinine per liter.
- Botox injection.
- If allergy related, antihistamine eye drops or antihistamine tablets.
Is Myokymia common?
Eyelid twitching (myokymia) affects only the eyelid. This type of twitch or spasm is very common and happens to most people at one time or another. It can involve either the upper or lower lid, but usually only one eye at a time.
What is the superior oblique muscle?
The superior oblique is a fusiform (spindle-shaped) muscle belonging to the extraocular group of muscles. It originates near the nose. The fourth cranial (trochlear) nerve supplies only this muscle and it supports the eye’s ability to depress downward.
Is myokymia treatable?
TREATMENT for Eye Lid Twitching (Myokymia) Get plenty of rest, eliminate caffeine and alcohol and reduce stress. 1. Quinine sulfate tablets (by prescription only) 130 mg. (half of a 230 mg tablet) at bedtime for one to two days.
How long can myokymia last?
Myokymia is commonly used to describe an involuntary eyelid muscle contraction, typically involving the lower eyelid or less often the upper eyelid. It occurs in normal individuals and typically starts and disappears spontaneously. However, it can sometimes last up to three weeks.
Is myokymia permanent?
Myokymia is commonly used to describe an involuntary eyelid muscle contraction, typically involving the lower eyelid or less often the upper eyelid. It occurs in normal individuals and typically starts and disappears spontaneously. However, it can sometimes last up to three weeks….
| Myokymia | |
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| Specialty | Neurology |
How do you examine superior oblique?
Instead, as mentioned above, the superior oblique is tested by having the patient look down and in. By canceling the action of the inferior rectus muscle via contraction of the medial rectus, one can isolate the action of the superior oblique.
Why is there no cure for superior oblique myokymia?
There is no established treatment for SOM due to two main reasons: a lack of sufficient patient populations to perform a randomized controlled clinical trial, and the unpredictability and variable time course of SOM, making it difficult to evaluate the efficacy of existing medical therapies .
Is there a treatment for right sided myokymia?
As a result, patients experience oscillopsia and diplopia, particularly when vision is directed downwards . SOM does not preferentially affect one age group, but right-sided SOM has been found statistically more prevalent in females than left-sided SOM . There is currently no treatment protocol for SOM .
When to use superior oblique tenotomy for SOM?
When medical management is unsuccessful, surgical intervention may be used . The procedures most commonly used for SOM are superior oblique tenotomy along with inferior oblique myectomy, or microvascular decompression of the trochlear nerve . The latter may only be used when vascular compression is identified as the cause of SOM by MRI.
How is oscillopsia caused by eyelid myokymia?
Oscillopsia caused by eyelid myokymia is also often confused with SOM . Individuals typically present with vertical diplopia when looking downwards. Patients may also experience image separation and hypertropia when looking away from the affected eye or when the patient’s head is tilted towards the affected eye .