Superior Oblique Myokymia - Three Patients with Recorded Attacks Using VOG and Frenzel Goggles

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Identifier Superior_oblique_myokymia_3_patients_with_recorded_attacks_using_VOG_and_Frenzel_goggles
Title Superior Oblique Myokymia - Three Patients with Recorded Attacks Using VOG and Frenzel Goggles
Alternative Title Video 5.39 Superior oblique myokymia (SOM) as seen with videooculography and Frenzel goggles from Neuro-Ophthalmology and Neuro-Otology Textbook
Creator Daniel R. Gold, DO
Affiliation (DRG) Departments of Neurology, Ophthalmology, Neurosurgery, Otolaryngology - Head & Neck Surgery, Emergency Medicine, and Medicine, The Johns Hopkins School of Medicine, Baltimore, Maryland
Subject Superior Oblique Myokymia; Fourth Troclear Nerve; Abnormal Alignment
Description 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: Patients with superior oblique myokymia (SOM) commonly present with complaints of monocular oscillopsia and/or vertical diplopia, which are related to the primary and secondary actions of the SO (incycloduction and depression, respectively). In many cases, SOM represents a neurovascular compression syndrome involving the 4th cranial nerve, although irritation by a compressive mass lesion is also possible. Additionally, the clinician should consider SOM in any patient complaining of transient visual symptoms or blurriness that last for <5 seconds and occur many times throughout the day. Monocular blurriness can result from alternating contraction and relaxation of the affected SO. Binocular blurriness can result from subtle vertical-torsional ocular misalignment during attacks. In each case, the SOM was subtle and could only be appreciated with the slit lamp, ophthalmoscope, video-oculography (VOG), or with the magnification of Frenzel goggles. Each of the three patients here responded well to gabapentin, although a variety of other anti-seizure medications may be beneficial. Unfortunately, there is no robust evidence for one particular therapy over another, and randomized controlled trials are lacking for SOM. 𝗡𝗲𝘂𝗿𝗼-𝗼𝗽𝗵𝘁𝗵𝗮𝗹𝗺𝗼𝗹𝗼𝗴𝘆 𝗮𝗻𝗱 𝗡𝗲𝘂𝗿𝗼-𝗼𝘁𝗼𝗹𝗼𝗴𝘆 𝗧𝗲𝘅𝘁𝗯𝗼𝗼𝗸 𝗟𝗲𝗴𝗲𝗻𝗱: Patients with superior oblique myokymia (SOM) commonly present with complaints of monocular oscillopsia and/or vertical diplopia, which are related to the primary and secondary actions of the SO (incycloduction and depression, respectively). In many cases, SOM represents a neurovascular compression syndrome involving the 4th cranial nerve, although irritation by a compressive mass lesion is also possible. Additionally, the clinician should consider SOM in any patient complaining of transient visual symptoms or blurriness that last for <5 seconds and occur many times throughout the day. Monocular blurriness can result from alternating contraction and relaxation of the affected SO. Binocular blurriness can result from subtle vertical-torsional ocular misalignment during attacks. In each case, the SOM was subtle and could only be appreciated with the slit lamp, ophthalmoscope, video-oculography (VOG), or with the magnification of Frenzel goggles. Each of the three patients here responded well to gabapentin, although a variety of other anti-seizure medications may be beneficial. Unfortunately, there is no robust evidence for one particular therapy over another, and randomized controlled trials are lacking for SOM. https://collections.lib.utah.edu/ark:/87278/s6993k7q
Date 2020-04
Language eng
Format video/mp4
Type Image/MovingImage
Collection Neuro-Ophthalmology Virtual Education Library: Dan Gold Collection: https://novel.utah.edu/Gold/
Publisher North American Neuro-Ophthalmology Society
Holding Institution Spencer S. Eccles Health Sciences Library, University of Utah
Rights Management Copyright 2016. For further information regarding the rights to this collection, please visit: https://NOVEL.utah.edu/about/copyright
ARK ark:/87278/s6993k7q
Setname ehsl_novel_gold
ID 1550676
Reference URL https://collections.lib.utah.edu/ark:/87278/s6993k7q
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