Microvascular decompression for superior oblique myokymia: first experience. Case report.

Abstract:

:Superior oblique myokymia (SOM) is a rare eye movement disorder presenting as uniocular rotatory microtremor due to intermittent contractions of the superior oblique muscle. Medical treatment usually fails to provide long-term benefit for the patient and has considerable side effects. Surgical alternatives including tenotomy or partial tenectomy of the superior oblique tendon often result in incomplete resolution of the visual symptoms. The authors report a patient who experienced immediate cessation of disabling SOM following microvascular decompression of the fourth nerve at the root exit zone. Temporary double vision at downgaze resolved 5 months after surgery. There was no recurrence of oscillopsia during a follow-up of 22 months to date. From this single observation it appears likely that vascular compression of the trochlear nerve could be a significant pathophysiological factor contributing to SOM. In the hands of an experienced surgeon, microvascular decompression at the brainstem exit zone of this nerve may evolve as the method of choice for selected cases of disabling SOM.

journal_name

J Neurosurg

journal_title

Journal of neurosurgery

authors

Samii M,Rosahl SK,Carvalho GA,Krzizok T

doi

10.3171/jns.1998.89.6.1020

subject

Has Abstract

pub_date

1998-12-01 00:00:00

pages

1020-4

issue

6

eissn

0022-3085

issn

1933-0693

journal_volume

89

pub_type

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