Mystery Case: Superior oblique myokymia: An uncommon cause of intermittent diplopia

Isis B. T. Joosten, Janneke G. J. Hoeijmakers*

*Corresponding author for this work

Research output: Contribution to journalEditorialAcademicpeer-review


A 31-year-old man presented with intermittent vertical diplopia, lasting for seconds to hours. He described a sensation of movement of his right eye, comparable to that of involuntary eyelid contractions. Fatigue induced the symptoms. Self-recorded videos (videos 1 and 2, and; video legends, showed involuntary paroxysmal, intorsional movements of the right eye, consistent with superior oblique myokymia.(1,2) This condition can be caused by trochlear neuropathy, for example due to microvascular compression, tumor in the tectal region, or trauma.(1,2) Brain MRI did not reveal any abnormalities. Carbamazepine, which is recommended as first-line treatment,(1,2) only slightly reduced the symptoms, making this essentially benign condition quite disabling.
Original languageEnglish
Pages (from-to)E814-E814
Number of pages1
Issue number9
Publication statusPublished - 27 Feb 2018

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