title: Intermittent esotropia associated with rippling muscle disease.
abstract: OBJECTIVE
  We report a rare myopathy known as rippling muscle disease, with the unique feature of extraocular muscle involvement, presenting as a variable esotropia.
  
  
  METHODS
  Chart review with a review of the literature.
  
  
  RESULTS
  Neurologic and neuro-ophthalmic examinations as well as electromyography and muscle biopsy confirm that this case closely resembles those described in the literature with the additional feature of a variable esotropia.
  
  
  CONCLUSIONS
  Rippling muscle disease may be associated with intermittent esotropia. The pathophysiology of this disorder is unknown, but the intermittent esotropia is likely related to "rippling" of the medial recti.
authors.affiliation: Department of Neurology, Cleveland Clinic Foundation, OH 44195-5024, USA.
authors.forename: G S
authors.initials: GS
authors.lastname: Kosmorsky
authors.forename: N
authors.initials: N
authors.lastname: Mehta
authors.forename: H
authors.initials: H
authors.lastname: Mitsumoto
authors.forename: R
authors.initials: R
authors.lastname: Prayson
mesh_terms: D001284:Atrophy; D001706:Biopsy; D004172:Diplopia / Q000209:etiology; D004576:Electromyography; D004948:Esotropia / Q000209:etiology* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000473:pathology / Q000503:physiopathology / Q000648:ultrastructure; D009135:Muscular Diseases / Q000150:complications* / Q000473:pathology / Q000503:physiopathology; D009220:Myositis / Q000473:pathology; D009801:Oculomotor Muscles / Q000473:pathology* / Q000503:physiopathology; D014792:Visual Acuity