title: Ocular neuromyotonia in Graves dysthyroid orbitopathy.
abstract: OBJECTIVE
  To describe 2 patients with ocular neuromyotonia in association with Graves orbitopathy and to consider the possible underlying mechanisms.
  
  
  METHODS
  Description of the clinical findings in 2 patients with these conditions.
  
  
  METHODS
  Neuro-ophthalmology referral centers.
  
  
  METHODS
  Two patients, aged 55 and 52 years, had episodic, involuntary periods of vertical diplopia and dysthyroid orbitopathy.
  
  
  METHODS
  Treatment with carbamazepine in one patient and external beam radiation therapy in the second patient.
  
  
  METHODS
  Frequency and duration of episodic spasms of the extraocular muscles.
  
  
  RESULTS
  Although radiation therapy is the most common association with ocular neuromyotonia, it cannot explain the involuntary contractions of extraocular muscles in all affected patients. Other mechanisms must be involved, such as those discussed in this article.
  
  
  CONCLUSIONS
  Ocular neuromyotonia is described in 2 patients with dysthyroid orbitopathy, confirming previous findings. Possible mechanisms are given.
authors.affiliation: Anheuser Busch Eye Institute, St Louis University School of Medicine, Mo, USA.
authors.forename: S M
authors.initials: SM
authors.lastname: Chung
authors.forename: A G
authors.initials: AG
authors.lastname: Lee
authors.forename: J B
authors.initials: JB
authors.lastname: Holds
authors.forename: G
authors.initials: G
authors.lastname: Roper-Hall
authors.forename: O A
authors.initials: OA
authors.lastname: Cruz
mesh_terms: D018712:Analgesics, Non-Narcotic / Q000627:therapeutic use; D002220:Carbamazepine / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant; D005133:Eye Movements; D005260:Female; D006111:Graves Disease / Q000150:complications* / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D006980:Hyperthyroidism / Q000150:complications; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009222:Myotonia / Q000150:complications* / Q000503:physiopathology / Q000628:therapy; D015835:Ocular Motility Disorders / Q000150:complications* / Q000503:physiopathology / Q000628:therapy; D009801:Oculomotor Muscles / Q000187:drug effects / Q000503:physiopathology / Q000528:radiation effects; D009915:Orbit / Q000528:radiation effects
chemical_list: D018712:Analgesics, Non-Narcotic; D002220:Carbamazepine