Ocular neuromyotonia in Graves dysthyroid orbitopathy.
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.
Chung
S M
SM
Anheuser Busch Eye Institute, St Louis University School of Medicine, Mo, USA.
Lee
A G
AG
Holds
J B
JB
Roper-Hall
G
G
Cruz
O A
OA
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
D018712:Analgesics, Non-Narcotic; D002220:Carbamazepine