title: Ocular neuromyotonia with spastic lid closure.
abstract: Ocular neuromyotonia is characterized by tonic spasms of extraocular muscles evoked by eccentric gaze that induces transient strabismus and diplopia. We report the case of a 70-year-old woman who initially presented with unilateral deficits in fifth and sixth cranial nerve functions attributed to a fifth cranial nerve schwannoma. After radiation treatment, she developed neuromyotonia and synkinesis of the ipsilateral third cranial nerve. During the attacks of neuromyotonia, the left eyelids were often spastically closed, a phenomenon not previously reported. The ocular neuromyotonia regressed spontaneously within 3 years, but components of the synkinesis persisted. Ephaptic transmission in a damaged third cranial nerve may be responsible for the neuromyotonia and synkinesis. Synkinesis is a more enduring manifestation.
authors.affiliation: Department of Ophthalmology, Tokyo Women's Medical University, Tokyo, Japan. ohira@wakaba-hp.or.jp
authors.forename: Akihiko
authors.initials: A
authors.lastname: Oohira
authors.forename: Tatsuyuki
authors.initials: T
authors.lastname: Furuya
mesh_terms: D020434:Abducens Nerve Diseases / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D000368:Aged; D000927:Anticonvulsants / Q000627:therapeutic use; D001369:Axons / Q000473:pathology / Q000528:radiation effects; D003390:Cranial Nerve Neoplasms / Q000473:pathology / Q000503:physiopathology / Q000532:radiotherapy; D005141:Eyelid Diseases / Q000209:etiology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D009128:Muscle Spasticity / Q000209:etiology / Q000503:physiopathology; D009410:Nerve Degeneration / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D009442:Neurilemmoma / Q000473:pathology / Q000503:physiopathology / Q000532:radiotherapy*; D015835:Ocular Motility Disorders / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology; D009802:Oculomotor Nerve / Q000473:pathology / Q000503:physiopathology / Q000528:radiation effects*; D015840:Oculomotor Nerve Diseases / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D011878:Radiotherapy / Q000009:adverse effects*; D016896:Treatment Outcome; D020433:Trigeminal Nerve Diseases / Q000473:pathology / Q000503:physiopathology / Q000532:radiotherapy
chemical_list: D000927:Anticonvulsants