Superior oblique myokymia: Efficacy of medical treatment

Cardinal features of superior oblique myokymia: An infrared oculography study

“… 1 , 2 , 5 , 6 , 8 Although absent in our patients, history of head trauma, 2 superior oblique palsy, 1 microvascular compression, 7 , 9 intracranial mass, 10 , 11 and evidence of superior oblique atrophy seen on MRI 12 have been associated with SOM. Microvascular compression has also been observed in hemifacial spasm (cranial nerve VII), 13 which has been associated with SOM 14 and trigeminal neuralgia (cranial nerve V). 13…”

Results of extraocular muscle surgery for superior oblique myokymia

“…Medical treatment options include oral carbemazepine, phenytoin sodium, clonazepam, baclofen, gabapentin and propranolol, and topical beta-blockers (Timolol maleate, betaxolol), all of which have been reported to have variable success. [5][6][7][8][9][10][27][28][29] In some patients treatment was not successful; in others the benefit was temporary, and numerous patients did not tolerate the medication due to side effects. Carbamazepine is the most frequently reported medication used followed by topical beta-blockers.…”

Gabapentin and Superior Oblique Myokymia

“…7,10-17 Eighty percent initial response to medication with sustained benefit in 45% of patients were reported with medical therapy. 18 When medication is unsuccessful, surgery, involving tenotomy or a tenectomy of the superior oblique muscle, combined with inferior oblique myectomy may be performed. 19 Surgical decompression of cranial nerve IV has been found to be beneficial when vascular compression is confirmed.…”