Ocular neuromyotonia treated by microvascular decompression: usefulness of preoperative 3D imaging

Case report

Takuro Inoue M.D., Ph.D.1, Hisao Hirai M.D., Ph.D.1, Toshiki Shimizu M.D.2, Masayuki Tsuji M.D.1, Ayako Shima M.D.3, Fumio Suzuki M.D., Ph.D.1, and Masayuki Matsuda M.D., Ph.D.1
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  • 1 Department of Neurosurgery, Subarukai Kotoh Kinen Hospital;
  • | 2 Department of Neurosurgery, Subarukai Hino Kinen Hospital; and
  • | 3 Department of Neurosurgery, Shiga University of Medical Science, Shiga, Japan
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Ocular neuromyotonia is a rare ocular motility disorder characterized by involuntary contraction of extraocular muscles resulting in paroxysmal diplopia. Although ocular neuromyotonia is reported as a rare complication after radiation therapy, there are a few cases of ocular neuromyotonia in the absence of irradiation. In the reported cases the possibility of vascular compression has been suggested on radiological imaging. The authors report a case of ocular neuromyotonia treated by microvascular decompression of the third cranial nerve, supporting the hypothesis that neurovascular compression may play a role in its pathogenesis. The usefulness of preoperative 3D imaging for microvascular decompression is also discussed.

Abbreviations used in this paper:

PCA = posterior cerebral artery; SCA = superior cerebellar artery.

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