Superior oblique myokymia

Superior oblique myokymia is an unusual eye movement phenomenon generally considered to be a uniocular rotary microtremor easily treated with carbamazepine. Eleven new cases are presented, one with a unique combination of motility problems, emphasizing that the disorder may have varying clinical manifestations. Long-term follow-up of the patients revealed a natural history of recurrent spontaneous remissions and relapses. Treatment with carbamazepine was of short-term benefit in most patients but failed to affect the long-term course of the disease. No patient developed other evidence of neurological disease. The condition seems to be a benign, permanent condition limited in its manifestations to the superior oblique muscle.