Category Archives: Central Oculomotor Signs

Superior Oblique Myokymia

This is an interesting case of a 48yr woman with a 2year complaint of missing lines when reading and blurring when focusing on something or someone. She has frequent fluttering of the right eye lasting less than a minute and feeling like right eye is crossing over left one.

The only thing I found in this patient was an objective flutter of the right eye, unpredictable, sometimes stronger sometimes less pronounced, more often when looking downward. Please look at this video with series of very discrete ocular flutter with mainly torsional movement.

The reason of this uniocular rotatory nystagmus usually is neurovascular conflict between the Trochlear nerve and superior cerebellar artery. But there are more etiologies described, so the MRI is obligatory to perform in this patients.