Wilmer Eye Institute, The Johns Hopkins School of Medicine, Baltimore, Maryland 21287, USA.
J Neuroophthalmol. 2013 Sep;33(3):263-5. doi: 10.1097/WNO.0b013e31829eb397.
Ocular neuromyotonia is an unusual condition in which sustained, undesired contraction of one or more extraocular muscles occurs after normal muscle activation. Although most commonly reported after paraseller cranial irradiation for tumor, chronic nonaneurysmal vascular compression of the third nerve can produce partial ocular motor nerve paresis and ocular neuromyotonia. A 75-year-old woman presented with intermittent left-gaze-evoked binocular diplopia. She had an incomplete right third nerve palsy but became symptomatically diplopic and esotropic upon sustained left gaze. High-resolution brain magnetic resonance imaging showed displacement of the right posterior communicating artery and contact with the right third nerve. Gaze-evoked diplopia resolved with carbamazepine, but a partial third nerve paresis remained.
眼肌肌强直性疾病是一种不常见的病症，表现为正常肌肉活动后，一只或多只眼外肌持续出现不受控制的收缩。尽管这种疾病最常发生于因肿瘤而行蝶鞍旁颅部放射治疗之后，但慢性非动脉瘤性血管压迫第三颅神经也可导致部分眼球运动神经麻痹和眼肌肌强直性疾病。一位 75 岁女性因间歇性左眼凝视诱发的双眼复视就诊。她存在不完全性右侧第三颅神经麻痹，但持续左眼凝视时出现症状性复视和内斜视。高分辨率脑磁共振成像显示右侧后交通动脉移位并与右侧第三颅神经接触。卡马西平治疗后，眼肌强直性疾病导致的复视得到缓解，但部分第三颅神经麻痹仍然存在。
