Superior oblique myokymia (SOM) is a rare, benign focal movement disorder of the eye. It is also known as sixth nerve palsy or lateral gaze palsy. This condition mainly affects one side of the face, causing it to twitch uncontrollably, especially when the patient looks up and slightly to the side (lateral gaze). The twitching typically occurs after prolonged downward gaze or looking up or sideways (e.g., while reading).
SYMPTOMS OF SUPERIOR OBLIQUE MYOKYMIA
Symptoms of SOM vary from person to person. Some people with the condition have no symptoms, while others have symptoms that are mild enough to be ignored. Some symptoms of SOM include:
Eye twitching – The most common symptom of SOM is a constant, uncontrollable eye twitch (myokymia). Most people with this condition report that one of their eyes twitches while the other eye is unaffected. The eye twitch is more likely to occur when the patient looks up or slightly to the side (lateral gaze). This symptom is often worse when the patient is reading, driving or when the room is dimly lit.
Eye pain – The eye may feel sensitive to light, or the patient may feel achy.
Headaches – Some people with this disorder report that the eye twitch causes headaches.
Feeling of dryness in the eye – Patients may feel as if there is something in the eye or a feeling of dryness.
CAUSES OF SUPERIOR OBLIQUE MYOKYMIA
Superior oblique myokymia generally affects people between the ages of 20 and 50. It can occur in both sexes and all races, but it is more common in women. Persons with this condition usually have a history of frequent eye twitching (myokymia) during childhood.
SOM is generally due to an injury to the sixth cranial nerve, which controls eye movement. The disorder can also be due to other causes, including:
Stroke – It is common for people with a stroke to experience eye twitching on the affected side. The twitching can be due to damage to the sixth cranial nerve or another part of the brain. – Herpes zoster ophthalmicus.
A complication of shingles, herpes zoster ophthalmicus, is a viral infection of the nerves. It can cause eye twitching on one side of the face.
Blepharitis – A painful, common eye condition caused by a bacterial or fungal infection of the eyelids; blepharitis can cause eye twitching on one side of the face.
Carpal tunnel syndrome – A painful and common hand and wrist disorder, carpal tunnel syndrome can cause eye twitching on one side of the face.
Bell’s palsy – A condition that causes weakness or paralysis of the facial muscles, Bell’s palsy can cause eye twitching on one side of the face.
Myasthenia gravis – A chronic disorder that causes muscle weakness, myasthenia gravis can cause eye twitching on one side of the face.
Superior longitudinal fasciculus syndrome – A rare disorder, superior longitudinal fasciculus syndrome causes eye twitching on one side of the face.
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