Adult-onet acquired oculomotor nerve parei with cyclic pam: relationhip to ocular neuromyotonia

Purpoe To decribe the characteritic and ignificance of acquired oculomotor nerve parei with cyclic pam. Method Retropective cae erie of two patient with a hitory of previou kull bae irradiation for intracranial tumor who developed double viion and were found to have oculomotor nerve parei with cyclic pam. Both patient underwent a complete neuroophthalmologic aement, including teting of eyelid poition, pupillary ize and reactivity, and ocular motility and alignment during both the paretic and patic phae of the condition. Reult Both patient developed unilateral lid retraction and ipilateral eotropia with limitation of abduction during the patic phae of the cycle, with ipilateral ptoi, exotropia, and variable limitation of adduction during the paretic phae. The cycle were continuou and were not induced or altered by eccentric gaze. Concluion Cyclic oculomotor nerve parei with pam may occur year after irradiation of the kull bae. Thi condition i different from the more common ocular motor diturbance that occur in thi etting—ocular neuromyotonia. However, in view of the imilarity between thee two diorder, it eem likely that they are caued by a imilar peripheral mechanim.