Ocular neuromyotonia--an unusual ocular motility complication after radiation therapy for nasopharyngeal carcinoma. 1995

E R Fu
Singapore National Eye Centre.

The incidence of nasopharyngeal carcinoma is high amongst the Chinese population in Singapore. Abnormal ocular motility, like abducens nerve palsy, is often a presenting feature. Ocular motility problems can also arise as a complication from the treatment or tumour recurrence. This is a case report of a patient who had been treated for nasopharyngeal carcinoma with radiotherapy 13 years ago. She presented with paroxysmal diplopia and the clinical findings were consistent with ocular neuromyotonia. She responded favourably to oral carbamazepine. Ocular neuromyotonia is uncommon and it has never been reported in the local literature. Recognition of the condition is of both diagnostic and therapeutic significance.

UI MeSH Term Description Entries
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009303 Nasopharyngeal Neoplasms Tumors or cancer of the NASOPHARYNX. Cancer of Nasopharynx,Nasopharyngeal Cancer,Cancer of the Nasopharynx,Nasopharynx Cancer,Nasopharynx Neoplasms,Neoplasms, Nasopharyngeal,Cancer, Nasopharyngeal,Cancer, Nasopharynx,Cancers, Nasopharyngeal,Cancers, Nasopharynx,Nasopharyngeal Cancers,Nasopharyngeal Neoplasm,Nasopharynx Cancers,Nasopharynx Neoplasm,Neoplasm, Nasopharyngeal,Neoplasm, Nasopharynx,Neoplasms, Nasopharynx
D010243 Paralysis A general term most often used to describe severe or complete loss of muscle strength due to motor system disease from the level of the cerebral cortex to the muscle fiber. This term may also occasionally refer to a loss of sensory function. (From Adams et al., Principles of Neurology, 6th ed, p45) Palsy,Plegia,Todd Paralysis,Todd's Paralysis,Palsies,Paralyses,Paralysis, Todd,Paralysis, Todd's,Plegias,Todds Paralysis
D011832 Radiation Injuries Harmful effects of non-experimental exposure to ionizing or non-ionizing radiation in VERTEBRATES. Radiation Sickness,Radiation Syndrome,Injuries, Radiation,Injury, Radiation,Radiation Injury,Radiation Sicknesses,Radiation Syndromes,Sickness, Radiation,Sicknesses, Radiation,Syndrome, Radiation,Syndromes, Radiation
D002220 Carbamazepine A dibenzazepine that acts as a sodium channel blocker. It is used as an anticonvulsant for the treatment of grand mal and psychomotor or focal SEIZURES. It may also be used in the management of BIPOLAR DISORDER, and has analgesic properties. Amizepine,Carbamazepine Acetate,Carbamazepine Anhydrous,Carbamazepine Dihydrate,Carbamazepine Hydrochloride,Carbamazepine L-Tartrate (4:1),Carbamazepine Phosphate,Carbamazepine Sulfate (2:1),Carbazepin,Epitol,Finlepsin,Neurotol,Tegretol
D002277 Carcinoma A malignant neoplasm made up of epithelial cells tending to infiltrate the surrounding tissues and give rise to metastases. It is a histological type of neoplasm and not a synonym for "cancer." Carcinoma, Anaplastic,Carcinoma, Spindle-Cell,Carcinoma, Undifferentiated,Carcinomatosis,Epithelial Neoplasms, Malignant,Epithelioma,Epithelial Tumors, Malignant,Malignant Epithelial Neoplasms,Neoplasms, Malignant Epithelial,Anaplastic Carcinoma,Anaplastic Carcinomas,Carcinoma, Spindle Cell,Carcinomas,Carcinomatoses,Epithelial Neoplasm, Malignant,Epithelial Tumor, Malignant,Epitheliomas,Malignant Epithelial Neoplasm,Malignant Epithelial Tumor,Malignant Epithelial Tumors,Neoplasm, Malignant Epithelial,Spindle-Cell Carcinoma,Spindle-Cell Carcinomas,Tumor, Malignant Epithelial,Undifferentiated Carcinoma,Undifferentiated Carcinomas
D002491 Central Nervous System Agents A class of drugs producing both physiological and psychological effects through a variety of mechanisms. They can be divided into "specific" agents, e.g., affecting an identifiable molecular mechanism unique to target cells bearing receptors for that agent, and "nonspecific" agents, those producing effects on different target cells and acting by diverse molecular mechanisms. Those with nonspecific mechanisms are generally further classed according to whether they produce behavioral depression or stimulation. Those with specific mechanisms are classed by locus of action or specific therapeutic use. (From Gilman AG, et al., Goodman and Gilman's The Pharmacological Basis of Therapeutics, 8th ed, p252) Central Nervous System Drugs
D003037 Cobalt Radioisotopes Unstable isotopes of cobalt that decay or disintegrate emitting radiation. Co atoms with atomic weights of 54-64, except 59, are radioactive cobalt isotopes. Radioisotopes, Cobalt
D004172 Diplopia A visual symptom in which a single object is perceived by the visual cortex as two objects rather than one. Disorders associated with this condition include REFRACTIVE ERRORS; STRABISMUS; OCULOMOTOR NERVE DISEASES; TROCHLEAR NERVE DISEASES; ABDUCENS NERVE DISEASES; and diseases of the BRAIN STEM and OCCIPITAL LOBE. Double Vision,Polyopsia,Diplopia, Cortical,Diplopia, Horizontal,Diplopia, Intermittent,Diplopia, Monocular,Diplopia, Refractive,Diplopia, Unilateral,Diplopia, Vertical,Cortical Diplopia,Cortical Diplopias,Diplopias,Diplopias, Cortical,Diplopias, Horizontal,Diplopias, Intermittent,Diplopias, Monocular,Diplopias, Refractive,Diplopias, Unilateral,Diplopias, Vertical,Horizontal Diplopia,Horizontal Diplopias,Intermittent Diplopia,Intermittent Diplopias,Monocular Diplopia,Monocular Diplopias,Polyopsias,Refractive Diplopia,Refractive Diplopias,Unilateral Diplopia,Unilateral Diplopias,Vertical Diplopia,Vertical Diplopias,Vision, Double
D005260 Female Females

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