Neuromiotonía ocular (NMO) post radioterapia: reporte de caso

Roberto Ebner

doi:10.70313/2718.7446.v16.n03.244

Authors

Roberto Ebner Unidad de Neurooftalmología, Servicio de Oftalmología, Hospital Británico de Buenos Aires

DOI:

https://doi.org/10.70313/2718.7446.v16.n03.244

Keywords:

diplopia, myotonia, radiation, ephaptic transmission

Abstract

Objective: A case of ocular myotonia three decades after surgery of the selar region followed by radiotherapy is presented.

Clinical case: A 52-year-old female patient reported inconstant diplopia appearing a few years before the consultation. Although she presented residual paresis of the right third cranial nerve post-operatively, the diplopia she refers is new and does not behave like those caused by neuro-muscular plate involvement or by a new selar mass or other associated pathologies. The study of specific neuroimaging for cranial nerves allowed to demonstrate the presence of edema of the third affected nerve. Treatment with membrane stabilizers and application of botulinum toxin in the middle rectus of the right side of the right side of the right eye was established to provide a solution to this type of diplopia.

Conclusion: Neuromyotonia is an infrequent situation in patients irradiated after surgery of the selar region. Early or late onset of inconstant diplopia leads to the diagnosis of NMO, after ruling out myasthenia, presence of new selar mass and others, by neuro-ophthalmologic evaluation and appropriate imaging.

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