関: fourth nerve palsy、trochlear nerve disease、trochlear nerve palsy

WordNet

of or characteristic of high rank or importance; "a superior ruler"
one of greater rank or station or quality (同)higher-up, superordinate
the head of a religious community
(often followed by `to'
(sometimes followed by `to'
having an orbit farther from the sun than the Earths orbit; "Mars and Jupiter are the closest in of the superior planets"
of high or superior quality or performance; "superior wisdom derived from experience"; "superior math students"
slanting or inclined in direction or course or position--neither parallel nor perpendicular nor right-angled; "the oblique rays of the winter sun"; "acute and obtuse angles are oblique angles"; "the axis of an oblique cone is not perpendicular to its base"
any grammatical case other than the nominative (同)oblique case
a town in northwest Wisconsin on Lake Superior across from Duluth

PrepTutorEJDIC

(程度・質が)『普通(平均)以上に優れた』,優秀な / (地位・階級などが)『上位の』,上級の,目上の / (数量的に)勝る,優勢な / (用動が)偉ぶった,高慢な / 《補語にのみ用いて》(…に)屈しない,動じない《+to+名》 / 《名詞の前にのみ用いて》(動・植物の器官や部分が)上位の,上についている / (地位・階級などが)『上位の人』,上役,上司,先輩 / 『いっそう優れた人』 / 《しばしば S-》修道院長
傾いた,斜めの / 間接の,遠回しの / 〈C〉〈U〉斜線(/)
スペリオル湖(lake~;北米五大湖中で最北最大のもの)

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2013/02/27 17:04:45」(JST)

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Superior oblique myokymia is a neurological disorder affecting vision and was named by Hoyt and Keane in 1970.^[1]

It is a condition that presents as repeated, brief episodes of movement, shimmering or shaking of the vision of one eye, a feeling of the eye trembling, or vertical/tilted vision. It can present as one or more of these symptoms. Diagnosis is most often made by the elimination of other conditions, disorders or diseases.

Onset usually occurs in adulthood, and the course is benign and is not commonly associated with other disorders.

Causes

In 1983, Bringewald postulated that superior oblique myokymia resulted from vascular compression of the trochlear nerve (fourth cranial nerve), which controls the action of the superior oblique muscle in the eye.^[2] By 1998, there had been only one reported case of compression of the trochlear nerve by vessels.^[3]^[4] More recently, magnetic resonance imaging experiments have shown that neurovascular compression at the root exit zone of the trochlear nerve can result in superior oblique myokymia.^[5]

Treatment

Treatment can include pharmaceutical or surgical means. The drug carbamazepine (Tegretol) has been used successfully. Other drugs used with variable success include gabapentin and, recently, memantine. Successful surgery options include superior oblique tenectomy accompanied by inferior oblique myectomy.^[6]

Samii et al.^[3] and Scharwey and Samii^[4] described a patient who had superior oblique myokymia for 17 years. The interposition of a Teflon pad between the trochlear nerve and a compressing artery and vein at the nerve's exit from the midbrain led to a remission lasting for a follow-up of 22 months.

References

^ Hoyt WF, Keane JR (October 1970). "Superior oblique myokymia. Report and discussion on five cases of benign intermittent uniocular microtremor". Arch. Ophthalmol. 84 (4): 461–7. PMID 5492451.
^ Bringewald PR (August 1983). "Superior oblique myokymia". Arch. Neurol. 40 (8): 526. PMID 6870617.
^ ^a ^b Samii M, Rosahl SK, Carvalho GA, Krzizok T (1998). "Microvascular decompression for superior oblique myokymia: first experience. Case report". J. Neurosurg. 89 (6): 1020–4. doi:10.3171/jns.1998.89.6.1020. PMID 9833830.
^ ^a ^b Scharwey K, Krzizok T, Samii M, Rosahl SK, Kaufmann H (2000). "Remission of superior oblique myokymia after microvascular decompression". Ophthalmologica 214 (6): 426–8. doi:10.1159/000027537. PMID 11054004.
^ Yousry I, Dieterich M, Naidich TP, Schmid UD, Yousry TA (March 2002). "Superior oblique myokymia: magnetic resonance imaging support for the neurovascular compression hypothesis". Ann. Neurol. 51 (3): 361–8. doi:10.1002/ana.10118. PMID 11891831.
^ "Superior Oblique Myokymia 379.58". http://telemedicine.orbis.org/bins/volume_page.asp?cid=735-954-1328-1350&lang=1. Retrieved 2007-06-25.

UpToDate Contents

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English Journal

Microvascular decompression for superior oblique myokymia: Case report.

Fam MD1, Scott C, Forster A, Kamel MH.Author information 1Department of Neurosurgery, Ninewells Hospital Dundee , Dundee , UK.AbstractBackground. Superior oblique myokymia (SOM) is a rare disorder in which the patient suffers episodic uniocular torsional eye movement associated with diplopia and oscillopsia . Although the pathophysiology has been narrowed down to erratic discharge of the trochlear nerve, yet the exact etiology remains unclear; a handful of cases have been described in association with an identifiable space occupying lesions or dural AV fistulae. Neurovascular compression theory has been postulated in the early 1980s and to our knowledge, very few reports exist in the literature accrediting this hypothesis in the pathogenesis of superior oblique myokymia. Case report. We report a case of successful resolution of severe medication refractory SOM following microvascular decompression of the trochlear nerve. The clinical response has been sustained for a follow-up period of 18 months to date. Conclusion. Microvascular decompression may be considered as a definitive and least destructive surgical option for the treatment of medication refractory superior oblique myokymia.
British journal of neurosurgery.Br J Neurosurg.2014 Jan 7. [Epub ahead of print]
Background. Superior oblique myokymia (SOM) is a rare disorder in which the patient suffers episodic uniocular torsional eye movement associated with diplopia and oscillopsia . Although the pathophysiology has been narrowed down to erratic discharge of the trochlear nerve, yet the exact etiology rem
PMID 24392739

Does the clinical phenotype of fatal familial insomnia depend on PRNP codon 129 methionine-valine polymorphism?

Rupprecht S1, Grimm A, Schultze T, Zinke J, Karvouniari P, Axer H, Witte OW, Schwab M.Author information 1Hans-Berger-Department of Neurology, Jena University Hospital, Germany ; Center for Sepsis Control and Care, Jena University Hospital, Germany.AbstractFatal familial insomnia (FFI) is a rare, hereditary prion-protein disease. Methionine-valine polymorphism at codon 129 of the prion-protein gene (PRNP) determines the phenotype in other hereditary prion-protein diseases, but association with the clinical phenotype in FFI remains uncertain. Early clinical findings in FFI comprise disturbances of the sleep-wake cycle and mild neuropsychiatric changes which typically emerge during middle to late adulthood. Here we describe an unusually early onset and rapid progression of FFI associated with dorsal midbrain involvement in a female patient with PRNP mutation at codon 178 and homozygote methionine polymorphism at codon 129. Early dorsal midbrain involvement became apparent by total loss of REM sleep and isolated bilateral trochlear nerve palsy. Early onset and rapid progression disease type associated with dorsal midbrain involvement may indicate a different spatiotemporal distribution of the neurodegenerative process in FFI patients with PRNP mutation and codon 129 methionine homozygosity compared to methioninevaline heterozygosity.
Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine.J Clin Sleep Med.2013 Dec 15;9(12):1343-5. doi: 10.5664/jcsm.3286.
Fatal familial insomnia (FFI) is a rare, hereditary prion-protein disease. Methionine-valine polymorphism at codon 129 of the prion-protein gene (PRNP) determines the phenotype in other hereditary prion-protein diseases, but association with the clinical phenotype in FFI remains uncertain. Early cli
PMID 24340298

Clinical utility and assessment of cyclodeviation.

Lemos J1, Eggenberger E.Author information 1Michigan State University, East Lansing, Michigan, USA.AbstractPURPOSE OF REVIEW: This article reviews and updates basic concepts, diagnosis and treatment of cyclotorsion.
Current opinion in ophthalmology.Curr Opin Ophthalmol.2013 Nov;24(6):558-65. doi: 10.1097/ICU.0000000000000003.
PURPOSE OF REVIEW: This article reviews and updates basic concepts, diagnosis and treatment of cyclotorsion.RECENT FINDINGS: Cyclodeviation in congenital superior oblique palsy (SOP) seems to correlate with the extent of superior oblique muscle hypoplasia. Genetic polymorphisms such as PHOX2B polymo
PMID 24100374

Japanese Journal

上斜筋ミオキミアは血管圧迫症候群なのか

吉田正樹,敷島敬悟,井田正博
あたらしい眼科 = Journal of the eye 29(6), 727-730, 2012-06-30
NAID 10030788701

上斜筋ミオキミアは血管圧迫症候群なのか (特集神経眼科 : 最新の話題)

吉田正樹,敷島敬悟,井田正博
あたらしい眼科 29(6), 727-730, 2012-06
NAID 40019362688

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リンク元	「上斜筋波動症」「fourth nerve palsy」「trochlear nerve disease」「上斜筋ミオキミア」
関連記事	「superior」「oblique」「superio」