"Abducens neuromyotonia" with partial oculomotor paralysis]

Paroxysmal involuntary spasms of extraocular eye muscles which can lead to reversible pathological eye positions and limitations of eye movements are etiologically heterogenous. Despite the diagnostic difficulty, they are important as a neurological sign because of the usually good response to treatment. We report on a patient with the unusual combination of ocular neuromyotonia with brief paroxysmal tonic lateral deviation of the left eye and a concomitant partial third nerve palsy. The paroxysmal episodes disappeared with carbamazepine therapy. Possible pathomechanisms are discussed.