Bilateral ocular neuromyotonia: oculographic correlations.

We observed bilateral ocular neuromyotonia in a 45-year-old woman previously treated for a pituitary adenoma. She experienced episodic diplopia attributable to dysfunction of muscles innervated by both oculomotor nerves. Oculography demonstrated episodes of tonic adduction with slowing and restriction of saccades in all directions, but no oscillatory component. A combination of impaired phasic firing in agonist muscles and tonic contraction of antagonist muscles explains the paroxysms of eye movement limitation in this disorder.