Presentation features of ocular neuromyotonia in children
Reviewed by Fiona Rowe

The authors report five cases of ocular neuromyotonia (ON) in children following radiation treatment for brain tumours. Children were aged four, nine, twelve, five and nine years. Three had craniopharyngioma, one had fourth ventricle ependymoma and one had posterior fossa Medulloblastoma. Three had proton beam therapy, one had conventional radiation therapy and one with craniospinal radiation therapy with posterior fossa boost. Two had left fourth nerve / superior oblique ON and three had left sixth nerve / lateral rectus ON. Two had no symptoms of diplopia and others had vague complaints of blurred vision or had abnormal head posture. One had a failed trial with pyridostigmine followed by treatment with gabapentin which was later stopped. Others declined treatment. Two showed resolution of symptoms, one had improvement and one remains under review. One had tumour recurrence and died. These findings show differences to how adults present with ON.

Ocular neuromyotonia in children and adolescents following radiation therapy of pediatric brain tumors.
Richardson C, Smith C, Merchant T, et al.
JOURNAL OF PEDIATRIC OPHTHALMOLOGY AND STRABISMUS
2022;59(5):338-43.