Ocular Neuromyotonia in Thyroid Eye Disease.

We present the case of a 61-year-old male thyroid eye disease patient who developed spontaneous transient neuromyotonic infradeviation of the right eye every ~1 minute in the setting of prominent enlargement of the right inferior rectus muscle and restriction of supraduction.

Neither carbamazepine or lacosamide were able to abate ocular neuromyotonia.

Following subsequent thyroid eye disease worsening with almost complete restriction of the right eye, ocular neuromyotonia was no longer observed.