SUMMARY / RELATED TOPICS

Superior oblique myokymia

Superior oblique myokymia is a neurological disorder affecting vision and was named by Hoyt and Keane in 1970. 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 made by the elimination of other conditions, disorders or diseases. Onset occurs in adulthood, the course is benign and is not associated with other disorders. In 1983, Bringewald postulated that superior oblique myokymia resulted from vascular compression of the trochlear nerve, which controls the action of the superior oblique muscle in the eye. By 1998, there had been only one reported case of compression of the trochlear nerve by vessels. More magnetic resonance imaging experiments have shown that neurovascular compression at the root exit zone of the trochlear nerve can result in superior oblique myokymia. Treatment can include surgical means.

The drug carbamazepine has been used successfully. Other drugs used with variable success include gabapentin and memantine. Successful surgery options include superior oblique tenectomy accompanied by inferior oblique myectomy. However, "Overall, the bulk of the ophthalmic literature would agree with the viewpoint that invasive craniotomy surgical procedures should be justified only by the presence of intractable and unbearable symptoms."Samii et al. and Scharwey and Samii 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

Union Congregational Church (Amesbury, Massachusetts)

The Union Congregational Church is a historic church facility at 350-354 Main Street in the Salisbury Point section of Amesbury, Massachusetts. It is a two-story structure, set on a granite foundation, with a tower; the main facade has two symmetrically-placed entrances, each flanked by sidelight windows and pilasters, topped by an entablature. Palladian windows are located above each entry on the second level, there is a small lunette in the gable end; the tower rises in stepped stages, starting with a square section, followed by an open belfry with round-arch openings and pilastered supports. Above the belfry is an octagonal section topped by a rounded cupola; the building, built in 1835 by local shipwrights, is an excellent local example of Greek Revival style. To its west is a vestry building, constructed in 1854, joined to the church in 1892 by adapting an old horse shed as a connector; the building was added to the National Register of Historic Places in 2014. National Register of Historic Places listings in Essex County, Massachusetts Official Website