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Comprehensive analyses of SOM symptomatology and long-term progression are limited. No diagnostic criteria are available.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Adult patients who were diagnosed with SOM between 2008 and 2024 were asked to complete a detailed questionnaire on disease symptomatology, time course, and medication. The impact of the disease on patient-reported functioning was assessed using a Likert scale. In addition, medical records were screened in all patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 35 patients with SOM were identified (21 females; mean age at symptom onset 42.8\u2009\u00b1\u200915.0\u00a0years). 30 patients experienced visuo-perceptual symptoms (i.e., diplopia or oscillopsia, 85.7%), 22 patients ocular\u00a0motor symptoms (i.e., noticeable \u201ceye-twitching\u201d, 62.9%), and 15 patients dizziness or gait instability (42.9%). Of 22 patients analyzed for their long-term therapeutic outcome, 13 described symptom improvement with pharmacotherapy, and six without pharmacotherapy. Patients experienced a moderate to high impact of the disease on their daily private and professional lives. Based on these findings, specific diagnostic criteria for SOM were proposed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>SOM can substantially impair patients\u2019 quality of life and daily functioning. The long-term course appears favorable, with most patients experiencing either complete remission or significant symptom reduction over time. Pharmaceutical treatment proved effective in nearly 90% of patients, and spontaneous remission was also observed. Further research should focus on larger patient cohorts defined by clear diagnostic criteria to enhance understanding of SOM\u2019s natural history and treatment outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00415-026-13773-6","type":"journal-article","created":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T15:41:50Z","timestamp":1775058110000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Superior oblique myokymia: diagnostic criteria and long-term outcome"],"prefix":"10.1007","volume":"273","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5053-1462","authenticated-orcid":false,"given":"Johannes","family":"Gerb","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas","family":"Zwergal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicole","family":"Lehrer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nedda","family":"Hansel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marius","family":"N\u00e4her","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Franziska","family":"Thiessen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marianne","family":"Dieterich","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Doreen","family":"Huppert","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,4,1]]},"reference":[{"key":"13773_CR1","first-page":"63","volume":"11","author":"A Duane","year":"1906","unstructured":"Duane A (1906) Unilateral rotary nystagmus. 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