Misdirection revisited. A critical appraisal of acquired oculomotor nerve synkinesis
F. E. Lepore and J. S. Glaser
Two patients exhibiting "primary" oculomotor misdirection caused by
intracavernous mass lesions, and a third boy with transient oculomotor
synkinesis after migrainous ophthalmoplegia provide background for a
reassessment of the currently accepted explanation of anomalous synkineses
subsequent to oculomotor nerve palsies. The hypothesis of peripheral
misdirection of regenerating motor axons is inconsistent with these
clinical observations, and an alternate mechanism is suggested, based on
concepts of ephaptic neuronal transmission of impulses or on
chromatolysis-induced reorganization of nuclear synapses.
