Superior oblique myokymia is a well-described disorder in which patients have monocular, high-frequency, low-amplitude contractions of the superior oblique muscle producing torsional or vertical oscillopsia. These episodes often last seconds to hours and can occur several times a day. These movements can sometimes be induced by infraduction but otherwise occur spontaneously. The etiology of this disorder is unknown, although it is almost always benign. In recent years, some have suggested that superior oblique myokymia is due to vascular or nonvascular mechanical compression of the trochlear nerve at the root exit zone or is a primary brainstem disorder.1- 5 However, in the vast majority of cases, no underlying cause is ever found. The clinical course is highly variable, ranging from spontaneous recovery to chronic oscillopsia and diplopia.6 Several therapies have been tried with varied success, including topical β-blockers, carbamazepine, phenytoin, baclofen, gabapentin, and, in severe cases, incisional surgery.1 We describe a unique form of myokymia involving monocular, high-frequency, low-amplitude contractions causing excyclotorsion, not incyclotorsion, induced by supraduction, suggesting an inferior oblique myokymia. Based on a PubMed search, this has not been described in the literature to date.