EOM atrophy is reported in a number of other neuromuscular disorders. Cranial nerve palsies (III, IV or VI) cause atrophy which is restricted to the muscle innervated by the affected nerve, thereby making it straight-forward to distinguish the affected muscle radiologically [6]. EOM atrophy is variably apparent in myasthenia gravis, but consistently seen in cases left untreated [7]. Radiological atrophy of clinically affected muscles has also been found in congenital fibrosis of EOMs type 1 [12] and type 2 [13] (now known to be dysinnervation syndromes). Taken together, these studies suggest that EOM atrophy is a feature of late-stage muscle pathology irrespective of the underlying cause, comparable to the atrophy of skeletal limb muscles on MRI in both neurogenic and myopathic disorders [14].