ABSTRACT
ABSTRACT This report documents an unusual phenomenon. A 6-year-old girl with trochlear-oculomotor synkinesis presented with superior oblique and palpebral levator co-contraction. The literature was reviewed and the possibility of classifying this entity as a congenital cranial dysinnervation disorder was speculated.
RESUMO Este relato descreve um fenômeno incomum. Uma menina de 6 anos com sincinesia troclear-oculomotora apresentou co-contração do oblíquo superior e do levantador da pálpebra. A literatura foi revisada e especulou-se a possibilidade de classificar essa desordem como um distúrbio da congenital cranial dysinnervation disorder.
Subject(s)
Humans , Female , Child , Ocular Motility Disorders/congenital , Cranial Nerves/abnormalities , Trochlear Nerve Diseases/congenital , Synkinesis/congenital , Oculomotor Muscles/innervation , Ocular Motility Disorders/classification , Ocular Motility Disorders/pathology , Trochlear Nerve Diseases/classification , Trochlear Nerve Diseases/pathology , Rare Diseases , Synkinesis/classification , Synkinesis/pathology , Eyelids/abnormalitiesABSTRACT
This report documents an unusual phenomenon. A 6-year-old girl with trochlear-oculomotor synkinesis presented with superior oblique and palpebral levator co-contraction. The literature was reviewed and the possibility of classifying this entity as a congenital cranial dysinnervation disorder was speculated.
Subject(s)
Cranial Nerves/abnormalities , Ocular Motility Disorders/congenital , Oculomotor Muscles/innervation , Synkinesis/congenital , Trochlear Nerve Diseases/congenital , Child , Eyelids/abnormalities , Female , Humans , Ocular Motility Disorders/classification , Ocular Motility Disorders/pathology , Rare Diseases , Synkinesis/classification , Synkinesis/pathology , Trochlear Nerve Diseases/classification , Trochlear Nerve Diseases/pathologyABSTRACT
OBJECTIVE: To evaluate the efficacy of treating Knapp class II superior oblique muscle palsy with 7-mm nasal transposition of the ipsilateral inferior rectus muscle combined with recession of the contralateral inferior rectus muscle when the primary position hypertropia is 10 prism diopters (PD) or less. METHOD: A retrospective review of 8 consecutive patients with superior oblique muscle paresis who had nasal transposition of the inferior rectus muscle in the paretic eye and recession of the inferior rectus muscle in the nonparetic eye. Ocular motility, including objective and subjective torsion, were evaluated before and after surgery. RESULTS: The mean (SD) preoperative hypertropia was 5 PD (1.5) and 13.1 (3.6) PD in the primary position and downgaze, respectively. After surgery the mean (SD) hypertropia was 1.25 (1.0) and 3.25 (1.3) PD in the primary position and downgaze, respectively. The mean (SD) subjective excyclotropia decreased from 6.6 degrees (1.3 degrees) preoperatively to 0.5 degrees (0.9 degrees) after surgery, and there was a mean (SD) objective decrease in the excyclotorsion of the paretic eye by 7.8 degrees (1.4 degrees). All patients were diplopic before surgery and asymptomatic after surgery. CONCLUSION: Treatment with 7-mm nasal transposition of the ipsilateral inferior rectus muscle combined with recession of the contralateral inferior rectus muscle can effectively treat Knapp class II superior oblique muscle palsy when the primary position hypertropia is 10 PD or less.
