Brown Syndrome

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Classification according to ICD-10
H50.6 Mechanically induced strabismus - Brown syndrome
ICD-10 online (WHO version 2019)

When Brown syndrome ( synonym: oblique superior carpal tunnel syndrome ) is a rare, congenital or acquired movement disorder of the eye . The disease is named after the US ophthalmologist Harold Whaley Brown , who first described it in 1950.

Symptoms

The main symptom is restricted movement of the eye , caused by a pathological thickening of the tendon of the superior oblique muscle (upper oblique eye muscle) or, in congenital cases, by a false innervation. Depending on the current direction of gaze, this muscle has the function of lowering the eye, rolling it inward and turning it outward.

As a result of the thickening, the muscle or its tendon can no longer move completely through the trochlea , a cartilage sheath on the inner, upper orbital edge . As a result, the eye experiences both a passive and an active, mechanically conditioned motility restriction. This cannot be overcome even with the traction test (passive mobility). In general, double vision occurs . Disturbances occur more frequently in the middle and upper areas of the field of vision, less in the lower half of the field of vision.

etiology

Acquired Brown Syndrome is often triggered by trauma or allergic reactions and rheumatism . In rare cases, a special procedure for eye muscle surgery (superior oblique folding) can also lead to typical symptoms known as postoperative Brown syndrome .

There are also innate variants. The latest MRI- based series of examinations allow the thesis that, in some cases, the cause may be a misinervation of the superior oblique muscle caused by fibers of the oculomotor nerve . This would mean that they belong to the group of congenital cranial malnervation syndromes ("Congenital Cranial Dysinnervation Disorders - CCDD").

therapy

The extent of the movement disorder can vary widely. Treatment is therefore not necessary in all cases and must be discussed depending on the symptoms. If indicated, there are surgical treatment options. The administration of ibuprofen has shown itself to be potentially effective in terms of medication .

Differential diagnosis

A distinction is made between Brown syndrome with its persistent symptoms and superior oblique click syndrome with intermittent symptoms and symptoms.

Prominent victims

Allegedly Alexander the Great suffered from this disease. This hypothesis was put forward by Greek scientists in the 1990s on the basis of statues of the general .

Web links

literature

  • Herbert Kaufmann (Ed.): Strabismus. 3rd, fundamentally revised and expanded edition. Georg Thieme, Stuttgart et al. 2003, ISBN 3-131-29723-9 .

Individual evidence

  1. ↑ Gerold H. Kolling: Genesis and mechanics of strabismus sursoadductorius and congenital Brown syndrome . From "orthoptik - pleoptik" issue 36/2013.