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Congenital Cranial Dysinnervation Disorder
Published in Vivek Lal, A Clinical Approach to Neuro-Ophthalmic Disorders, 2023
Congenital Brown syndrome often occurs sporadically but several familial cases have been reported in the literature including identical twins (27, 28). Brown syndrome is mostly unilateral with around 10% of the cases being bilateral and no sexual preference is usually seen (29).
Ophthalmology
Published in Stephan Strobel, Lewis Spitz, Stephen D. Marks, Great Ormond Street Handbook of Paediatrics, 2019
Brown syndrome: this is not an uncommon condition where the tendon of the superior oblique muscle is unable to pass freely through its pulley (the trochlea, at the superomedial orbital rim). This results in restriction of elevation in upgaze usually just in the adducted position. As a result there may be a coincident downshoot in adduction on version testing. It is usually idiopathic but may be acquired due to inflammation at the trochlea or trauma.
Strabismus patterns after cataract surgery in adults
Published in Strabismus, 2021
Mirjam Johanna Rossel-Zemkouo, Richard Bergholz, Daniel J Salchow
Cataract surgery had been performed under regional anesthesia in 37 cases. The remaining three patients were operated under general anesthesia. In these cases, the diagnoses were decompensated esophoria, exotropia at near due to convergence insufficiency associated with Parkinson's disease, and acquired Brown syndrome of the operated right eye. After cataract surgery under regional anesthesia, 36 of 37 patients had vertical strabismus, one patient had a decompensated exophoria at near. In three cases, a vertical deviation resulted from acquired Brown syndrome, two of them had restriction of elevation in adduction of the operated eye (one right, one left). One of these had a history of sclerouveitis associated with granulomatosis with polyangiitis and had received a microimplant during cataract surgery for secondary glaucoma. The third patient had Brown syndrome on the contralateral (non-operated right) eye.
Brown Syndrome Following Upper Eyelid Ptosis Repair
Published in Neuro-Ophthalmology, 2018
Yao Wang, Timothy J. McCulley, Jefferson J. Doyle, Jessica Chang, Michael S. Lee, Collin M. McClelland
In the superonasal orbit, the superior oblique tendon lies in close proximity to the medial edge of the levator palpebrae superioris aponeurosis.6 Surgical manipulation in this region during ptosis surgery, blepharoplasty, or orbital mass biopsy can lead to damage of the superior oblique tendon and/or trochlea. Involutional changes of the upper eyelid, such as medial dehiscence of the Whitnall ligament, fatty infiltration of the levator muscle, and lateral tarsal shift can disturb normal anatomy and increase the risk of inadvertent injury to the trochlea.7 Despite this close anatomical relationship, Brown syndrome following eyelid surgery has only rarely been reported in the literature.
Superior oblique palsy: A case report
Published in Cogent Medicine, 2020
Ngozika Esther Ezinne, Kingsley Kenechukwu Ekemiri, Aliyah Khan
Based on the reported symptoms, the possible differential diagnosis are Brown syndrome, myasthenia gravis, thyroid eye diseases (TED), SOP or fourth nerve palsy and skew deviation. Brown syndrome is characterized by restriction of the superior oblique trochlea-tendon complex such that the affected eye does not elevate in adduction (Yang et al., 2017). Individuals with Brown syndrome may exhibit compensatory head turn or chin-up head posture and, occasionally, amblyopia; which was not the case in our patient as she had chin down rather than up; therefore, Brown syndrome was ruled out.