Document Detail

Absence of the fourth cranial nerve in congenital Brown syndrome.
MedLine Citation:
PMID:  22268674     Owner:  NLM     Status:  Publisher    
Purpose:  To elucidate the aetiology of congenital Brown syndrome. Methods:  Four consecutive patients diagnosed with unilateral congenital Brown syndrome had a comprehensive standardized ocular motility examination. Any compensatory head posture was measured. Brain magnetic resonance imaging (MRI) with regard for the IV cranial nerve (CN) was performed in all patients. Orbital MRI was performed in 2/4 patients, with images acquired in eight directions of gaze and superior oblique (SO) muscle areas compared. Results:  CN IV could not be identified bilaterally in two patients, but was absent only on the side of the Brown syndrome in the two other patients. On the normal side, orbital MRI revealed a smaller SO muscle area in upgaze than in downgaze, demonstrating normal actions of this muscle. On the side of the Brown syndrome, the SO area remained the same in upgaze and in downgaze and approximately symmetric to the area of SO in downgaze on the normal side. Conclusions:  These cases add further anatomical support to the theory of paradoxical innervation in congenital Brown syndrome. CN IV was absent in two patients on the side of the Brown syndrome, but without muscle hypoplasia. SO muscle size did not vary in up- and downgaze, which we interpreted as a sign of constant innervation through branches of CN III.
Pierre-François Kaeser; Bodo Kress; Stefan Rohde; Gerold Kolling
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-1-23
Journal Detail:
Title:  Acta ophthalmologica     Volume:  -     ISSN:  1755-3768     ISO Abbreviation:  -     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2012-1-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101468102     Medline TA:  Acta Ophthalmol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2012 The Authors. Acta Ophthalmologica © 2012 Acta Ophthalmologica Scandinavica Foundation.
Hôpital Ophtalmique Jules Gonin, Lausanne University Ophthalmology Department, Lausanne, Switzerland Zentralinstitut für Radiologie und Neuroradiologie, Krankenhaus Nordwest GmbH, Frankfurt, Germany Department of Neuroradiology, University of Heidelberg, Heidelberg, Germany Heidelberg University Eye Clinic, Heidelberg, Germany.
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