Marcus Gunn syndrome - A body of polietiologic disease manifested blepharoptosis upper eyelid, which spontaneously rises with movements in the temporomandibular joint. Diagnosis includes a medical history, conduct visual inspection, radiography, magnetic resonance imaging (MRI), ophthalmoscopy, visometry, biomicroscopy. Tactics of treatment depends on the severity of ptosis. With minimal manifestations surgery is not indicated. In severe tarzomioektomiya carried out, partial resection of the levator of the upper eyelid and its subsequent consolidation using autograft.
Marcus Gunn Syndrome
ophthalmology, upper eyelid ptosis manifested in combination with synkineses. The disease was first described in 1883 by the British ophthalmologist M. Hun, who observed clinical symptoms syndrome in a child of fifteen. According to statistics, pathology occurs in 5% of patients with congenital blepharoptosis. Marcus Gunn syndrome is widespread. Among the representatives of the male and female found with the same frequency. Usually, the first signs of the disease in children detected during breastfeeding. Parents pay attention to the synchronous opening of the mouth of the upper eyelid movement.
cerebral ischemia, traumatic brain injury, encephalitis. Less provoking factor is the loss of the facial nerve during surgery, tooth extraction, or invasive cosmetic procedures. The mechanism of development palpebromandibulyarnoy synkineses Marcus Gunn plays the main role the formation of pathological relations between the oculomotor, trigeminal and facial nerves. In this hotbed of abnormal impulses is supranuclear.
According to the phylogenetic theory of the cause of the disease it is a rudimentary gill-oral synkinesis, t. To. At the fish during the opening of the mouth gill arches are lifted. The basis for the formation of a person may be congenital or acquired lesion pyramidal system. This compensatory activation of subcortical structures of the brain triggers the development of clinical manifestations of the syndrome Marcus Gunn.
amblyopia. Palpebromandibulyarnaya synkinesis can develop in isolation or combined with Waardenburg syndrome, and Hirschsprung.
X-ray, magnetic resonance imaging (MRI), ophthalmoscopy. Additional methods of research - visometry, biomicroscopy. In rare cases, a history of the patient has familial forms of the disease, but most often develops sporadically congenital abnormality. Patients acquired form of Marcus Gunn syndrome often say traumatic eye injury prior to the appearance of clinical symptoms. At external examination visualized ptosis one, rarely two age who independently liquidated during movement in the temporomandibular joint.
Radiography is carried out in the case of acquired forms to identify organic damage. MRI can detect a pathological relationship between the oculomotor, trigeminal and facial nerve. Usually, the abnormal foci supranuclear located. The consequence of these changes may be wasting of the masseter muscle and the circular muscles of the eye. During the ophthalmoscopy pathological changes in the optic nerve is not found. biomicroscopy method can detect congestion and swelling of the conjunctiva. Visual acuity is usually correct. The differential diagnosis of Marcus Gunn syndrome should be carried out with congenital ptosis. In this disease of the lower jaw movements are not conducive to raising the age. Palpebromandibulyarnaya synkinesis is one of neurogenic ptosis, so for diagnosis in addition to examination by an ophthalmologist is necessary to consult a neurologist.