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Miller MT, Strömland K, Ventura L. Congenital aberrant tearing: a re-look. TRANSACTIONS OF THE AMERICAN OPHTHALMOLOGICAL SOCIETY 2008; 106:100-15; discussion 115-6. [PMID: 19277226 PMCID: PMC2646435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
PURPOSE Congenital aberrant tearing is characterized by tearing when eating ("crocodile tears"), lack of emotional tearing, or both. Most reported cases are associated with Duane syndrome. In our previous studies we observed aberrant tearing in individuals with thalidomide embryopathy and Möbius sequence. This report summarizes the literature on the subject and adds 3 new studies that give information on this unusual condition. METHODS Twenty-eight individuals with Möbius sequence were interviewed about tearing symptoms at a support group meeting in Italy. In Sweden 30 adults primarily from the original thalidomide series were reexamined. In this latter study, a Schirmer test was done at baseline and repeated 5 minutes after eating. Twenty families in Brazil who have children with Möbius sequence were questioned about tearing symptoms and exposure to misoprostol during pregnancy. RESULTS In the 28 Italian individuals, either "crocodile tears" or lack of emotional tearing was noted in 7 cases. In the thalidomide study, 10 of 30 patients had tearing when eating and 7 had no emotional tearing. Low Schirmer scores or increased tearing after eating was noted in a few asymptomatic individuals. Among the 20 Brazilian children with Möbius sequence, 10 had some tearing abnormality. CONCLUSION Congenital anomalous lacrimation is rare but usually associated with Duane syndrome or abduction deficits, as in Möbius sequence and, less frequently, facial nerve palsy. Studies implicate an early insult in development at 4 to 6 weeks. At that time the facial nerve, sixth nerve, and lacrimal nucleus are in close proximity in the embryo.
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Anvari F, Hatef E, Mohammadi SF, Eskandari A. Duane's retraction syndrome, a case series from Iran. Int Ophthalmol 2007; 28:275-80. [PMID: 17701102 DOI: 10.1007/s10792-007-9125-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2006] [Accepted: 06/13/2007] [Indexed: 10/23/2022]
Abstract
PURPOSE To determine the relative prevalence of Duane's retraction syndrome (DRS) in a population of Iranian strabismus cases and to describe the clinical features. METHODS Retrospectively, a population of 7,349 strabismus cases visited during 2000-2003 were evaluated for the diagnosis of DRS. Data regarding onset (noticed age), type, head turn, primary position deviation, narrowing of the palpebral fissure, leash phenomenon, refractive error, amblyopia, and history of surgery were collected. Chi-square test and Student's t-test were used. RESULTS About 125 DRS cases were diagnosed (prevalence: 1.7%). The noticed age of the syndrome was at birth in 35.6%, during infancy in 25.4%, or childhood in 39.0%; the age at referral ranged from 3.5 months to 65.0 (median: 10.0) years. The female/male and left/right eye involvement ratios were 3:2 and 3.5:1, respectively. The syndrome was of type I in 87.0%, II in 6.5%, and III in 5.7%; 7.2% were bilateral. Horizontal deviations existed in 76.0% and vertical deviations in 12.8%. 26.8% had different degrees of amblyopia. Leash phenomenon was detected in 37.6% of cases. Head turn, primary position deviation (without turn), and orthophoria were observed in 71.2%, 13.6%, and 15.2%. Surgery had been performed in 71.2% of the cases. Vertical deviations and leash phenomenon were more common in types II and III and hypermetropia in type I (P values: 0.036, <0.001, and 0.025, respectively). CONCLUSION Basic features of our series seem to be comparable with previous reports. The incidences of bilateral involvement and type III syndrome were lower. The proportion of cases with head turn was higher and surgery was performed more frequently.
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Kim JH, Hwang JM. MR imaging diagnosis of familial Duane's retraction syndrome by documentation of the absence of the abducens nerves. Eye (Lond) 2007; 21:1431-3. [PMID: 17676019 DOI: 10.1038/sj.eye.6702945] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Pandey PK, Shroff D, Kapoor S, Kaur N, Srivastava N, Jain P, Garg D. Bilateral incyclotorsion, absent facial nerve, and anotia: fellow travelers in Möbius sequence or oculoauriculovertebral spectrum? J AAPOS 2007; 11:310-2. [PMID: 17280850 DOI: 10.1016/j.jaapos.2006.11.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2006] [Revised: 10/31/2006] [Accepted: 11/01/2006] [Indexed: 11/22/2022]
Abstract
We report a patient with bilateral incyclotorsion, asymmetric facial palsy, monocular depression deficiency, and unilateral Type 3 Duane syndrome, along with contralateral anotia and a midline cleft palate. A dysplastic middle ear cavity and unilateral absence of the facial nerve were noted on magnetic resonance imaging scanning. The differential diagnosis includes Möbius sequence, oculoauriculovertebral spectrum, and a congenital cranial dysinnervation disorder.
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Traboulsi EI. Congenital cranial dysinnervation disorders and more. J AAPOS 2007; 11:215-7. [PMID: 17572338 DOI: 10.1016/j.jaapos.2007.04.007] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2007] [Revised: 04/17/2007] [Accepted: 04/18/2007] [Indexed: 11/29/2022]
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Jethani J, Parija S, Shetty S, Vijayalakshmi P. Atypical association of Duane retraction syndrome and Bardet Biedl syndrome. Indian J Ophthalmol 2007; 55:139-41. [PMID: 17322606 DOI: 10.4103/0301-4738.30710] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Duane's retraction syndrome (DRS) includes changes in palpebral fissure width along with restriction of ocular motility. Bardet Biedl syndrome (BBS) includes presence of retinitis pigmentosa (RP) with obesity, mental retardation, polydactyly and renal abnormalities. We report a case of rare association of DRS with BBS in a seven-year-old child. The ocular motility examination revealed left DRS with esotropia. Fundus examination revealed findings characteristic of an atypical retinitis pigmentosa. The electro-retinogram waveforms were extinguished both for rods and cones. He was diagnosed as a case of BBS on the basis of the ophthalmological findings plus association with the systemic features of obesity, polydactyly, hypogonadism, mental retardation and renal abnormalities. This case gives further evidence of the fact that BBS may be associated with abnormalities of eye movements.
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Ozkan SB, Aribal ME. Comparison of orbital magnetic resonance imaging in duane syndrome and abducens palsy. Am J Ophthalmol 2007; 143:907; author reply 907-8. [PMID: 17452191 DOI: 10.1016/j.ajo.2007.01.041] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2007] [Accepted: 01/23/2007] [Indexed: 10/23/2022]
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Demer JL, Clark RA, Lim KH, Engle EC. Magnetic resonance imaging evidence for widespread orbital dysinnervation in dominant Duane's retraction syndrome linked to the DURS2 locus. Invest Ophthalmol Vis Sci 2007; 48:194-202. [PMID: 17197533 PMCID: PMC1850629 DOI: 10.1167/iovs.06-0632] [Citation(s) in RCA: 70] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE High-resolution, multipositional magnetic resonance imaging (MRI) was used to demonstrate extraocular muscles (EOMs) and associated motor nerves in Duane retraction syndrome (DRS) linked to the DURS2 locus on chromosome 2. METHODS Five male and three female affected members of two autosomal dominant DURS2 pedigrees were enrolled in the study. Coronal T(1)-weighted MRI of the orbits was obtained in multiple gaze positions, as well as with heavy T(2) weighting in the plane of the cranial nerves. MRI findings were correlated with motility. RESULTS All subjects had unilateral or bilateral limitation of abduction, or of both abduction and adduction, with palpebral fissure narrowing and globe retraction in adduction. Orbital motor nerves were typically small, with the abducens nerve (cranial nerve [CN]6) often nondetectable. Lateral rectus (LR) muscles were structurally abnormal in seven subjects, with structural and motility evidence of oculomotor nerve (CN3) innervation from vertical rectus EOMs leading to A or V patterns of strabismus in three cases. Four cases had superior oblique, two cases superior rectus, and one case levator EOM hypoplasia. Only the medial and inferior rectus and inferior oblique EOMs were spared. Two cases had small CN3s. CONCLUSIONS DRS linked to the DURS2 locus is associated with bilateral abnormalities of many orbital motor nerves, and structural abnormalities of all EOMs except those innervated by the inferior division of CN3. The LR may be coinnervated by CN3 branches normally destined for any other rectus EOMs. Therefore, DURS2-linked DRS is a diffuse congenital cranial dysinnervation disorder involving but not limited to CN6.
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Kato Z, Yamagishi A, Kondo N. Interstitial deletion of 1q42.13-q43 with Duane retraction syndrome. J AAPOS 2007; 11:62-4. [PMID: 17126050 DOI: 10.1016/j.jaapos.2006.09.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2006] [Revised: 09/04/2006] [Accepted: 09/05/2006] [Indexed: 11/26/2022]
Abstract
Duane retraction syndrome is a congenital eye movement disorder characterized by failure of the sixth cranial nerve or nucleus to develop properly, resulting in restriction of abduction, narrowing of the palpebral fissure, and retraction of the globe on attempted adduction and/or restricted adduction. The gene loci of Duane syndrome have been mapped on 8q and 2q, indicating a heterogeneity. We report here a patient with interstitial deletion of 1q with Duane syndrome. The karyotype of our patient suggests another possible locus of the Duane syndrome, and the mapped genes around the deleted region, 1q42.13-43, contain possible candidate genes such as a homeobox gene. However, further clinical descriptions of patients with Duane syndrome and genetic investigations of the deleted regions are needed for a more accurate delineation.
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Kang NY, Demer JL. Comparison of orbital magnetic resonance imaging in duane syndrome and abducens palsy. Am J Ophthalmol 2006; 142:827-34. [PMID: 16989758 PMCID: PMC1850671 DOI: 10.1016/j.ajo.2006.06.012] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2005] [Revised: 06/05/2006] [Accepted: 06/05/2006] [Indexed: 11/29/2022]
Abstract
PURPOSE To help resolve the clinical ambiguity between Duane syndrome with severe abduction deficit and abducens palsy, we performed orbital magnetic resonance imaging (MRI) to qualify abnormalities of the lateral rectus (LR) muscle in these entities. DESIGN Prospective observational case series. METHODS Orbital MRI was performed in 13 subjects with Duane syndrome (19 eyes), 10 subjects with chronic abducens palsy (10 eyes), and 10 orthotropic control subjects (18 eyes). High-resolution, surface coil, T(1)-weighted MRI was used to obtain contiguous, 2-mm thick quasi-coronal images of the orbits in central gaze. Digital image analysis was used to quantify cross-sectional area of the ipsilesional and contralesional LR to provide comparison with control measurements. RESULTS Mean maximum LR cross-sectional area in Duane syndrome was statistically similar to control (P = .454) and contralesional LR cross-sectional area (P = .227). However, in chronic abducens palsy, mean maximum ipsilesional LR cross-sectional area was markedly smaller than contralesional (P = .003) and control cross-sectional areas (P < .0001), as well as smaller than the LR in Duane syndrome (P= .0017). CONCLUSIONS The LR muscle in abducens palsy exhibits profound atrophy. The sparing of the LR in Duane syndrome from denervation atrophy despite absence of normal abducens innervation suggests existence of alternative LR innervation. High-resolution MRI can noninvasively demonstrate LR muscle size and distinguish Duane syndrome from chronic abducens palsy in uncertain cases.
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Abstract
PURPOSE To describe the clinical characteristics of bilateral Duane syndrome. METHODS Retrospective medical record review (1982 to 2003) for patients with a diagnosis of Duane syndrome (examined by a pediatric ophthalmologist) who were bilaterally affected and had no prior ocular surgery. Data collected included type of Duane syndrome, gender, family history for strabismus, abnormal head position, versions, strabismus measurements, associated ocular and/or nonocular abnormalities, and amblyopia status. RESULTS Of 270 patients with the diagnosis of Duane syndrome, 37 (14%) were bilaterally affected. None had ocular surgery prior to referral. Twenty-two (59%) were male, 35 (95%) had the same Duane syndrome type in both eyes, 29 (78%) had strabismus in primary position, 9 (24%) had ocular and nonocular congenital abnormalities, 6 (16%) had amblyopia, and 8 (22%) had a recorded strabismus family history. CONCLUSIONS Unlike unilateral Duane syndrome, bilateral Duane syndrome may be more common in males and associated with a higher prevalence of strabismus in primary gaze position. The prevalences of amblyopia, positive strabismus family history, and associated congenital abnormalities in this series of bilateral cases is similar to the reported prevalence.
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Abstract
BACKGROUND A causative therapy for Duane's retraction syndrome, which is the most prominent example of connatal ocular misinnervation, does not exist. Eye muscle surgery is indicated in cases with manifest strabismus in primary position and an annoying compensatory head posture to maintain binocular single vision. Different surgical approaches to the different types of Duane's retraction syndrome, mostly on the affected eye but also on the fellow eye, are described in the literature. METHOD We retrospectively analyzed the pre- and postoperative findings of 55 patients in whom we performed surgery because of Duane's retraction syndrome during the years 1999 to 2004. The type of retraction syndrome, the angle reduction in primary position and the reduction of head posture were evaluated in regard to the surgical procedure chosen. RESULTS In 37 cases surgery was primary. In 25 cases a single recession of the medial rectus (16 cases) or the lateral rectus (9 cases) muscle of the affected eye was performed. For a dose-response relationship of the one-muscle recessions, the mean angle reduction in the primary position was 2 pdpt (cm/m) per mm recession. The mean reduction of head posture was 1.5 degrees per mm recession. In 10 cases combined surgery on the affected eye was performed. The correlation between the mean angle reduction and the recession was 3 pdpt (cm/m) per 1 mm. CONCLUSION Depending on the type of retraction syndrome, the angle in primary position, the head posture and the globe retraction, different surgical options exist which aim at rehabilitation of the patient suffering from Duane's retraction syndrome.
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Wabbels B, Höckele N, Roggenkämper P. ["Sometimes my left eye disappears under the eyelid"]. Ophthalmologe 2006; 103:345-6. [PMID: 16538475 DOI: 10.1007/s00347-006-1326-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Abstract
Brown syndrome and esotropic Duane syndrome are common forms of noncomitant strabismus. We report the unusual coexistence of these two eye movement abnormalities in a 5-year-old boy. Strabismus surgery for both conditions was required to improve the head posture.
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Kim JH, Hwang JM. Presence of the abducens nerve according to the type of Duane's retraction syndrome. Ophthalmology 2005; 112:109-13. [PMID: 15629829 DOI: 10.1016/j.ophtha.2004.06.040] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2004] [Accepted: 06/28/2004] [Indexed: 10/26/2022] Open
Abstract
OBJECTIVE To analyze whether the presence of the abducens nerve might depend upon the type of Duane's retraction syndrome (DRS). DESIGN Observational case series. PARTICIPANTS Sixteen patients with type 1 DRS, 2 patients with type 2 DRS, and 5 patients with type 3 DRS. METHODS Ophthalmologic examination and thin-sectioned magnetic resonance imaging (MRI) at the brain stem level were performed in 23 DRS patients. To confirm the accuracy of the procedure, we compared the results obtained with those of a control group of 30 individuals using the same technique. MAIN OUTCOME MEASURES Examination of ductions and versions and the presence of the abducens nerve on MRI. RESULTS The abducens nerve on the affected side could not be observed using MRI in 18 (100%) of 18 eyes (16 patients) with type 1 DRS and in 3 of 5 eyes with type 3 DRS. Conversely, the abducens nerve was observed in 2 of 2 eyes with type 2 DRS and 2 of 5 eyes with type 3 DRS. The abducens nerve was observed in 60 (100%) of 60 eyes screened as controls. CONCLUSIONS The abducens nerve on the affected side was absent in type 1 DRS patients and some type 3 DRS patients, but present in type 2 DRS patients as well as in some type 3 DRS patients. In terms of the presence or absence of the abducens nerve, type 1 and type 2 DRS were homogenous, and type 3 DRS was heterogenous.
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Connell BJ, Wilkinson RM, Barbour JM, Scotter LW, Poulsen JL, Wirth MG, Essex RW, Savarirayan R, Mackey DA. Are Duane syndrome and infantile esotropia allelic? Ophthalmic Genet 2005; 25:189-98. [PMID: 15512995 DOI: 10.1080/13816810490498323] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
PURPOSE To evaluate the clinical overlap of families with Duane syndrome and infantile esotropia to determine whether the identification of genes for Duane syndrome may explain some cases of infantile esotropia. METHODS Three separate groups of patients were evaluated. 1) Families with features of infantile esotropia were identified through the Strabismus Inheritance Study Tasmania (SIST). Clinical details of participants and their families were reviewed for any cases of Duane syndrome. 2) Cases of Duane syndrome were identified through the clinical diagnostic database at the Royal Children's Hospital, Melbourne, and private ophthalmology clinics in Melbourne and Tasmania. Previous medical notes were reviewed and family history of strabismus noted. All affected individuals were invited for re-examination in cases where a positive family history of strabismus was reported; siblings, parents, and other family members, where appropriate, were invited to be examined for signs of Duane syndrome or infantile esotropia. 3) Cases of mosaic trisomy 8, which has been associated with Duane syndrome and infantile esotropia, were reviewed for signs of strabismus. RESULTS A total of 133 families from the SIST were reviewed, but no 'pure' families of Duane syndrome were identified. Two families with infantile esotropia had several members affected with Duane syndrome. Of the 40 index cases with Duane syndrome whose families agreed to be involved in the study, 21 had a family history of ocular motility disorders, but only two of these families had multiple cases of Duane syndrome. From 24 cases with mosaic trisomy 8, one individual case had Duane syndrome and another had mild congenital cataracts and infantile esotropia. CONCLUSIONS There is clinical overlap in families with Duane syndrome and infantile esotropia. We confirmed the previous association of mosaic trisomy 8 with both Duane syndrome and infantile esotropia. These data suggest that the two conditions may be allelic and may be due to a gene on chromosome 8.
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Abstract
BACKGROUND Duane retraction syndrome is the most common cause of congenital aberrant ocular innervation. We report referral practices, clinical characteristics and complications, prevalence of congenital and familial anomalies, and management outcomes from a clinic-based series. METHODS Retrospective clinic-based study of 65 patients with Duane retraction syndrome seen between January 1994 and March 2004. RESULTS The majority of patients were girls with type I Duane retraction syndrome associated with esotropia in primary gaze. Twenty percent of cases were complicated by absent binocular stereoacuity and 16.9% had amblyopia. Family history of any ocular disorder was reported in 38.5% of cases, while an associated congenital abnormality was found in 46% of patients. There was a significant delay between the age when ocular abnormalities were first noticed and the age when patients presented at our tertiary referral center (P < .001). Twenty-two percent of patients underwent surgical correction at a mean age of 6 years. Most procedures were unilateral or bilateral medial or lateral rectus recessions. Postoperative ocular alignment < or = 15 prism diopters (PD) was achieved in 86% of cases, with 50% of cases having < or = 5 PD. CONCLUSIONS Amblyopia and absent binocular stereo vision affected one in five patients with Duane retraction syndrome. There was significant delay between identification of an abnormality and presentation at the eye clinic.
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Tomi A, Preda C, Poenaru O, Zamfiroiu F. [Duane's syndrome--etiopathogenesis, clinical features and diagnosis]. OFTALMOLOGIA (BUCHAREST, ROMANIA : 1990) 2005; 49:10-4. [PMID: 16245737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Duane syndrome is a congenital disease also known as congenital retraction syndrome or Stilling-Turk-Duane retraction syndrome. There are three types of Duane syndrome; their variability is given by the aberrant innervation of the lateral rectus muscle. The symptoms of the disease were described and they are all known, but the etiology and the pathology remain unclear. Although Duane syndrome was considered as a pure local myogenic phenomenon (the lateral rectus muscle fibrosis), the modern theory is the absence of the abducens nuclei. Various theories have been put forward on the basis of data collected from surgical, autopsy and electromyography studies. The most frequent and terrifying differential diagnosis is the VI nerve palsy and the symptoms of Duane syndrome suggest an intracranial disease, so we understand the parents and patient fear. That's why is very important to explain them the causes and the consequences of the disease and to educate the patients to obtain the optimal functional and mental comfort. Finally, we have in mind one, at least subjective, question: why is the abducens nerve nucleus affected and how?
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Abstract
The authors describe the case of a 5-year-old girl traumatized from a dog bite to the superior aspect of the orbit in the right eye. The dog's canine tooth penetrated deep into the posterior orbit and severed the attachment of the superior oblique muscle from the globe posterior to the trochlea. The management and clinical course of the patient are described and photographs documenting the initial ocular damage and postoperative course are provided. In addition, the entity known as 'canine tooth syndrome' is reviewed.
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Wabbels BK, Kohlhase J, Lorenz B. [Clinical and molecular genetic findings in isolated sporadic Duane syndrome]. Klin Monbl Augenheilkd 2004; 221:849-53. [PMID: 15499520 DOI: 10.1055/s-2004-813662] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Duane retraction syndrome (DURS) accounts for 1 - 4 % of all cases of strabismus. Approximately 90 % of the cases are sporadic with a preponderance for females and the left eye. Many associated ocular and systemic findings have been described. Recently, mutations of SALL4 have been found in patients with autosomal-dominantly inherited Okihiro syndrome (DURS associated with forearm malformations). The aim of this study was the clinical examination of patients with isolated sporadic DURS and the molecular genetic analysis of SALL4 in these patients. SUBJECTS AND METHODS Twenty-five patients with non-familial DURS (aged 1 - 75 years, 16 female, 9male) were examined clinically and were interviewed concerning associated pathologies. DNA was prepared from peripheral lymphocytes, and the complete coding region of SALL4 was sequenced. RESULTS In 18 patients DURS affected the left eye, in four the right eye, and was bilateral in three patients. One patient had fused vertebrae, one had a cone-rod-dystrophy. No hearing impairments or malformation of the upper limbs were observed. No mutation in the coding region of SALL4 could be detected. DISCUSSION Associated conditions in DURS patients most commonly involve the ear, the spinal column, the kidneys and the heart and the upper limbs. No mutations in SALL4 could be detected in patients with isolated sporadic DURS as opposed to findings in familial Okihiro syndrome. However, Okihiro syndrome shows marked intra- and interfamilial variability, suggesting that in rare cases of isolated DURS a causative SALL4 mutation may be found.
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Bogdănici C, Preutesi A, Ciobanu C. [Treatment modalities in Duane syndrome]. OFTALMOLOGIA (BUCHAREST, ROMANIA : 1990) 2004; 48:85-9. [PMID: 15279427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
Stilling-Türk-Duane syndrome is a restrictive syndrome caused by an abnormal innervation of the lateral rectus muscle, which is the result of nerve VI agenesia. One of the most important feature is represented by "co-contraction phenomenon" which means the simultaneous contraction of lateral and medial muscles in adduction. The treatment is individualised and most patients may benefit of surgical procedures. The goals of surgical treatment is: improved head posture, elimination of vertical deviation, reduced of enophthalmos and normal ocular alignment. This issue represent the surgical management and the postoperative results in 3 cases of Stilling-Türk-Duane syndrome treated in Eye Clinic, Iasi.
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Pelit A, Aydogan N, Oto S, Haciyakupoglu G, Yilmaz Z, Akova YA. Duane's retraction syndrome in association with retinitis pigmentosa. J AAPOS 2003; 7:423-4. [PMID: 14730296 DOI: 10.1016/s1091853103002155] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
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Urbaniak J, Durko A, Selmaj K. [Familial congenital bilateral Duane's retraction syndrome (Stilling-Turk-Duane syndrome). A case report]. Neurol Neurochir Pol 2003; 37:429-35. [PMID: 14558489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
Abstract
The authors describe a case of Duane's Retraction Syndrome, which is an unfrequent cause of eye movement disturbances. The classic syndrome is characterized by a disability for horizontal eyes movements without concurrent diplopia. It is a multi-etiological, congenital or acquired syndrome.
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Abstract
PURPOSE The aim of this study was to visualize the subarachnoid portion of the nervus abducens by magnetic resonance imaging and to analyze whether aplasia of the nervus abducens is an etiologic factor in Duane's retraction syndrome. METHODS We performed thin-sectioned magnetic resonance imaging across the brainstem level in 8 cases (11 eyes) that were clinically diagnosed as Duane's retraction syndrome. The same test was applied to 8 healthy control subjects to verify the accuracy of this technique. RESULTS The nervus abducens on the affected side could not be observed in 6 (54.5%) of 11 eyes (8 cases) that were clinically diagnosed as having Duane's retraction syndrome. The nervus abducens was observed in 15 (94%) of 16 eyes that were screened as the control group. CONCLUSIONS The results showed that aplasia of the nervus abducens, although an important etiologic factor, is not the only factor responsible for the diagnosis of Duane's retraction syndrome.
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