Magnetic resonance imaging of an unusual case of Brown's syndrome with contralateral superior oblique palsy

[Brown's syndrome]

Brown's syndrome is related to an abnormality of the superior oblique muscle: it is manifested by an oculomotor disorder with active and passive limitation of elevation in adduction, the field of action of the inferior oblique muscle. The origin is congenital or acquired secondary to multiple causes - inflammatory-infectious, traumatic or iatrogenic. The clinical and paraclinical signs are suggestive. Cerebral and orbital imaging including CT and magnetic resonance imaging (MRI) is essential for the diagnosis and management of congenital or acquired Brown's syndrome. The course may yield improvement (spontaneous or after etiological treatment) or a steady state. Treatment is rarely surgical. The indication for surgery requires specific functional and clinical signs: torticollis, hypotropia in primary position, associated strabismus and impaired binocular vision; the long-term results of the various surgical techniques are variable.