title: Fourth cranial nerve palsy and Brown syndrome: two interrelated congenital cranial dysinnervation disorders?
abstract: Based on neuroimaging data showing absence of the trochlear nerve, congenital superior oblique palsy is now classified as a congenital cranial dysinnervation disorder. A similar absence of the abducens nerve is accompanied by misinnervation to the lateral rectus muscle from a branch of oculomotor nerve in the Duane retraction syndrome. This similarity raises the question of whether some cases of Brown syndrome could arise from a similar synkinesis between the inferior and superior oblique muscles in the setting of congenital superior oblique palsy. This hypothesis has gained support from the confluence of evidence from a number of independent studies. Using Duane syndrome as a model, we critically review the accumulating evidence that some cases of Brown syndrome are ultimately attributable to dysgenesis of the trochlear nerve.
authors: Jules Gonin Eye Hospital, University of Lausanne, Avenue de France 15, 1004, Lausanne, Switzerland. pierre-francois.kaeser@fa2.ch
authors: Pierre-François
authors: PF
authors: Kaeser
authors: Michael C
authors: MC
authors: Brodsky
mesh_terms: D006801:Humans; D015835:Ocular Motility Disorders / Q000150:complications / Q000151:congenital*; D009801:Oculomotor Muscles / Q000002:abnormalities* / Q000294:innervation; D014321:Trochlear Nerve / Q000002:abnormalities*; D020432:Trochlear Nerve Diseases / Q000150:complications / Q000151:congenital*
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