Surely many people have heard of a phenomenon such as Marcus-Hunn syndrome. In short, this is an abnormal eyelid movement. It has much in common with unilateral ptosis, it only disappears as soon as a person opens his mouth or begins to move his jaw.
What causes this anomaly? Is it possible to learn about its formation before the appearance of the main symptom? Is she being treated? If so, how? There are many questions. And the most important ones should be answered now.
Anomaly Description
Marcus-Hunn syndrome is also called palpebromandibular synkinesia. This is a congenital pathology. Cases when it was acquired are few. Yes, and the disease itself is rare.
An anomaly is accompanied by a prolapse of the upper eyelid, combined with synkinesia. They appear in the following: when a person moves his jaw, the eyelid affected by ptosis rises.
It is important to make a reservation that other pathologies often accompany the disease. As a rule, this is amblyopia and strabismus.
Disease options
Speaking about Marcus-Hunn syndrome, it should be noted that this anomaly is observed in 5% of patients suffering from congenital blepharoptosis. This is the condition in which the lower or upper eyelid falls, covering part of the pupil. Blepharoptosis is bilateral (31% of cases) and unilateral (69%).
Marcus-Hunn syndrome is not just a cosmetic defect, as some might think. This is a disease that mechanically complicates vision, and also creates obstacles to the normal development of visual analyzers.
By severity, the syndrome is divided into the following types:
- Partial. 1/3 of the pupil is slightly covered.
- Incomplete. The pupil is blocked by 2/3.
- Full. The pupil is not visible at all.
There is also a false and true syndrome. Pseudoptosis usually occurs when fatty tissue accumulates under the skin. This is also called a hernia of the century. Also, false syndrome can occur due to a decrease in the elasticity of the eyeballs.
Causes
Marcus-Hunn syndrome in children is diagnosed immediately. As already mentioned, this pathology is most often congenital. The reason may be a violation of the normal development of the muscle, which regulates the rise of the eyelid. Less commonly, this syndrome becomes a consequence of birth trauma.
But the disease can be acquired. The causes of Marcus-Hunn syndrome include:
- Multiple sclerosis.
- The weakening muscles that regulate the lifting of the eyelids.
- Horner's syndrome (damage to the sympathetic nervous system).
- Diabetic neuropathy.
- The consequence of an unsuccessful Botox administration procedure.
- Stroke.
- Chronic circulatory failure of the brain.
- Encephalitis.
- Ophthomoplegic migraine.
- Traumatic brain injuries.
So far, the pathogenesis of this syndrome has not been established. However, some experts claim that it develops due to disorders that occur either in the work of the mandibular and oculomotor nerves, or between their nuclei.
Symptomatology
Based on the foregoing, one could already understand how the Marcus-Hunn syndrome manifests itself. Photos are also able to help understand visual symptoms.
But it’s worth describing. The ailment manifests itself in the following: one or both eyes do not open completely when a person is in a calm state. The affected eyelid (one or both) rises reflexively if the patient is talking or chewing food.
The extent to which these manifestations are expressed depends on the individual characteristics of the patient. But in any case, each patient has to make significant efforts in order to close his eyes. This, of course, causes increased fatigue and fatigue. The result is chronic increased lacrimation.
By the way, in young children, the Marcus-Hunn syndrome, the treatment of which will be described later, is also manifested by other symptoms. The child may experience weakness, swelling of the eyelid, persistent lacrimation.
Patients themselves note that with age, clinical manifestations become weaker. But diagnostic tests suggest that people simply acquire the skills of masking symptoms.
Diagnostics
It involves the following procedures:
- External inspection.
- Magnetic resonance imaging.
- Roentgenography.
- Ophthalmoscopy
Based on the anamnestic data obtained during these procedures, a diagnosis is established. But additional biomicroscopy and visometry may be required.
It is rarely possible to detect a family history of a disease in a patient’s history. However, in the vast majority of cases, it turns out that the congenital pathology has received sporadic development. Patients themselves often recall that before the onset of clinical symptoms, they had some kind of traumatic injury.
Usually, of course, the diagnosis can be made even on the basis of the results of an external examination. But radiography in any case is necessary, because organic damage can not be detected otherwise.
Thanks to MRI, it is possible to detect the presence of a pathological connection between the facial, trigeminal and oculomotor nerves.
Ophthalmoscopy is needed to detect the presence or absence of pathological changes in the optic nerve. Sometimes biomicroscopy is sometimes prescribed to detect swelling of the conjunctiva or hyperemia.
Be that as it may, the patient will have to visit at least two doctors - a neurologist and an ophthalmologist.
Gymnastics
Unfortunately, the treatment of Marcus-Hunn syndrome of the century (with mandibular synkinesia or any other concomitant symptom) is not possible. Because pathology is congenital. But to reduce its manifestation is real. Here are some exercises you can do at home:
- The gaze is directed forward. 5 times to make circular movements of the eyes at a slow pace clockwise.
- Look up, open your mouth, start blinking frequently and quickly. Do for 30 seconds. In the following days, gradually increase the time.
- Close your eyelids, count to 5, then sharply open your eyes, looking forward. Do 6 reps.
- Eyes close. Pull the skin of the outer corners of the eyes slightly, and in this position, lift the eyelids as much as possible.
Work out every day. They say that this is an effective set of exercises that helps fight Marcus-Hunn syndrome.
Massage
Physical effects on the eyelids can also help. First you need to clean the surface of makeup (if any) and treat your hands with an antibacterial agent. Then apply a little massage oil and start the procedure. The actions are as simple as possible:
- The upper eyelid needs to be stroked from the inner corner to the outer.
- Lower - in the opposite direction.
When the massage is over, it is recommended to cover your eyes with cotton pads moistened with fresh chamomile infusion for 10 minutes.
Operation
The main treatment for the syndrome is surgery. This is also called blepharoplasty. The procedure is aimed at adjusting the eyelid.
First, of course, a complete diagnosis is made. Then the doctor prescribes an operation, an intervention is performed. And then - the rehabilitation period. After its completion (after 3-6 weeks) it will be possible to evaluate the result. During this time, the seams will dissolve, the swelling will come off, and the tissue will finally restore flexibility.
Emergency help
It may be required if the syndrome has arisen due to unsuccessful botulinum therapy. In such situations, the patient is prescribed a special treatment for Marcus-Hunn syndrome:
- Taking the drug "Proserin".
- The introduction of vitamins B6 and B1 injection.
- Face massage.
- Physiotherapeutic procedures.
All of the above is aimed at restoring muscle functions. The pathology itself disappears in 1-2 months. Sometimes it may take longer.
The same treatment is indicated in cases where the syndrome occurs due to a neurogenic cause. Or with a false form.
Prevention and prognosis
This is the last thing. One can guess that there are no specific methods for the prevention of this disease. Because it is innate. But non-specific methods include compliance with safety rules when working in production (wearing safety glasses, masks).
Children who have been diagnosed with the syndrome in question should wear special patch dressings. You can take them off at night. And in the afternoon - no, because they contribute to the development of the visual analyzer.
Also, every person who is diagnosed with this ailment is required to undergo an examination by an ophthalmologist twice a year.
In general, the forecast is favorable. This ailment does not lead to a decrease in visual acuity. In rare cases, a consequence such as secondary conjunctivitis is observed. The phenomenon, of course, is unpleasant, but quickly eliminated.