The setting sun syndrome is a beautiful name for a disease of the newborn. It is characterized by a downward displacement of the eyeball, with a slight deviation inward. With involuntary rotation of the eye, a strip of sclera is clearly visible from above. The syndrome can be combined with strabismus. Its appearance is associated with the process of accumulation of cerebrospinal fluid in the ventricles of the brain.
Syndrome or symptom?
Very often, many people confuse the concept of symptom and syndrome of the setting sun. Syndrome is a whole complex of symptoms that indicate certain violations in the body.
Most newborns are stray gazers, and this is due to the fact that they have not yet fully developed the nervous system. A kid needs a little time to adapt to the world around him. As a rule, before 21 days of birth, a wandering gaze disappears. If the pediatrician made a mark in the medical history about the presence of the setting sun syndrome in a baby, then do not worry, this is done only in order not to miss the pathology.
Also, do not confuse the syndrome with Hephre syndrome. Indeed, these two phenomena have fairly similar symptoms, but have different genesis factors. Today, the pathology described in the 19th century by the ophthalmologist Gefre is called hydrocephalic syndrome and is referred to a neurological pathology in which degeneration of brain nerve cells in the newborn is observed. Typically, such children do not have the mobility of their eyes, they throw their head back.
In light of this, when it comes to the “setting sun”, this does not mean at all that the child has a pathology. In 99% of children, a wandering gaze is observed at the beginning of life. Such a symptom may be associated with a genetic feature, for example, if one of the relatives had such an anomaly. In such cases, no treatment is required.
If the baby was born prematurely, then the syndrome can be observed for a longer time, up to about 28 days from birth. In very rare cases, the defect manifests itself at a later age. The syndrome may appear against the background of some infectious diseases, due to a head injury or metabolic disorder.
Main reasons
One of the causes of the setting sun syndrome is hypoxia or birth injury. It can influence its development:
- pathologies in the mother, who developed late in gestation;
- exacerbation of chronic diseases during pregnancy;
- bradycardia or ischemia;
- infectious diseases.
Such a deviation can also appear against the background of the diseases suffered by the baby himself:
- encephalitis or meningitis;
- disturbances in the endocrine system;
- spinal cord injuries;
- birth injuries;
- brain cyst;
- disruptions in the hormonal system.
After the diagnosis is made, the pediatrician observes the baby, but in most cases the symptoms completely disappear after a few weeks.
When to worry
In addition to the main symptom of the setting sun syndrome - a pronounced strip of sclera under the eyelid over the iris - parents should take a closer look at their baby and immediately consult a doctor if he has the following symptoms:
- vomiting, spitting up;
- constant crying, while in the absence of any apparent reason;
- at rest in a newborn, an intense fontanel;
- tipping the head back;
- strabismus;
- weakened muscles and a decrease in the manifestation of natural reflexes.
In such situations, the pediatrician prescribes additional studies.
Additional symptoms requiring immediate medical attention
Suspicion that the child has Gefre syndrome can occur when the baby makes an involuntary movement of the eyes with which he can move, being both in horizontal and vertical position.
If the baby has problems with the vegetovascular or cardiovascular system, then blueness of the limbs and the area between the nose and lips can be observed. Marble color can acquire skin if the child has problems with blood supply.
In cases where the newborn is really diagnosed with a pathology, cerebrospinal fluid can provoke the development of severe diseases, it can be coma, paralysis and epilepsy. If the cerebrospinal fluid enters the venous system, the child may lose hearing, eyesight and there will be obvious deviations in the development of the psyche and physiology.
Diagnostic measures
Additional diagnostics are required to exclude the development of pathology. In such cases, an ultrasound of the brain (neurosonography), computed tomography can be performed. X-ray of the bones of the skull can be assigned solely for certain indications, when the likelihood of developing pathology is high. Electroencephalography may also be performed.
In addition, the baby should be taken to an ophthalmologist who will examine the structure of the eye and exclude or confirm the presence of a genetic predisposition.
Treatment
As a rule, the syndrome of the setting sun in children before the 28th day of life does not require any treatment, only observation by a doctor. If there are concomitant symptoms, the doctor may prescribe a conservative treatment. Swimming is also recommended, but not diving. At home, you can carry out massage and gymnastics. Be sure to observe the regimen of the day and avoid situations in which intracranial pressure may increase.
If there are no negative factors during the development of the baby, then the nervous system fully matures and all symptoms of the syndrome disappear.
In some cases, the doctor may prescribe drugs from the group of nootropics and improve cerebral circulation. A diuretic treatment course may also be given.
Surgical intervention
If, with age, the symptoms of the syndrome only increase, then a question may arise about neuroendoscopic surgery or bypass surgery.
The installation of a shunt system allows you not to linger in the ventricles of the brain of the cerebrospinal fluid, it smoothly passes into the atrium or abdominal cavity. Today it is one of the most effective methods of treating severe manifestations of the setting sun syndrome in newborns, but still carries a certain risk for the child.
The existing technique - endoscopic surgery - is based on perforation of the bottom of the third ventricle. Such an operation has much less risk of developing complications, but, as a rule, the expected effect is much harder to achieve. After some time, the child still has to install a shunt.
It should be understood that after installing the shunt system, the baby is put on a disability due to the presence of a foreign body in the body. The main danger of the shunt is that it can stop pumping out cerebrospinal fluid at any time, so surgery will be required immediately.
What parents should do
You can find out how the symptoms look by looking at photos of newborns with the setting sun syndrome. The first signs of this phenomenon should be a mandatory appeal to a pediatrician. In addition, you should never neglect a scheduled visit to a doctor. It is also recommended to be examined by a neurologist, although a visit to this doctor is not necessary. Nevertheless, the nervous system is of great importance for a person, therefore it is very important to identify any deviations from the norm in time.
After looking at the photo of the setting sun syndrome in children, pay attention to your baby, if there is even the slightest suspicion, consult a doctor and undergo an examination once again to prevent the development of a serious pathology. The syndrome with timely diagnosis has a favorable outcome if the parents follow all the doctor's recommendations.