Complete Information on Brown syndrome

                                                                                         

Brown's syndrome, also called superior oblique tendon sheath syndrome. Brown Syndrome is a rare eye disorder characterized by defects in eye movements. It involving fibrous adhesions in the upper medial quadrant of the orbit. These lesions involve the superior oblique tendon and trochlea and mechanically limit eye elevation. Brown's syndrome is produced by a restriction of the superior oblique muscle tendon, usually in the region of the trochlear notch. Brown's syndromemay be caused by a spinal cord tumor, trauma , ischemia or infectious or inflammatory diseases such as tuberculosis, or multiple sclerosis.

Brown syndrome can be shared into congenital and acquired. Congenital Brown syndrome as originally demonstrated by Brown, normal elevation of the eye into adduction increases the distance between the trochlea and the superior oblique insertion as the eye moves up and into adduction. A tight or inelastic superior oblique tendon muscle complex would restrict ocular elevation in adduction.Congenital Brown syndrome could be caused by a developmental abnormality of the elastic-crossed fibers that normally allow the telescoping movement of the central tendon fibers.

Acquired Brown syndrome is excellent and may be seen following surgery, direct or indirect trauma or in association with inflammatory diseases such as adult and juvenile rheumatoid arthritis, systemic lupus erythematosus, and sinusitis. Treatment recommendations for Brown syndrome vary with the cause and severity of the movement disorder. Nonsurgical treatment is often advised for recently acquired, traumatic and variable cases. Close observation alone is usually sufficient in mild cases. Visual acuity and the ability to use both eyes at the same time (binocular vision) should be monitored closely in young children.

Surgery may be appropriate when the problem is stable and interferes with daily visual interaction. Systemic and locally injected corticosteroids have been used to treat inflammation in some cases of acquired Brown syndrome. Nonsteroidal anti-inflammatory agents (like Ibuprofen) have also been used with limited success. Other treatment is symptomatic and supportive.

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