'Black curtain, Brown window' - A case of recurrent intermittent idiopathic Brown syndrome with atypical presenting symptoms

Brown syndrome is characterized by limited elevation of the eye in an adducted position, most often secondary to mechanical restriction of the superior oblique tendon/trochlea complex. It can be constant or intermittent/recurrent.We report on a 5 years-old boy who complained of seeing dark curtain a...

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Main Authors: Voichanski Shilo, Rabinovich Ronen, Rappoport Daniel
Format: Article
Language:English
Published: Elsevier 2022-03-01
Series:American Journal of Ophthalmology Case Reports
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2451993622001244
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author Voichanski Shilo
Rabinovich Ronen
Rappoport Daniel
author_facet Voichanski Shilo
Rabinovich Ronen
Rappoport Daniel
author_sort Voichanski Shilo
collection DOAJ
description Brown syndrome is characterized by limited elevation of the eye in an adducted position, most often secondary to mechanical restriction of the superior oblique tendon/trochlea complex. It can be constant or intermittent/recurrent.We report on a 5 years-old boy who complained of seeing dark curtain and had strange head movements. He had similar symptoms 6 months prior. Examination revealed binocular vertical diplopia, multiplanar abnormal head position and limitation of the elevation of the right eye adduction only. Pain was elicited during attempt to elevate and adduct the right eye, with downshoot of right eye, and reflexive eyelid closure.The patient was diagnosed with intermittent idiopathic Brown syndrome.One day later, the patient was found to be asymptomatic, and had spontaneous resolution without any treatment.Literature on acquired Brown's syndrome in children is scarce.Very few have described the idiopathic intermittent or recurrent form. The acute, short and recurrent pattern of our patient's symptoms showed an atypical, non-classical presentation and course. The initial misleading symptoms presented a diagnostic challenge. These might be explained by the prominent acute inflammatory component upon presentation, and we suggest two theories that might explain such an atypical clinical course.
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spelling doaj.art-0756f6236bd0459c8646f4b7e5ea6c802022-12-21T23:48:03ZengElsevierAmerican Journal of Ophthalmology Case Reports2451-99362022-03-0125101378'Black curtain, Brown window' - A case of recurrent intermittent idiopathic Brown syndrome with atypical presenting symptomsVoichanski Shilo0Rabinovich Ronen1Rappoport Daniel2Corresponding author. Hapalmach Street 30/5, Jerusalem, Israel.; Shaare Zedek Medical Center, Jerusalem, IsraelShaare Zedek Medical Center, Jerusalem, IsraelShaare Zedek Medical Center, Jerusalem, IsraelBrown syndrome is characterized by limited elevation of the eye in an adducted position, most often secondary to mechanical restriction of the superior oblique tendon/trochlea complex. It can be constant or intermittent/recurrent.We report on a 5 years-old boy who complained of seeing dark curtain and had strange head movements. He had similar symptoms 6 months prior. Examination revealed binocular vertical diplopia, multiplanar abnormal head position and limitation of the elevation of the right eye adduction only. Pain was elicited during attempt to elevate and adduct the right eye, with downshoot of right eye, and reflexive eyelid closure.The patient was diagnosed with intermittent idiopathic Brown syndrome.One day later, the patient was found to be asymptomatic, and had spontaneous resolution without any treatment.Literature on acquired Brown's syndrome in children is scarce.Very few have described the idiopathic intermittent or recurrent form. The acute, short and recurrent pattern of our patient's symptoms showed an atypical, non-classical presentation and course. The initial misleading symptoms presented a diagnostic challenge. These might be explained by the prominent acute inflammatory component upon presentation, and we suggest two theories that might explain such an atypical clinical course.http://www.sciencedirect.com/science/article/pii/S2451993622001244Brown syndromeAbnormal head positionIntermittent BrownRecurrent Brown
spellingShingle Voichanski Shilo
Rabinovich Ronen
Rappoport Daniel
'Black curtain, Brown window' - A case of recurrent intermittent idiopathic Brown syndrome with atypical presenting symptoms
American Journal of Ophthalmology Case Reports
Brown syndrome
Abnormal head position
Intermittent Brown
Recurrent Brown
title 'Black curtain, Brown window' - A case of recurrent intermittent idiopathic Brown syndrome with atypical presenting symptoms
title_full 'Black curtain, Brown window' - A case of recurrent intermittent idiopathic Brown syndrome with atypical presenting symptoms
title_fullStr 'Black curtain, Brown window' - A case of recurrent intermittent idiopathic Brown syndrome with atypical presenting symptoms
title_full_unstemmed 'Black curtain, Brown window' - A case of recurrent intermittent idiopathic Brown syndrome with atypical presenting symptoms
title_short 'Black curtain, Brown window' - A case of recurrent intermittent idiopathic Brown syndrome with atypical presenting symptoms
title_sort black curtain brown window a case of recurrent intermittent idiopathic brown syndrome with atypical presenting symptoms
topic Brown syndrome
Abnormal head position
Intermittent Brown
Recurrent Brown
url http://www.sciencedirect.com/science/article/pii/S2451993622001244
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AT rabinovichronen blackcurtainbrownwindowacaseofrecurrentintermittentidiopathicbrownsyndromewithatypicalpresentingsymptoms
AT rappoportdaniel blackcurtainbrownwindowacaseofrecurrentintermittentidiopathicbrownsyndromewithatypicalpresentingsymptoms