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Brown syndrome.
Last reviewed: 04.07.2025
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[ Symptoms of Brown syndrome
Right-sided Brown syndrome has the following symptoms.
Main symptoms of Brown syndrome
- Usually the correct primary eye position.
- Limitation of eyeball elevation in adduction on the right and sometimes in the medial position.
- As a rule, there is normal elevation of the right eyeball in abduction.
- There is minimal or no hyperfunction of the superior oblique muscle.
- Positive traction test with elevation of the eyeball in adduction.
Intermittent symptoms of Brown syndrome
- Downward deviation in adduction.
- Hypotropia in the primary position.
- Abnormal head position with head tilt to the same side and chin lift.
Classification of Brown syndrome
Congenital
- Idiopathic.
- Congenital click syndrome with impaired movement of the superior oblique tendon through the trochlea.
Acquired
- Iatrogenic injury to the trochlea or superior oblique tendon.
- Inflammation of the tendon caused by rheumatoid arthritis, pansinusitis or scleritis.
What do need to examine?
How to examine?
Differential diagnosis of Brown syndrome
- Inferior oblique muscle paralysis is characterized by a more pronounced vertical deviation in the primary position, an A-pattern, and a negative traction test.
- Monocular elevator insufficiency is characterized by the inability to elevate the eyeball in any position.
Treatment of Brown syndrome
Congenital cases usually do not require treatment. Indications for surgical treatment are hypotropia in the primary position and/or forced head position. Weakening of the superior oblique muscle is recommended.
In acquired cases, steroid therapy (orally or by injection into the area of the block) may be effective along with treatment of the cause.