Duane’s Retraction Syndrome - Review and Diagnosis of Clinical Forms

Overview

The author presents a postgraduate review of the problem. In the introduction hereviews typical features of Duane’s retraction syndrome (DS) and its main symptoms and reminds of the main approaches to classification: (1) Malbrane s (DuaneI, IIandIII), (2)Huber’swhichisbasedonEMGfindingsinZOSand(3) Kaufman’ s whichclassifies DS according to the enforced position of the head. The author maintainsthat even according to the above many atypical rare pictures cannot be classifiedor explained pathogenetically. Some are mentioned: (1) „Inverse“ DS, which wasrecorded and documented by Chytilová-Divišová (1949) in a girl with congenitalparalysis of abduction on both eyes retraction of the bulbus developed andnarrowing of the palpebral aperture when attempting abduction (1) of the eye, (2)Bilateral acquired DS in a female patient with a tumour of the brain stem confirmed by EMG records of both horizontal muscles. (3) Unilateral DS in a child froma family with familial incidence of congenital ZOS fibrosis with an obscure ratioof the neurogenic and myogenic and fibrous component of the two pictures. Inanother member of this family the Marcus Gunn phenomenon was present.The latter findings support the idea that in the development of the fairly uniformpicture of DS a combination of neurogenic, myogenic and connective tissuechanges participate.

Key words:
Duane’s retraction syndrome, classification, diagnosis