Summary:
Aberrant innervations of oculomotor muscles are a special group of clinical
entities, the common sign of which is an abnormal innervation of the oculomotor
muscles with nerve fibres which originally were not meant for this purpose. The
majority of these anomalies develops during the embryonic period of lesions at
the level of nuclei of cranial nerves or peripheral fibres. Congenital aberrations
affect most frequently n. VI, less frequently n. III and rarely n. IV. Acquired
affections are most frequent in n. III. Abnormal innervation connections concern
not only oculomotor muscles but also muscles engaged in mastication and those
of the upper eyelid. Clinically they are manifested as eyelid and facial synkinesias.
Among aberrant innervations which lack an uniform terminology belong according
to the more recent classification the following clinical units: Duan´s syndrome,
synergic divergence, double-elevator palsy, misdirection syndrome, Marcus
Gunn phenomenon, some forms of congenital fibrous syndrome, trigemino-abducens
synkinesia, pseudohyperfunctionof the lower obliquemuscle,crocodile tears
syndrome, and aberrant affection of n. III. The authors describe the course,
possible etiology of these anomalies and demonstrate, based on their own observations,
clinical cases which can be explained by these mechanisms.
Key words:
congenital and acquired aberrant innervations, aplasia of the nuclei
of oculomotor nerves, eyelid synkinesis, facial synkinesis
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