Summary:
The author presents a postgraduate review of the problem. In the introduction he
reviews typical features of Duane’s retraction syndrome (DS) and its main symptoms and reminds of the main approaches to classification: (1) Malbrane s (Duane
I, IIandIII), (2)Huber’swhichisbasedonEMGfindingsinZOSand(3) Kaufman’ s which
classifies DS according to the enforced position of the head. The author maintains
that even according to the above many atypical rare pictures cannot be classified
or explained pathogenetically. Some are mentioned: (1) „Inverse“ DS, which was
recorded and documented by Chytilová-Divišová (1949) in a girl with congenital
paralysis of abduction on both eyes retraction of the bulbus developed and
narrowing 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 from
a family with familial incidence of congenital ZOS fibrosis with an obscure ratio
of the neurogenic and myogenic and fibrous component of the two pictures. In
another member of this family the Marcus Gunn phenomenon was present.
The latter findings support the idea that in the development of the fairly uniform
picture of DS a combination of neurogenic, myogenic and connective tissue
changes participate.
Key words:
Duane’s retraction syndrome, classification, diagnosis
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