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Related Experiment Videos

Patterns of III nerve synkinesis.

Shuttleworth1, Steel, Silverman

  • 1Bristol Eye Hospital, Bristol, BS1 2LX, England

Strabismus
|January 7, 2000
PubMed
Summary

Aberrant regeneration, specifically misdirection of nerve fibers at the injury site, best explains synkinesis patterns in oculomotor nerve (III nerve) palsies. Central collateral axon sprouting appears less involved in acquired lesions.

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Area of Science:

  • Neuroscience
  • Ophthalmology
  • Regenerative Medicine

Background:

  • Synkinesis, or aberrant nerve regeneration, is frequently observed in oculomotor nerve (III nerve) palsies.
  • Two primary models explain aberrant regeneration: central collateral axon sprouting and misdirection of regenerating neurons.

Purpose of the Study:

  • To investigate clinical patterns of III nerve recovery and synkinesis.
  • To correlate observed synkinetic patterns with proposed models of aberrant regeneration.

Main Methods:

  • Reviewed twelve patients with acquired and two with early-onset III nerve synkinesis.
  • Assessed ocular motility, pupil size, eyelid position, and intraocular pressure changes.
  • Documented synkinetic movements, including contralateral ones.

Main Results:

  • Upper eyelid retraction during attempted down gaze and adduction was the most common synkinesis.
  • Pupillary-extraocular muscle synkinesis occurred in all gaze positions except abduction.
  • Widespread extraocular muscle co-contraction, including synkinetic levator innervation, was observed.

Conclusions:

  • Observed synkinesis patterns in III nerve palsy are widespread and consistent across etiologies.
  • Random aberrant regeneration at the nerve injury site, particularly misdirection, is the most likely explanation.
  • Central collateral axon sprouting plays a minimal role in acquired III nerve lesions.

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