jaw-winking syndrome

Jaw-Winking Syndrome: A Rare Congenital Condition

Jaw-winking syndrome, also known as Marcus Gunn syndrome, is a rare congenital condition characterized by the involuntary movement of one upper eyelid in sync with the movements of the jaw. This phenomenon occurs when there is an aberrant connection between the motor branches of the trigeminal nerve and the levator palpebrae superioris muscle.

Key Features:

• The upper eyelid droops over the eye, a condition known as ptosis.
• When the jaw moves, the upper eyelid elevates or "winks" in sync with the movement.
• This phenomenon can be present unilaterally (in one eye) or bilaterally (in both eyes).
• In rare cases, it may be associated with other symptoms such as rhythmic eyelid jerking when sucking, chewing, or opening the mouth.

Causes and Prevalence:

• The exact cause of jaw-winking syndrome is not yet fully understood.
• It is believed to be a congenital condition, meaning it is present at birth.
• The prevalence of this condition is rare, with only a few reported cases in medical literature.

Treatment and Management:

• In most cases, jaw-winking syndrome is harmless and improves with age.
• However, if the condition affects vision or appearance, treatment may be necessary.
• Surgical intervention can help manage the condition and improve eyelid symmetry and function.

References:

[1] (Context 1) - Marcus Gunn jaw-winking syndrome was first described by Dr. Robert Marcus Gunn in 1883. [2] (Context 2) - Jaw-winking syndrome is a rare condition that causes a droopy eyelid (ptosis) that moves with jaw movements. [3] (Context 3) - Marcus Gunn jaw-winking is thought to be a form of synkinetic ptosis, characterized by an aberrant connection between the motor branches of the trigeminal nerve and the levator palpebrae superioris muscle. [4] (Context 4) - The condition can cause concern due to its unusual presentation, but appropriate diagnosis, observation, and surgical intervention can help manage it. [5] (Context 5) - Marcus Gunn phenomenon is a rare genetic disorder that is usually present at birth, characterized by the movement of one upper eyelid in a rapid rising motion each time the jaw moves.

Signs and Symptoms of Jaw-Winking Syndrome

Jaw-winking syndrome, also known as Marcus Gunn jaw-winking ptosis, is a congenital condition characterized by abnormal eye movements and an involuntary winking motion of the eyelid. The signs and symptoms of this condition can vary in severity and may include:

• Mild to moderate ptosis: A droopy upper eyelid, usually on one side.
• Upper eyelid movement: The upper eyelid moves when chewing, sucking, jaw moving forward, clenching teeth, or swallowing.
• Worsening of symptoms: Symptoms worsen when looking downwards.
• Blepharoptosis: A condition where the upper eyelid droops over the eye, usually unilateral.

These signs and symptoms are often present at birth, although they may not be immediately recognized by parents. The wink reflex, which consists of a momentary upper eyelid retraction or elevation to an equal or higher level than the normal fellow eyelid upon jaw movement, is a characteristic feature of this condition [6][7].

In some cases, additional testing may be necessary to assess the severity of the condition and rule out other potential causes. Abnormal oculocardiac reflex has been seen in patients with Marcus Gunn jaw-winking syndrome, so preoperative electrocardiogram (EKG or ECG) may be considered prior to surgery [11].

It's essential to note that each individual's experience with jaw-winking syndrome can vary, and not all people will exhibit the same signs and symptoms. If you suspect you or your child may have this condition, consult a medical professional for proper evaluation and guidance.

References: [1] Context result 10 [6] Context result 6 [7] Context result 7 [11] Context result 11

The differential diagnosis for Marcus Gunn jaw-winking syndrome (MGJWS) includes other synkinetic movement disorders, such as:

• Inverted Marcus Gunn Phenomenon: This condition is characterized by worsening ptosis in the primary gaze with mouth opening, which is opposite to MGJWS where ptosis improves with mouth opening [1][2].
• Marin-Amat syndrome: This is another congenital cranial innervation disorder that presents similarly to MGJWS, but with different characteristics [3].

These conditions can be considered in the differential diagnosis of patients presenting with synkinetic movements of the upper lid on masticating movements of the jaw [6]. It's essential to note that the diagnosis of MGJWS is made based on clinical presentation and may require further evaluation to rule out other potential causes [5][9].

In addition, the differential diagnosis for congenital ptosis includes anomalies of extraocular muscle development and innervation. The former group comprises disorders such as Duane's syndrome, while the latter group includes conditions like MGJWS and its inverse phenomenon [13].