Duane's Syndrome: A Brain Stem Lesion

Abstract
Duane's syndrome consists of a reduction in or loss of abduction of the globe, retraction on adduction with occasional limitation of this movement, a narrowing of the palpebral fissure on adduction, and widening of the fissure on attempted abduction. There is a deficiency of convergence and occasionally an up or down deviation on adduction. The syndrome is congenital and cases of familial incidence have been reported. Numerous theories have been brought forward to explain these unusual anomalies of ocular motility. Most of the older hypotheses attributed this abnormality to pathologic changes in the extraocular muscles or in their tendons.1,2 Many found the external rectus muscle transformed into a band of rather inelastic cord-like tissue.3This could explain the retraction on adduction but cannot account for the narrowing of the palpebral fissure. Such a band should also eventually lead to a secondary strabismus which is usually absent in this

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