Recommended Reading – VIDEO NEUROIMAGES – Bilateral Marcus Gunn jaw-winking syndrome
Deepa Kannaditharayil, Howard Geyer, Henry Hasson, Steven Herskovitz
Neurology. 2015; 84 (10)
ARTICLE
A 10-year-old boy presented with an alternating elevation of his eyelids upon chewing, present since birth (video on the Neurology® Web site at http://www.neurology.org). Examination showed mild left ptosis but no ophthalmoparesis. This represents Marcus Gunn jaw-winking syndrome (MGJWS), also called trigemino-oculomotor synkinesis or pterygoid-levator synkinesis. It likely results from aberrant connections in the midbrain between the trigeminal mesencephalic nucleus and oculomotor nucleus, although others have postulated connections between the mandibular division of trigeminal nerve innervating lateral pterygoid and the superior division of oculomotor nerve innervating levator palpebrae superioris. MGJWS occurs in 2%–13% of patients with congenital ptosis.1 It is usually unilateral but rarely presents bilaterally.2
Video https://www.youtube.com/watch?v=_m6HAys9cdQ
References:
1. Demirci H, Frueh BR, Nelson CC. Marcus Gunn jaw-winking synkinesis: clinical features and management. Ophthalmology 2010;117:1447–1452.
2. Shah AD, Kumar AB, Kothari K. Bilateral Marcus Gunn jaw-winking synkinesis with monocular elevation deficiency: a case report and literature review. Int Ophthalmol 2012;32:199–201.