Somatic experiencing
One patient have complaining that he has one left eye continuously blinking when when was talking,but if patient don't made concentration on his activit problems during talk to other people he would forgatted of his problems, others symptoms gas trouble...and suspected that it can possible due to a Gas trouble. Chief Complaints Blinking of eyelid with gas trouble History Was taking Tab.oxcarbamazepine 200mg no much improvement since 10 year 45 year old male. Vitals Normal Physical Examination NAD Investigations CT brain normal RBS normal blood pressure control Diagnosis Psychosomatic disorder Management Tab.trifluphenazine 5mg with tab.rihexyphendyl 2mg
Marcus Gunn syndrome.. It is a congenital condition where a drooping eyelid briefly opens wider and appears to wink when the jaw is moved. (A congenital condition means a baby is born with it.). For reasons that are unclear, there is a bad connection between the nerves that stimulate, and the muscles that move, the eyelids and the jaw. Some clinical researchers believe that about half of the cases of Marcus Gunn phenomenon are genetically determined.. If the jaw-winking is cosmetically insignificant or if the ptosis is mild, it is advisable not to proceed with surgery. If a correction is desired in mild ptosis, then procedures of choice include Muller muscle and conjunctival resection, a Fasanella– Servat procedure, or a standard external levator resection..( From web reference)
THIS IS CALLED MARCUS GUN PHENOMENON COMMON NERVE INNERVATION OF EYE MUSCLE AND MUSCLES OF MADTICATION IT LEADS TO SYNKY ETC PTOSIS ASDICIATED WITH SYNKY ERIC MOVEMENTS OF JAW AND LIDS TEARING MAY OCCUR WHICH IS CALLED CROCODILE TEARS
Marcus Gun phenomena of cosmetic problem Miller’s muscle resection or levator resection if there is severe ptosis with normal superior rectus function If mild ptosis surgery is not advised
Marcus Gunn syndrome. Reassurance and counciling required. Assessment and evaluation to conclude and treatment.
Mild anti anxiety drug like haloperidol 0.25 mg in bd doses may help to releave anxiety .minimise use of mobile enjoy music and reading. It may go away . Keep quiet stay calm
? RAPD .. ? MGP ..
POSSIBLY PSYCHOLOGICAL SOMATOFORM DISORDER
Psychological. Reassured the Pt.
It may b Somatoform Disorder followed by Anxious personalit ity. Presence or Stressor , his PMP. Management: Abreaction Therapy, Stress inoculation therapy n anxiolytics.
Tics, Councelling needed
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A 2 y/o girl presented with ptosis of the right upper eyelid since the age of 3–4 months. The patient had a twin sister without symptoms. The initial clinical examination revealed no signs of strabismus, and the motility of both eyes was normal. There was significant ptosis of the right upper eyelid covering most of the cornea, but the patient was able to elevate the eyelid 3 mm over the upper edge of the pupil. What is diagnosis?
Dr. Gunjan Toora1 Like15 Answers - Login to View the image
A 6year boy came to me for extraction. I noticed there is difference in eyelids. Rt. eye eyelid is at lower level seems like dropping. Lt. eyrlud is OK.Is this some pathological condition n if yes what is the treatment.
Dr. Manisha Saxena0 Like16 Answers - Login to View the image
8 yr have presenting rt side eye problem which is not open fully snc birth which investigation shuld be done ? Dx
Dr. Kapil Sahu5 Likes41 Answers - Login to View the image
69yr person k/c/oDM since 10yr @@Dr. Bappasaheb Chavare @@Dr. Dnyandeo Londhe @Dr. Vivek Patil Now complaining of pain in rt. Eye with dropping of Eyelid What is your diagnosis and further manegment .
Dr. Babasaheb Dudhe2 Likes17 Answers - Login to View the image
DIAGNOSE THE CASE A girl was admitted with unilateral ptosis of her right eye .she started tripping and fell on several occasions. Since this time she had seemed off colour and tired very easily, although half an hour's rest was sufficient to restore her strength temporarily. On one occasion she was said to have collapsed suddenly for 2 minutes. A contrast enhanced computed tomograph (CT) scan of the head and orbit revealed no abnormalities. Cerebrospinal fluid examination was also normal.Funduscopic examination is normal.the most likely diagnosis is : A. Congenital ptosis B. Marcus Gunn jaw winking C. juvenile myasthenia gravis D. Third cranial nerve palsy E. Infectious botulism F. Kearne Sayre's Syndrome G. Horner's syndrome
Dr. Md Shahbaz Ali3 Likes14 Answers
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