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

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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

I got to learn more sir.
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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.

Thanks Dr Dinesh Gupta
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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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