Marcus gunn syndrome (jaw-winking syndrome; congenital trigeminooculomotor synkinesis)

General: Familial occurrence rare, although dominant inheritance has been reported; symptoms caused by abnormal connecti 111b18b ons between external pterygoid muscle and levator palpebrae, with supranuclear or supranuclear-nuclear involvement (see Marin Amat Syndrome).

Ocular: Unilateral congenital ptosis in more than 90% of cases; 10% have spontaneous onset, usually in older persons; lid elevates rapidly when mouth is opened or mandible is moved to one or the other side; left eye seems to be more frequently affected than right eye; high incidences of strabismus (36%); amblyopia (34%); bilateral jaw-winking; decreased abduction.

Clinical: Stimulation of ipsilateral pterygoid with chewing, opening mouth, sucking, or contralateral jaw thrusts.

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Gunn RM. Congenital ptosis with peculiar associated movements of the affected lid. Trans Ophthalmol Soc U K 1883; 3:283.

Pratt SG, Beyer CK, Johnson CC. The Marcus Gunn phenomenon. A review of 71 cases. Ophthalmology 1984; 91: 27-30.

Rowland LP. Marcus Gunn syndrome. In: Rowland LP, ed. Merritts Textbook of Neurology, 9th ed. Baltimore: Williams & Wilkins, 1995:533.

Schultz RO, Burian HM. Bilateral jaw winking. Reflex in association with multiple congenital anomalies. Arch Ophthalmol 1960; 64:946.