What syndrome is also known as Superior Oblique tendon sheath syndrome?

• A. Moebius syndrome
• B. Parinaud syndrome
• C. Traumatic ptosis syndrome
• D. Brown's syndrome

Answer: (D)

Brown's syndrome is the condition known as Superior Oblique tendon sheath syndrome. It presents as a limitation of elevation when the eye is in adduction because the superior oblique tendon cannot glide smoothly through the trochlea, usually due to an inelastic or tight tendon sheath or pulley. This causes restricted upgaze in adduction with relatively normal movement in other directions. It can be congenital or acquired from inflammation or scarring around the trochlea. Other listed conditions involve different issues (facial nerve palsy, dorsal midbrain syndromes with vertical gaze problems, or eyelid ptosis) and do not explain the specific limitation of elevation in adduction.