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Otolaryngology (ENT)37 papers

Oculomotor nerve synkinesis

Last edited: 4/15/2026

Overview

Marcus Gunn phenomenon (MGP), also known as jaw-winking or pterygoid-levator synkinesis, is a congenital condition characterized by synchronous elevation of the eyelid with mouth opening due to aberrant innervation of the levator palpebrae superioris muscle by a branch of the trigeminal nerve instead of the oculomotor nerve 1.

Diagnosis

  • Clinical Presentation: Synchronous eyelid elevation with jaw movement 1.
  • Diagnostic Tests: Detailed neurological examination focusing on cranial nerves, particularly trigeminal and oculomotor nerves 1.
  • Interdisciplinary Approach: Consider laryngological evaluation and assessment for olfactory disturbances to guide comprehensive diagnostics 1.
  • Management

  • Conservative Management: Often no specific treatment is required; management focuses on addressing associated symptoms and functional impacts 1.
  • Interdisciplinary Care: Collaboration with ENT specialists for comprehensive evaluation and management, especially in cases with olfactory dysfunction 1.
  • Special Populations

  • Pediatrics: Early diagnosis and interdisciplinary diagnostics are crucial due to potential associated olfactory disturbances 1.
  • Key Recommendations

  • Conduct a thorough interdisciplinary evaluation including ENT specialists for children presenting with MGP to assess for olfactory disturbances 1 (Evidence: Moderate).
  • Focus on detailed neurological assessment of cranial nerves, particularly trigeminal and oculomotor nerves, in diagnosing MGP 1 (Evidence: Moderate).
  • Implement conservative management strategies, emphasizing supportive care and addressing functional impairments 1 (Evidence: Expert opinion).
  • References

    1 Dżaman K, Zborowska-Piskadło K, Pietniczka-Załęska M, Kantor I. Marcus Gunn (jaw-winking) phenomenon in pediatric otorhinolaryngology practice. International journal of pediatric otorhinolaryngology 2019. link

    Original source

    1. [1]
      Marcus Gunn (jaw-winking) phenomenon in pediatric otorhinolaryngology practice.Dżaman K, Zborowska-Piskadło K, Pietniczka-Załęska M, Kantor I International journal of pediatric otorhinolaryngology (2019)

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