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Double elevator palsy

MedGen UID:
573280
•Concept ID:
C0339643
•
Disease or Syndrome
Synonyms: double elevator palsy; monocular elevation deficiency
SNOMED CT: Monocular elevation deficiency (232109006); Double elevator palsy (232109006)
 
HPO: HP:0020041

Definition

A type of incomitant strabismus in which both elevator muscles (i.e., the inferior oblique and superior rectus muscles) of the same eye are weak leading to restricted elevation and hypotropia. [from HPO]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVDouble elevator palsy

Recent clinical studies

Etiology

Combined Rectus Muscle Transposition With Posterior Fixation Sutures (Augmented Knapp Procedure) for the Surgical Treatment of Double Elevator Palsy.
Akar S, Gokyigit B, Kayaarasi Ozturker Z
J Pediatr Ophthalmol Strabismus 2022 Jan-Feb;59(1):17-23. Epub 2021 Aug 26 doi: 10.3928/01913913-20210707-02. PMID: 34435907
Surgery for Supranuclear Monocular Elevation Deficiency.
Struck MC, Larson JC
Strabismus 2015;23(4):176-81. doi: 10.3109/09273972.2015.1099710. PMID: 26669423
"Double elevator palsy" eye supraducts during stage II general anesthesia supporting hypothesis of (supra)nuclear etiology.
Mims JL 3rd
Binocul Vis Strabismus Q 2005;20(4):199-204. PMID: 16384528
Selective management of double elevator palsy by either inferior rectus recession and/or knapp type transposition surgery.
Kocak-Altintas AG, Kocakkkk-Midillioglu I, Dabil H, Duman S
Binocul Vis Strabismus Q 2000;15(1):39-46. PMID: 10767681
Vertical transposition of the horizontal recti (Knapp procedure) for the treatment of double elevator palsy: effectiveness and long-term stability.
Burke JP, Ruben JB, Scott WE
Br J Ophthalmol 1992 Dec;76(12):734-7. doi: 10.1136/bjo.76.12.734. PMID: 1486075Free PMC Article

Diagnosis

Diplopia in a patient with Hashimoto's thyroiditis: A case report and literature review.
Ju C, Zhang L
Medicine (Baltimore) 2017 Jun;96(26):e7330. doi: 10.1097/MD.0000000000007330. PMID: 28658146Free PMC Article
Surgical treatment in patients with double elevator palsy.
Yurdakul NS, Ugurlu S, Maden A
Eur J Ophthalmol 2009 Sep-Oct;19(5):697-701. doi: 10.1177/112067210901900502. PMID: 19787584
Selective management of double elevator palsy by either inferior rectus recession and/or knapp type transposition surgery.
Kocak-Altintas AG, Kocakkkk-Midillioglu I, Dabil H, Duman S
Binocul Vis Strabismus Q 2000;15(1):39-46. PMID: 10767681
Double elevator palsy.
Metz HS
Arch Ophthalmol 1979 May;97(5):901-3. doi: 10.1001/archopht.1979.01020010459013. PMID: 444125
Acquired "double elevator" palsy and polycythemia vera.
Hoyt CS
J Pediatr Ophthalmol Strabismus 1978 Nov-Dec;15(6):362-5. doi: 10.3928/0191-3913-19781101-06. PMID: 739364

Therapy

Extraocular muscle cysticercosis: a clinical masquerade.
Pandey PK, Chaudhuri Z, Sharma P, Bhomaj S
J Pediatr Ophthalmol Strabismus 2000 Sep-Oct;37(5):273-8. PMID: 11020108

Prognosis

"Jampolsky Syndrome": superior rectus overaction-contracture syndrome: prevalence, characteristics, etiology and management.
Khawam E, Ghazi N, Salti H
Binocul Vis Strabismus Q 2000;15(4):331-42. PMID: 11093093
Vertical transposition of the horizontal rectus muscles for congenital/early onset "acquired" double elevator palsy: a retrospective long term study of 10 consecutive patients.
Caldeira JA
Binocul Vis Strabismus Q 2000;15(1):29-38. PMID: 10767680
Vertical transposition of the horizontal recti (Knapp procedure) for the treatment of double elevator palsy: effectiveness and long-term stability.
Burke JP, Ruben JB, Scott WE
Br J Ophthalmol 1992 Dec;76(12):734-7. doi: 10.1136/bjo.76.12.734. PMID: 1486075Free PMC Article
The Marcus Gunn phenomenon. A review of 71 cases.
Pratt SG, Beyer CK, Johnson CC
Ophthalmology 1984 Jan;91(1):27-30. doi: 10.1016/s0161-6420(84)34331-7. PMID: 6709318
Surgically mismanaged ptosis associated with double elevator palsy.
Callahan MA
Arch Ophthalmol 1981 Jan;99(1):108-12. doi: 10.1001/archopht.1981.03930010110014. PMID: 7458735

Clinical prediction guides

Results and complications of silicone frontalis sling surgery for ptosis.
Bansal RK, Sharma S
J Pediatr Ophthalmol Strabismus 2015 Mar-Apr;52(2):93-7. doi: 10.3928/01913913-20150313-11. PMID: 25973459
"Double elevator palsy" eye supraducts during stage II general anesthesia supporting hypothesis of (supra)nuclear etiology.
Mims JL 3rd
Binocul Vis Strabismus Q 2005;20(4):199-204. PMID: 16384528
Combined rectus muscle transposition with posterior fixation sutures for the treatment of double-elevator palsy.
Snir M, Friling R, Kalish-Stiebel H, Bourla D, Weinberger D, Axer-Siegel R
Ophthalmology 2005 May;112(5):933-8. doi: 10.1016/j.ophtha.2004.11.058. PMID: 15878078
Vertical transposition of the horizontal recti (Knapp procedure) for the treatment of double elevator palsy: effectiveness and long-term stability.
Burke JP, Ruben JB, Scott WE
Br J Ophthalmol 1992 Dec;76(12):734-7. doi: 10.1136/bjo.76.12.734. PMID: 1486075Free PMC Article
The Marcus Gunn phenomenon. A review of 71 cases.
Pratt SG, Beyer CK, Johnson CC
Ophthalmology 1984 Jan;91(1):27-30. doi: 10.1016/s0161-6420(84)34331-7. PMID: 6709318

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