Duane Syndrome - Differential Diagnosis

Differential Diagnosis

Disorders similar in presentation to Duane syndrome can be acquired as a result of trauma, or following localised infection of the orbit leading to inflammation and consequent mechanical restrictions of eye movement. In such cases a full case history will usually help in distinguishing between these conditions. In the clinical setting, the principal difficulties in differential diagnosis arise as a consequence of the very early age at which patients with this condition first present. The clinician must be persistent in examining abduction and adduction, and in looking for any associated palpebral fissure changes or head postures, when attempting to determine whether what often presents as a common childhood squint is in fact Duane syndrome. Fissure changes, and the other associated characteristics of Duane's such as up or down shoots and globe retraction, are also vital when deciding whether any abduction limitation is the result of Duane's and not a consequence of VI or abducens cranial nerve palsy.