Acquired Brownʼs Syndrome from a Trochleitis: A Diagnostic Challenge with Spontaneous Resolution

Introduction

Brownʼs syndrome is a rare variation of restrictive strabismus characterized by limited elevation of the affected eye in adduction. This motility restriction results from mechanical impairment of the superior oblique tendon as it passes through the trochlea [1] [2] [3] [4]. Brownʼs syndrome occurs in both congenital and acquired forms, the latter is usually secondary to identifiable causes such as inflammation, trauma, or surgery [2], [4].

Trochleitis – an inflammatory process of the trochlea and peritrochlear region – is an uncommon cause of acquired Brownʼs syndrome. It can be detected on MRI, which typically shows focal enhancement and thickening of the trochlear region [5]. Because of its rarity and often nonspecific clinical presentation, it may be mistaken for cranial nerve palsies. Awareness of this entity is essential, as targeted orbital imaging can confirm the diagnosis and prevent unnecessary invasive investigations or interventions.

Publikationsverlauf

Eingereicht: 31. Oktober 2025

Angenommen: 12. Januar 2026

Artikel online veröffentlicht:
17. Februar 2026

• References

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