Marcus gunn treatment

[cpu2007]

Hello everyone
I hope someone here can provide me some usefull information.
I live in the uk and wanted and have the jaw winking marcus gunn problem which occur when i my jaw is in movement(like when i eat basically),and during this movement when i open the mouth the left eyelid lifts up too.
Over here it seems like that also the specialists don't know about the problem and i have a 30 seconds visit where all he said was that nothing can't be done.
I wanted to know if there is a treatment to remove this movement ?
thank you

[ninabelcaid]

Hi, I am 47 yeards old and have Marcus Gunn and ptosis. I live in Denmark. When I was in my teens I considered operation but the doctors did not recommend it as it would require at least 3 operations and they would not be able to guarantee a good result, and I must say that today I am quite happy that I did not do anything about it back then. The tough time is when you are a child because everyone asks you about it (both grown-ups and kids). Usually you are not teased but asked out of curiousity I guess. When I became adult I have only been asked a very few times....sometimes I choose to tell people about it myself. My ptosis is quite severe so app. 50-70% of my right eye is covered by the eye lid in most situations. But I think I have lived a happy life until now. I am married and have two beautiful kids (20 and 18 years old) and they have not inherited MG. I have a university degree and a challenging job. I have always read tons of books (even though I read only with my left eye).
Based upon your letter it seems as if you have only the MG and not ptosis. But it is actually the ptosis which is the cosmetical challenge. So therefore...if you only have the MG I think you should relax and appreciate yourself...consider it a small speciality of yours...it is charming you know;-) If you have ptosis as well you can of course consider an operation, but frankly speaking...you are now 27 years old. You are grown up and in charge of your life....and I don't think an operation will change so much for you at this time of life. So I think you should reconsider if it is really worth while. Good luck with your decision.

[cpu2007]

Thank you very much for the reply Dr. Sharma.
So by what you saying if everything is fine with me and If the surgeon is able to perform the surgey,is it possible to cure the movement of the eyelid?

I have researched about arrhythmias and have seen that there are different type of it,some are not dangerous and some are very dangerous.
I just wanted to know which of these a marcus gunn patient is most likely to get?

As I have mentioned in my previous post the specialists I have consulted here gave me a feeling of not being educated in this field and wanted to know if you can suggest me any good specialist active right now in the Manchester area.
thank you

[Dr Sharma]

Welcome to the medhelp neurology forum. Thanks for posting in. Marcus gunn jaw winking is an exaggerated response to trigeminal nerve stimulation by contraction of the pterygoid muscles of jaw which results in the excitation of the oculomotor nerve innervating the levator palpebrae superioris on the same side. You need to consult an oculoplastic surgeon or a strabismologist to assess your eyes, pupils, lids, squint and the degree of the abnormality and whether it is crippling enough for a surgery. The anesthesiologist should be cautioned  that because of  Marcus Gunn jaw-winking ptosis you  are at a greater risk of developing arrhythmias during eyelid surgery. Certain laboratory investigations are mandatory prior to surgery like creatine phosphokinase level to rule out the possibility of malignant hyperthermia prior to any surgery if past medical or family history of any reactions to anesthesia exists. The other investigations will be as per the surgeon’s requirement. I hope this information helps and you get respite from this distressing condition. Take care.