Journal of Case Reports in Practice
Volume:4 Issue: 1, Jan 2016

Primary Sjögren"s syndrome is a rare collagen vascular disorder in children. It can be primary or secondary to other connective tissue disorders mostly systemic lupus erythematous. Keratoconjunctivitis sicca, xerostomia and inflammatory rheumatoid arthritis or collagenosis can be seen in this syndrome. Neurologic involvement such as dysarthria, extrapyramidal signs, aphasia, hemiparesis, sensory symptoms, brainstem and cerebellar involvement (some of which are similar to those seen in systemic lupus erythematous) has also been reported specially in primary form. In this study a 9-year-old girl with the diagnosis of primary Sjögren"s syndrome with neurologic manifestations including decreased level of consciousness, restlessness, aphasia, ataxia, headache and paralysis is presented. Other symptoms such as dry mouth and parotiditis had also existed although they were less prominent in our patient. It is notable that Sjögren"s syndrome does not always manifest typically as dry mouth or eyes and may present with less common symptoms including neurologic ones.

Hodgkin lymphoma (HL), is a cancer of primarily B lymphocytes. It is thought that immune-deficiency as one of strongest risk factor of Hodgkin lymphoma, can be caused multiple infectious in this patients, here, we reported a case who despite of numerous infections from birth, was not detected immune-deficiency. Hence, despite the multiple infections in patients with Hodgkin lymphoma, can not necessarily seal immune-deficiency from birth to them.

Penetrating eye injuries are common and an important cause of visual disability in children and adults. Many of these injuries are preventable and additional education of children, parents and carers on potential dangers is required. Prognosis is influenced by wound location, mechanism of injury, the extent of initial damage and prompt referral for management. Here we describe a case of 7-year-old girl who presented with a penetrating injury to the left eye and was successfully treated. This case also demonstrates that the need for serial neuro-imaging, especially computerised tomography (CT) scan may arise to deliver adequate and prompt care.

Marcus Gunn jaw winking syndrome (MGJWS) first described in 1883 by Marcus Gunn is a synkinesis of masticatory muscles (usually) and levator palpebrae superioris resulting in a synchronic eyelid and pterygoid muscles contraction. It is a rare, congenital, unilateral and non-progressive eye synkinesis usually first noticed by mother feeding or nursing the baby. Although association of systemic anomalies with MGJWS are rare but ocular associations are common and with their average prevalence include: anisometropia (15%), amblyopia (45%) and strabismus (55%) that most of them should be managed as soon as possible for preventing vision loss. Before any surgical repair, medical treatment should be considered for possible ocular associations. The most disturbing aspect of the jaw-winking syndrome maybe rapid, abnormal and involuntary motion of the eyelid. We report a case with MGJWS without any ptosis just presenting with eyelid retraction and special social and behavioral aspects making the patient not to face any public environment and always worried about his appearance as seen by others.