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Alencar TN, Botelho MM, Carasek N, Bahmad F. Surgical Treatment Outcome for Familial Melkersson-Rosenthal Syndrome. AMERICAN JOURNAL OF CASE REPORTS 2023; 24:e938670. [PMID: 36755481 PMCID: PMC9923774 DOI: 10.12659/ajcr.938670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BACKGROUND Recurrent facial nerve palsy, orofacial edema, and fissured tongue are a triad of manifestations that characterize a rare disorder named Melkersson-Rosenthal syndrome. It is important to consider this syndrome when diagnosing atypical, unilateral, or bilateral facial palsies with characteristics of familial prevalence. There is no established outcome prediction for this disease and the syndrome does not have a specific duration or prospective timeline. Recurrent facial paralysis can require surgery and a multidisciplinary approach with regular follow-up. CASE REPORT We describe a 38-year-old woman presenting with a third episode of facial paralysis and discuss her pedigree chart and the treatment course chosen. After conservative treatment with oral corticosteroids, antiviral therapy, and motor physical therapy with no significant improvements, the patient underwent facial nerve decompression surgery with outstanding results. Eight months after surgery and intense postoperative physical therapy, the patient improved from grade VI to grade II palsy on the House-Brackmann Scale. The patient's older brother also presented a fissured tongue and had a history of 2 episodes of facial paralysis. The patient's son, mother, and sister also presented tongue fissuring but did not have any other clinical signs of the syndrome. CONCLUSIONS Despite being rare, Melkersson-Rosenthal syndrome is associated with a family inheritance and its diagnosis has prognostic implications. Therefore, it is of the utmost importance to have suspicion of this disorder in order to improve quality of care and target the treatment accordingly. Surgical treatment in these cases seems to be an excellent choice to treat current facial paralysis and prevent further episodes.
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Affiliation(s)
- Tannara Nobile Alencar
- Post-Graduate Program of the School of Health Science, Superior School of Health Science (ESCS), Brasilia, DF, Brazil
| | - Marcela Machado Botelho
- Post-Graduation Program at Health Science Faculty, University of Brasilia, Brasilia, DF, Brazil
| | - Natália Carasek
- Post-Graduation Program at Health Science Faculty, University of Brasilia, Brasilia, DF, Brazil
| | - Fayez Bahmad
- Post-Graduation Program at Health Science Faculty, University of Brasilia, Brasilia, DF, Brazil,Corresponding Author: Fayez Bahmad Jr., e-mail:
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Aoun G, Skandri N, Ghattas H, Maksoud C. Melkersson-Rosenthal Syndrome in a 38-Year-Old Female Patient: A Rare Case With Complete Triad. Cureus 2022; 14:e27427. [PMID: 36051736 PMCID: PMC9420175 DOI: 10.7759/cureus.27427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/28/2022] [Indexed: 11/29/2022] Open
Abstract
Melkersson-Rosenthal syndrome (MRS) is an uncommon neuro-mucocutaneous disease, clinically characterized by a triad of recurrent facial palsy, orofacial swelling, and fissured tongue. This report presents the case of a 38-year-old female diagnosed with MRS based on its three clinical features. A corticosteroid (1 mg/kg/day of oral prednisolone) was prescribed for a week, and then tapered off over two weeks by gradually lowering the dose. Regular annual long-term follow-ups were requested to monitor the disease activity.
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Dhawan SR, Saini AG, Singhi PD. Management Strategies of Melkersson-Rosenthal Syndrome: A Review. Int J Gen Med 2020; 13:61-65. [PMID: 32161488 PMCID: PMC7049838 DOI: 10.2147/ijgm.s186315] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 01/22/2020] [Indexed: 12/23/2022] Open
Abstract
Melkerrson-Rosenthal syndrome is a rare disorder of unknown aetiology and characterized by the triad of oro-facial edema, facial nerve palsy, and furrowing of the tongue. Two or more of the above are essential for making a clinical diagnosis. The mainstay of treatment is corticosteroids. Intralesional triamcinolone acetonide may be used for the treatment of oro-facial edema. Another treatment option for oro-facial edema includes intralesional betamethasone, along with oral doxycycline. The review discusses the management strategies in Melkersson-Rosenthal syndrome.
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Affiliation(s)
- Sumeet R Dhawan
- Department of Pediatrics, Maharishi Markandeshwar Institute of Medical Sciences and Research, Mullana, Ambala, 133207, India
| | - Arushi G Saini
- Pediatric Neurology Unit, Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India
| | - Pratibha D Singhi
- Pediatric Neurology Unit, Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India.,Medanta, The Medicity, Gurgaon, Haryana, India
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Savasta S, Rossi A, Foiadelli T, Licari A, Elena Perini AM, Farello G, Verrotti A, Marseglia GL. Melkersson⁻Rosenthal Syndrome in Childhood: Report of Three Paediatric Cases and a Review of the Literature. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16071289. [PMID: 30974872 PMCID: PMC6479526 DOI: 10.3390/ijerph16071289] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 04/02/2019] [Accepted: 04/09/2019] [Indexed: 11/16/2022]
Abstract
Melkersson–Rosenthal syndrome (MRS) in children is a rare condition, clinically characterised by a triad of synchronous or metachronous symptoms: recurrent peripheral facial palsy, relapsing orofacial oedema, and a fissured tongue; the most recent review published on the topic has reported 30 published patients. The aetiology of this disease is still unclear. However, genetic factors, as well as alterations in immune functions, infections, and allergic reactions have been postulated. We report three children suffering from MRS and perform a literature review of paediatric cases. Taking into account that clinical and laboratoristical criteria for the diagnosis of MRS are lacking, this syndrome is probably underestimated, and we suggest increasing awareness of such a rare syndrome. Close multidisciplinary follow-up of these children with a team composed by paediatricians, neurologists, neuro-ophthalmologists, dermatologists, and otolaryngologists is crucial to guarantee exhaustive management and treatment success, while minimising relapses.
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Affiliation(s)
- Salvatore Savasta
- Pediatric Clinic Fondazione IRCCS Policlinico San Matteo⁻V.le Golgi, 19 Pavia, Italy.
| | - Alessandra Rossi
- Pediatric Clinic Fondazione IRCCS Policlinico San Matteo⁻V.le Golgi, 19 Pavia, Italy.
| | - Thomas Foiadelli
- Pediatric Clinic Fondazione IRCCS Policlinico San Matteo⁻V.le Golgi, 19 Pavia, Italy.
| | - Amelia Licari
- Pediatric Clinic Fondazione IRCCS Policlinico San Matteo⁻V.le Golgi, 19 Pavia, Italy.
| | | | - Giovanni Farello
- Pediatric Clinic⁻Department of Life, Health and Environmental Sciences⁻Piazzale Salvatore Tommasi 1, 67100 Coppito (AQ), Italy.
| | - Alberto Verrotti
- Pediatric Clinic⁻Biotechnological and Applied Clinical Sciences Via Vetoio (Coppito 2), 67100 Coppito (AQ), Italy.
| | - Gian Luigi Marseglia
- Pediatric Clinic Fondazione IRCCS Policlinico San Matteo⁻V.le Golgi, 19 Pavia, Italy.
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Mu CQ, Wang SQ, Liu Y, Li CL, Hu XS, Hua H. Development of a facescan 3D facial reconstruction technology method for quantitative evaluation of cheilitis granulomatosa. Sci Rep 2017; 7:1295. [PMID: 28465526 PMCID: PMC5430966 DOI: 10.1038/s41598-017-01378-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Accepted: 03/29/2017] [Indexed: 11/10/2022] Open
Abstract
We explored the applicability of Facescan three-dimensional (3D) facial reconstruction technology for adjunctive diagnosis and therapeutic evaluation of cheilitis granulomatosa (CG) in 33 patients with CG and 29 healthy controls at the Dept. of Oral Medicine, Peking University, School and Hospital of Stomatology (PKUSS), from January 2015 to May 2016. The Facescan structured-light 3D facial reconstruction scanner was used to scan the scope of lips in both groups, in order to acquire 3D morphological data of the lips. The lengths of six characteristic line segments were measured from the 3D lip model of the two groups, and the acquired data were compared. The results showed that the distance between the labiale superius and labiale inferius, and the lengths of the upper and lower vermilion borders showed significant differences between the CG and control groups, by using the 3D lip model. Thus, Facescan 3D facial reconstruction technology showed good reproducibility in the evaluation of lip swelling in CG patients, and it can be used to analyse the degree of lip swelling and evaluate the therapeutic efficacy of different treatments for CG.
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Affiliation(s)
- Chang-Qing Mu
- Department of Oral Medicine, Peking University School and Hospital of Stomatology & National Engineering Laboratory for Digital and Material Technology of Stomatology, 22 South Zhongguancun Ave, Haidian District, Beijing, 100081, China
| | - Shi-Qin Wang
- Department of Oral Medicine, Peking University School and Hospital of Stomatology & National Engineering Laboratory for Digital and Material Technology of Stomatology, 22 South Zhongguancun Ave, Haidian District, Beijing, 100081, China
| | - Yang Liu
- Department of Oral Medicine, Peking University School and Hospital of Stomatology & National Engineering Laboratory for Digital and Material Technology of Stomatology, 22 South Zhongguancun Ave, Haidian District, Beijing, 100081, China
| | - Chun-Lei Li
- Department of Oral Medicine, Peking University School and Hospital of Stomatology & National Engineering Laboratory for Digital and Material Technology of Stomatology, 22 South Zhongguancun Ave, Haidian District, Beijing, 100081, China
| | - Xiao-Sheng Hu
- Department of Oral Medicine, Peking University School and Hospital of Stomatology & National Engineering Laboratory for Digital and Material Technology of Stomatology, 22 South Zhongguancun Ave, Haidian District, Beijing, 100081, China
| | - Hong Hua
- Department of Oral Medicine, Peking University School and Hospital of Stomatology & National Engineering Laboratory for Digital and Material Technology of Stomatology, 22 South Zhongguancun Ave, Haidian District, Beijing, 100081, China.
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