Abstract
The authors report the case of a 14-year-old girl with Melkersson-Rosenthal syndrome in its classical form, with the triad of recurrent peripheral facial paralysis, upper lip edema and fissured tongue. A rare disease of unknown etiology, it has a chronic and progressive course, and clinical diagnosis is usually by exclusion. An individualized, multidisciplinary approach is fundamental for the treatment of the symptoms and avoids complications and permanent sequelae. The therapeutic options are varied, though most commonly include corticosteroid therapy and nerve decompression surgery.
Highlights
The most frequent etiology of facial paralysis is its idiopathic form (Bell’s palsy), which occurs in 80% of cases and generally presents complete resolution in most cases and without the occurrence of relapses
The authors report the case of a 14-year-old girl with Melkersson-Rosenthal syndrome in its classical form, with the triad of recurrent peripheral facial paralysis, upper lip edema and fissured tongue
In patients that suffer from Melkersson-Rosenthal syndrome (MRS), paralysis in the face is recurrent, accompanied by lip edema and a plicate or fissured tongue (Figure 1)
Summary
The most frequent etiology of facial paralysis is its idiopathic form (Bell’s palsy), which occurs in 80% of cases and generally presents complete resolution in most cases and without the occurrence of relapses. In patients that suffer from Melkersson-Rosenthal syndrome (MRS), paralysis in the face is recurrent, accompanied by lip edema and a plicate or fissured tongue (Figure 1). The edema may regress quickly in hours or days, but, after numerous relapses, its regression may be difficult, and can generate localized fibrosis that will culminate in a deforming aspect [5] This syndrome is not often observed in its complete form (labial edema, plicate tongue and peripheral facial paralysis), since monosymptomatic or oligosymptomatic variants are more usually found. The patient denied associated symptoms on the most recent occasion On physical examination, she presented grade IV (House-Brackmann) peripheral facial palsy (PFP), on the right side andmarked edema of the upper lip and plicate tongue. After 5 months, the patient presented significant improvement inthe facial paralysis (House-Brackmann grade II) and reduction of the lip swelling (Figure 3)
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