title: The boy who lost his smile: facioscapulohumeral dystrophy in the head and neck.
abstract: BACKGROUND
  Facioscapulohumeral dystrophy is the third most common muscular dystrophy and the one most likely to present primarily in the head and neck.
  
  
  METHODS
  In this report, we present a case of a young child with subtle progressive bilateral facial weakness whose workup ultimately led to this diagnosis. Paralysis in this disorder is secondary to worsening muscle atrophy, which typically progresses in a cephalad to caudad direction. Despite facial paralysis being a key and early component of this illness, no prior descriptions in the otolaryngology literature exist.
  
  
  CONCLUSIONS
  The case described is unusual in that the patient initially presented to a community otolaryngologist. In addition to workup, the disease characteristics, head and neck manifestations, and prognosis are discussed.
authors: Department of Otolaryngology-Head and Neck Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA.
authors: Jonathan C
authors: JC
authors: Kopelovich
authors: Department of Otolaryngology-Head and Neck Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA.
authors: Scott
authors: S
authors: Owen
authors: Department of Neurology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA Department of Pediatrics, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA.
authors: Katherine D
authors: KD
authors: Mathews
authors: Department of Otolaryngology-Head and Neck Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA Division of Plastic Surgery and Cosmetic Services, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA douglas-henstrom@uiowa.edu.
authors: Douglas K
authors: DK
authors: Henstrom
mesh_terms: D002648:Child; D003937:Diagnosis, Differential; D019468:Disease Management; D005158:Facial Paralysis / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D006257:Head / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D020391:Muscular Dystrophy, Facioscapulohumeral / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D009333:Neck / Q000473:pathology*; D011379:Prognosis; D042262:Retinoscopy / Q000379:methods; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome
keywords: facial paralysis; muscular dystrophy