title: Recurrent Facial Palsy and Electrophysiological Findings in Oligosymptomatic Melkersson Rosenthal Syndrome.
abstract: Melkersson Rosenthal Syndrome is a rare neuro-mucocutaneous disorder characterized by the classic triad of facial swelling, recurrent facial nerve palsy and fissured tongue. The clinical course is usually progressive, and etiology is unknown. The authors describe oligosymptomatic Melkersson Rosenthal Syndrome in a young girl presenting sequentially with recurrent, metachronous facial nerve palsy and hemifacial swelling in early childhood followed by fissuring in the tongue in late-childhood. Histopathological examination from the affected labial area showed non-granulomatous inflammation. Bilateral facial nerve conduction and blink reflex studies showed asymmetrical affection of both facial nerves with mixed features of axonal and demyelinating involvement. The patient remained steroid-refractory, and subsequent attacks remitted with partial recovery. The combination of facial edema and facial palsy in a child should alert the physicians to the diagnosis of Melkersson Rosenthal Syndrome. A diagnostic mucosal biopsy, evaluation for systemic and oro-facial granulomatous disorders, and short course of corticosteroid treatment are recommended.
authors.affiliation: Unit of Pediatric Neurology and Neurodevelopment, Department of Pediatrics, Advanced Pediatrics Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India.
authors.forename: Arushi Gahlot
authors.initials: AG
authors.lastname: Saini
authors.affiliation: Unit of Pediatric Neurology and Neurodevelopment, Department of Pediatrics, Advanced Pediatrics Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India.
authors.forename: Naveen
authors.initials: N
authors.lastname: Sankhyan
authors.affiliation: Unit of Pediatric Neurology and Neurodevelopment, Department of Pediatrics, Advanced Pediatrics Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India.
authors.forename: Hansashree
authors.initials: H
authors.lastname: Padmanabh
authors.affiliation: Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Ashim
authors.initials: A
authors.lastname: Das
authors.affiliation: Unit of Pediatric Neurology and Neurodevelopment, Department of Pediatrics, Advanced Pediatrics Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India. doctorpratibhasinghi@gmail.com.
authors.forename: Pratibha
authors.initials: P
authors.lastname: Singhi
mesh_terms: D002675:Child, Preschool; D005154:Facial Nerve; D005158:Facial Paralysis; D005260:Female; D006099:Granuloma; D006801:Humans; D008556:Melkersson-Rosenthal Syndrome / Q000150:complications*; D009431:Neural Conduction
keywords: Facial swelling; Fissured tongue