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Abstract Details

Melkerrson Rosenthal Syndrome: A Rare Neurologic Disorder
General Neurology
P5 - Poster Session 5 (8:00 AM-9:00 AM)
6-011
Not Applicable 
Melkerrson- Rosenthal syndrome (MRS) is a rare neuro-mucocutaneous disease characterized by a triad of persistent or recurrent oro-facial edema, facial nerve palsy and fissured tongue. Approximately 300 cases have been reported so far in the literature.
Not Applicable
A 25-year-old Caucasian female with no significant past medical history presented to the emergency department for 2-day history of sudden onset right facial weakness, numbness and lip swelling. On examination patient had decreased sensation on the right side of face, lower motor neuron type right facial paralysis and lip swelling on the right side. She had normal vision, hearing and taste sensations. Her rest of the neurological exam and laboratory work up was normal. Magnetic resonance imaging (MRI) of brain, angiogram of head and neck revealed no abnormalities. Patient was diagnosed with Bell’s palsy and discharged on oral steroids with taper and Valacyclovir. Her symptoms resolved after one month but recurred with similar presentations at 2 months and an year later. Each episode lasted for 4-5 days and resolved spontaneously. Repeat MRI Brain during those episodes was also unremarkable. She was diagnosed with Melkerrson Rosenthal syndrome after the third episode.
MRS is a rare neurologic disorder, it is uncommon to observe the complete triad of symptoms at the time of initial presentation, making this condition difficult to diagnose. In a retrospective study done with MRS patients, only 13 percent of them presented with full triad of symptoms. Recurrence rate of Bell’s palsy is also low, thus, in patients presenting with recurrent idiopathic peripheral facial nerve palsy, additional careful mucocutaneous exam may lead to a diagnosis of MRS. This can reduce the number of the additional imaging studies that are done and also lead to earlier diagnosis of MRS.  
Authors/Disclosures
Neeharika Thottempudi, MD
PRESENTER 		Dr. Thottempudi has nothing to disclose.
Diaa Hamouda (Erlanger Baroness Hospital) No disclosure on file
Laura J. Wu, MD, PhD (UTMB Neurology) Dr. Wu has nothing to disclose.