| Meige's syndrome |
| Classification and external resources |
| ICD-10 |
G24.4 |
| ICD-9 |
333.82 |
| DiseasesDB |
31428 |
| MeSH |
D008538 |
- Not to be confused with Meigs syndrome
Meige's syndrome is a type of dystonia. It is also known as Brueghel's syndrome and oral facial dystonia. It is actually a combination of two forms of dystonia, blepharospasm and oromandibular dystonia (OMD).
When OMD is combined with Blepharospasm, it may be referred to as Meige’s Syndrome named after Henri Meige,[1] the French neurologist who first described the symptoms in detail in 1910. The symptoms usually begin between the ages of 30 and 70 years old and appear to be more common in women than in men (2:1 ratio). The combination of upper and lower dystonia is sometimes called cranial-cervical dystonia.[2] The incidence is about one case in 20,000 people.[3]
|
Contents
- 1 Symptoms
- 2 A few upper and lower dystonia types
- 3 Diagnosis
- 4 Presentation
- 5 Treatment
- 6 See also
- 7 References
- 8 External links
|
Symptoms
Oromandibular Symptoms
- difficulty opening the mouth (trismus)
- clenching or grinding of the teeth (bruxism)
- spasms of jaw opening
- sideways deviation or protrusion of the jaw
- lip tightening and pursing
- drawing back (retraction) of the corners of the mouth
- deviation or protrusion of the tongue.
- jaw pain
- difficulties eating and drinking
- difficulties speaking (dysarthria).
Blepharospasm symptoms
- the first symptom to appear is an increased rate of blinking .[4]
- uncontrollable squinting/closing of eyes
- light sensitivity(photophobic)
- squinting/eyes closing during speech
- uncontrollable eyes closing shut (rare instances completely causing blindness)
In addition, in some patients, the dystonic spasms may sometimes be provoked by certain activities, such as talking, chewing, or biting. Particular activities or sensory tricks may sometimes temporarily alleviate OMD symptoms, including chewing gum, talking, placing a toothpick in the mouth, lightly touching the lips or chin, or applying pressure beneath the chin.
A few upper and lower dystonia types
Blepharo means "eyelid". Spasm means "uncontrolled muscle contraction". The term blepharospasm ['blef-a-ro-spaz-m] can be applied to any abnormal blinking or eyelid tic or twitch resulting from any cause, ranging from dry eyes to Tourette's syndrome to tardive dyskinesia. The blepharospasm referred to here is officially called benign essential blepharospasm (BEB) to distinguish it from the less serious secondary blinking disorders. "Benign" indicates the condition is not life threatening, and "essential" is a medical term meaning "of unknown cause". It is both a cranial and a focal dystonia. Cranial refers to the head and focal indicates confinement to one part. The word dystonia describes abnormal involuntary sustained muscle contractions and spasms. Patients with blepharospasm have normal eyes. The visual disturbance is due solely to the forced closure of the eyelids.
Oromandibular dystonia (OMD) is a form of focal dystonia that affects varying areas of the head and neck including the lower face, jaw, tongue and larynx. The spasms may cause the mouth to pull open, shut tight, or move repetitively. Speech and swallowing may be distorted. It is often associated with dystonia of the cervical muscles (Spasmodic Torticollis), eyelids (Blepharospasm), or larynx (Spasmodic Dysphonia).
In patients with OMD, involuntary contractions may involve the muscles used for chewing (masticatory muscles). These may include the thick muscle in the cheek that closes the jaw (masseter muscle) and the broad muscle that draws back the lower jaw and closes the mouth (temporalis muscle). Some patients may also experience involuntary contractions of the wide muscle at the side of the neck (platysmal muscle). This muscle draws down the corner of the mouth and lower lip or other muscle groups.
Diagnosis
Meige's is commonly misdiagnosed and most doctors will have not seen this condition before. Usually a neurologist who specializes in movement disorders can detect Meige's. There is no way to detect Meige's by blood test or MRI or CT scans. OMD by itself may be misdiagnosed as TMJ.
The lack of prompt response to anticholinergic drugs in cases of idiopathic Meige's syndrome is important in differentiating it from acute dystonia, which does respond to anticholinergics.[2]
Presentation
The main symptoms involve involuntary blinking and chin thrusting. Some patients may experience excessive tongue protrusion, squinting, light sensitivity, muddled speech, or uncontrollable contraction of the platysma muscle. Some Meige's patients also have "laryngeal dystonia" (spasms of the larynx). Blepharospasm may lead to embarrassment in social situations, and oromandibular dystonia can affect speech, making it difficult to carry on the simplest conversations. This can cause difficulty in both personal and professional contexts, and in some cases may cause patients to withdraw from social situations.
The condition tends to affect women more frequently than men.
Treatment
There is no cure for Meige's Syndrome, nor can it be prevented, except in cases where it is caused by medication. Palliative treatments are available, such as Botox injections.
See also
- Blepharospasm
- Mogigraphia
References
- ^ synd/547 at Who Named It?
- ^ a b Ananth, J et al. (1988). "Meige's Syndrome Associated with Neuroleptic Treatment". American Journal of Psychiatry 145:4 (4): 513–515. PMID 2894781.
- ^ [1] Boodman, Sandra G., "Medical mysteries: I opened my laptop and my eyes snapped shut," Washington Post, March 26, 2012. Updated April 23, 2012. Retrieved April 24, 2012
- ^ Ananth, J et al. (1988). "Meige's Syndrome Associated with Neuroleptic Treatment". American Journal of Psychiatry 145:4 (4): 513–5. PMID 2894781.
External links
- Benign Essential Blepharospasm Research Foundation article
- [5]
- [6]
- [7]
- [8]
- a Commercial clinic
|
Pathology of the nervous system, primarily CNS (G04–G47, 323–349)
|
|
| Inflammation |
|
Brain
|
Encephalitis (Viral encephalitis, Herpesviral encephalitis) · Cavernous sinus thrombosis · Brain abscess (Amoebic)
|
|
|
Spinal cord
|
Myelitis: Poliomyelitis · Demyelinating disease (Transverse myelitis) · Tropical spastic paraparesis · Epidural abscess
|
|
|
Both/either
|
Encephalomyelitis (Acute disseminated)
Meningoencephalitis
|
|
|
Brain/
encephalopathy |
|
Degenerative
|
|
Extrapyramidal and
movement disorders
|
Basal ganglia disease: Parkinsonism (PD, Postencephalitic, NMS) · PKAN · Tauopathy (PSP) · Striatonigral degeneration · Hemiballismus · HD · OA
Dyskinesia: Dystonia (Status dystonicus, Spasmodic torticollis, Meige's, Blepharospasm) · Athetosis, Chorea (Choreoathetosis) · Myoclonus (Myoclonic epilepsy) · Akathesia
Tremor (Essential tremor, Intention tremor) · Restless legs · Stiff person
|
|
|
Dementia
|
Tauopathy: Alzheimer's (Early-onset) Primary progressive aphasia · Frontotemporal dementia/Frontotemporal lobar degeneration (Pick's, Dementia with Lewy bodies)
Multi-infarct dementia
|
|
|
Mitochondrial disease
|
Leigh's disease
|
|
|
|
Demyelinating
|
autoimmune (Multiple sclerosis, Neuromyelitis optica, Schilder's disease) · hereditary (Adrenoleukodystrophy, Alexander, Canavan, Krabbe, ML, PMD, VWM, MFC, CAMFAK syndrome) · Central pontine myelinolysis · Marchiafava-Bignami disease · Alpers' disease
|
|
|
Episodic/
paroxysmal
|
|
Seizure/epilepsy
|
Focal · Generalised · Status epilepticus · Myoclonic epilepsy
|
|
|
Headache
|
Migraine (Familial hemiplegic) · Cluster · Tension
|
|
|
Cerebrovascular
|
TIA (Amaurosis fugax, Transient global amnesia Acute aphasia)
Stroke (MCA, ACA, PCA, Foville's, Millard-Gubler, Lateral medullary, Weber's, Lacunar stroke)
|
|
|
Sleep disorders
|
Insomnia · Hypersomnia · Sleep apnea (Obstructive, Ondine's curse) · Narcolepsy · Cataplexy · Kleine-Levin · Circadian rhythm sleep disorder (Advanced sleep phase disorder, Delayed sleep phase disorder, Non-24-hour sleep-wake disorder, Jet lag)
|
|
|
|
CSF
|
Intracranial hypertension (Hydrocephalus/NPH, Idiopathic intracranial hypertension) · Cerebral edema · Intracranial hypotension
|
|
|
Other
|
Brain herniation · Reye's · Hepatic encephalopathy · Toxic encephalopathy
|
|
|
Spinal cord/
myelopathy |
Syringomyelia · Syringobulbia · Morvan's syndrome · Vascular myelopathy (Foix-Alajouanine syndrome) · Spinal cord compression
|
|
| Both/either |
|
Degenerative
|
|
SA
|
Friedreich's ataxia · Ataxia telangiectasia
|
|
|
MND
|
UMN only: PLS · PP · HSP
LMN only: Distal hereditary motor neuropathies · Spinal muscular atrophies (SMA, SMAX1, SMAX2, DSMA1, SMA-PCH, SMA-LED) · PMA · PBP (Fazio-Londe, Infantile progressive bulbar palsy)
both: ALS
|
|
|
|
|
|
anat(n/s/m/p/4/e/b/d/c/a/f/l/g)/phys/devp
|
noco(m/d/e/h/v/s)/cong/tumr, sysi/epon, injr
|
proc, drug(N1A/2AB/C/3/4/7A/B/C/D)
|
|
|
|
