Melkersson Rosenthal Syndrome

Melkersson-Rosenthal syndrome (MRS) is a rare neurological disorder that affects facial nerves. It can cause facial swelling, furrows (grooves) in your tongue and facial paralysis.

Causes of Melkersson Rosenthal Syndrome

Scientists don’t know what causes Melkersson-Rosenthal syndrome, but it’s been associated with:

  • Crohn’s disease.

  • Genetic inheritance.

  • Hypersensitivity reaction (the body’s exaggerated immune response to an antigen or allergen).

  • Sarcoidosis.

  • Viral or bacterial infection.

Symptoms of Melkersson Rosenthal Syndrome

Facial palsy

Facial weakness or paralysis may occur on one side or both. It may not happen until later episodes. Paralysis may last longer with each episode as the disease progresses.

Facial swelling

  • People with Melkersson-Rosenthal syndrome usually experience swelling of their face (orofacial edema), lips (cheilitis granulomatosis) or both.

  • Their upper lip swells before their lower lip.

  • Lips may become hard, cracked, painful and reddish-brown. Other areas that may swell include cheeks, eyelids and scalp.

  • Swelling may worsen and last longer with each episode.

Furrowed tongue

The top of your tongue may develop deep grooves, also known as scrotal tongue or lingua plicata. This symptom usually doesn’t hurt, but it can cause swelling, itching and burning. It also may lead to loss of taste buds or oral infections.

Diagnosis of Melkersson Rosenthal Syndrome

  • MRS diagnosis is often difficult because the symptoms can be confused with other conditions.

  • Examples include allergic reactions and Bell’s palsy.

  • Your healthcare provider usually diagnoses MRS based on a history of at least two of the classic symptoms.

  • They may perform a biopsy on a tissue sample from your lips to confirm the diagnosis or rule out other conditions.

Treatment of Melkersson Rosenthal Syndrome

If symptoms recur and are bothersome, certain treatments can lessen pain, prevent infections and improve appearance, such as:

  • Antibiotics.

  • Antihistamines.

  • Corticosteroid injections.

  • Immunosuppressants.

  • Methotrexate.

  • Nonsteroidal anti-inflammatory drugs.

  • Surgery to reduce swollen lips or relieve pressure on facial nerves.

  • TNF-alpha inhibitors, which help stop inflammation.

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