Melkersson-Rosenthal syndrome: a disease of the face and character

There is a pathology in nature, called Melkersson-Rosenthal syndrome, or "face of the tapir," which is widespread not only between the peoples of Bolivia, where this proboscide is on the verge of extinction, but also among the Earth's population quite civilized.

In general, the "face" of an animal is a muzzle, but in this case it is a person, therefore it is "the face of a tapir".

Externally it is very similar to scalded by boiling water: sharply narrowed by massive "glass" edemas, eye-slits, super-thick - to "super-Negro" state - lips.

With a stronger defeat of the upper lip, it sharply protrudes forward, rounding the area under the nose and as if taking it forward like a tapir's proboscis, the "grubby"( the tapirs grunt like pigs)."Grunt" nose and patients with the syndrome of Merkelsson-Rosenthal.

In the photo, a tapir - it is with him that people are compared to the Melkersson Rosenthal syndrome

For not only the lips but also all that flow in the nasal cavity - due to the development of vasomotor rhinopathy disorders.

And discharge from the nasal cavity here is just as common as spilling liquid food from the corner of the mouth when it is taken.

Because the syndrome is characterized by paralysis or paresis of the facial nerve, with its one-sided version combined with a "tragic sagging" of the corner of the mouth and development of a "hare's eye" with an unnatural width of the eye gap.

Notpleasing eye "silicone" and other deviations

What is crucial for the emergence of the syndrome? Does slowing of blood and lymph flow in the head-neck basin, leading to tissue trophism disorder and the growth of granuloma in the vicinity of the vessels altered by chronic angioedema?

Either a chronic odontogenic infection, along with features of a hereditary predisposition to chronic allergies? Sarcoidosis? Crohn's disease? Science has not yet established this.

Lips like vareniki

And millions of people live with serious disorders of facial expressions, speech, and even swallowing due to considerable tension due to edema of the facial tissues, in the chronic state of the non-pleasing eyes of the "hyper-silicone" parts of the face, especially the lips.

Lips asymmetrically inflated by the "tide" of the disease at a certain time of the year, with a varying degree of reversal of their red rims, cyanotic from a sharp tension( 3-4 times the norm), unevenly dense, with no impressions left after feeling.

And with the retreat of the disease, a little fallen, hard and cracked in places, with a peeling and creeping red-brown "bark" of thin skin.

After several years of such "tidal" activity, having reached the established disfiguration within certain limits, the "rolling-in" of the lips ends.

As well as the cheeks and eyelids, like brushes of hands and clothes hidden by other parts of the body: breasts, buttocks.

The tongue in the fold

When swelling on the tissues of the cheeks arises a picture of granulomatous parieta with the sharpness of dental prints on the inner surface of the cheeks without signs of their inflammatory lesion. But the picture is an abnormally torn by the disease of the language, characteristic for almost all variants of the syndrome.

In addition to the unnatural uneven edema of the tongue, the phenomenon of its folding arises with the formation of fairly deep grooves on its back in a variety of directions, often symmetrical. The deepest of them is dividing the tongue into two halves of the "abyss" of the central fold.

The tongue itself with papillae of increased size becomes as if cut into lobules, keeping the purity and naturalness of the color, or becoming pale pink. But it can be covered with grayish spots or have areas similar to leukoplakic foci.

The main symptoms of

The main symptoms of the Melkersson syndrome of Rosenthal are characterized by the manifestation of the following triad of symptoms:

• "avalanche-like", unpredictable on time edema of the whole face or its parts;
• asymmetry of the face due to unilateral paralysis of the facial nerve;
• different degrees of folding of the tongue, there are less significant signs of the syndrome.

Neurological side of the

Syndrome Rossolimo-Melkerson-Rosenthal Syndrome may also manifest itself with other related neurologic symptoms:

• hyperacupuncture;
• with dysarthria;
• with blepharospasm;
• episodic swallowing disorders:
• hyperhidrosis;
• with paresthesia of the fingers;
• disorders by the type of chronic migraine, hypochondria or depression due to persistent disfigurement of the appearance and inconvenience in the "use and maintenance" of such an unusual person.

Diagnosis based on complaints and toolkit

At the first acquaintance with the patient, attention is drawn to complaints, troubles both neurological and general-somatic, as well as:

• relapse link with a certain time of year;
• age from 25 to 35 years;
• provocation of relapse weakening the body condition factors;
• comparative efficacy against the use of anti-angioneurotic therapy and treatment with antihistamines.

In a study on blood serology and X-ray studies, they are trying to find the etiological - infectious basis of the pathology in the form of:

• AIDS;
• of syphilis;
• sarcoidosis.

EMG data show excessive biomechanical excitability of the facial musculature, examination of the patient's condition with an ophthalmologist reveals signs of retrobulbar neuritis and keratoconjunctivitis, and MRI of the brain allows to exclude the presence of multiple sclerosis both in the bridge of the brain and inside the trunks of the facial nerve.

How to treat the body. ..

Taking into account the data of the carried out studies, the centers of chronic infections are sanitized and suppressed, and treatment aimed at eliminating the existing manifestations of the Rosenthal Melkersson syndrome:

• edema:
• intoxication;
• sensitization and immunosuppression;
• rheological disorders.

In accordance with the declared principles, measures are taken to influence the pathology:

• with antimicrobial ( including anti-tuberculosis) and with anticandidase preparations;
• antibiotics class Oletetrina( up to 750 000 units / day);
• with antiprotozoal agents ( Delagil up to 20-25 g / course);
• with antihistamine ( Dimedrol, Suprastin, Pipolphen);
• with powerful anti-inflammatory drugs , including glucocorticoid( Prednisolone, Dexamethasone) and NSAIDs .

Treatment with diuretics( Furosemide and others), immunosuppressant agents( Plakvenil) is no less important, and pyrogenic agents( Pyrogenal, Prodigiozan) are administered in the treatment of especially persistent forms of the disease in the period outside exacerbation.

. .. and "face of the tapir"

The use of agents that improve the rheology of biological fluids and the state of body tissues( Complamine, vitamin C and group B, autohemotherapy and others) is shown.

As topical, mouthwashes are used with infusion-antiseptics, applying zinc and prednisolone ointments, ointments with retinol to the skin around the mouth.

To reduce the effects of macrohailitis, iontophoresis of Heparin or Dimexide is shown, with no choice to use to reduce tissue tension in the lips, face and facial nerve, surgical techniques are used.

For this condition, the prognosis is not very pleasant, and despite the ongoing research and therapy using the most modern means, the number of patients in the world continues to increase.