Meige syndrom as a first relapse of multiplesclerosis
Author(s):
S.A. Hatteb
,
S.A. Hatteb
Affiliations:
S. Daoudi
S. Daoudi
Affiliations:
ECTRIMS Online Library. Samira H. 09/16/16; 146717; P877
Hatteb Samira
Hatteb Samira
Contributions
Abstract

Abstract: P877

Type: Poster

Abstract Category: Clinical aspects of MS - MS symptoms

Background: Multiple sclerosis is an inflammatory demyelinating disease of central nervous system characterized by dissemination of the lesions in time and space. MS evolution is rarely punctuated by the occurrence of movement disorders, except for cerebellar tremor. we report in this context a Meige syndrom revealing the disease.

Observation: A young woman aged 36 years, presented with headache, hemifacial numbness and involuntary movements interesting first left eyelid, then both. Examination showed bilateral spasms in the frontal and orbicularis muscles of the eyelids predominantly on left side making a blepharospasm. These movements appeared to be exagerated by emotion and also to exposure to light. The examination showed the extension of spasms to the platysma muscle neck on left side and exagerated tendon reflexes. Brain MRI showed T2 and T2 Flair disseminated nodular lésions fulfilling McDonald 2010 criteria. one T2 lesion was located in midbrain. Cerebrospinal fluid (CSF) analysis showed oligoclonal bands of IgG.

Complete regression of blepharospasm with neck spasm and headache was obtained after a five-day infusion of methylprednisolone (1 g / day).

The diagnosis of multiple sclerosis (MS) was made according to the McDonald criteria 2010, after exclusion of other possible causes including infectious, autoimmune, metabolic or toxic.

Discussion: Occurence of movement disorders and MS may be coincidental or really caused by disease. In our case, MRI scans showed a midbrain demyelinating lesion, providing a potential link between symptoms and the autoimmune disorder, also suggested by oligoclonal IgG synthesis in CSF. About abnormal facial movement, blepharospasm are rarely described, but it is to our knowledge the first description of an MS case in which the sole primary manifestation was a Meige syndrome

Conclusion: Meige syndrom is a particular form of abnormal facial movement whose etiopathogenic bases remain unknown. its occurrence during MS is exceptional. In our case, there seems radiological correlation between symptoms and MRI scans. The other causal argument would be rapid and complete response to corticosteroids.

Disclosure: S Hatteb, S.Daoudi: nothing to disclose

Abstract: P877

Type: Poster

Abstract Category: Clinical aspects of MS - MS symptoms

Background: Multiple sclerosis is an inflammatory demyelinating disease of central nervous system characterized by dissemination of the lesions in time and space. MS evolution is rarely punctuated by the occurrence of movement disorders, except for cerebellar tremor. we report in this context a Meige syndrom revealing the disease.

Observation: A young woman aged 36 years, presented with headache, hemifacial numbness and involuntary movements interesting first left eyelid, then both. Examination showed bilateral spasms in the frontal and orbicularis muscles of the eyelids predominantly on left side making a blepharospasm. These movements appeared to be exagerated by emotion and also to exposure to light. The examination showed the extension of spasms to the platysma muscle neck on left side and exagerated tendon reflexes. Brain MRI showed T2 and T2 Flair disseminated nodular lésions fulfilling McDonald 2010 criteria. one T2 lesion was located in midbrain. Cerebrospinal fluid (CSF) analysis showed oligoclonal bands of IgG.

Complete regression of blepharospasm with neck spasm and headache was obtained after a five-day infusion of methylprednisolone (1 g / day).

The diagnosis of multiple sclerosis (MS) was made according to the McDonald criteria 2010, after exclusion of other possible causes including infectious, autoimmune, metabolic or toxic.

Discussion: Occurence of movement disorders and MS may be coincidental or really caused by disease. In our case, MRI scans showed a midbrain demyelinating lesion, providing a potential link between symptoms and the autoimmune disorder, also suggested by oligoclonal IgG synthesis in CSF. About abnormal facial movement, blepharospasm are rarely described, but it is to our knowledge the first description of an MS case in which the sole primary manifestation was a Meige syndrome

Conclusion: Meige syndrom is a particular form of abnormal facial movement whose etiopathogenic bases remain unknown. its occurrence during MS is exceptional. In our case, there seems radiological correlation between symptoms and MRI scans. The other causal argument would be rapid and complete response to corticosteroids.

Disclosure: S Hatteb, S.Daoudi: nothing to disclose

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