Images in clinical medicine | Volume 36, Article 325, 24 Aug 2020 | 10.11604/pamj.2020.36.325.25052

Furrowed tongue, fatten lip and facial droop

Philip Babatunde Adebayo, Hanifa Mbithe

Corresponding author: Philip Babatunde Adebayo, Neurology Section, Department of Medicine, Aga Khan University, Dar es Salaam, Tanzania

Received: 18 Jul 2020 - Accepted: 11 Aug 2020 - Published: 24 Aug 2020

Domain: Neurology (general)

Keywords: Facial palsy, furrowed tongue, Melkersson-Rosenthal syndrome

©Philip Babatunde Adebayo et al. Pan African Medical Journal (ISSN: 1937-8688). This is an Open Access article distributed under the terms of the Creative Commons Attribution International 4.0 License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Cite this article: Philip Babatunde Adebayo et al. Furrowed tongue, fatten lip and facial droop. Pan African Medical Journal. 2020;36:325. [doi: 10.11604/pamj.2020.36.325.25052]

Available online at: https://www.panafrican-med-journal.com/content/article/36/325/full

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Images in clinical medicine

Furrowed tongue, fatten lip and facial droop

Furrowed tongue, fatten lip and facial droop

Philip Babatunde Adebayo1,&, Hanifa Mbithe1

 

1Neurology Section, Department of Medicine, Aga Khan University, Dar es Salaam, Tanzania

 

 

&Corresponding author
Philip Babatunde Adebayo, Neurology Section, Department of Medicine, Aga Khan University, Dar es Salaam, Tanzania

 

 

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Melkersson-Rosenthal syndrome (MRS) is a rare, neuro-mucocutaneous syndrome characterized by recurrent facial nerve palsy, swelling of the upper lip, and fissured tongue. Young adults in the second and third decades are more predisposed. We report a case of a 23-years old female Chinese who presented with 5 days history of right facial weakness; her second event in one year (first weakness was on the left). On examination, she had right peripheral facial nerve palsy (House-Brackmann stage IV) and, mild swelling of the upper lip (Image-Arrow A). Her tongue revealed two central furrows. The anterior central furrow (Image-Arrow B) measured about 2cm and the posterior one measured about 1.5cm with lateral grooves and few posterior perpendicular furrows measuring about 1-2 mm in depth. Her complete blood count, blood sugar, urine routine, C-reactive protein, Serum angiotensin-converting enzyme level was all normal. Her brain magnetic resonance imaging revealed no abnormal signals. She was commenced on oral prednisolone 60mg daily for 5 days, acyclovir 800mg 4 times daily for 5 days, Vitamin B capsules and methylcellulose drops to prevent scleritis. She was commenced on physiotherapy with steady clinical improvement. Although fissured tongue is a common clinical condition with a long list of differential diagnosis, the presence of recurrent facia nerve palsy and swollen lip should raise the suspicion of MRS. Other causes of recurrent facial nerve palsy and buccal mucosa involvement like sarcoidosis, system lupus erythematosus, Bechet disease and Crohn disease should be considered.

 

 

Figure 1: (A) swelling of the upper lip; (B) anterior central tongue furrow

 

 

 

 

 

 

 

 

 

 

 

 

Images in clinical medicine

Furrowed tongue, fatten lip and facial droop

Images in clinical medicine

Furrowed tongue, fatten lip and facial droop

Images in clinical medicine

Furrowed tongue, fatten lip and facial droop

Volume 37 (Sep - Dec 2020)
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Key words

Facial palsy

Furrowed tongue

Melkersson-Rosenthal syndrome

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