More Than Skin Deep: The Diverse Symptoms of Parry‐Romberg Syndrome - Healthcare-netizens/arpita-kamat GitHub Wiki
While the progressive facial atrophy is the defining characteristic of Parry-Romberg Syndrome, the condition can manifest with a wide array of other symptoms, highlighting that it's often "more than skin deep." These associated features can vary significantly in their presence and severity among affected individuals.
Neurological abnormalities are surprisingly common in PRS. Migraine headaches, sometimes accompanied by visual disturbances, nausea, and vomiting, affect a significant portion of individuals with the syndrome. Trigeminal neuralgia, characterized by episodes of intense, stabbing facial pain along the trigeminal nerve pathways, is another distressing neurological symptom that can occur. In some cases, seizures, ranging from mild to more severe, can also develop.
Ophthalmological issues are also frequently observed. Enophthalmos, a sinking of the eyeball into the socket due to fat loss around the eye, is a common finding. Other eye-related symptoms can include drooping of the eyelid (ptosis), constriction of the pupil (miosis), redness of the conjunctiva, and decreased sweating on the affected side of the face (anhidrosis) – a combination known as Horner's syndrome. In rarer instances, individuals may experience double vision, inflammation of the eye structures (uveitis, retinitis), or changes in eye color (heterochromia).
Oral and dental abnormalities are also frequently reported. Atrophy of one side of the tongue or upper lip can occur. Some individuals may experience difficulties opening or closing their jaw, or develop involuntary muscle spasms in the chewing muscles (hemi-masticatory spasm). Dental issues can include delayed tooth eruption, exposure of tooth roots, and resorption of dental roots on the affected side. The alignment of the upper and lower teeth (malocclusion) may also be affected.
Changes in skin pigmentation are another notable symptom. This can manifest as darkening of the skin (hyperpigmentation) or patches of unpigmented skin (hypopigmentation) on the affected side of the face. In some cases, facial hair, such as eyebrows and eyelashes, may turn white and fall out (alopecia).
Less common symptoms can include weakness on one side of the body (hemiparesis) and abnormalities in other parts of the body, such as the arm, trunk, or leg on the affected side. The presence and severity of these diverse symptoms underscore the complex and systemic nature of Parry-Romberg Syndrome, requiring a multidisciplinary approach to care.
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