Tiia Pihlamaa1, Tapani Salmi2, Sinikka Suominen1, Sari Kiuru-Enari3. 1. Department of Plastic and Reconstructive Surgery, Töölö Hospital of Helsinki University Central Hospital, P.O. Box 266, 00029 HUS, Finland. 2. Department of Clinical Neurophysiology, Helsinki University Central Hospital, Helsinki, Finland. 3. Department of Neurology, Helsinki University Central Hospital, Finland.
Abstract
INTRODUCTION: Hereditary gelsolin amyloidosis (GA) is a rare condition caused by the gelsolin gene mutation. The diagnostic triad includes corneal lattice dystrophy (type 2), progressive bilateral facial paralysis, and cutis laxa. Detailed information on facial paralysis in GA and the extent of cranial nerve injury is lacking. METHODS: 29 GA patients undergoing facial corrective surgery were interviewed, examined, and studied electroneurophysiologically. RESULTS: All showed dysfunction of facial (VII) and trigeminal (V) nerves, two-thirds of oculomotor (III) and hypoglossal (XII) nerves, and half of vestibulocochlear (acoustic) (VIII) nerve. Clinical involvement of frontal, zygomatic, and buccal facial nerve branches was seen in 97%, 83%, and 52% of patients, respectively. Electromyography showed marked motor unit potential loss in facial musculature. CONCLUSIONS: Cranial nerve involvement in GA is more widespread than previously described, and correlates with age, severity of facial paralysis, and electromyographic findings. We describe a grading method for bilateral facial paralysis in GA, which is essential for evaluation of disease progression and the need for treatment.
INTRODUCTION: Hereditary gelsolinamyloidosis (GA) is a rare condition caused by the gelsolin gene mutation. The diagnostic triad includes corneal lattice dystrophy (type 2), progressive bilateral facial paralysis, and cutis laxa. Detailed information on facial paralysis in GA and the extent of cranial nerve injury is lacking. METHODS: 29 GA patients undergoing facial corrective surgery were interviewed, examined, and studied electroneurophysiologically. RESULTS: All showed dysfunction of facial (VII) and trigeminal (V) nerves, two-thirds of oculomotor (III) and hypoglossal (XII) nerves, and half of vestibulocochlear (acoustic) (VIII) nerve. Clinical involvement of frontal, zygomatic, and buccal facial nerve branches was seen in 97%, 83%, and 52% of patients, respectively. Electromyography showed marked motor unit potential loss in facial musculature. CONCLUSIONS:Cranial nerve involvement in GA is more widespread than previously described, and correlates with age, severity of facial paralysis, and electromyographic findings. We describe a grading method for bilateral facial paralysis in GA, which is essential for evaluation of disease progression and the need for treatment.
Authors: James B Caress; Janel O Johnson; Yevgeniya A Abramzon; Gregory A Hawkins; J Raphael Gibbs; Elizabeth A Sullivan; Chamanpreet S Chahal; Bryan J Traynor Journal: Muscle Nerve Date: 2017-03-23 Impact factor: 3.217
Authors: E Nae Cheong; Wooyul Paik; Young Chul Choi; Young Min Lim; Hyunjin Kim; Woo Hyun Shim; Hyung Jun Park Journal: Yonsei Med J Date: 2021-05 Impact factor: 2.759