What is Moebius syndrome?
Moebius syndrome is a rare neurological disorder. It causes facial paralysis and prevent the eyes from moving one side to the other. Generally people affected by this syndrome are born as such with total paralysis of the face. They are neither able to close their eyes nor make facial expressions like smiling, frowning or raising the eye brows.
The disorder is named after the neurologist Paul Julius Moebius who first described the disorder/syndrome about 130 years back. However it is also on record that the syndrome was described by another scientist Von Graefe about a decade earlier to Moebius.
Since each facial and eye function is attributed to one particular nerve, the non – functioning of the particular nerve make the relevant function impossible and consequently the person is not able to make facial expressions or move or close the eyes.
Generally this syndrome is without any cause. However there are studies that show both genetic and environmental factors can be the causes. The cause of the syndrome cannot be generalized. Each person affected may have a different cause. If the syndrome is inherited it may be from one of the parents.
Many theories have been floated on the causes. One such hypothesis suggests that decreased or interrupted flow of blood to the growing fetus during pregnancy may cause the disorder. Blood vessels nourish the facial nerves. When such blood vessels are not properly nourished due to poor flow of blood it causes facial paralysis. In spite of various such hypothesis, cause of the syndrome still remain to be conclusively established.
- The risk of Moebius syndrome is increased during fetal development due to vascular disturbances. Even a temporary break of blood supply to the brain during the first trimester of pregnancy has the potential to decrease the supply of oxygen to the brain which affects the healthy growth of the cranial nerves. Unhealthy cranial nerves induce paralysis of the facial nerves.
- The other potential contributor to the syndrome is illness or other medical conditions encountered by the mother during pregnancy. Moreover if the mother is on medications or using toxins or other recreational drugs during pregnancy that could affect the healthy growth of fetus and can become a cause for Moebius syndrome.
Impact of the syndrome
- Children with Moebius syndrome move their face from one side to the other to see as they are unable to move their eyes. Such children also have difficulty in laughing or crying. Infants affected by the syndrome may experience difficulty in sucking milk from the mother or nipple of the bottle which is attributed to the malformed tongue essential for sucking milk. On account of the fact that such child is not able to move the tongue properly dental hygiene is also at risk.
- However their mental ability or intelligence level is not disabled. Just because they are not able to make appropriate facial expression it is misunderstood that they have learning disabilities too which is not true. Such children can learn things as quickly as normal children.
- Children with the syndrome also have skeletal abnormalities of the limbs. Such abnormality may be malformation of fingers or even absence of certain fingers or spine curvatures. Besides, some children may take unusually longer tome to reach various stages of growth like crawling or walking. The retarded growth is due to skeletal malformations caused by the syndrome.
Moebius syndrome can be diagnosed just by physical examination of the malformations or by observation of the movements of the person affected by it. There is no particular clinical test to diagnose or confirm the syndrome.
Having diagnosed the syndrome it has to be appropriately treated. It needs to be treated by the collective wisdom of a number of doctors and other health care professionals jointly each supplementing the other. The specialists required include, speech therapists, dentists, neurologists, pediatricians, ear, nose and throat specialists, eye care specialists and so on. The specialists evolve a clinical program based on abnormalities noted by each one of them to correct the facial paralysis.
- Quite a few modern treatments like micro vascular transfer of the muscles can be undertaken to alleviate the problems.
- Smile surgery involving grafting thigh muscle to the face is also performed sometimes.
- Genetic counselling for the person affected and members of immediate family will also go a long way in providing the needed relief.
Since no single course of medical treatment can solve the problem, every type of treatment each of which support the other has to be explored and involved as a comprehensive medical treatment for Moebius syndrome.