What is Moebius Syndrome?
Moebius Syndrome is an extremely rare congenital neurological condition in which there is weakness or paralysis of the cranial nerves, especially the 6th and the 7th cranial nerve. In some cases other cranial nerves may also be affected but those are rare.
A child with Moebius Syndrome in whom the cranial nerve 7th is affected will have problems with smiling, frowning, raising the eyebrows, and closing the eyelids. If the 6th nerve is affected in the child then he or she will have problems with turning the eye past midline.
Some of the other defects associated with Moebius Syndrome are that the pectoralis muscles may remain underdeveloped and there may be deformities of the limbs as well. Moebius Syndrome may be congenital but it does not progress as the child grows and hence the deformities and abnormalities that the child may be having at birth do not worsen with time.
The exact cause of Moebius Syndrome is not yet known but it is believed to occur in children born to mothers who may have abused recreational drugs while pregnant. In some cases, Moebius Syndrome tends to occur in families suggesting a genetic connection to the development of Moebius Syndrome.
What Causes Moebius Syndrome?
As stated, the exact cause of Moebius Syndrome is not yet known but mothers who abuse recreational drugs in pregnancy may have a child with Moebius Syndrome. In some cases, it is suggested that a temporary vascular abnormality in the fetus in the initial stages of pregnancy may also result in development of Moebius Syndrome.
Some females who use abortion medicines like misoprostol may also have a child with Moebius Syndrome. There has been no confirmed gene defect that has been linked to Moebius Syndrome but certain genes have been identified that may be linked to the development of Moebius Syndrome.
What are the Symptoms of Moebius Syndrome?
The abnormalities present in a child with Moebius Syndrome are quite variable and the severity of the deficits and abnormalities also differ from case to case. The classic presenting feature which has been widely accepted as symptoms of Moebius Syndrome are
- Facial paralysis affecting at least one but usually both sides of the face
- Paralysis of lateral movement of the eyes
- Lack of vertical movements of the eyes
Some of the other symptoms of Moebius Syndrome include excessive drooling, strabismus, inability to move the eye sideways, mask like facies, problems with feeding, poor sucking abilities, and swallowing problems.
Children with Moebius Syndrome may have certain deformities as well to include short and malformed tongue, small jaw, cleft palate, frequent ear infections, abnormalities of the external ear with complete absence of the outer portion of the ear in some cases of Moebius Syndrome.
Treatment for Moebius Syndrome
Treatment for Moebius Syndrome is aimed at treating the specific abnormality that the child has. This involves a multidisciplinary approach with physicians and surgeons from almost all the specialties being involved. To treat facial paralysis, surgery will be required which may include transfer of muscles or nerves from other parts of the body to the face.
A traditional procedure called as temporalis tendon transfer may be done in some cases of Moebius Syndrome which involves taking the temporalis muscle which facilitates chewing and transferring them to the corners of the mouth to facilitate smiling. The same type of procedure may be done to improve closure of the eyelids as well.
If the paralysis is unilateral meaning that only one part of the face is involved then a surgical procedure may be done by taking a healthy sensory nerve from the usually the calf and attaching it to branch of the opposite and healthy facial nerve. This nerve regenerates and when it reaches the affected or paralyzed part of the facial nerve then it is joined to the motor nerve.
There is yet another surgical procedure for Moebius Syndrome that is being most preferred nowadays in which muscle from the thigh is transferred to the face and connecting the nerves that supply blood and nutrients to the masseter muscles to this transferred muscle. This procedure has proven to be quite effective in improving speech, facial movements, and improves overall appearance of the child despite suffering from Moebius Syndrome.
Physical therapy is extremely vital for children with Moebius Syndrome to deal with the different types of orthopedic abnormalities that they have to deal with.
Occupational therapy has also been found to be helpful for children with Moebius Syndrome to improve function of the fingers, hands, foot. Speech therapy is required to improve the speech of the child.
Strabismus is something which in some cases goes away on its own with age but in case if it does not then this condition might be surgically corrected as well. A child with this condition may also have to undergo various surgeries to correct the deformities of the limbs and jaws. These children may be provided specialized braces and splints and in some case prosthesis to allow them to move better despite the limb abnormalities caused by Moebius Syndrome.