Diagnosis and Treatment of Parry Romberg syndrome

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How is the Parry Romberg Syndrome diagnosed?

Physicians often diagnose Parry Romberg
syndrome in patients by obtaining the medical reports from the following
examinations:

Physical
examination:
Physicians observe the patients clinically and perform physical
examination to diagnose the condition. Diagnosis depends upon the patient's complete
medical history, who generally presents with an abnormal facial asymmetry. Some
of the patients present with neurological symptoms such as seizures or migraine.



Magnetic
resonance imaging or MRI scan:
An, MRI scan is the most preferred imaging tool to
scan the brain and it helps to detect the condition. Alternately, one can
obtain CT scan reports of the brain in case of migraine or seizures.


Lumbar
puncture:
A diagnostic lumbar puncture test is indicated in patients presenting
with a recent onset of seizures.


Autoantibodies
serum examination or test:
Serum test for autoantibodies is conducted in
patients presenting with seizures.

What is the treatment for Parry Romberg Syndrome?

The
treatment protocol for parry Romberg syndrome is basically aimed at reducing
the associated symptoms and one should understand that the condition cannot be cured.
There are no treatments that prevent the progression of the condition however
one can control the disease complications with either medication or surgical therapy.
Following are the below mentioned treatment options that are used to treat
patients suffering from parry Romberg syndrome.

Medical
treatment:
Some of the commonly prescribed medications include: immunosuppressive
drugs such as azathioprine, corticosteroids, methotrexate, and
cyclosphosphamide. These medications relieve from migraine pain and are
effective in treating seizures. However, no clinical studies have been conducted
to support the efficacy and benefits of medication therapy.

Surgery:
Parry-Romberg syndrome affected person often requires a micro-vascular or reconstructive
surgery in order to regenerate the wasted tissue. Generally, the period of surgical
intervention is planned during the course of disease exhaustion and on complete
growth of facial bones although few of them prefer an early surgical
intervention. However, the physician choses an appropriate surgery and plans
for the best time to perform it. These surgeries are effective in restoring the
facial contour to normal. Additional surgical procedures such as orthognathic
surgery, cartilage grafts, bone distraction, bone grafts, and pedicled temporal
fascia flaps are often advised in patients presenting with severe form of disease.
Majority of surgeons usually plan for the reconstructive surgery after waiting
for a period of 1 or 2 years. Bone or muscle grafts are usually recommended as
surgical options while the other treatments are supportive and symptomatic.

http://www.youtube.com/watch?v=L6mzaRBBgUQ

Microsurgical
reconstructive surgery involves the transfer of tissues from various parts of
the body such as free flap from the groin, parascapular fasciocutaneous flap or
latissimus dorsi muscle or a rectus abdominis muscle (Transverse Rectus
Abdominis Myocutaneous or "TRAM" flap) to the face. Some of the
additional procedures that are performed to recover from severe deformities include
cartilage grafts, pedicled temporal fascia flaps, orthognathic surgery, bone grafts,
and bone distraction.

What is the disease Prognosis?

The
prognosis for the parry Romberg Syndrome patient is specific to each patient
and varies for each patient. In few cases, the atrophy usually subsides before it
affects the patient's face completely. Although patients suffering from milder form
of syndrome usually experience facial disability and doesn't require aggressive
therapy.

References:
http://en.wikipedia.org/wiki/Parry%E2%80%93Romberg_syndrome

http://www.medicinenet.com/parry-romberg_syndrome/article.htm

http://children.webmd.com/parry-romberg-syndrome

http://syndromespedia.com/parry-romberg-syndrome.html

http://www.medicinenet.com/parry-romberg_syndrome/page2.htm

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About the Author

Dr Chaitra S's picture
Author: Dr Chaitra S

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