How is Meige’s syndrome (Meige’s syndrome) diagnosed?

Meige’s syndrome (Meige’s syndrome) is a segmental dystonic disorder. It was first reported by Meige, a French neurologist, in 1910. It is an adult-onset dystonic disorder of the face, mainly causing eyelid spasms and various forms of dystonia of the low face, jaw, and neck; also known as eyelid spasm-mouth-mandibular dystonia syndrome. It is also considered to be a form of adult ADHD. Severe cases can cause severe symptoms such as difficulty opening the eyes, functional blindness, dysphagia, whistling difficulties, and dysarthria, causing extreme pain to the patient. Because its clinical manifestations are similar to many diseases, it is easily confused with dry eye, facial spasm, myasthenia gravis, senile ptosis, tic disorder, post-facial palsy hypermobility, neurosis, etc. Therefore, it is still difficult for inexperienced physicians to diagnose this disease. The diagnosis of Meijer syndrome is based on the patient’s age at onset, the evolution of symptoms during the course of the disease, previous exclusionary diagnostic treatments (e.g., ineffective treatment with artificial tears, lacrimal punctal embolization, ineffective treatment with drugs for myasthenia gravis, etc.), past medical history (history of trauma, long-term antipsychotic medication, dental surgery, nasopharyngeal radiation therapy, etc.), and then on the patient’s typical Clinical manifestations: bilateral blepharospasm, combined or uncombined symmetrical and irregular contractions of the orofacial muscles, Tricks phenomenon (also known as sensory trickery phenomenon – that is, the patient can see dramatic reduction or disappearance of symptoms during some specific actions: yawning, eating, coughing, singing, playing the piano, quizzing, playing the harmonica, whistling, etc.) The diagnosis of the disease can be made by clinical features such as the disappearance of the syndrome during sleep, and so on. Therefore, the diagnosis of Meijer syndrome is mainly based on medical history, typical clinical manifestations, combined with past medical history and treatment history. There are no specific tests to help confirm the diagnosis, but facial electromyography, cranial MRI or CT, functional MRI or PET can be done to exclude some diseases and provide some help for the diagnosis. The current treatment for Meijer syndrome is mainly medication, local injection of Botox and surgery. The internationally recognized method for the surgical treatment of Meijer syndrome is Deep Brain Stimulation (DBS), commonly known as “brain pacemaker” surgery, which has the characteristics of small trauma, fast recovery, no damage to the normal structure of the brain, reversible, adjustable and personalized, etc. It is a relatively safe and effective method with fewer side effects. It is a safe and effective treatment with fewer side effects. It is true that it is more expensive at present. The Neurology Center of the General Aviation Hospital is one of the first few centers in China to carry out this type of surgery, and the number of cases and the efficacy of the surgery are in the leading position at home and abroad, with an efficiency rate of over 80-90% and an improvement rate of 77-90% on average, and more than half of the patients have completely disappeared and returned to normal life after surgery. Therefore, it is a useful choice for patients with drug-refractory Meijer syndrome, which can significantly improve the symptoms and quality of life.