What Are the Symptoms of Moebius Syndrome?

People can experience facial paralysis that results in speech difficulties and problems opening and closing the eyes. In these instances, people should undergo a medical evaluation. Because they may be coping with Moebius syndrome.

Moebius Syndrome: An In-Depth Look at the History of the Disorder

To understand Moebius syndrome and its impact on patients, it is important to first consider the history of the disorder.

The syndrome was initially identified by German physician Paul Julius Möbius in the late 1880s. At this time, Möbius encountered a man who was dealing with a lack of facial expressions. The man could not blink his eyes or move them laterally.

Since that time, researchers have studied the disorder in detail. Researchers continue to gain insights into the condition and its impact on patients. Furthermore, they are working toward finding ways to treat patients coping with the condition, so they can achieve long-lasting symptomatic relief.

How Does Moebius Syndrome Impact the Facial Nerves?

Moebius syndrome is generally characterized by paralysis or weakness of multiple facial nerves. The National Organization for Rare Disorders (NORD) indicates the condition most often affects the sixth and seventh facial nerves, but other nerves can also be impacted.

In Moebius syndrome instances where the sixth cranial nerve is paralyzed or weakened, the eye is unable to turn past its midline. Or, in cases where other cranial nerves are affected, facial paralysis or weakness can occur. 

The syndrome has been linked to a wide range of facial abnormalities. Children with the syndrome sometimes have a short, malformed tongue, extremely small jaw, or cleft palate. In these cases, children are susceptible to feeding and breathing problems.

Kids with this condition can also experience ear abnormalities, such as underdevelopment or no development of the outer part of the ear. If the eighth cranial nerve has been affected, children with this condition are susceptible to hearing loss.

Moebius syndrome has been linked to dental problems as well. Kids dealing with this condition are prone to cavities and other oral health issues. In addition, they can have trouble speaking clearly and experience speech delays.

Along with the aforementioned abnormalities, skeletal problems have been associated with the syndrome. Kids diagnosed with the condition are susceptible to clubbed feet and other lower leg abnormalities, along with webbed fingers and other malformations that affect the upper extremities.

Why Do Cases of Moebius Syndrome Occur?

Moebius syndrome cases are frequently isolated and impact patients who previously had no family history of the condition, the Genetic and Rare Diseases Information Center notes. However, a small portion of cases of Moebius syndrome have been reported in multiple blood relatives.

Meanwhile, the U.S. National Library of Medicine states the syndrome may be related to blood flow changes in the brain stem that occur during early embryonic development. Although research has been conducted to study why these changes may occur, additional studies are required to fully understand their potential link to the condition. 

Is There a Pattern of Inheritance Associated with Cases of Moebius Syndrome?

Some research suggests Moebius syndrome can be inherited as an autosomal dominant trait, NORD points out. In these instances, the condition may be caused by only a single copy of an abnormal gene.

Comparatively, studies indicate the syndrome may be multifactorial, with a combination of genetic and environmental factors causing it to occur. It is possible that the condition can have multiple underlying causes as well.  

How Is Moebius Syndrome Diagnosed? 

At least one estimate suggests Moebius syndrome affects approximately one out of every 50,000 live births in the United States, NORD reports. Yet, a lack of diagnostic tests can make it difficult to properly identify and treat the condition.

If a patient displays symptoms of Moebius syndrome, a review of their medical history and a physical exam can be performed. Specialized tests can also be used to verify if the patient is dealing with other types of facial paralysis.

How Is Moebius Syndrome Treated?

The ideal treatment varies based on the severity of a patient’s symptoms and other factors. Once a patient receives their diagnosis, a personalized treatment plan is developed to ensure the patient can safely and effectively treat their symptoms.

A temporalis tendon transfer is one of the treatment options available to correct Moebius syndrome symptoms. This treatment involves reattachment of the temporalis muscle (used for chewing) to the corner of the mouth.

During a temporalis tendon transfer, a small incision is made near the laugh lines of a patient’s mouth. Next, the temporalis muscle tendon is rotated and connected to the corner of the mouth. The result: a temporalis tendon transfer can restore dynamic facial movement and improve facial symmetry. 

A bilateral gracilis muscle transfer to the masseter nerve is another option to help patients. The procedure involves harvesting the gracilis muscle (found in the inner thigh) and transferring it to a patient’s face.

With a bilateral gracilis muscle transfer to the masseter nerve, a small portion of a patient’s gracilis muscle is taken from each thigh. Then, the muscle is transferred to both sides of a patient’s face and connected to the masseter nerve, which manages the muscles used for chewing. Following a bilateral gracilis muscle transfer to the masseter nerve, the patient can gradually improve their facial movement within six to nine months after surgery. The patient’s ability to smile improves within a few years of the bilateral gracilis muscle transfer to the masseter nerve procedure as well.

Bilateral selective neurolysis is a revolutionary treatment available to patients. The surgery involves releasing the platysma muscles that pull the corners of the mouth down and otherwise hamper a patient’s ability to smile. To date, bilateral selective neurolysis has helped patients regain the ability to naturally smile, frown, and make other facial expressions.

Eyelid reconstruction can be performed for patients who experience crossed eyes or eyelid closure issues. Platinum chains, eyelid springs, and other eyelid reconstruction treatment options are offered, and they can help patients improve their vision and tighten their eyelid muscles.

Can Symptoms of Moebius Syndrome Be Treated Without Surgery?

Physical and speech therapies can be used to help patients coping with Moebius syndrome. Patients can leverage these therapies to improve motor skills and coordination to alleviate speech difficulties and other problems associated with the condition. Plus, physical and speech therapies won’t require patients to go under the knife to treat their symptoms. 

Which Moebius Syndrome Treatment Option Is Right for You?

The optimal treatment for Moebius syndrome varies. To identify the best course of action to address facial paralysis and other symptoms associated with the disorder, meet with a doctor. Next, a patient can receive proper testing to determine the root cause of their symptoms. Finally, the doctor can provide their patient with a personalized diagnosis and treatment. Patients who have been diagnosed with Moebius syndrome but are uncertain about how to treat the condition or have been dealing with long-term facial paralysis symptoms can consult with Dr. Babak Azizzadeh of The Facial Paralysis Institute. Dr. Azizzadeh is globally recognized for his facial plastic and reconstructive surgery and head and neck surgery expertise, and he can meet with a Moebius syndrome patient to explore a variety of treatment options. To learn more or to schedule a treatment consultation with Dr. Azizzadeh, please contact us online or call us today at (310) 657-2203.

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