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  1. Blepharospasm-oromandibular dystonia syndrome (Brueghel's syndrome). A variant of adult-onset torsion dystonia? by C. D Marsden, 1976

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26. Uncontrol Of Facial Muscles
Dear Nelson What you describe may sound very much like orofacial or orofacio-mandibulardystonia (also called Meige syndrome / brueghel syndrome).
Welcome to
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A not-for-profit organization Questions in The Neurology Forum are being answered by doctors from
The Cleveland Clinic , consistently ranked one of the best hospitals in America. Subject: Uncontrol of facial muscles
Topic Area: Neurology - General
Forum: The Neurology and Neurosurgery Forum
Question Posted By: Nelson Hart on Friday, July 17, 1998
About 2 years ago in February 1996, I had a series of headaches that even Tylenol would not give but slight comfort. By the end of the month I problems controlling my lip muscles as I ate or drank. Even to the point where I would spill liquid from my mouth as I drank. I went to a neurologist and he could not find what was causing the problem.
Over a period of time it seems that the uncontrol of facial muscles shifted from one area of my face to another. Currently I seem to have uncontrol of muscles that causes me to froun and press my lips tightly together when I don't want to. Especialy when I am tense. However, even when I am not tense, I still have some uncontrolled facial movements that make me look like I am tense or mad or trying to hold back a laugh. I have also seen a neurologist at the University of Cincinnati. No one can find what is causing the problem and have also expressed that they have never seen such a thing. It is something that is very hard for me to explain. If I should face you as I explained my problem, you probably would not see it at first. As we continue to talk, you will see what I am talking about. The headaches are gone but my muscles around the temple area seems to feel very tight at times especially when I fight hard to take control.

27. EMedicine - Blepharospasm, Benign Essential : Article By Stanley M Saulny, MD
Postencephalitic syndrome Reflex blepharospasm Meige syndrome (blepharospasmoromandibulardystonia, orofacial-cervical dystonia, brueghel syndrome) Apraxia of
(advertisement) Home Specialties CME PDA ... Patient Education Articles Images CME Patient Education Advanced Search Link to this site Back to: eMedicine Specialties Ophthalmology Lid
Blepharospasm, Benign Essential
Last Updated: November 15, 2001 Rate this Article Email to a Colleague Synonyms and related keywords: BEB, essential blepharospasm AUTHOR INFORMATION Section 1 of 10 Author Information Introduction Clinical Differentials ... Bibliography
Author: Stanley M Saulny, MD , Fellow, Department of Ophthalmology, Casey Eye Institute Stanley M Saulny, MD, is a member of the following medical societies: American Academy of Ophthalmology American Medical Writers Association , and American Society of Cataract and Refractive Surgery Editor(s): Ron W Pelton, MD, PhD , Consulting Staff, Department of Surgery, Memorial Hospital; Francisco Talavera, PharmD, PhD , Senior Pharmacy Editor, eMedicine; Mark T Duffy, MD, PhD Lance L Brown, OD, MD , Ophthalmologist, Regional Eye Center, Affiliated With Freeman Hospital and St John's Hospital, Joplin, Missouri; and Hampton Roy, Sr, MD

28. Early-Onset Primary Dystonia (DYT1)
dystonia (the jaw is held open or shut). (Note Blepharospasm and oromandibulardystonia occurring together are called Meige or brueghel syndrome.);
Early-Onset Primary Dystonia (DYT1)
[DYT1, Dystonia Musculorum Deformans, Idiopathic Torsion Dystonia ] Authors: Deborah de Leon, MS
Susan B Bressman, MD
Beth Israel Medical Center Initial Posting:
14 April 1999 Last Update
21 January 2003
Disease characteristics. Early-onset primary dystonia (DYT1) typically presents before age 21 years with involuntary sustained muscle contractions that cause posturing of a foot, leg, or arm. The contractions frequently, but not invariably, generalize to other body regions. No other neurological abnormalities are present, except for postural arm tremor. Disease severity varies considerably even within the same family. Isolated writer's cramp may be the only sign. DYT1 is the most common cause of early-onset primary dystonia. Diagnosis/testing. DYT1 is diagnosed by molecular genetic testing of the gene which reveals a 3-base pair GAG deletion in all affected individuals. Genetic counseling. DYT1 is inherited in an autosomal dominant manner. Offspring of an affected individual or an asymptomatic individual known to have a disease-causing mutation have a 50% chance of inheriting the disease-causing mutation and a 30-40% chance of developing clinical findings. Prenatal testing is available.

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  • 31. Emergency Clinical Guide Presents Clinical Eponyms A-B
    brueghel syndrome, Dystonia of the motor trigeminal nerve producing a widely openedmouth, named after painting by Flemish painter Brueghel (Neurol 1996;461768
    Clinical Eponyms
    A-B A-B C-D E-F G-H ... W-Z This list is available for the Palm Pilot at Andrew Yee's website Adamkiewicz, artery of Artery responsible for anterior spinal syndrome; could be bagged in AAA repair Tonic pupil, larger than contralateral unaffected pupil, reacts sluggishly to changes in illumination, q.v. Holmes-Adie syndrome; seen in young women; no neurologic significance Alagille syndrome Inherited cholestatic syndrome, associated with biliary hypoplasia (ductopenia), vertebral anomalies, prominent forehead, deep-set eyes, peripheral pulmonic stenosis Albers-Schönberg disease Osteopetrosis or marble bone disease Alder-Reilly anomaly Large, dark, pink-purple granules in cytoplasm of neutrophils; AR trait resulting in abnormal granule development in neutrophils resembling severe toxic granulation Alexander’s disease Leukodystrophy-like neurodegenerative disease presenting in infancy or childhood; characterized by Rosenthal fibers Alexander’s law Peripheral vestibular nystagmus increases in intensity when the gaze is in the direction of the fast phase, and decreases in intensity when the gaze is away from the fast phase Hereditary nephritis accompanied by nerve deafness and various eye disorders, including lens dislocation, posterior cataracts, and corneal dystrophy

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  • 33. Pieter Brueghel (
    oromandibular dystonia and suggested the eponym "brueghel's syndrome" (Marsden CD, J Neurol Neurosurg Psychiatry


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    Pieter Brueghel
    Dutch painter, 1525-1569.
    Associated eponyms:
    Meige's syndrome II

    A disabling spasm of the facial musculature consisting of primary blepharospasm followed by abnormal facial movement. Biography: In his painting De Gaper, Brueghel described the condition now commonly referred to as Meige's syndrome II, or blepharospasm-oromandibular dystonia. The term Brueghel's syndrome is used when extensive mandibular involvement is a major component of the disease. For more information on Pieter Brueghel, see any good encyclopaedia. Ole Daniel Enersen

    34. Meige's Syndrome II (
    The term Meige's syndrome II/brueghel's syndromeis used for blepharospasm and oromandibular dystonia occurring together....... brueghel Henri Meige


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    Meige's syndrome II Also known as:
    Brueghel’s syndrome
    Blepharospasm-oromandibular dystonia syndrome, median facial spasm, oral facial dystonia.
    Associated persons: Pieter Brueghel Henri Meige Description: The term Meige's syndrome II/Brueghel's syndrome is used for blepharospasm and oromandibular dystonia occurring together. It is a disabling spasm of the facial musculature consisting of primary blepharospasm followed by abnormal facial movement. Squinting may begin unilaterally but soon becomes bilateral. In time, the lower facial muscles becomes involved with yawning, jaw opening, and abnormal tongue movements. The voice is often affected as well. The involuntary movements cease during sleep. The condition may be aggravated by eating or talking and is sometimes lessened by humming, singing, yawning or voluntary opening of the mouth. Henry Meige in 1910 described a condition characterized by blepharospasm and facial, mandibular, oral, lingual, and laryngeal spasms and called it "spasm facial median." There is a distinct overlap between benign essential blepharospasm (BEB) and Meige although either can exist without the other. One of the earliest suspected documentations of blepharospasm is a painting - De Gaper - by the Flemish artist Brueghel (1525-1569), who painted a woman with apparent blepharospasm with facial and neck involvement. The term "Brueghel syndrome" is used when extensive mandibular involvement is a major component of the disease.

    35. Baillement-brueghel
    Translate this page Oromandibular Dystonia ? « brueghel's syndrome » Revisited Stephen G.Reich and Robert L. Ruff, Cleveland, OH retour vers les peintres,

    36. Baillement-lettre15
    Translate this page Après que Marsden CD ait publié en 1976 une série de cas de dystonie oro-mandibulaireet baptisé ce trouble «brueghel's syndrome» en interprètant le
    Dr O Walusinski
    mercredi 1er janvier 2003
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    37. Dystonias
    OrofacialBuccal Dystonia (aka Meige's or brueghel's syndrome) This is a combinationof blepharospasm and oromandibular dystonia Spasmodic Dysphonia (or SD
    Dystonia Dystonia Overview:
    Dystonia is not a new disease. For example, the 15th century Flemish painter, Pieter Brueghel portrayed persons afflicted with one form of dystonia, blepharospasm (eyelid spasms). There is no known cause of dystonia, nor is there a definitive test for it. Although dystonia has no cure, there are successful treatments which greatly reduce the symptoms and restore patients to many daily living activities. Treatments include drug therapy, botulinum toxin injections and several types of surgery.
    In primary dystonia, there is no alteration of consciousness, sensation or intellectual function.
    There are a number of ways of classifying the different types of dystonia. The two most common classifications are:
    Primary or idiopathic (no known organic lesion) vs secondary (generally arises from some insult to the basal ganglia of the central nervous system such as: trauma, toxins, drugs, neoplasm, infarction, other organic causes) Classification based on the body region involved (see following)
    Generalized Dystonia or Idiopathic Torsion Dystonia
    Onset age: typically children (especially in early teen years)
    Symptoms: abnormal foot inversion, awkward gait, contractions of many different muscle groups; may involve one or more limbs of the proximal or distal muscle groups

    38. Dorlands Medical Dictionary
    brueghel's syndrome (Brue·ghel's syndrome) (broi¢gschwalz) Pieter brueghel theElder, Flemish painter, 1525–1569, whose painting De Gaper shows a person

    39. Botox, Blepharospasm, Botox, Wrinkles, Feet, Spasm, Dry Eye,
    Meige syndrome spasm in the eyelids and midface; brueghel's syndrome spasmsin eyelids associated with marked spasms in the lower face and neck;
    Supported in part by an unrestricted educational grant by Allergan About Botox How does Botox work?
    Botulinum - Latest News
    Botulinum for Wrinkles

    • Blepharopspasm was first described in the 16th century by the painting by Pieter Brueghel entitled "De Gaper." During the 16th century, patients were institutionalized in insane asylums Little progress was made in understanding and treating blepharospasm until the mid-1900's. In 1907, Meige described a similar patient with dystonia which is now termed Meige syndrome. In 1956, Henderson wrote a classic article on Blepharopspasm describing the disability and treatments. can occur with specific precipitating stressors, such as bright lights, fatigue, and emotional tension; as the course continues, it occurs more frequently during the day and it may intensify so that when the spasms occur the eyelids may remain forcefully closed for short periods of time. Of note, the spasms disappear sleep and often by concentrating on a specific task. Possible origins include: basal ganglia, psychosomatic

    40. Orofaciomandibular And Lingual Dystonia (Meige Syndrome)
    4. Marsden CD. Blepharospasmoromandibular dystonia syndrome (brueghel'ssyndrome). A variant of adultonset torsion dystonia? I and lingual dystonia (meig
    Note: Graphics in this article were scanned from copies and not the original document. Article is from Handbook of Botulinum Toxin Treatment
    Edited by Peter Moore
    The Walton Centre for Neurology and Neurosurgery
    FORWARD BY A. J. LEES In the early sixteenth century, Brueghel painted faces with open mouths and contracted facial muscles, similar to those we now associate with cranial dystonia [1]. In 1899, Gowers [2] described conditions producing tonic and clonic jaw contractions. His differential diagnosis of tonic spasms included tetanus, trauma, hysteria, brainstem lesions and hypothermia. Convulsions, rigors, paralysis agitans, facial pain and chorea were recognized as causes of clonic spasms.
    In 1910, Meige [3] reported a syndrome of spasms of the eyelids in addition to contractions of the pharyngeal, jaw and tongue muscles. Characteristic of dystonia, these spasms were often provoked by voluntary action (e.g. talking, eating), or lessened by humming, singing, yawning or voluntarily opening the mouth. Some of the patients with Meige syndrome developed other signs of dystonia including torticollis or writer's cramp. In 1976, Marsden [4] concluded that blepharospasm and oromandibular dystonia were adult-onset segmental torsion dystonias. other reviews have supported this assertion [5-15]. We now use the term 'oromandibular dystonia' (OMD) when referring to dystonia of the masticatory, lower facial and tongue muscles with resulting spasms and jaw deviation.

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