Melkersson-Rosenthal Syndrome — ORE Part 1 MCQ

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HardOral MedicineMelkersson-Rosenthal SyndromeORE Part 1

A 35-year-old woman presents with recurrent episodes of unilateral facial swelling and paralysis. Examination reveals orofacial granulomatosis with a fissured tongue. What is this triad of findings called?

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Correct answer: A — Melkersson-Rosenthal syndrome

Explanation lettering: D = shown as B · B = shown as C · E = shown as D · C = shown as E

The correct answer is A: Melkersson-Rosenthal syndrome. Melkersson-Rosenthal syndrome is defined by the classic triad of recurrent orofacial swelling (often unilateral, with granulomatosis on biopsy), relapsing facial paralysis, and fissured tongue. Although the complete triad is present in only 8–25% of cases, when all three features are present together, the diagnosis is Melkersson-Rosenthal syndrome. Heerfordt syndrome (B)—a manifestation of sarcoidosis—features facial palsy, parotid swelling, uveitis, and fever; it does not typically present with orofacial granulomatosis or fissured tongue. Sjögren syndrome (C), Behçet disease (D), and Ramsay Hunt syndrome (E) do not classically present with this combination of granulomatosis, fissured tongue, and recurrent facial paralysis. The mention of orofacial granulomatosis on examination is diagnostically key and distinguishes MRS from other facial swelling syndromes.

Reference: Melkersson-Rosenthal syndrome and orofacial granulomatosis. PubMed. https://pubmed.ncbi.nlm.nih.gov/8725591/ (1996)