A young woman presents with recurrent episodes of unilateral lower motor neuron facial palsy. Examination reveals fissuring and wrinkling of the tongue and non-tender swelling of the lips. What is the most likely diagnosis?

• A Heerfordt syndrome
• B Melkersson-Rosenthal syndrome ✓
• C Mobius syndrome
• D Ramsay Hunt syndrome

Explanation

Melkersson-Rosenthal syndrome is the classic triad of recurrent facial palsy, lingua plicata (fissured tongue) and orofacial granulomatous oedema, thought to be a granulomatous neuritis. Heerfordt syndrome is sarcoidosis with uveitis, parotitis, fever and facial palsy, without the fissured tongue or lip swelling. Mobius syndrome is congenital bilateral facial and abducens palsy. Ramsay Hunt requires a vesicular eruption with otalgia.

Reference: Dhingra's Diseases of Ear, Nose and Throat, 8th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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