Moebius Syndrome

Moebius syndrome is a congenital abnormality characterized by weakness or paralysis of the facial nerves . This abnormality occurs in the nerves that function to control facial expressions, eye movements, as well as the ability to speak, chew, and swallow.

Moebius syndrome or Moebius syndrome is an abnormality that can be detected from birth. However, the detected symptoms usually do not worsen over time.

The exact cause of Moebius syndrome is not yet known . However, genetic and environmental factors are thought to influence the occurrence of this condition.

Causes of Moebius Syndrome

Moebius syndrome is a rare congenital abnormality that occurs in every 1 in 50,000 or 500,000 births. Most cases of Moebius syndrome occur randomly and can attack anyone.

Moebius syndrome occurs as a result of brain (cranial) nerves VI and VII not forming or developing incorrectly. Although rare, Moebius syndrome can also be accompanied by underdevelopment of cranial nerves V, VIII, IX, X, XI, and XII. This condition is thought to occur due to disruption of blood flow to the fetal brain stem during development.

Although it happens randomly, it is suspected that there are several factors and conditions that can increase the risk of Moebius syndrome , namely:

Genetic abnormalities , especially on chromosomes 3, 10, and 13
Cocaine use during pregnancy
Medical conditions during fetal development, such as hypoxia and ischemia

Symptoms of Moebius Syndrome

The symptoms that appear as a result of Moebius syndrome depend on the affected nerve. Symptoms of Moebius syndrome can also be seen from the time the baby is born.

The following are some of the most common symptoms of Moebius syndrome :

Absence of facial expression, such as not being able to smile, close eyes, raise eyebrows, or frown
Weakness or total paralysis of the facial muscles
A small chin or jaw and a small mouth
squint ( strabismus )
Cleft lip
Short or deformed tongue
Chest muscles that are not well developed
Hand and foot disorders, such as club foot and fused fingers ( syndactyly )

In addition, there are a number of other symptoms that appear when a person experiences Moebius syndrome , namely:

Difficulty chewing, sucking, or swallowing
Difficulty speaking
Dental problems
Hearing impairment
Dry and irritated eyes
Frequent salivation
Delay in the development of motor skills

When should you go to the doctor?

Symptoms of Moebius syndrome generally appear since the baby is born. Immediately check with a doctor if your child experiences the complaints mentioned above. Early detection and treatment should be done to prevent complications.

If your child is diagnosed with Moebius syndrome , follow the doctor's recommendations and do routine check-ups to monitor the child's development and response to therapy.

Diagnosis of Moebius Syndrome

To diagnose Moebius syndrome , the doctor will ask the patient's parents about the symptoms experienced by the child, as well as the child's and family's health history, including the mother's health history during pregnancy. After that, the doctor will do a thorough examination of the child.

To ascertain the condition and cause of the complaint, the doctor will also perform several supporting examinations, such as:

Genetic test , to find out if there is a genetic abnormality
CT scan or MRI scan, to detect abnormalities in the cranial nerves
Electromyography (EMG), to check if symptoms are caused by other conditions

Treatment of Moebius Syndrome

The treatment of Moebius syndrome involves a number of medical teams, including paediatricians, neurologists, surgeons, ophthalmologists, ENT doctors, orthopedic doctors, and physiotherapists. Quick and accurate treatment, especially in the first year after birth, will help improve the patient's quality of life.

There are several handling methods that will be used for patients with Moebius syndrome , namely:

Installation of auxiliary equipment

Installation of aids such as NGT ( nasogastric tube ) is done if the patient has difficulty eating due to paralysis of the tongue, jaw, and throat muscles. The goal is to ensure that the patient's nutritional needs are met.

Operation

Some types of operations that can be performed to deal with symptoms and complaints experienced by patients are:

Bone and joint surgery, to deal with disorders of the bones and joints
Muscle or nerve grafts from other parts of the body, to deal with facial paralysis
Tracheostomy , to help breathing and clear the airway, by inserting a breathing tube through a hole made in the airway (trachea)
Gastrostomy, to help meet food intake by attaching an artificial feeding tube to the stomach
Eye surgery, to improve vision and deal with eye disorders

Therapy

Therapy can be done to help improve the abilities of children who are inhibited due to Moebius syndrome . Here are some types of therapy that can be done:

Physical therapy , to help overcome movement disorders due to abnormalities in bones and joints
Occupational therapy , to help patients do daily activities
Speech therapy , to improve the patient's ability to communicate

Medicines

The administration of antibiotic drugs is necessary if there is an infection in the body, such as pneumonia and otitis media . Some antibiotics that can be given include amoxicillin, trimethoprim, and sulfamethoxazole.

Complications of Moebius Syndrome

If the M oebius syndrome experienced is severe enough or not treated well, there are several complications that can occur, namely:

Malnutrition
Wounds on the cornea ( corneal abrasion )
Dysphagia
Difficulty breathing
Aspiration pneumonia
Bacterial infections, such as otitis media or pneumonia

Prevention of Moebius Syndrome

There is no sure way to prevent the occurrence of Moebius syndrome , because the cause is not yet known. However, there are several things that can be done to take care of the pregnancy and the health of the fetus, namely: