Moebius Syndrome

Moebius syndrome is an uncommon neurological disease. The disorder is present from birth and is characterized by deficient capability to laterally move the eyes as well as paralysis of the muscles in the face. Moebius syndrome was first reported in 1888 by Paul Julius Moebius.

Most of the children affected by Moebius syndrome are born with complete paralysis of the face, which makes it impossible for them to develop expressions or close their eyes. The affected children may be unusually and increasingly dull, but they are born with normal intelligence.

As per estimates, it is believed that the average rate of occurrence of Moebius syndrome is around 2 to 20 in every 1 million live births. Since the condition is so rare, its diagnosis is generally delayed. However, most children with Moebius syndrome can be easily identified by symptoms such as absence of sucking during nursing and a display of marked impassiveness by them. Additionally, such children have to move their heads to track the movement of objects as they cannot move their eyes sideways

Symptoms of Moebius syndrome

The first symptom of Moebius syndrome elicited by affected children is the incapability to suck. Other problems such as feeding and swallowing difficulties, etc. develop later.

Some of the signs and symptoms of Moebius syndrome are discussed below:

• Children having Moebius syndrome are born with facial paralysis and incapacity to move their eyes back and forth. The upper lip may be retracted because of muscle shrinkage.
• The children affected by Moebius syndrome are born with paralysis of the face and the inability to move the to and fro. Instead they have to move their heads.
• There may be withdrawal of the upper lip due to contraction of the muscles
• The affected children are prone to drooling
• Their faces are usually without any expression
• A few children with Moebius syndrome may be affected by hearing loss
• Paralysis of the lips may result in delayed development of speech
• Some children may elicit signs of irregularities of the chest wall
• Anomalies of the limbs may also be experienced by children with Moebius syndrome. Some limb abnormalities include missing fingers or toes and clubbed feet
• There is a possibility that the patient is cross-eyed
• There is erosion of the cornea due to difficulties in blinking
• The child may experience swallowing problems and occasions difficulties with breathing
• Children affected by Moebius syndrome have an increased risk to develop symptom of autism

Causes of Moebius syndrome

Moebius syndrome is a comparatively uncommon condition that is caused due to the absence or impaired growth of the sixth and seventh cranial nerves that are responsible for facial expressions and movements of the eyes. Some children with Moebius syndrome may also experience abnormalities of the third,, fifth, eighth, ninth, eleventh and twelfth cranial nerves.

Moebius syndrome has no known causes. However, it is believed that the following factors may increase the vulnerability to developing the condition.

• Vascular problems or disturbance: This is one of the most common risk factors for Moebius syndrome. Interruption of the vascular process can result in a temporary decrease in the supply of blood to the brain. Vascular disturbance generally occurs in the first trimester. Reduction in the flow of blood leads to decreased oxygen supply to the brain, which hampers the growth of the cranial nerves, resulting in the development of Moebius syndrome.
• Illness or trauma to the mother: Maternal trauma and different kinds of illnesses can trigger interference with the vascular process, leading to Moebius syndrome. Some of the common triggers include prenatal testing procedures such as chorionic villus sampling, illnesses like hyperthermia and trauma like electric shocks.
• Drug abuse by the mother: The use of drugs can also trigger vascular interruption. Use of drugs such as benzodiazepines, cocaine, thalidomide, etc. can result in the development of Moebius syndrome. Alcohol use is another trigger.
• The presence of genetic defects are thought to result in preventing the development of the cranial nerves. However, this is still a subject of research.

Treatment of Moebius syndrome

There is no known cure for Moebius syndrome. The treatment is aimed at alleviating the various symptoms associated with the condition. Surgery may be recommended for certain individuals affected by Moebius syndrome. However, surgical intervention is purely for cosmetic purposes and not for curative uses.

Some treatment methods include:

• Babies with Moebius syndrome generally tend to experience feeding difficulties and hence they should be given the vital nutrients via special bottles or feeding tubes. Sometimes a feeding gastrostomy tube may also be used
• Corneal erosion and other eye abnormalities are taken care with the help of eye-drop medications. Surgery to correct crossed eyes and corneal abnormalities is usually delayed till the child has achieved a proper age, and as long as the doctor’s judgment.
• Physiotherapy and speech therapy aid in enhancing co-ordination and motor skills, in addition to improvements in speech and feeding capabilities.
• Physical therapy may be needed to correct the many musculo-skeletal abnormalities
• Learning deficits and signs of autism can be gauged via intelligence tests, so as to opt for the best course of action
• Psychotherapy and counseling may be necessary to deal with the social and emotional problems that may arise due to the presence of bodily deformities. It is important to note that children with Moebius syndrome have improvements in facial movements as they grow older
• Tracheotomy is recommend to correct compromised or impaired airway.

Moebius Syndrome Pictures