Objective: Meige syndrome is a type of cranial dystonia characterized by blepharospasm and oromandibular dystonia and can be associated with complex movements of the muscles of the lower face, mouth, jaw, tongue, pharynx, and cervical muscles. In most patients, Meige syndrome is primary or idiopathic but secondary cases may occur after long-term use of neuroleptics or secondary to an underlying brain disorder. In this case report, we will report 2 cases of Meige syndrome with comorbid hyperthyroidism [1]

Background: Meige syndrome is a focal dystonic movement disorder identified as blepharospasm (double eyelid spasm) and oromandibular dystonia. The prevalence ranges from 13-130 cases per million for blepharospasm and 69 per million for oromandibular dystonia in the US. With a male:female ratio of 1:2. with an average age of 55.7 years. Meige syndrome is a rare case with various etiologies [2]

Method: Case Report

Results: Case I:
A 47-year-old woman with complaints that her eyes are often closed and blinking accompanied by pursed lips pulled to the right and left. The patient has a history of Grave’s disease and regularly consumes Propylthiouracil and Bisoprolol. Physical examination reveals Charcoat sign positive bilaterally, Laboratory results indicate hyperthyroidism. Electromyography (EMG) showed Mild demyelinating axonal motor-sensory polyneuropathy. On contrast head MRI, white matter lesions were found in bilateral frontal lobes. 
Case 2:
A 57-year-old man complained that his eyes are often closed and his mouth and jaw are pulled. The patient has a history of hyperthyroidism and routinely consumes Tyrozol 2×10 mg, diagnosed Myasthenia Gravis 2017 on therapy and Tuberculous lymphadenitis on therapy. Physical examination revealed Charcoat sign positive bilaterally, laboratory results obtained TSH/fT4 are currently normal, Electromyography results: Myasthenia Gravis is not clear obtained. MRI results: No infarct or bleeding lesions are seen.

Conclusion: Meige Syndrome is a rare case, the cause can be idiopathic or secondary. Clinical and supportive diagnosis is very important in the management of Meige syndrome. Comorbid control factors in patients are important for prognosis in patients.

References: [1] Ma, H., Qu, J., Ye, L., Shu, Y., & Qu, Q. (2021). Blepharospasm, Oromandibular Dystonia, and Meige Syndrome: Clinical and Genetic Update. Frontiers in Neurology, 12. https://doi.org/10.3389/fneur.2021.630221
[2] Pandey, S., & Sharma, S. (2017, January 15). Meige’s syndrome: History, epidemiology, clinical features, pathogenesis and treatment. Journal of the Neurological Sciences. Elsevier B.V. https://doi.org/10.1016/j.jns.2016.11.053

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MDS Abstracts - https://www.mdsabstracts.org/abstract/serial-cases-blepharospasm-with-oromandibular-dystonia-meige-syndrome-rare-case/