2.A Case of Meige Syndrome in 80-year-old Patient Under Treatment of Cerebral Hemorrhage
Akiko TERAUCHI ; Yasushi KUROIWA ; Yorimichi IZUMI ; Tadasige FUJII
Journal of the Japanese Association of Rural Medicine 2015;64(4):705-710
Meige syndrome is an idiopathic disorder characterized by blepharospasm and oromandibular dystonia. Symptoms persist for a long time and treatment is difficult. This disease is categorized as a neurodegenerative disorder of extrapyramidal tract. The causes are not known well as yet. However, it has been recognized that the disease is induced by several kinds of drugs such as antipshycotic drugs and antiparkinson agents. We have treated a patient with Meige syndrome for several years. The patient is an 80-year-old-man. At age 54, he underwent total gastrectomy for stomach cancer. After the surgical therapy, he landed a job as office worker. At age 74, he suffered a left thalamic hemorrhage. He was treated conservatively. After six weeks from the onset, he was transferred to our hospital. His cognitive and daily life function were gradually deteriorating and became bedridden. When he reached somewhere around 76 years of age, he presented some of the typical symptoms of Parkinson’s disease, akinesia, tremor or muscle rigidity, so we started medication of dopamin. Three years after, he exhibited blepharospasm, retroflexion of the head and grimaced face. As this conditions continued for several months, we diagnose him as having Meige syndrome. We have decreased antiparkinsonian drugs, and started medication with trihexyphenidyl hydrochloride, clonazepam, muscle relaxant or injection botulinum toxin on eye lid and muscle of neck. Now the symptoms still linger, but his condition is not so poor.