Melkersson-Rosenthal Syndrome

What is Melkersson-Rosenthal syndrome?

Melkersson-Rosenthal syndrome is a rare condition affecting the nerves and soft tissues of the face. It typically involves three main features: episodes of facial weakness or paralysis, swelling of the face and lips (most often the upper lip), and grooves or furrows developing on the tongue.

Not everyone with the condition experiences all three features — in fact, fewer than 1 in 4 people with Melkersson-Rosenthal syndrome have the full combination. [1] Many people only notice one or two of these signs, which can make the condition tricky to recognise and diagnose.

When does it start?

The condition usually first appears in childhood or the early teenage years. Episodes can come and go, sometimes with gaps of days between them, and sometimes with years passing before symptoms return. Over time, if swelling keeps recurring, it can become permanent rather than settling down between episodes. The upper lip in particular may become firm, cracked, and take on a reddish-brown colour.

What causes Melkersson-Rosenthal syndrome?

The exact cause isn’t known. It sometimes runs in families, though no specific gene has been identified yet, so researchers don’t fully understand why some families are more affected than others.

How is it treated?

There’s no single cure, but symptoms can often be managed. Treatment usually involves anti-inflammatory medication and corticosteroids to help bring swelling down.

In severe or long-lasting cases, surgery may be considered to relieve pressure on the facial nerve or reduce swollen tissue — though it isn’t always successful and its benefits aren’t fully proven.

Facial rehabilitation — working with physiotherapists and speech and language therapists who specialise in facial palsy — is also available at specialist centres. This is similar to the therapy used for Bell’s palsy, even though the two conditions have very different underlying causes.

What is the prognosis?

Melkersson-Rosenthal syndrome tends to come and go over time. Facial weakness during an episode often improves as the nerve recovers, but with each new episode, recovery can become less complete. This means the condition can become a long-term, ongoing issue for some people, even though individual episodes may resolve.

Sources

1. Tidke M, Borghare P, Pardhekar P, Sheikh RS. Melkersson-Rosenthal syndrome: a review of clinical presentation, diagnosis and management. J Clin Diagn Res. 2025;19(6):ME01-ME05. doi:10.7860/jcdr/2025/76474.21058.