Document Detail

What's in a smile?: Quantification of the vertical smile of patients with myasthenia gravis.
MedLine Citation:
PMID:  10675656     Owner:  NLM     Status:  MEDLINE    
Many patients with myasthenia gravis who experience bulbar symptoms show a vertical smile, which may have a considerable, and often underestimated, impact on social life. Peri-oral muscle function can be quantified by calculating lip-length and snout indices, which indicate the degree to which a person is capable of smiling and of pursing the lips, respectively. In the present study patients with bulbar myasthenia gravis were compared to patients with ocular myasthenia gravis, patients now in remission (but previously suffering from bulbar myasthenia gravis), and healthy subjects. The lip-length and snout indices of patients with bulbar myasthenia gravis were significantly lower than those of the other groups. The facial impairments were no longer detectable in patients with bulbar myasthenia gravis in remission and no subclinical impairments in lip-length and snout indices were found in the ocular myasthenia gravis group. These findings were consistent with the patients' reports of impairment of smiling and other oral functions. The patients suffering from a vertical smile or other oral impairments were well aware of their condition, most probably because of the social consequences of being unable to smile. The indices could be of importance in the longitudinal evaluation of therapy in individual patients and in pharmacotherapeutical research. We found a low correlation between the lip-length and snout indices, which reflects the capricious pattern of involvement of separate muscles in myasthenia gravis. Therefore both indices deserve special attention if they are used for monitoring myasthenic symptoms.
F G Weijnen; A van der Bilt; J H Wokke; J B Kuks; H W van der Glas; F Bosman
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of the neurological sciences     Volume:  173     ISSN:  0022-510X     ISO Abbreviation:  J. Neurol. Sci.     Publication Date:  2000 Feb 
Date Detail:
Created Date:  2000-04-24     Completed Date:  2000-04-24     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0375403     Medline TA:  J Neurol Sci     Country:  NETHERLANDS    
Other Details:
Languages:  eng     Pagination:  124-8     Citation Subset:  IM    
Department of Oral-Maxillofacial Surgery, Prosthodontics and Special Dental Care, Universiteit Utrecht, Utrecht, The Netherlands.
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MeSH Terms
Brain Stem / physiopathology
Cholinesterase Inhibitors / pharmacology,  therapeutic use
Facial Muscles / physiopathology*
Lip / pathology
Middle Aged
Myasthenia Gravis / classification,  drug therapy,  physiopathology*
Nose / pathology
Smiling / physiology*
Reg. No./Substance:
0/Cholinesterase Inhibitors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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