J Pediatr Genet 2023; 12(04): 318-324
DOI: 10.1055/s-0041-1731683
Case-Based Review

Marked Facial Weakness, Ptosis, and Hanging Jaw: A Case with RYR1-Related Congenital Centronuclear Myopathy

1   Pediatric Neurology Unit, Department of Pediatrics, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
,
Shivan Kesavan
1   Pediatric Neurology Unit, Department of Pediatrics, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
,
Divya Aggarwal
2   Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
,
Debajyoti Chatterjee
2   Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
,
Andoni Urtizberea
3   Institut de Myologie, La Salpetriere Hospital, Paris, France
,
Renu Suthar
1   Pediatric Neurology Unit, Department of Pediatrics, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
› Author Affiliations
Funding None.

Abstract

Congenital myopathies are an expanding spectrum of neuromuscular disorders with early infantile or childhood onset hypotonia and slowly or nonprogressive skeletal muscle weakness. RYR1-related myopathies are the most common and frequently diagnosed class of congenital myopathies. Malignant hyperthermia susceptibility and central core disease are autosomal dominant or de novo RYR1 disorder, whereas multiminicore, congenital fiber type disproportion and centronuclear myopathy are autosomal recessive RYR1 disorders. The presence of ptosis, ophthalmoparesis, facial, and proximal muscles weakness, with the presence of dusty cores and multiple internal nuclei on muscle biopsy are clues to the diagnosis. We describe an 18-year-old male, who presented with early infantile onset ptosis, ophthalmoplegia, myopathic facies, hanging lower jaw, and proximal muscle weakness confirmed as an RYR1-related congenital centronuclear myopathy on genetic analysis and muscle biopsy.

Note

The manuscript was approved by the Departmental Review Board.


Authors' Contributions

B.S. and S.K. prepared the initial draft of the manuscript and reviewed the literature. D.A. and D.C. provided histopathological inputs to the manuscript. A.U. provided neuromuscular inputs and intellectual content. R.S. involved in a critical review of the manuscript and reviewed the literature and edited the final version of the manuscript. All the authors approved the final version of the manuscript.




Publication History

Received: 21 November 2020

Accepted: 22 May 2021

Article published online:
03 July 2021

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