Inclusion-body myositis presenting with facial diplegia.

[inclusion body myositis]

The hallmark clinical presentation of inclusion-body myositis (IBM ) is slowly progressive weakness that characteristically affects the quadriceps and finger and wrist finger flexor muscles . Facial weakness can also occur , but it is typically mild and not a prominent finding .We describe the clinical features , laboratory investigations , and muscle biopsy findings in a 58 -year old man who presented with a 6 -year history of marked progressive symmetrical facial weakness . Examination also showed shoulder abduction and hip extensor weakness .The patient 's serum creatine kinase level was 655 U /L , and electromyography showed fibrillation potentials and myopathic motor unit potentials . A biopsy specimen of the left biceps muscle was pathognomonic for IBM .T his patient did not have a typical presentation for IBM but rather fulfilled the pathological criteria for IBM . To our knowledge , facial diplegia has not been reported previously as a presenting manifestation of IBM .