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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
.
Diseases
Validation
Diseases presenting
"weakness"
symptom
achondroplasia
adrenomyeloneuropathy
alexander disease
aniridia
aromatase deficiency
coats disease
congenital toxoplasmosis
epidermolysis bullosa simplex
esophageal adenocarcinoma
familial hypocalciuric hypercalcemia
familial mediterranean fever
focal myositis
gm1 gangliosidosis
hydrocephalus with stenosis of the aqueduct of sylvius
inclusion body myositis
locked-in syndrome
lymphangioleiomyomatosis
malignant atrophic papulosis
neuralgic amyotrophy
pendred syndrome
pleomorphic liposarcoma
pyomyositis
pyruvate dehydrogenase deficiency
sneddon syndrome
systemic capillary leak syndrome
thoracic outlet syndrome
triple a syndrome
typhoid
von hippel-lindau disease
waldenström macroglobulinemia
werner syndrome
x-linked adrenoleukodystrophy
This symptom has already been validated