Case report: Myotonic discharges in facial muscles and asymmetrical „facies myopathica“ in a patient with myotonic dystrophy type 1

A 35-year-old, otherwise healthy patient noticed an increasing tear production by his left eye since 2001 as a result of a palsy of the lower eyelid, which had been surgically corrected in 2003. For the first time the patient was examined in our clinic in summer 2005. He showed a severe asymmetry of his face, primarily because of the previous operation. In addition, a bilateral mild palsy of the orbicularis oculi muscle was noted, which was more pronounced on the left side. Otherwise the neurological examination was normal; in particular no other palsy, atrophy or myotonic symptoms were observed. The EMG of the…