A case of parasympathetic hyperactivity and associated Parry–Romberg syndrome

Abstract

This case report describes a 46-year-old female with a history of multiple endocrine neoplasia type 1 syndrome status post-parathyroidectomy, thymectomy via robotic video-assisted thoracoscopic surgery, and pituitary adenoma resection presenting with parasympathetic hyperactivity and Parry–Romberg syndrome. Parry–Romberg syndrome is a rare disorder that manifests as facial hemiatrophy. Reported symptoms include cognitive dysfunction, olfactory hallucinations, and parasympathetic hyperactivity: miosis of the right eye, anhidrosis, diarrhea, urinary incontinence, bowel incontinence, and orthostatic hypotension. Previous reports have noted associations between Parry–Romberg syndrome and sympathetic hyperactivity and dysregulation. This case report focuses on an association between Parry–Romberg syndrome and unopposed parasympathetic activity.

Combined Surgical-Orthodontic Treatment of Patients With Severe Parry-Romberg Syndrome

“…Although its pathogenesis remains obscure, PRS has been associated with the linear scleroderma en coup de sabre. 3 Current hypothesized etiologies and mechanisms involve sympathetic dysfunction, infection, genetic factors, autoimmune disorders, trigeminal neuritis, scleroderma, trauma, and other theories. The exact pathogenic mechanism remains to be studied.…”