Melkersson-Rosenthal syndrome (MRS) is a rare syndrome of facial nerve palsy, 
facial edema, and lingua plicata that can be difficult to treat. We observed a 
patient with MRS of 4 years' duration that was unsuccessfully treated with 
multiple therapies. After a variety of diagnoses were considered at outside 
institutions, including Bell palsy, we diagnosed the patient with MRS based on 
clinical presentation of the classic triad. Treatment with adalimumab, a tumor 
necrosis factor α (TNF-α) antibody, showed improvement and relapse-free 
progress. Further research is needed regarding the role of TNF-α inhibitors in 
managing this rare condition.