Melkersson Rosenthal Syndrome is a rare neuro-mucocutaneous disorder 
characterized by the classic triad of facial swelling, recurrent facial nerve 
palsy and fissured tongue. The clinical course is usually progressive, and 
etiology is unknown. The authors describe oligosymptomatic Melkersson Rosenthal 
Syndrome in a young girl presenting sequentially with recurrent, metachronous 
facial nerve palsy and hemifacial swelling in early childhood followed by 
fissuring in the tongue in late-childhood. Histopathological examination from 
the affected labial area showed non-granulomatous inflammation. Bilateral facial 
nerve conduction and blink reflex studies showed asymmetrical affection of both 
facial nerves with mixed features of axonal and demyelinating involvement. The 
patient remained steroid-refractory, and subsequent attacks remitted with 
partial recovery. The combination of facial edema and facial palsy in a child 
should alert the physicians to the diagnosis of Melkersson Rosenthal Syndrome. A 
diagnostic mucosal biopsy, evaluation for systemic and oro-facial granulomatous 
disorders, and short course of corticosteroid treatment are recommended.