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. 2023 Jul 19;9(5):e200089. doi: 10.1212/NXG.0000000000200089

Figure 1. Facial Muscle Weakness and Dysmorphic Features in Patients With LAMA2-MD.

Figure 1

(A) neutral position, showing bilateral ptosis. (B) orbicularis oculi weakness. (C) inadequate puckering movements, indicating orbicularis ori weakness. (D) inadequate blowing movements, indicating orbicularis ori weakness. (E) risorius weakness. (F) macroglossia and elongated face. (G) inability of neck flexion indicating rigid spine. (H) scapular winging. (I) spinal and thorax deformities. (J) pseudohypertrophy and hypotrophy of calve muscles, respectively. All identifiable patients provided consent for publication of their pictures. (K) Median muscle strength according to the MRC grading scale in patients with LAMA2-MD. The median muscle strength (MRC) in neck flexor, neck extensor, deltoid, biceps brachii, triceps brachii, wrist flexor, wrist extensor, finger flexor, finger extensor, iliopsoas, gluteus, quadriceps, hamstrings, foot flexor, foot extensor, and toe flexor and extensor hallucis longus muscles.