We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Article |

Picture of the Month

Sydney S. Gellis, MD; Murray Feingold, MD; Emanuel Tirosh, MD; Daniel Hardoff, MD; Rachel Friedman-Birnbaum, MD
Am J Dis Child. 1980;134(9):883-884. doi:10.1001/archpedi.1980.02130210065017.
Text Size: A A A
Published online


Denouement and Discussion 

Hemifacial Atrophy (Romberg's Syndrome) 

Manifestations  Major manifestations include progressive atrophy of the face accompanied by seizures, trigeminal neuralgia, and increased pigmentation of the overlying skin.The atrophy involves skin, subcutaneous tissue, muscles, and occasionally cartilage and bone. It usually appears by age 10 and, initially, frequently involves the temporal or buccinator muscles; it then extends to the brow, angle of the mouth, neck; and subsequently it may involve other parts of the body. The left side is more frequently affected than the right. The atrophy continues for approximately three years and then becomes nonprogressive. Changes in the hair may precede the skin findings and include alopecia and poliosis. Eye abnormalities, frequently secondary to the atrophy, may occur and consist of enophthalmos, outward slanting of the outer canthus, muscular paralyses, inflammation of the eyes, heterochromia of the iris, and Homer's syndrome. Epilepsy, mainly of the Jacksonian type, is a common neurologic occurrence and usually appears late.


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?





Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.