Facial paresis as the first sign in atypical facioscapulohumeral muscular dystrophy

Facioscapulohumeral muscular dystrophy (FSHD) is the one of most common types dystrophy. We present a retrospective case description patient with late-onset, atypical FSHD and provide an overview clinical history, physical exam findings, diagnosis treatment FSHD. A 71-year old male subjective facial weakness dysarthria presented initially without findings paresis normal diagnostic lab work. Over time, unilateral incomplete appeared on exam, as well mild scapular winging. classically presents in muscles face, shoulder/upper arms, proximal lower extremities. Diagnosis challenging requires multidisciplinary approach, due to high variability presentation timing symptoms. supplementary video provided, demonstrating midfacial lip 71-year-old male.