Joffroy's sign
| Joffroy's sign | |
|---|---|
| Synonyms | |
| Pronounce | N/A |
| Specialty | Neurology |
| Symptoms | Absence of forehead wrinkling when looking upwards |
| Complications | N/A |
| Onset | N/A |
| Duration | N/A |
| Types | N/A |
| Causes | Graves' disease, Thyroid eye disease |
| Risks | N/A |
| Diagnosis | Clinical examination |
| Differential diagnosis | Myasthenia gravis, Botulism |
| Prevention | N/A |
| Treatment | Treatment of underlying condition |
| Medication | N/A |
| Prognosis | Depends on underlying cause |
| Frequency | Rare |
| Deaths | N/A |
Joffroy's sign is a clinical sign in which there is absence of forehead wrinkling on upward gaze. It is seen in Graves' disease, an autoimmune disorder that causes hyperthyroidism, or overactive thyroid. This sign is named after Alexis Joffroy, a French neurologist.
Overview
Graves' disease is an autoimmune disorder that results in the overproduction of thyroid hormones, or hyperthyroidism. While a number of disorders may result in hyperthyroidism, Graves' disease is a common cause. Thyroid hormones regulate the body's metabolic rate as well as heart and digestive function, muscle control, brain development, mood, and bone maintenance. Its symptoms can include rapid heartbeat, weight loss, nervousness, irritability, and shakiness. Joffroy's sign is one of the clinical signs of Graves' disease. It is characterized by the absence of forehead wrinkling when a person looks upward. This is due to the involvement of the levator palpebrae superioris muscle, which is innervated by the sympathetic nervous system. In Graves' disease, there is an overactivity of the sympathetic nervous system, which results in the inhibition of the frontalis muscle, preventing it from contracting and causing the forehead to wrinkle.
Clinical Significance
The presence of Joffroy's sign can help in the diagnosis of Graves' disease. However, it is not a definitive sign and should be used in conjunction with other clinical signs and diagnostic tests. It is also important to note that Joffroy's sign can be present in other conditions that affect the sympathetic nervous system.
See Also
References
- Joffroy A. Deux cas de myxœdème avec névrite optique. Revue de médecine, Paris, 1888, 8: 785-792.
- Joffroy A. Nouvelle contribution à l'étude du myxœdème. Revue de médecine, Paris, 1889, 9: 5-29.
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Contributors: Prab R. Tumpati, MD