National Center for Advancing and Translational Sciences Genetic and Rare Diseases Information Center, a program of the National Center for Advancing and Translational Sciences

Morgagni-Stewart-Morel syndrome

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Other Names:
MSM syndrome; Hyperostosis frontalis interna, obesity, shortness and cognitive impairment
Categories:
Morgagni-Stewart-Morel (MSM) syndrome is a disorder characterized by thickening of the frontal bone of the skull (hyperostosis frontalis interna), as well as obesity and excessive hair growth (hypertrichosis).[1] Other signs and symptoms may include seizures, headaches, diabetes insipidus, and sex gland disturbances.[2] The cause of Morgagni-Stewart-Morel syndrome is not fully understood. Some instances of dominant inheritance have been reported, but whether it is autosomal dominant or X-linked dominant is not known.[3] Treatment may include medication for headaches and seizures and surgery to remove the excessive bone of the skull.[2][4]
Last updated: 2/24/2017
Morgagni-Stewart-Morel (MSM) syndrome typically include a characteristic X-ray finding of thickening of the frontal bone of the skull (hyperostosis frontalis interna). The signs and symptoms of MSM commonly include:[2][3][5]
Some people may also have the following signs and symptoms:[2][3][5] 
  • Depression
  • Irritability
  • Fatigue
  • Temporary paralysis on one side of the body
  • Hearing impairment
  • Paralysis of the cranial nerves
  • Muscle weakness
  • Seizures
While people with Morgagni-Stewart-Morel syndrome nearly always have hyperostosis frontalis interna, hyperostosis frontalis interna is usually an incidental finding on x-ray films, computed tomography, or magnetic resonance imaging of the head and by itself is not indicative of any disease.[6]
Last updated: 2/24/2017

This table lists symptoms that people with this disease may have. For most diseases, symptoms will vary from person to person. People with the same disease may not have all the symptoms listed. This information comes from a database called the Human Phenotype Ontology (HPO) . The HPO collects information on symptoms that have been described in medical resources. The HPO is updated regularly. Use the HPO ID to access more in-depth information about a symptom.

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Medical Terms Other Names
Learn More:
HPO ID
Percent of people who have these symptoms is not available through HPO
Autosomal dominant inheritance 0000006
Diabetes mellitus 0000819
Elevated alkaline phosphatase
Greatly elevated alkaline phosphatase
High serum alkaline phosphatase
Increased alkaline phosphatase
Increased serum alkaline phosphatase
[ more ] 		0003155
Galactorrhea
Spontaneous milk flow from breast
0100829
Hyperostosis frontalis interna 0004438
Hypertrichosis 0000998
Increased circulating prolactin concentration 0000870
Irregular menstruation
Menstrual irregularity
0000858
Obesity
Having too much body fat
0001513
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Last updated: 7/1/2020
The cause of Morgagni-Stewart-Morel syndrome and hyperostosis frontalis interna is unknown, although some have suggested that a hormonal imbalance due to genetic and environmental factors may be the cause of many of the symptoms of the syndrome.[3]
Last updated: 2/24/2017
The diagnosis of Morgagni-Stewart-Morel syndrome is based upon a radiological finding of hyperostosis frontalis interna, as well as a combination of clinical features including obesity, virulism (a female disorder in which there is development of secondary male sexual characteristics like growth of facial and body hair), possible mental disturbance, and other findings.[3][6]
Last updated: 2/24/2017
Currently, there is no cure or specific recommendations for the treatment of this syndrome. Treatment depends on the symptoms present, and may include medication and diet and lifestyle modification for weight control. Diabetes and hypertension are treated with standard medication.[7] 

Seizures and headaches that may be associated with hyperostosis frontalis interna (HFI) are typically treated with standard medications.[2]

In one journal article, the authors discuss a person with Morgagni-Stewart-Morel syndrome who reportedly had violent headaches. Surgery was performed to remove the hypertrophic frontal bone on the patient. He then had dura and bone reconstruction. The authors reported that the headaches stopped immediately after the operation. [4]

Another article described a patient with HFI and intracranial hypertension (increased pressure inside the skull and brain). The authors reported good results with a craniotomy (a surgical operation in which a bone flap is temporarily removed from the skull to access the brain) performed to decrease the intracranial pressure.[8] 
Last updated: 2/26/2017

If you need medical advice, you can look for doctors or other healthcare professionals who have experience with this disease. You may find these specialists through advocacy organizations, clinical trials, or articles published in medical journals. You may also want to contact a university or tertiary medical center in your area, because these centers tend to see more complex cases and have the latest technology and treatments.

If you can’t find a specialist in your local area, try contacting national or international specialists. They may be able to refer you to someone they know through conferences or research efforts. Some specialists may be willing to consult with you or your local doctors over the phone or by email if you can't travel to them for care.

You can find more tips in our guide, How to Find a Disease Specialist. We also encourage you to explore the rest of this page to find resources that can help you find specialists.

Healthcare Resources

Support and advocacy groups can help you connect with other patients and families, and they can provide valuable services. Many develop patient-centered information and are the driving force behind research for better treatments and possible cures. They can direct you to research, resources, and services. Many organizations also have experts who serve as medical advisors or provide lists of doctors/clinics. Visit the group’s website or contact them to learn about the services they offer. Inclusion on this list is not an endorsement by GARD.

Organizations Supporting this Disease

These resources provide more information about this condition or associated symptoms. The in-depth resources contain medical and scientific language that may be hard to understand. You may want to review these resources with a medical professional.

Where to Start

  • The National Organization for Rare Disorders (NORD) has a report for patients and families about this condition. NORD is a patient advocacy organization for individuals with rare diseases and the organizations that serve them.

In-Depth Information

  • MeSH® (Medical Subject Headings) is a terminology tool used by the National Library of Medicine. Click on the link to view information on this topic.
  • The Monarch Initiative brings together data about this condition from humans and other species to help physicians and biomedical researchers. Monarch’s tools are designed to make it easier to compare the signs and symptoms (phenotypes) of different diseases and discover common features. This initiative is a collaboration between several academic institutions across the world and is funded by the National Institutes of Health. Visit the website to explore the biology of this condition.
  • Online Mendelian Inheritance in Man (OMIM) is a catalog of human genes and genetic disorders. Each entry has a summary of related medical articles. It is meant for health care professionals and researchers. OMIM is maintained by Johns Hopkins University School of Medicine. 
  • Orphanet is a European reference portal for information on rare diseases and orphan drugs. Access to this database is free of charge.
  • PubMed is a searchable database of medical literature and lists journal articles that discuss Morgagni-Stewart-Morel syndrome. Click on the link to view a sample search on this topic.

Questions sent to GARD may be posted here if the information could be helpful to others. We remove all identifying information when posting a question to protect your privacy. If you do not want your question posted, please let us know. Submit a new question

  • It is my understanding that hyperostosis frontalis interna can be a symptom of Morgagni-Stewart-Morel syndrome. What medical tests would you normally use to identify this condition? What are the symptoms of this condition? Is there any treatment, especially for the headaches associated with this condition? See answer

  • Could you provide me with information on Morgagni-Stewart-Morel syndrome? See answer


  1. Morgagni-Stewart-Morel syndrome. Orphanet. June 2006; http://www.orpha.net/consor/cgi-bin/OC_Exp.php?lng=EN&Expert=77296.
  2. Hyperostosis Frontalis Interna. NORD. 2007; https://rarediseases.org/rare-diseases/hyperostosis-frontalis-interna/.
  3. Hyperostosis frontalis interna. OMIM. 2016; https://omim.org/entry/144800.
  4. Latka D, Szydlik W, Glaubic-Latka M & Mrówka R. [A case of Morgagni-Morel-Stewart syndrome with violent headaches predominant in the clinical course treated surgically]. Neurologia Neurochirurgia Polska. March-April 1995; 29(2):253-256. http://www.ncbi.nlm.nih.gov/pubmed/7651598.
  5. Nallegowda M, Singh U, Khanna M, Yadav SL, Choudhary AR &Thakar A. Morgagni Stewart morel syndrome-Additional features. Neurology India. 2005; https://www.ncbi.nlm.nih.gov/pubmed/15805672.
  6. Waclawik AJ. Hyperostosis frontalis interna. Arch Neurol. 2006; https://www.ncbi.nlm.nih.gov/pubmed/16476822.
  7. Gracia-Ramos AE. Morgagni-Stewart-Morel syndrome. Case report and review of the literature.. Rev Med Inst Mex Seg Soc. 2016; 54(5):664-9. http://www.ncbi.nlm.nih.gov/pubmed/27428347.
  8. Elliott C, Johnson E & Chow M. Hyperostosis frontalis interna requiring craniotomy for intracranial hypertension. Can J Neurol Sci.. January, 2014; 41(1):109-11. https://www.ncbi.nlm.nih.gov/pubmed/24384350.