ADSS1 and distal myopathy: Distal myopathies are genetic muscle diseases, presenting at the onset with weakness of foot and lower leg and/or hand and forearm muscles, which cause progressive loss of muscle tissue.1 Prominent anterior lower leg weakness, facial weakness, and scapular winging are the hallmarks of facioscapulohumeral muscular dystrophy.2 Facial weakness has also been reported in patients with distal myopathies due to mutations in ADSSL1, RYR1, MYH7, NEB, and DNM2. 1