Parapharyngeal cystic hygroma is a rare tumor of the neck. This report describes two cases in which surgical resection was necessary to overcome sudden airway obstruction and details the surgical technique. These cases were considered "near misses" for sudden infant death syndrome (SIDS) and were revealed by computed tomography (CT) and echography to be parapharyngeal cystic hygroma. The location of this malformation could have produced sudden airway collapse and be erroneously diagnosed as SIDS. The postoperative follow-up was satisfactory and no recurrence was detected. We believe CT and echography should be included in the evaluation of such cases.

Airway Obstruction↗

PubMedDate not supplied

F responses and central motor conduction in multiple sclerosis.

Two electrophysiological investigations were used to study 18 patients with multiple sclerosis--F wave characteristics including amplitude, persistence and frequency, which can provide a measure of motoneurone excitability, and magnetic stimulation of the cortex, which enables measurement of conduction along central motor pathways. There was an increase in the mean amplitude and persistence of the F response in patients with abnormal central motor conduction (CMC), although no correlation between the degree of abnormality of CMC and increase in F response amplitude was found. Increase in mean amplitude and persistence of the F response were also found in patients with normal CMC but clinical evidence of a UMN disorder (spasticity and/or weakness); there was no correlation, however, between any single F response characteristic and any particular clinical sign. CMC appears to be the preferred test for detecting subclinical motor lesions in MS: of the patient sides with normal clinical examination, 36% showed abnormal CMC, whereas 23% showed abnormal F responses.

Adult↗

PubMedDate not supplied

Early diagnosis of diabetic small fiber neuropathy by disturbed cold perception.

In diabetes mellitus, polyneuropathy is an important complication and should be diagnosed as early as possible in order to prevent damage to the patient. Determination of warm, cold, and heat pain thresholds enables one to judge small nerve fiber sensitivity. This investigation was carried out to determine which parameters best predict such alterations. Using a "Marstock" Thermostimulator, 26 diabetics and 32 healthy subjects were stimulated behind both medial malleoli. At three different rates of temperature rise, repeated warm, cold, and heat pain threshold determinations were performed. The variability of intraindividual threshold ranges was noted. While heat pain determinations were not useful, determination of cold perception, at a moderate rate of temperature change, proved to be the most reliable indicator of small fiber lesions. Cold thresholds as well as their intraindividual ranges were most often impaired. The importance of this clinical investigatory method is discussed with respect to the importance of early prophylaxis of complications such as trophic lesions.

Adolescent↗

PubMedDate not supplied