Biomedical subjects

R Laskawi

Publications and source records attributed to R Laskawi.

At least 73 records · Page 4Linked to original sources

PubMed1994

[Prognostic value of electrodiagnosis of Bell's palsy].

Many papers report on a poor rate of complete restitution of Bell's palsy if signs of degeneration can be detected in neuromyography (NMG) or electromyography (EMG). In 119 patients who underwent infusion therapy (as developed by Stennert) 39% showed signs of degeneration in EMG or NMG. Complete restitution was achieved in 93% of these patients. Degeneration was more frequent in elderly patients (< 20 years: 20%, > 60 years: 55%). This did not affect the rate of complete restitution, which was constantly high for every age. If infusion therapy was started within 7 days after onset of the disease, no defects in restitution were observed, which was frequently so if therapy was started later. After one year the rate of complete restitution was about equal in cases with signs of degeneration (91%) and non-degenerative cases (94%). But 80% of the non-degenerative cases showed complete restitution within 3 months after onset of the palsy, whereas 80% of cases with signs of degeneration healed after this date (mean 6.1 months). After oral therapy with cortisol exclusively half of the degenerative cases did not attain complete restitution. After infusion therapy EMG and NMG do not answer the question if a Bell's palsy will heal completely or not but enable us to predict when this will probably be the case.

Administration, Oral↗

PubMed1993

Facial nerve lesions lead to increased immunostaining of the astrocytic gap junction protein (connexin 43) in the corresponding facial nucleus of rats.

After peripheral transection of the facial nerve, immunostaining of astrocytic gap junction protein changed in the corresponding brainstem nucleus of the rat. Enhanced connexin-43 immunoreactivity was restricted to the ipsilateral facial nucleus and to astrocytes surrounding lesioned motoneurons. This reaction is focally distinct, and marks only a part of the astrocytic network indicating a local plasticity of intercellular coupling. These results suggest that astrocytes work as sensors of signals which either depend on the integrity of neighboring neurons or inform about neuronal disorders.

Animals↗

PubMed1993

[Electrophysiologic studies of the pattern of lesions of mimetic muscles in Bell's palsy].

This paper reports on 379 investigations of patients with the diagnosis of Bell's palsy. The computerized analysis was carried out retrospectively with the programme FANDOS (6). In most electrophysiological measurements five standard muscles (frontalis muscle, orbicularis oculi muscle, levator labii muscle, zygomaticus muscle, orbicularis oris muscle) were investigated with electromyography (EMG); further, neuromyography was performed. In 77.3% of the cases electromyographically incomplete and 22.7% complete palsies were found. The distribution of the reduced innervation patterns and the degeneration of the muscles did not show a preferred lesion of certain muscles. In about sixty per cent of all cases in at least four muscles a homogeneous electromyographic pattern of the lesion in the mimic musculature could be detected. Degeneration potentials, however, were mostly found in one muscle only. In order to provide a differentiated analysis of the electromyographical state of a facial paresis an "EMG-index" was introduced that allows a general judgement of the "degree of palsy" in all five investigated muscles. An analysis of the time dependence of the "EMG-index" over the course of two weeks following onset of the palsy showed no variation during this time period. This proves that the complete status of the palsy is reached early after onset and that a deterioration or improvement is rarely seen within this time interval.

Adult↗

PubMed1993

[Psychosocial problems and coping with illness by patients with defective healing after facial paralysis].

Twenty patients with defective healing following idiopathic or infection-induced facial paralysis (group 1) and 14 patients with defective healing after excision of an acoustic neuroma and subsequent hypoglossal-facial nerve anastomosis (group 2) were questioned as to their psychosocial conditions. The principle gueries involved the impact of facial impairment on social activities, behavior in public, professional performance and communication, as well as strategies in coping with disfigurement. One third of the patients (with a majority in group 2) experienced stigmatization and a feeling of embarrassment or anxiety in public. Many patients minimized facial expressions and communication in order to hide their paralyses. In particular, patients in group 2 frequently had to change their employment and had great problems in accepting their conditions. Additional problems had with a clinical diagnosis of "acoustic neuroma" involved greater stress and more pronounced social withdrawal than experienced by the patients with idiopathic pareses.

Adaptation, Psychological↗

PubMed1991

[Magnetic stimulation in patients with essential blepharospasm].

In 31 patients with an essential blepharospasm investigations were undertaken with transcranial cortical and cisternal magnetic stimulation of the facial nerve. Cortical stimulation was performed contralaterally, whereas cisternal stimulation was ipsilateral; the latencies and amplitudes of the potentials were determined. However, the extracranial part of the facial nerve was stimulated in the region of the stylomastoid foramen for neuromyography electrically. In most measurements the response potentials in the orbicularis oculi muscle and the levator labii muscle were determined. Cisternal stimulation yielded normal latencies, whereas cortical stimulation showed an increase of latency in some blepharospasm patients. A difference between the orbicularis oculi muscle and the levator labii muscle as known in patients with hemifacial spasm (20) could not be observed. The mean values of all latencies after cortical stimulation were normal. The method of transcranial magnetic stimulation is an important part of the complete investigation of patients with facial hyperkinesias as shown here in blepharospasm patients.

Blepharospasm↗

PubMed1991

[Involuntary lid closure caused by defective healing of facial paralysis and its treatment with botulinum toxin].

Unvoluntary lidclosure with movement of the mouth is not so rare in aberrant regeneration of nerve fibers after Bell's palsy. There was no therapy until now. 10 patients with this disease were treated with botulinum-toxin injections into the orbicularis muscle. For an average time of 11 weeks after injection there was a complete absence of synkinesis, followed by a time of 9 weeks of less complaints. Thus 2-3 injections might be sufficient treatment within a year. Complications worth mentioning, especially due to the reduced force of lidclosure, were not observed.

Adult↗

PubMed1991

[Changes in the blink reflex in patients with essential blepharospasm and hemifacial spasm].

Electrophysiological investigations have been carried out in 46 patients with essential blepharospasm and 41 with hemifacial spasm. In both diseases reproducible pathologic alterations in the blink reflex were found. In essential blepharospasm a direct R1/R2 transition and a contralateral early component with and without direct transition into the R2C component were recorded. In patients with hemifacial spasm there was a loss of the R1 component in addition. In repeated treatments with botulinum toxin the amplitude (R1,R2) of the blink reflex was reduced in some cases, although in some cases the intensity of spasm was as high as before treatment once the effect had faded.

Blepharospasm↗

PubMed1990

[The trigemino-facial reflex in patients with essential blepharospasm. A contribution to the etiology of the disease picture].

We conducted electrophysiological investigations in altogether 11 patients with an essential blepharospasm. In all patients the blink reflex - ipsi- and contralateral - was measured. We found reproducible pathologic changes (direct R1/R2 transition, contralateral early component with and without direct transition into the R2-component, increase of R2-duration). These findings point to a central genesis of blepharospasm in some cases.

Blepharospasm↗

PubMed1990

[Hydroxyethyl starch in the treatment of Bell's facial paralysis. A clinical study].

Nowadays an infusion therapy composed of cortisone, low-molecular dextran, and pentoxifylline is the most common treatment of Bell's palsy. During recent years it has become well known that low-molecular dextran has several severe side effects (e.g. acute renal failure). - At the ENT Department of the University of Göttingen 33 patients with Bell's palsy were treated with an infusion therapy which replaced low-molecular dextran by hydroxyethyl starch. Before and after therapy patients underwent a special diagnostic procedure for the facial nerve function consisting of --determination of the degree of paralysis and secondary defects (14) --a complete electrophysiological examination. The patients were followed up for at least 6 months. It was found that 97% of the patients had a complete functional recovery.

Adult↗

PubMed1990

[Magnetic stimulation in patients with facial hemispasm].

A total of 28 patients with a hemifacial spasm were examined using transcranial magnetic stimulation. The potentials were evoked cortically and cisternally; latencies and amplitudes of each potential were measured in the levator labii muscle and in the orbicularis oculi muscle. After cortical stimulation, differences in latencies were found between the healthy and the diseased side of the levator labii muscle. Prolonged latencies were measured more frequently on the diseased side (cortical stimulation). The method of magnetic stimulation is an important addition to electrophysiological diagnostic procedures in facial hyperkinesias. Cortical stimulation combined with measurements of the blink reflex and neuromyography may allow separate parts of the route of the whole facial nerve and supranuclear structures to be examined.

Electric Stimulation Therapy↗

PubMed1990

[Esophageal caustic injury in childhood. A critical elucidation with indication for esophagoscopy].

From 1983 through 1988, esophagoscopies were performed in 41 children because of suspected caustic esophageal injury. Of these 41 children, 11 had endoscopically significant esophageal burns and were treated with steroids and antibiotics. Of these 11 patients, two had no chemical burns of the facial skin, mouth, or pharyngeal mucosa. The authors therefore believe that esophagoscopy must not be omitted in cases of suspected caustic ingestion.

Anti-Bacterial Agents↗

PubMed1990

[Relevance of combined electrodiagnosis in facial hyperkinesia].

We present a combined electrophysiological diagnostic procedure for patients with facial hyperkinesia. With the new method of magnetic stimulation a central cortical stimulation is possible to represent the total way of the facial nerve. The combination of magnetic stimulation with other methods such as the blink reflex may lead to topodiagnostic statements in facial hyperkinesias.

Cerebral Cortex↗

PubMed1990

[Squamous cell carcinoma in the area of the parotid gland. Metastasis or primary tumor?].

A total of 61 patients with a histological diagnosis of squamous cell carcinoma of the parotid gland were studied. The patients were classified into three categories. There were 34 patients with a metastasis to the parotid gland from a squamous cell carcinoma elsewhere within the head and neck who presented on average 2.1 years (range 3 months to 7 years) after diagnosis of the primary tumour; in one case a salivary gland tumor presented 32 years after irradiation of a squamous cell carcinoma of the temple. Six patients had histological evidence of a metastasis within the parotid gland, but no evidence of a primary tumour. Twenty-one patients presented with a primary epidermoid carcinoma of the parotid gland. Two patients showed a primary squamous cell carcinoma of the parotid arising in myoepithelial sialadenitis.

Adult↗

PubMed1990

[Botulinum toxin treatment of synkinesia following facial paralysis].

We report ten patients with unilateral synkinesias after facial palsy treated with botulinum toxin injections. All patients suffered from extensive mass movements around the eye. After periocular injections all patients showed much improvement: a period of 11 weeks free of symptoms was followed by a 9-week period of minimal symptoms. There were no important complications. The use of botulinum toxin injections is an effective therapy for mass movements after defect healing of facial palsy.

Adult↗

PubMed1990

The effects of botulinum toxin on hemifacial spasm: an electrophysiologic investigation.

Forty-one patients with unilateral or bilateral facial spasm were studied by electrophysiologic examination. All patients received local treatment with botulinum toxin. In the patients and controls, the measurements of the blink reflex revealed changes that (1) may indicate a central origin of the spasm in some cases, and (2) make it likely that the trigeminal nerve influences the facial nucleus and is thus involved in the regulation of the spasm.

Adult↗

PubMed1990

[Essential blepharospasm and botulinum toxin. An electrophysiologic study].

Thirty-five patients with essential blepharospasm were investigated electrophysiologically after local treatment with subcutaneous periocular injections of botulinum toxin. In all patients the blink reflex was measured on both sides. The results showed in some cases reproducible changes in the reflexes, indicating a central supranuclear origin for the spasm. Furthermore, an influence of afferent information on the "spasm threshold" via the trigeminal nerve is suggested.

Blepharospasm↗

PubMed1990

[FANDOS--a new standardized computer-assisted documentation and evaluation of diseases of the facial nerve].

The personal computer program package FANDOS (Facial Nerve Documentation System) has been designed especially for diseases of the facial nerve. It provides a very simple and exact method of documentation; it does not require much time and is easy to handle. In the ENT department of the University of Göttingen, this program has been tested in the clinical routine. In this paper we present the program package and explain its use in prospective studies.

Cranial Nerve Diseases↗

PubMed1989

[The psychosocial environment of patients with neoplasms of the head and neck. A clinical study].

A survey was made of 96 patients of the University ENT Clinic Göttingen suffering from malignomas in the head and neck region, to gain insight into the patients' personal assessment of discomfort during and after tumour therapy, and into their psychological and social environment. The questionnaires were developed in cooperation with a psychologist trained in oncology. The most important result of the survey was a tendency to idealisation and alexithymia in patients with head and neck tumours. The situation of the tumour patients is characterised by a feeling of lonesomeness and isolation within their social environment. It also became evident that some of the patients in the survey had a certain "health-promoting potential". Our results are compared with reports published on the subject so far and suggestions are made for the incorporation of psychological support during and after tumour therapy.

Adaptation, Psychological↗