Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Facial Paralysis”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 37 records · Page 2Linked to original sources

Pediatric bilateral facial paralysis.

Bilateral facial paralysis is an unusual clinical entity that occurs in less than 1% of patients with facial paralysis. In children bilateral facial paralysis is even more rare, and establishing its etiology can be challenging. Four pediatric patients ranging in age from 3 to 17 years are presented who developed bilateral facial paralysis as a result of acute otitis media, Lyme disease, recurrent central nervous system leukemia, and acute disseminated encephalomyelitis. The diagnosis and treatment of pediatric bilateral facial paralysis are reviewed, as well as the pertinent literature.

Acute Disease↗

The VlsE (IR6) peptide ELISA in the serodiagnosis of lyme facial paralysis.

OBJECTIVE: Facial paralysis is a manifestation of early disseminated Lyme neuroborreliosis. In the current study, we compared the immunoglobulin G (IgG) VlsE (sixth invariant region) peptide enzyme-linked immunosorbent assay (ELISA) with the current two-tier approach of sonicate ELISA and Western blot in the serodiagnosis of Lyme facial paralysis. STUDY DESIGN: Retrospective. SETTING: Tertiary referral center. PATIENTS: Serum samples from 47 Lyme patients with facial paralysis and 86 control subjects were analyzed for IgG antibodies to VlsE peptide of Borrelia burgdorferi and for immunoglobulin M (IgM) and IgG antibodies to sonicate antigens of B. burgdorferi using the two-tier approach. INTERVENTION: Diagnostic. MAIN OUTCOME MEASURE: Serum IgG antibody responses to VlsE (IR6) peptide. RESULTS: All 47 (100%) patients with facial paralysis and 4 (5%) of 86 controls had positive antibody responses to the VlsE peptide. In the two-tier test, 41 (87%) patients had positive IgM, 31 (66%) had positive IgG, and all 47 patients had positive IgM or IgG responses. Of the 86 control subjects, 2 (2%) had positive results with the two-tier test. Thus, the sensitivities of the VlsE and the two-tier tests were 100%; the specificity of the VlsE ELISA was 95% and the specificity of the two-tier test was 98%. CONCLUSIONS: The VlsE peptide ELISA showed a high sensitivity and specificity in the serological diagnosis of Lyme facial paralysis, similar to the two-tier test. The principal advantage of the VlsE peptide ELISA is that it requires only one test rather than four tests. However, the specificity of the VlsE test may not be as high as that of the two-tier test.

Adolescent↗

[Infantile peripheral facial paralysis].

Peripheral facial paralysis is a common mononeuropathy in adults. It is less frequent in children, but is very upsetting for parents when it occurs. Its causes in children are similar to those found in adults, the most common being idiopathic. However, secondary facial paralysis is the most frequent cause in children. The results of a 4-year follow-up of 29 cases of peripheral facial paralysis in 26 children age 14 and under are reported. The causes, evolution, treatment, recuperation, care, and rate of admission are reviewed. Results are compared to those found in the follow-up of 196 adult cases of peripheral facial paralysis made by the authors.

Adolescent↗

The assessment and treatment of facial paralysis.

A facial paralysis is a major cosmetic handicap and can be an emotional and occupational disaster. There are, in addition, problems with speech and the eye. These problems are more severe if the facial paralysis is combined with other cranial nerve palsies. This discussion will be limited to lower motor neurone paralysis. Every patient with a facial paralysis can be helped to some degree and, in some, facial function can be restored to near normality. It is important that the underlying condition be diagnosed early to ensure a good prognosis.

Facial Paralysis↗

Bilateral facial paralysis.

Bilateral facial paralysis is a rare disorder, and its work-up should include a complete neurotologic assessment plus neurologic consultation and lumbar puncture. The various causes and their treatment are discussed and the treatment of longstanding facial paralysis is reviewed.

Brain Neoplasms↗

Lip transposition in patients with facial paralysis.

Since facial reanimation is not always possible in patients with facial paralysis, one must have alternate methods of reconstruction available. Satisfactory static reconstruction of the face may be accomplished with the use of a brow lift, tarsorrhaphy, and correction of the paralyzed mouth. Transposition of the corner of the mouth utilizing the Z-plasty technique has proven to be an effective method to correct the drooling and garbled speech associated with facial paralysis. When combined with a brow lift and tarsorrhaphy, symmetry of the facial appearance while at rest has also been obtained.

Aged↗

[Analytical study of the treatment of facial paralysis by hypoglossal-facial anastomosis. Apropos of 25 cases].

Hypoglosso-facial anastomosis (HFA) is an already old alternative for the surgical treatment of facial paralysis. 25 patients, 17 men and 8 women, with complete facial paralysis were operated according to this technique, 6 to 12 months after onset of the paralysis. Based on analysis of the results, the authors describe the advantages and disadvantages of this technique. The advantages are: facial symmetry at rest, protection of the cornea, voluntary movements of facial muscles. The disadvantages are: paralysis and atrophy of one side of the tongue, absence of expression of emotional and involuntary states on one half of the face, synkinesia, disorders of mastication. Disorders of deglutition improve with time. In this series of 25 patients, the authors never observed eyelid movements independent of movements of the labial commissure. By comparing these advantages and disadvantages, the authors consider that HFA should no longer be proposed for the treatment of facial paralysis. In the current state of microsurgery, if the facial nerve cannot be repaired by direct suture or graft, the authors recommend revascularized, reinnervated muscle transfer onto the facial nerve of the healthy side.

Adult↗

Facial paralysis: traumatic neuromas vs. facial nerve neoplasms.

Traumatic neuromas (TN) are benign proliferations of neural tissue that may occur without disruption of the facial nerve. The clinical presentation, as well as the radiographic appearance, may suggest neoplastic involvement of the facial nerve. Histologically, they may closely resemble neurilemomas (Schwannomas) or neurofibromas. Three cases of TN of the facial nerve associated with facial paralysis are presented here. Unlike previously reported cases, these tumors were not associated with chronic inflammatory middle ear disease. TN must be considered in the differential diagnosis and treatment of facial paralysis.

Adolescent↗

[Risks of upper eyelid gold implantation in peripheral facial paralysis].

Peripheral facial paresis is often accompanied by incomplete closure of the eyelids and may lead to varying degrees of keratopathy. Conservative therapeutic measures are often not sufficient. To achieve better lid closure tarsorraphy has been the primary method of treatment but has certain functional and cosmetic drawbacks for the patient. Alternatively gold weight implants have been used to close the upper lid by the force of gravity and if needed can be combined with further reconstructive facial surgery. From May 1994 to January 1997 29 patients with peripheral facial paralysis were treated with gold weight upper lid implants. Postoperative closure of the lids was sufficient in all cases, and there was a statistically significant decrease in lagophthalmos and improvement in keratopathy. Complications observed included ptosis (n = 5), cosmetically unacceptable bulging of the gold implant (n = 5), extrusion of the implant (n = 1) and the development of a low-grade corneal astigmatism (n = 7). In all cases of astigmatism correction was achieved by the fitting of cylinder glasses. In all, functional results achieved showed that the gold implant was superior to the cosmetically bothersome tarsorraphy.

Adult↗

Role of magnetic resonance imaging in the diagnosis of bilateral facial paralysis.

Bilateral facial paralysis (BFP) is a rare clinical finding that may be caused by Guillain-Barré syndrome, a medical emergency. The differential diagnosis of BFP is lengthy but can be narrowed to a limited group of disorders by the patient's history and physical examination. The most important diagnostic tests to obtain initially are the lumbar puncture and magnetic resonance imaging (MRI) scan with gadolinium contrast enhancement. Based on the MRI and lumbar puncture findings, additional tests may be appropriately ordered. The diagnosis of bilateral Bell's palsy is made by exclusion of other disorders. This report presents five cases of BFP (Guillain-Barré syndrome, herpes simplex polyneuritis, meningeal lymphoma, and two cases of bilateral Bell's palsy) in which MRI imaging helped in the diagnosis and subsequent management of the patient. The appropriate sequence of diagnostic studies for patients with BFP is discussed.

Adult↗

Facial paralysis.

Explore the source record for details and available documents.

Facial Paralysis↗

Recovery from facial paralysis following crush injury of the facial nerve in hamsters: differential effects of gender and androgen exposure.

In recent studies, we have shown that administration of androgens to male hamsters enhances functional recovery from facial paralysis induced by facial nerve crush at the level of the stylomastoid foramen. Furthermore, we have established that the mechanism behind this enhancement of regeneration involves an acceleration of the rate of regeneration, without a shortening in the delay of sprout formation. From those studies, several unexpected findings of inherent sex differences emerged. First, intact (nongonadectomized) females have a faster facial nerve regeneration rate than males and, second, testosterone has a less dramatic effect on the rate of regeneration in females compared to males. In the present study, we explored these novel findings of sex differences in the response of motor neurons to injury. Adult intact female hamsters were subjected to right facial nerve crush axotomy at the level of stylomastoid foramen and either implanted with two or four silastic capsules containing 5 alpha-dihydrotestosterone, or sham-implanted for controls. A group of adult intact male hamsters was also subjected to right facial nerve crush axotomy. Animals were observed daily, beginning on Day 1 postoperatively and continuing throughout a 3-week recovery period for signs of functional recovery from facial paralysis. The average day of return of each of four behavioral components (semi-blink, blink reflex, full vibrissae movement, and complete recovery) was calculated for all four experimental groups. The results indicate that intact females recover functional return of movement following crush injury significantly faster than intact males. In contrast to our previous findings in male hamsters, administration of exogenous steroids does not accelerate recovery from facial paralysis in adult female hamsters.(ABSTRACT TRUNCATED AT 250 WORDS)

Androgens↗

Testosterone-induced acceleration of recovery from facial paralysis following crush axotomy of the facial nerve in male hamsters.

In this study, the effects of testosterone propionate (TP) on recovery from facial paralysis following crush axotomy of the facial nerve in male hamsters were examined. In the first experiment, TP (5 mg/ml sesame oil; 0.1 ml) was injected subcutaneously and on alternate days in one-half of the animals subjected to crush axotomies of the facial nerve, with the second half receiving vehicle alone. An accelerative effect of TP on recovery from facial paralysis was observed near the end of the first and beginning of the second week after crush axotomy. When the dosage and frequency were doubled in the next experiment, a greater accelerative effect of TP on recovery from facial paralysis was observed. In the last experiment, castrated animals were used in order to eliminate the endogenous source of the hormone and two different modes of hormone administration, TP implants vs TP injections, were compared. The results of that experiment indicate that continuous exposure to the hormone, in the form of subcutaneous implants of 100% crystalline TP, had the most pronounced effect on acceleration of recovery from facial paralysis. In addition, no differences in the responses of the castrated, axotomized animals and the normal, axotomized animals were found. This suggests that the presence of endogenous hormone contributes little to the acceleration of functional recovery observed with TP. Finally, the time course of the accelerative effect of TP suggests that the hormone is acting primarily at the level of the facial neuron, which contains androgen receptors, and perhaps secondarily at the level of the facial muscles, which are also known to contain androgen receptors.

Animals↗

Problems with eating and drinking in patients with unilateral peripheral facial paralysis.

Patients with facial paralysis not only suffer from asymmetry of the face, but also from problems with eating and drinking. To demonstrate that these patients have many problems with activities such as eating and drinking, we examined 17 outpatients with a unilateral peripheral facial paralysis for the presence of problems in these functions. To collect data, all patients completed a questionnaire concerning the problems they had directly following onset of the paralysis and at the moment of this study. In addition, they were examined to determine the severity of the paralysis, the problems with eating and drinking, their experiences regarding impairments and disabilities, and the compensatory behavior. The result of the study is a portrayal of problems and conscious or unconscious compensations. Furthermore, we concluded that the Sunnybrook Facial Grading System score does not predict the number of problems in eating and drinking, the number of compensations, and the emotional impact. Significant correlations are found only between various scores on Visual Analog Scales and the number of compensatory actions. Patients differ in how they experience the extensive problems due to the facial paralysis and in the extent to which they are successful in adaptation. Consulting a speech therapist for treatment of functional problems is a meaningful adjunct to regular therapy. The treatment of deglutition disorders can be best based upon the detailed information of the questionnaire and the examination of eating, drinking, and compensatory behavior.

Adaptation, Physiological↗

Upper eyelid gold weight implantation in the Asian patient with facial paralysis.

Patients with facial paralysis may develop ophthalmic complications. Poor eyelid closure and lagophthalmos place the patient at increased risk for the development of corneal problems such as epithelial defects, stromal thinning, bacterial infection, and even perforation. Initial treatment should be conservative and include the use of ocular lubricants, moisture chambers, and taping of the lower eyelid into proper position. Surgical intervention may be required in patients who have failed medical therapy or in whom the facial paralysis is not expected to improve. Gold weight implantation in the upper eyelid has become a popular procedure to correct upper eyelid retraction and to improve corneal coverage. Previous descriptions of gold weight placement in the upper eyelid have focused on Caucasian eyelid anatomy. However, there are distinct anatomic differences between the Caucasian and Asian eyelids, which dictate the overlying aesthetic differences. We describe our technique for placement of a gold weight in the Asian upper lid, with attention to the maintenance of symmetric eyelid creases. We reviewed the charts of six Asian patients with facial paralysis who underwent gold weight placement in the upper eyelid for the correction of lid retraction. All patients did well functionally and aesthetically, and none developed an extrusion of the implant with this approach.

Adult↗