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At least 415 records · Page 23Linked to original sources
PubMed1999

Vocal fold injection of collagen for unilateral vocal fold paralysis caused by chest diseases.

BACKGROUND: Patients having malignant chest diseases sometimes suffer from vocal fold paralysis. Treatment for vocal fold paralysis is important for such patients, because vocal fold paralysis causes lack of the versatility of the human voice which is essential for our communication. METHODS: Seventeen patients suffering from unilateral vocal fold paralysis were treated with vocal fold injections of collagen. Three patients received twice, and 20 treatments were conducted. A flexible bronchofiberscope was used under local anesthesia in order to observe the whole procedure of vocal fold injection. Using an injector and a long needle, collagen was injected with transcutaneous technique mainly through the cricothyroid membrane. The amount of collagen was determined with bronchoscopic findings. RESULTS: During and after treatment, no complication was observed. Of 20 treatments, a marked improvement was observed in 8, and moderate improvement was observed in 9 treatments. CONCLUSIONS: Vocal fold injection of collagen is a very useful and safe treatment for unilateral vocal fold paralysis caused by chest diseases.

Adult↗
PubMed1999

Low-dose vincristine-associated bilateral vocal cord paralysis.

BACKGROUND: Vincristine-associated peripheral neuropathy is a well-described entity. We describe a case of vincristine-induced vocal cord paralysis, which is a rare complication of this drug. We report herein the second case of bilateral vocal cord paralysis in a patient receiving conventional doses of vincristine. OBJECTIVE: To present a case report of vincristine-associated vocal cord paralysis and to review the relevant English language literature on this subject. DESIGN: Report and review of the literature. SETTING: Outpatient community cancer center. PATIENT: A 58-year-old female with a diffuse large cell lymphoma stage IV receiving cyclophosphamide, doxorubicin, vincristine, and prednisone. RESULTS: Bilateral vocal cord paralysis occurred in this patient receiving vincristine as part of her chemotherapy regimen. In addition to this case there have been a total of 25 prior reports, which are reviewed in the text. CONCLUSION: The incidence of bilateral vocal cord paralysis in patients receiving vincristine on the usual low-dose schedule is low. Prompt withdrawal of the offending agent results in prompt recovery without untoward long-lasting sequela.

Antineoplastic Agents, Phytogenic↗
PubMed2000

Thyrotoxic periodic paralysis in a Caucasian man in treatment for Graves' disease.

Thyrotoxic periodic paralysis (TPP) is the main secondary form of hypokalemic periodic paralysis and is mostly associated with Graves' disease. Initially diagnosed in Asian countries, TPP has been sporadically reported in different populations of the Western World. Increased Na+/K(+)-ATPase activity seems to be responsible for the marked hypokalemia observed during the transient paralysis attacks. We report on a 35-year-old Italian man without history of hypokalemic periodic paralysis and hyperthyroidism, in treatment for Graves' disease, who suffered episodes of flaccid paralysis even with normal thyroid hormone levels. An insulin-glucose provocation test confirmed our diagnosis. Oral and parenteral potassium reverse the symptoms. Monitoring of thyroid function is also important to prevent further attacks.

Adult↗
PubMed1998

[A probe into the relationship between spasmodic dysphonia and laryngeal paralysis].

OBJECTIVE: To investigate into the relationship between spasmodic dysphonia and laryngeal paralysis. METHODS: The intrinsic laryngeal muscle potential was recorded with electromyography. Vocal cord movements were observed with a videostroboscope. Laryngeal paralysis was divided into mild, moderate, and severe degrees based on the potentials of intrinsic laryngeal muscles and on the status of vocal cord movements. RESULTS: In the past 12 years (from 1983 to 1994) 1300 cases were diagnosed as having mild, moderate, and severe laryngeal paralysis. Among them, there were 5 cases with laryngospasm including 3 mild, 1 moderate, and 1 severe case. CONCLUSION: The findings obtained from careful observation on these 5 cases of spasmodic dysphonia demonstrated that there existed certain relationships between laryngeal paralysis and spasmodic dysphonia. During the course of exacerbation or restoration of paralysis, spasmodic dysphonia might occur.

Adult↗
PubMedDate not supplied

[Postictal paralysis during video-EEG monitoring studies].

OBJECTIVE: To know the frequency of Todd s paralysis during the video EEG monitoring studies, to investigate in its pathophysiology, and to confirm its value to localise the epileptic focus. PATIENTS AND METHODS: We reviewed 114 monitoring studies, in 102 patients. RESULTS: Sixty patients had epileptic seizures. An obvious paresis was noted in four seizures of two patients (3 and 1, respectively). Both patients had frontal epilepsy. During the paralysis, in the first patient the EEG showed ictal discharges on the contralateral centrotemporal area. In the second patient, the EEG demonstrated slow waves in the contralateral frontal region. The ictal onset was contralateral to the paresis in all cases. No patient with pseudoseizures had paralysis. CONCLUSIONS: Postconvulsive paralysis are not frequent in video EEG monitoring studies. However, if present it points out to a contralateral seizure onset. In our series it happened in patients with frontal seizures. The EEG may help to clarify if it correspond to a true postictal phenomenon or to a ictal paralysis.

Adult↗
PubMed1976

Levodopa-enhanced recovery from paralysis induced by air embolism.

In this study levodopa was chosen as an agent that might ameliorate the clinical manifestations of paralysis induced by air embolism because of reported effects of this drug on muscle spasticity and locomotion. In order to induce air embolism, the aorta of rats was cannulated chronically. Fifteen days later, after full recovery of the animals, air was administered through the chronic cannula into the descending aorta of each rat (0.35 ml. of air per 100 Gm. during 4 seconds). The paralysis of both hind legs was observed one to 10 minutes later. Only animals that had total paralysis of both hind legs, without any sensation, were used in the experiments. levodopa was administered 2 minutes after experimentally induced paralysis. The levodopa treatment was repeated every day for 6 days. After 6 days, six levodopa-treated (intraperitoneally) animals in a group of eight and ten levodopa-treated (intra-arterially) animals in a group of 12 recovered fully from the paralysis. Only three animals in a group of 13 (untreated) or two animals in 12 (solvent administration) recovered without the levodopa treatment.

Animals↗
PubMed2002

Facial paralysis caused by malignant skull base neoplasms.

OBJECT: Bell palsy remains the most common cause of facial paralysis. Unfortunately, this term is often erroneously applied to all cases of facial paralysis. METHODS: The authors performed a retrospective review of data obtained in 11 patients who were treated at a university-based referral practice between July 1988 and September 2001 and who presented with acute facial nerve paralysis mimicking Bell palsy. All patients were subsequently found to harbor an occult skull base neoplasm. A delay in diagnosis was demonstrated in all cases. Seven patients died of their disease, and four patients are currently free of disease. CONCLUSIONS: Although Bell palsy remains the most common cause of peripheral facial nerve paralysis, patients in whom neoplasms invade the facial nerve may present with acute paralysis mimicking Bell palsy that fails to resolve. Delays in diagnosis and treatment in such cases may result in increased rates of mortality and morbidity.

Adenocarcinoma↗
PubMed1992

Screening of cases of acute flaccid paralysis for poliomyelitis eradication: ways to improve specificity.

The Pan American Health Organization in 1985 adopted an initiative to eradicate poliomyelitis from the Western Hemisphere. In 1990, over 2000 cases of acute flaccid paralysis (AFP) were reported in this region, of which < 1% were determined to be caused by wild poliovirus. At present, the eradication programme uses AFP as the criterion for surveillance of children aged < 15 years; this is 100% sensitive, but not specific. To minimize unnecessary diagnostic investigations, we studied all 4333 cases of AFP reported to the programme during 1989 and 1990 in order to develop more efficient operational screening criteria for cases of AFP. Among children with AFP, the use of criteria such as age < 6 years and either presence of fever at the onset of paralysis or a < 4-day period for complete development of paralysis resulted in a sensitivity of 96% (95% C.I. 90-103%) and specificity of 49% (C.I. 47-52%). With criteria of age < 6 years and fever present at the onset of paralysis the sensitivity was 75% (C.I. 61-89%) and specificity was 73% (C.I. 71-75%). These results suggest that by screening young children with AFP who either had fever at the onset or showed a rapid progression of paralysis, the number of cases of AFP requiring investigation can be reduced by one half, with minimal compromise in the sensitivity of confirmed poliomyelitis case detection.

Adolescent↗
PubMed1992

[Acute posterior interosseous nerve paralysis with constrictions possibly due to twists in the nerve trunk].

This report is concerning a case of acute spontaneous paralysis of the posterior interosseous nerve (P.I.O.N.), possibly caused by twists in the nerve trunk, in a 23-year-old woman. The subject felt a tingling pain over the lateral epicondyle of the right forearm when grasping and lifting a basin, and noticed that the fingers of the right hand could not be extended three days later. The fingers of the left hand also experienced paralysis 3 months after the first injury when she pronated and extended left forearm. Neurological examination revealed bilateral P.I.O.N. paralysis. When, after a period of time, the bilateral P.I.O.N. paralysis had not improved, surgical exploration of both P.I.O.N. was performed. It revealed that the right P.I.O.N. underwent a severe constriction at 2 cm proximal to the superficial portion of the supinator muscle, and that the proximal portion of the right nerve was swollen. The constricted portion of the right nerve was resected 5 mm in length, and nerve suturing was performed. The left P.I.O.N. was also constricted at the same location, and was found to be a sausage-like neurinoma with two constrictions. In the histological examination of the right resected P.I.O.N., edema of the interstitial tissue and a great number of regenerating cluster formations, including swollen axons, were observed proximal to the constriction. Distal to this, severe Wallerian degeneration was found. These histological findings were the same as those of chronic compression neuropathy. The authors reviewed and analysed reports on 20 other cases of P.I.O.N. paralysis that had compressions at 2 cm proximal to the superficial portion of the supinator muscle.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗
PubMed2003

[Montgomery thyroplasty implant under local anesthesia for unilateral laryngeal paralysis].

OBJECTIVES: Based on an inception cohort of 63 patients with unilateral vocal fold paralysis consecutively treated with thyroplasty and Montgomery's implant under local anesthesia during the years 1997-2002, we recorded i) morbidity and mortality, ii) evolution of dysphonia and swallowing impairment and iii) a prospective analysis of selected speech and voice parameters in an attempt to determine their evolution during the first 12 postoperative months and to search for potential statistical relationships with the following variables (age, gender, side of the paralysis, etiology of the paralysis, time between onset of paralysis and thyroplasty, position of the paralyzed true vocal fold, nerve involved, associated pneumonectomy, prior intracordal injection of autologous fat and surgeon). RESULTS: The overall complication rate was 8%. Minor complications occurred in 6.5% of the patients and included 4 cases of laryngeal edema successfully treated with oral steroids. Major complications occurred in 1.5% of the patients. Intralaryngeal hematoma requiring temporary tracheotomy was the major complication. Swallowing was improved in 93.5% of the patients. Immediate improvement of speech and voice was noted in all. Secondary degradation of speech and voice occurred in one patient. At revision thyroplasty lateral displacement of the implant was noted and successfully repositioned. At one month post-operatively, the values of maximum phonation time, speech rate, group phrasing standard deviation of the fundamental frequency, jitter and shimmer were statistically improved while the fundamental frequency did not vary significantly. At 12 months post-operatively the noise to harmonic ratio was improved while the other parameters remained stable. No significant statistical relationship was found between the post-operative speech and voice parameters and the variables under analysis. CONCLUSION: Based on the current series and a review of the medical literature, thyroplasty with Montgomery's implant under local anesthesia appears to be an easy, effective and safe procedure that might be used in all patients with unilateral laryngeal nerve paralysis.

Adult↗
PubMed1992

Pathogenesis of age dependent paralysis by a temperature sensitive mutant (tsl) of Moloney murine leukemia virus-TB.

The tsl mutant of Moloney murine leukemia virus-TB produces neurological disease leading to fatal hind limb paralysis when inoculated in newborn BALB/c mice. The present study was under taken to assess the role of T and B lymphocytes in age dependent resistance to tsl induced paralysis in BALB/c mice. The adoptive transfer of non-immune splenic unseparated lymphoid cells, T cells and B cells and tsl immune B cells and T cells to newborn BALB/c mice infected with tsl did not prevent the development of paralysis. However, adoptive transfer of immune splenic unseparated lymphoid cells and immune T cells delayed the onset of paralysis by 5 to 10 days as compared to the mice which did not receive the immune lymphocytes. Athymic BALB/c nude mice inoculated with tsl at days 1 and 10 after birth failed to develop the paralytic disease. Transfer of tsl neutralising antibody also delayed the onset of paralysis. Mice (10 days old) treated with cyclophosphamide, cyclosporine A, cortisone acetate and anti-T cell serum when inoculated with tsl also did not develop neurological disease. The results suggest that age related resistance to neurological disease may not be associated with B cell mediated immunity.

Age Factors↗
PubMedDate not supplied

Outcome of vocal cord paralysis in infants.

Although laryngomalacia is the leading cause of stridor in infancy, vocal cord paralysis, despite its low incidence, is still the second most common cause. However, the etiology of infant vocal cord paralysis is different from that of adults, and the management protocol is controversial. Therefore, we conducted this study to better characterize the cause and outcome of vocal cord paralysis in infants. From January 1997 to December 2003, we treated thirteen infants younger than one year for vocal cord paralysis. Seven infants were idiopathic (idiopathic group), two might be caused by prior surgery (iatrogenic group), two might be caused by central neuropathy (neurological group), and two were born after difficult delivery (obstetrical group). In the idiopathic group, six infants spontaneously recovered and one infant had right-side recovery, but the left side was still paralytic. All infants in the iatrogenic and obstetrical groups spontaneously recovered. However, no infant in the neurological group recovered. Spontaneous recovery occurred in 76.9% of affected infants. More than half (70%) of these spontaneous recoveries occurred within 6 months. In our experience, direct flexible laryngoscopy is mandatory for all infants younger than one year of age presenting with stridor. Except for extreme infants (e. g. bilateral vocal cord paralysis with severe respiratory distress and central neuropathy) who require a temporary tracheotomy to relieve the airway obstruction, we recommend waiting for at least 6 months before proceeding to invasive surgical interventions.

Dyspnea↗
PubMed2005

[Hypokalemic and thyrotoxic paralysis--similarities and differences].

Hypokalaemic periodic paralysis (HPP) is a rare myopathy inherited in autosomal dominantly pattern, characterized by episodic attacks of muscle weakness due to the decrease in serum potassium concentration because of ion channel's dysfunction. The thyrotoxic hypokalaemic paralysis (TPP) is an acquired form of a periodic paralysis associated directly with hyperthyroidism. HPP predominates in Caucasians, in contrast to TPP which occurs in 13-24% Asian with hyperthyroidism. Both types of hypokalaemic paralysis are similar in symptoms i.e. the sudden onset of limbs paralysis, often in the morning, after the night rest, preceded by intense exercise testing or hard work. The treatment and the prevention of TPP differs from that of HPP. Both, similarities and differences, between HPP and TPP are described in this report.

Diagnosis, Differential↗
PubMedDate not supplied

Medialization laryngoplasty for the treatment of unilateral vocal cord paralysis: a perceptual, acoustic and stroboscopic evaluation.

Vocal cord paralysis remains a frustrating condition. The etiology can be subdivided roughly into surgically induced, neoplastic and idiopathic paralysis. In the surgical group, thyroidectomy is the most common cause. In unilateral vocal cord paralysis most patients suffer from a change in voice quality described as hoarseness or breathiness with or without aspiration and dysphagia. Laryngeal examination usually reveals the paralyzed cord shorter than the normal side and mostly in the paramedian position. Endostroboscopic examination shows invariably incomplete closure of the vocal cords with marked decrease in the mucosal waves of the folds during phonation. Several procedures for vocal cord medialization such as endoscopic injection of different materials, medialization thyroplasty, arytenoids adduction and re-innervation procedures have been described in the literature. Laryngoplastic phonosurgery for surgical rehabilitation of the paralyzed vocal cord has markedly evolved over the last few decades. This is a review of patients with unilateral vocal cord paralysis treated by medialization laryngoplasty at the American University of Beirut, Department of Otolaryngology Head and Neck Surgery, between 1994 and 2003. The etiology of the paralysis, symptomatology, endostroboscopic and acoustic findings will be presented together with a description of the surgical technique.

Adolescent↗
PubMed2006

[Thyroid malignant tumor with flare up glottic paralysis for first symptom].

OBJECTIVE: To approach clinical feature of thyroid malignant tumor with Flare up glottic paralysis for first symptom, and analysis that should be avoided missed diagnosis and misdiagnosis during diagnosis and treatment. METHOD: Retrospective research five cases of thyroid malignant tumor with flare up glottic paralysis papillary adenocarcinoma of thyroid by pathology. Four cases had one side glottic paralysis, the same side thyroid were moved after dissecting the recurrent laryngeal nerve. Three cases of them recovered normal vocal cord function, the function of one case was compensated by another side vocal cord. The last one had right gliotic paralysis first, then both cricoarytenoid joint had been fixed, hoarse voice was worse and developed to dyspnea since the tumor invaded in larynx one year later. We only did cut the right thyroid and right half larynx, but the tumor came back again in larynx in three months, then had to removal whole larynx without recurrence follow up two years. CONCLUSION: For the flare up glottic paralysis with same side tiny thyroid tumor, we suggest that the thyroid must be made operation research if no other reasons, dissecting and protecting the recurrent laryngeal nerve during operation, and cut reasonable thyroid and others according to fast pathologic diagnosis.

Carcinoma, Papillary↗
PubMed2006

[Recent progress on the searchs of pathogenesis of thyrotoxic periodic paralysis].

In Japan, more than 60% of hypokalemic periodic paralysis is thyrotoxic instead of familial type frequently experienced in Caucasian countries. The pathogenesis of familial hypokalemic periodic paralysis (FHPP) has been elucidated to be due to the mutation of one of the genes in either Ca(CACN1AS), Na(SCN4A) or K channel(KCNE3). Clinical features of thyrotoxic periodic paralysis (TPP) is very similar to that of FHPP and rigorous attempts have been devoted to the search of the gene mutation of ion channels in TPP. To date, however, no such an attempt has been successful except for the findings of SNiPs in those ion channel genes or in the vicinity of TRE of CACN1AS. Those SNiPs may provide a risk to the attack of TPP. In TPP, we and others reported that the serum insulin level tremendously elevated prior to the attack of paralysis. There were clinical evidences indicating that hypokalemic periodic paralysis is caused by the depolarization block of muscle cell membrane instead of hyperpolarization block once assumed previously. Otsuka reported that insulin can induce depolarization block of muscle membrane in low K concentration by increasing membrane permeability to Na. We have reported that K deficiency and thyroid hormone excess increased NaK-ATPase and may sensitize the muscle membrane to the effect of insulin to cause depolarization in an animal model. In fact, in Japan, incidence of TPP of male decreased from 8.6% in 1958 to 4.3% in 1998. During this 40 years, intake of K was increased from 43 to 65 mEq per day per person as described by the National Survey of Nutrition. The SNiPs of ion channel genes, together with K deficiency or thyroid hormone excess, may provide a risk to the occurrence of TPP.

Animals↗
PubMed1976

[Prognostic assessment in peripheral facial nerve paralysis with particular reference to electroneurography (author's transl)].

Electrophysiological investigations were carried out on 20 healthy controls and 130 patients with peripheral facial nerve paralysis. The aetiology was as follows: idiopathic (Bell's palsy) in 60 cases, viral in 29, traumatic in 18, postoperative in 4, in connexion with chronic otitis media in 6, diabetes mellitus in 4, positive rheumatological tests in 3, disturbed lipid metabolism in 2, the Melkersson-Rosenthal syndrome in 1, as a complication of pregnancy in 2, and in association with a tumour in 1 case. The compound action potential (CAP) of the orbicularis oris muscle was determinedi n 370 occasions in a right/left comparision, the record of the muscle response was intergrated over the time of action (IAR) on 32 occasions and trison of 255 occasions. The normal values are given in the first place and their dependence of the age of the subject. Then, the prognostic sifnficance of the above-mentioned parameters is investigated in cases of peripheral facial nerve paralysis. It is apparent that the determination of the CAP in a right/left comparison is a valuable prognostic guide as early as the 4th day, insofar as a decrease in this parameter of under 50% can be interpreted as a favourable sign and satisfactory reversal of the paralysis can be expected within 6-8 weeks. By contrast, a decrease of over 70% in the CAP is a bad prognostic sign, indicative of presumably only a poor trend to reversal of the paralysis. An intermediate depression of the CAP in the range of 50-70% signifies an expected moderate recovery within 6-8 weeks ahe case of CAP determination at the time of maximum amplitude depression (as opposed to the 4th day), then a decrease of less than 70% is taken to be indicative of satisfactory functional recovery within 6-8 weeks; a decrease of 95-100% signifies a bad prognosis, whilst a decrease amounting to between 70 and 95% carries an uncertain prognosis. The maximum decrease in amplitude was registered on the 8th day on average; the range lay between the 4th and the 14th day. An exception to these figures was the delayed response of the CAP in the case of 6 patients, 5 of whom showed a maximum decrease during the 3rd week and the last patient as late as the 4th week following the onset of facial nerve paresis. Similar reliance can be placed on the prognostic value of the IAR. however, the decrease in the IAR is smaller than that of the CAP measured on the same potential in a right/left comparison, so that a decrease in the IAR of over 60% can already herald a poor recovery. Repeated determination of the latency in cases of facial nerve paralysis showed that the mean latency value for the entire group of patients was slightly prolonged at the end of the 1st week, but the latency values obtained in any one particular patient are of no prognostic significance. A comparison between CAP and latency values obtained with the opposite (i.e...

Action Potentials↗
PubMed1990

Bell's palsy: a facial nerve paralysis diagnosis of exclusion.

Bell's Palsy is not synonymous with facial nerve paralysis. While it is a common cause of facial nerve paralysis, it is a diagnosis of exclusion and other causes of facial nerve paralysis should be ruled out by appropriate evaluation and follow-up. A case report is presented of a patient with a facial nerve paralysis, which was initially diagnosed as Bell's Palsy, but which was found to be a poorly differentiated parotid malignancy causing facial nerve paralysis. A review and discussion of Bells Palsy, evaluation and treatment is presented.

Age Factors↗