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PubMed2006

[Facial paralysis: functional and aesthetic rehabilitation techniques].

The diagnosis of a permanent facial paralysis can be devastating to a patient, because of the cosmetic, functional and psychological disorders. Our society places on physical appearance and leads to isolation of patients who are embarrassed with their paralyzed face. The objectives of the facial rehabilitation is to correct the functional and cosmetic losses of the patient. The main functional goals are to protect the eye and reestablish oral competence. The primary cosmetic goals are to create balance and symmetry of the face at rest and to reestablish the coordinated movement of the facial musculature. The surgeon should be familiar with the variety of options available so that an individual plan can be developed based on each patient's clinical picture. History of the facial paralysis, its etiology and the duration of the paralysis are of particular interest as they orientate the rehabilitation plan strategy.

Esthetics↗
PubMed1990

[Facial paralysis in chronic nonspecific inflammation of the parotid].

Benign diseases of the parotid gland only rarely cause facial nerve paralysis. A parotid gland tumour with peripheral facial nerve paralysis is generally accepted as being malignant, although this rule is not without exceptions. We report a case of chronic non-specific parotitis with an inflammatory pseudotumour causing a peripheral paralysis of the ipsilateral facial nerve. Antiinflammatory and antibiotic treatment caused the complete remission of the parotitis and facial nerve palsy within 6 weeks.

Aged↗
PubMed1975

Effect of thymectomy on zoxazolamine paralysis and metabolism in untreated and (PCN) pregnenolone-16alpha-carbonitril- or ACTH-pretreated rats.

The effect of thymectomy on zoxazolamine paralysis and metabolism was investigated in young female untreated and PCN- or ACTH-pretreated rats. Thymectomy performed at least 24 hr before injection of zoxazolamine significantly prolonges paralysis time. Pretreatment with PCN (an inducer of hepatic microsomal enzymes) or ACTH (known to alter protein binding and excretion of zoxazolamine) shortened paralysis in thymectomized animals; but only in comparison to thymus ablated controls. The surgical intervention seemed to decrease the metabolism of zoxazolamine in the 9,000g supernatant fraction of the liver.

Adrenocorticotropic Hormone↗
PubMed2006

[Advances of studies on acupuncture and moxibustion for treatment of spastic paralysis after stroke].

OBJECTIVE: To introduce progresses of studies on acupuncture and moxibustion for treatment of spastic paralysis after stroke. METHODS: The literature about acupuncture and moxibustion for treatment of spastic paralysis after stroke in recent ten years were reviewed from the clinical and mechanism studies and so on. CONCLUSION: A great number of clinical and mechanism studies have proved that acupuncture and moxibustion therapy can relieve spastic paralysis after stroke, with better therapeutic effect, no side-effects, flexible selection of acupoints and more methods, but clinical and mechanism studies still need further to be improved and raised.

Acupuncture Therapy↗
PubMed2006

Co-existince of sickle cell disease and hemidiaphragm paralysis.

Sickle cell anemia is a disease caused by production of abnormal hemoglobin. Infection, acute splenic sequestration crisis, aplastic crises, acute chest syndrome, stroke, cholelithiasis, renal disease and pain are the major complications. Unilateral or bilateral diaphragm paralysis maybe seen following phrenic nerve injury and with a variety of motor-neuron diseases, myelopathies, neuropathies, and myopathies. Prominent right hemi-diaphragma elevation was observed on chest radiograph of a 14 years' old female patient with sickle cell disease. Her medical history yielded neither trauma nor intra-thoracic surgery. She didn't have either motor deficit or sensation disorder on any region of her body. Thorax CT yielded no lesion except the significantly elevated right diaphragm. Her cranial CT showed no lesion, too. Diagnosis of right hemidiaphragm paralysis was confirmed by positive Hitzenberg Sniff test on fluoroscopy. Although several pathophysiologic mechanisms are known to be involved and lead to central neurologic complications in sickle cell disease, involvement of peripheric nerves have not been reported. Here we present a 14 years' old female patient with sickle cell anemia and unilateral diaphragm paralysis, co-existence of which have not been reported so far.

Adolescent↗
PubMed2006

Exercise test in the inter-attack period of thyrotoxic periodic paralysis: a useful diagnostic tool.

Exercise test was reported to be useful for some patients with periodic paralysis. We report here the results of exercise test in three cases of thyrotoxic periodic paralysis, for whom the exercise test was all positive. Exercise test could be one of the diagnostic tools in the "inter-attack" state of the probable cases with thyrotoxic periodic paralysis. However, the case number of this study is small and larger-scale studies may be warranted in the future.

Action Potentials↗
PubMedDate not supplied

[Peripheral facial paralysis and HIV infection].

Two cases of peripheral facial paralysis associated with infection by the human immunodeficiency virus in young intravenous drug abuser patients are reported. One patient manifested AIDS-related complex (ARC) and the other fulfilled the Center for Disease Control (CDC) criteria for AIDS. Clinical symptoms and signs occurred as facial paralysis and headache. One patient presented progressive motor slowing and the computerized tomography (CT) of the brain showed a wide hypodense lesion in the left temporal-anterior region and the involvement of the left basal ganglia. In this patient the impairment of the facial nerve was associated with a HIV-related encephalitis. In the second patient the CT did not show cerebral lesions and the etiology of the paralysis was unknown.

AIDS Dementia Complex↗
PubMed1991

Carbon dioxide laser cordectomy in the management of bilateral vocal cord paralysis.

Bilateral vocal cord paralysis is a rare but major complication of thyroid surgery. Since 1983, patients with bilateral cord paralysis have been managed in this department using the carbon dioxide laser. Six patients with bilateral cord paralysis secondary to thyroid surgery underwent partial cordectomy and arytenoidectomy. Two patients were operated on with tracheostomy tubes in situ, and both were successfully decannulated. In the remaining four patients, ventilation was maintained during anaesthesia using a Venturi jet ventilation system. None of these patients required a perioperative tracheostomy. Adequate airway improvement and satisfactory voice quality were achieved. Follow-up ranged from 6 to 17 months.

Adult↗
PubMed1991

[Congenital bilateral abducens paralysis and facial diplegia. The Moebius syndrome].

The patient, 9 years old, presents bilateral congenital paralysis of the facial, disability of the ocular globes abduction, facial cutanate atrophy and partial paralysis of hypoglos, syndrome manifestations that are framed in the disease described by Moebius. The patient also presents epicanthus, hiperthlorysm, atresia of the tear points. The disease is caused by some teratogenic factors which act between the fourth and the seventh week of the intrauterine life with the atresia of the sixth and seventh nucleus and partially of the ninth nucleus as well as of the supranuclear way from the proximity of these nucleus. The variety of the clinical manifestations can be explained through the affectation of the different nervous structures during the embryogenesis, but the congenital paralysis of the abduction and the facial diplegia are the most important manifestations of the syndrome.

Abducens Nerve↗
PubMed1991

Pyogenic vertebral osteomyelitis with paralysis. Prognosis and treatment.

In the interval between 1983 and 1988, 14 patients were treated for pyogenic spondylitis complicated by neurologic compromise. There were nine males and five females aged 39-80 years. The average time between onset of symptoms and diagnosis was 2.8 months. Predisposing factors were diabetes mellitus in four patients and urinary tract infections in five patients. The infection was blood borne in all 14 patients. In two patients, the infection was superimposed on a recent vertebral fracture. The cervical spine was involved in one patient; the thoracic spine in seven; and the lumbar spine in six patients. Six patients presented with a Frankel B paralysis, six with a Frankel C paralysis, and two with grade D paralysis. The neurologic symptoms lasted between one day and six weeks before surgery. Twelve patients had anterolateral decompression. Two of the 12 patients had a second stage posterior stabilization. Two patients were deemed inoperable. All surviving patients were managed by parenteral antibiotics for three to six weeks followed by enteral route for a total of three to six months. All 12 operated patients had a significant neurologic improvement (one grade or more on the Frankel scale) with solid interbody fusion.

Adult↗
PubMed1976

[Facial paralysis with inverse autonomic-voluntary dissociation from a frontal lesion. Cortical origin. Relation to supplementary motor area].

As a result of 6 cases of frontal tumour presenting central facial paralysis with inverse dissociation this symptom was investigated in patients subjected to cortical excisions for intractable epielpsy. A study of 8 cases of frontal cortical excision, 6 of them affecting the internal and posterior portion, and two the prefrontal region, has provided evidence of a link between inverse automatic-voluntary dissociation facial paralysis and lesions affecting the Penfield supplementary motor area. In such cases, facial palsy is usually associated with motor disorders in the limbs, the most characteristic of which is unilateral motor under-utilisation. The possibility of inverse dissociated facial paralysis occurring as a result of a rostral premotor lesion cannot be ruled out in our present state of knowledge.

Aged↗
PubMed1990

Lymphokine release as measurement of anti-mouse hepatitis virus type 3 (MHV3) cellular reactions in various mouse lines exhibiting differential susceptibilities to MHV3-induced paralysis.

We found that susceptibility to Murine Hepatitis Virus, type 3 (MHV3)-induced paralysis is controlled by genes of the H-2 complex. In this article, we compared MHV3 antigen specific cellular reactions, in congenic mice harbouring different H-2 genes (or gene). In a first set of experiments, paralysis susceptible (B10.A x A/J)F1, partly susceptible (B10.AQR x A/J)F1 and resistant (B10.Q x A/J)F1 hybrids were infected with live MHV3. Three weeks or more post-infection (p. i.), the spleens and peritoneal exudate (PE) cells from the mice were put into culture. Killed MHV3 was added to cultures, and antigen specific lymphokine production and utilization were measured: IL-1 production by PE cells after 24 hr in culture, IL-2 production by splenocytes after 24 hr in culture, IL-2 utilization (as appraised by splenocyte proliferation) after 96 hr in culture. No clearcut difference, resulting from genetic disparity, could be observed in the antigen-specific responses. In a second set of experiments, mice were primed with ultra-violet radiation killed MHV3. In that case, increases of IL-1 production by PE cells, of IL-2 production by splenocytes and splenocyte proliferation were always observed, compared to PE cells and splenocytes from non-primed (control) donor mice. However, in latter case, addition of MHV3 antigen to cultures did not result in augmentation of antigen specific IL-2 production and utilization. Here again, no genetic effect was observed. We conclude from these results that MHV3 infection elicited strong lymphokine responses, but that antigen-specific IL-1 and IL-2 production did not correlate with the susceptibility to MHV3-induced paralysis.

Animals↗
PubMed1991

[Measurement and clinical using of motor conduction latency time and motor conduction latency rate of facial nerve in health subjects and facial paralysis patients].

The motor conduction latency time (MCLT) and rate (MCLR) of facial nerve in 70 cases of health subjects and 60 cases of facial paralysis patients were measured using evoke EMG. The results showed that MCLT is below 4 ms and MCLR is above 25 m/sec in 70 cases of health subjects, while the MCLT is above 4 ms and MCLR is below 25 m/sec in 60 cases of facial paralysis patients. We have observed the difference of MCLR and MCLR on different age groups in health subjects. The results showed that MCLT is prolonged gradually and MCLR is gradual reduced after 50 years old groups. But the MCLT does not exceed 4 ms and MCLR is not slower than 25 m/sec. The results of this studies suggested that if MCLT is above 4 ms, and MCLR is below 25 m/sec, it is a index of facial nerve paralysis.

Adolescent↗
PubMed1991

[Evaluation of cardiac function during KCl-induced paralytic attack in the patients with normokalemic periodic paralysis].

Some reports have been written about hypokalemic periodic paralysis dealing with cardiac dysfunction and arrhythmia during the paralytic attack. However, no reports have been written about the cardiac function during the attack in cases of normokalemic periodic paralysis. So, we investigated cardiac function in two patients with normokalemic periodic paralysis. A 3.0 g dose of KCl was administered orally to the patients (1 male, 1 female) and 10 healthy volunteers (5 males, 5 females). Cardiac function by using ejection time (ET)/pre-ejection period (PEP), grasping power, and the level of plasma catecholamine were measured during the paralytic attack. Changes in the patients were compared with those in the volunteers. Next, a 3.0 g dose of KCl was administered to the patient, followed by intravenous dosing of 10% NaCl (50 ml) after which ET/PEP and grasping power measured. Lastly, a 60 mg dose of diltiazem, a 10 mg dose of nifedipine or a 80 mg dose of verapamil were administered, followed by a 3.0 g dose of KCl after which ET/PEP and grasping power were measured again. Thirty minutes after the administration of KCl, the grasping power decreased remarkably, from 32.0 kg to 17.0 kg in the male patient and from 30.0 kg to 20.0 kg in the female patient. By contrast, the ET/PEP showed a clear increase, from 3.47 to 6.17 in the male patient and from 2.84 to 5.45 in the female patient. Grasping power of the volunteers, however, did not change remarkably (avg. 40.3 kg before vs. 40.9 kg after in the males and avg. 26.9 kg before vs. 26.0 kg after in the females) and ET/PEP of the volunteers did not change remarkably (avg. 3.37 before vs. 3.17 after in the males and avg. 3.30 before vs. 3.43 after in the females). No significant changes were found in the levels of plasma catecholamine during the paralytic attack.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

[For a better diagnostic strategy in idiopathic diaphragmatic paralysis].

The authors report a case of right-sided paralysis of the diaphragm which revealed a lung cancer extending to the mediastinum and involving the right phrenic nerve. This case underlines the limitations of thoracic imaging in case of phrenic nerve paralysis. It also demonstrates the value of early exploratory thoracotomy in all patients with allegedly "idiopathic" unilateral phrenic nerve paralysis.

Echocardiography↗
PubMed1990

Ophthalmic surgical management of facial paralysis.

Combinations of these procedures have been performed on more than 50 patients to date, with the longest follow-up being greater than 8 years. All of these patients presented with complaints of ocular irritation, tearing, photophobia, and impaired vision. Several had severe epithelial keratopathy. Some patients have also been treated following neurosurgical procedures which caused paralysis of the fifth and seventh cranial nerves, resulting in both corneal anesthesia and facial paralysis. Patients have done very well after these procedures and have achieved ocular comfort, reduced tearing, and corneal protection without the need for disfiguring and visually occluding tarsorrhaphies or other procedures. In some instances, they may still require artificial tears during the day or a lubricating protective ointment for the eye at bedtime. There have been no significant complications in this series; no cases of gold weight extrusion, recurrent ectropion, or persistent corneal epithelial keratopathy. Some patients have complained of continued excessive tearing which is most likely due to paralysis of the lacrimal pump, resulting in ineffective tear drainage to the nasal lacrimal duct. However, these patients have still noted markedly reduced tearing compared to their preoperative condition. One patient underwent secondary release of her medial canthoplasty following return of facial nerve function.(ABSTRACT TRUNCATED AT 250 WORDS)

Eyelid Diseases↗
PubMed1990

A pseudo-malignant Warthin's tumor presenting with facial nerve paralysis.

Facial nerve paralysis, in association with a parotid mass, is generally considered pathognomonic of malignancy. However, nine cases of paralysis with benign tumors have been reported: four in association with a pleomorphic adenoma, three with a Warthin's tumor and one with an oncocytoma. The details of these cases are described and an additional case of Warthin's tumor causing a facial paralysis is reported. In all four cases of Warthin's tumor the pathology is similar, with inflammation, fibrosis and necrosis, especially in areas surrounding branches of the facial nerve. In view of the 10 cases reviewed herein, it is suggested that the pathology be confirmed at the time of surgery and every effort made to preserve facial nerve function.

Adenolymphoma↗
PubMed1990

Hyperthyroid hypokalemic periodic paralysis in a Hispanic male.

A case of hyperthyroid periodic paralysis in a Hispanic male is reported, the disorder in this race being described only once before. He presented with complete paralysis below the neck, and his admission potassium of 1.3 mEq/L is the lowest reported in the literature. Correction of the hypokalemia resolved his symptoms. Radionuclide imaging and thyroid function tests revealed the presence of hyperthyroidism which was managed medically. The pathophysiology of hyperthyroid hypokalemic periodic paralysis is discussed.

Adult↗