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At least 1,243 records · Page 69Linked to original sources
PubMed1994

Validation of esophageal pressure occlusion test after paralysis.

Measurements of respiratory mechanics are frequently made in ventilated infants and children. Esophageal pressure measurements (Pes) using a balloon on a catheter have been used to partition the respiratory mechanics into lung and chest wall components. Appropriate positioning of this balloon is crucial to obtain accurate estimates of pleural pressure. Traditionally, in spontaneously breathing subjects the balloon position is assessed with an occlusion test. In ventilated subjects, it is not always possible to perform an occlusion test prior to paralysis, and even if such a test is performed it may be relevant under conditions of positive pressure ventilation. By occluding the airway opening and applying gentle pressure to the abdomen or rib cage, positive swings in pressure can be measured by both Pes and airway opening pressure (Pao). We compared traditional occlusion tests measured in 16 spontaneously breathing puppies to the positive pressure occlusion test performed after paralysis. In 2 pups we were unable to obtain a reasonable traditional occlusion test (> 15% difference between Pes and Pao) but we obtained 10 traditional occlusion tests in each of the remaining 14 pups (2.1-14 kg). In 11 of these animals delta Pes was within 10% of delta Pao. This compared well to positive pressure occlusion test using abdominal pressure performed after analysis, where delta Pes was within 10% of delta Pao in 10 animals. In 9 of these pups occlusion tests were also performed by applying pressure on the rib cage, where delta Pes was within 10% of delta Pao in 6 animals.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1999

Acute lower extremity paralysis following radiation therapy for cervical cancer.

BACKGROUND: Acute lower extremity paralysis secondary to lumbosacral plexopathy is a rare but severe complication that may follow pelvic radiotherapy for cervical cancer. CASE: A 49-year-old female with newly diagnosed stage IIIB cervical cancer developed progressive bilateral lower extremity paralysis and pelvic pain only 10 weeks following completion of radiation therapy for cervical cancer with no evidence of metastasis or progression of disease. Her bladder and bowel function were not affected. Following extensive workup, the most likely etiology was presumed radiation-induced lumbosacral plexopathy. CONCLUSION: Although metastatic carcinoma is more commonly the reason for progressive lower extremity weakness with pelvic pain in women with advanced cervical cancer, radiation-induced lumbosacral plexopathy, a rare but devastating complication, may be the cause. Diagnosis is by exclusion.

Acute Disease↗
PubMed1995

An evaluation of strategic and threshold control measures against the Karoo paralysis tick, Ixodes rubicundus (Acari: Ixodidae) in South Africa.

Paralysis caused by feeding female Ixodes rubicundus ticks is a major problem in large areas of South Africa. As the life cycle of the tick extends over a period of 2 years, it was hypothesized that strategic treatment of sheep with an acaricide over a 2 year period, timed to kill most engorging females, should markedly lower the biotic potential of the tick. Two flocks of sheep grazing in separate paddocks known to be infested with I. rubicundus were treated either strategically or on a threshold basis (i.e. only when tick challenge exceeded a predetermined critical level in terms of paralysis) for a 2 year period. The tick burdens of untreated control sheep running with the two flocks were monitored over a 4 year period and their seasonal dynamics determined. The times at which peak infestations occurred were similar for both flocks of sheep, but significant differences in mean tick burdens between the two flocks were recorded. Tick numbers on sheep in the strategically treated flock did not decrease during the third and fourth years of the trial as was expected. Possible reasons for this were low stocking densities, especially during times of peak abundance of adults and the presence of wild hosts which maintained tick populations.

Animals↗
PubMed1996

Herpes simplex virus type I reactivation as a cause of a unilateral temporary paralysis of the vagus nerve.

Infection by neurotropic viruses, as exemplified by the herpes family, is universally accepted as a cause of palsies of the cochleo-vestibular and facial nerve. Palsies of the vagus nerve with a possible viral etiology have been described, although viruses have been identified in only a few selected cases. We report a 52-year-old man with unilateral otalgia, hoarseness and dysphagia. Examination revealed unilateral (left-sided) pharyngeal dysfunction, and paralysis of the left vocal cord fixed in the paramedian position. A barium swallow documented dysfunction of the left pharyngeal constrictor muscles. These findings suggested the lesion to be located either at the inferior ganglion of the vagus nerve or cranially. At direct laryngoscopy a smear was obtained from a 4-mm mucosal ulcer at the region of the left arytenoid cartilage. This smear demonstrated antibodies to herpes simplex virus (HSV) type I by immunofluorescence. On follow-up 19 months after the initial infection there was complete remission of the paralysis of the left vocal cord and normal pharyngeal function. The demonstration of HSV type 1 antibodies from a mucosal lesion in the distribution of the superior laryngeal nerve suggests that reactivation of HSV type I was the most likely explanation for the temporary nerve palsy seen.

Antibodies, Viral↗
PubMed1990

Otogenic facial paralysis. A histopathological study.

The histopathological changes of the facial canal and nerve in facial paralysis due to chronic suppurative otitis madia are described in six temporal bones. Bony destruction of the facial canal was found in its tympanic segment and in its upper mastoid part in all cases, but it was particularly notable in the labyrinthine segment as well. The pathological process, cholesteatoma or granulation tissue surrounding the exposed facial nerve was inflamed in all cases. The affected facial nerve showed degenerative and inflammatory changes throughout its tympanic segment in all cases, but its mastoid segment appeared to be relatively normal. Our findings suggest that facial paralysis occurs us chronic suppurative otitis when the inflammatory process specifically involves the facial nerve trunk.

Chronic Disease↗
PubMed1990

Neuropathy of the facial nerve in chronic otitis media without associated facial paralysis. A human temporal bone study.

In the present study we examined whether pathologic changes can exist in the facial nerve in chronic otitis media (COM) when facial nerve function is clinically normal. In so doing, 20 human temporal bones were examined. Each case had a premortem history of COM without facial paralysis. Nine normal temporal bones were also studied. Signs of degenerative neuropathy involving the facial nerve were found in 2 out of the 20 cases studied. In the first of these 2 cases the tympanic segment of the facial nerve showed focal areas of demyelinization, as well as hypertrophy and proliferation of the Schwann cells but without loss of the axons. These areas were also occasionally associated with increased numbers of mast cells. In the second case the most striking finding was the presence of small dark globules in the mastoid segment of the facial nerve. These formations were assumed to be products of cellular and myelin degeneration. Our studies suggest that COM may be associated with degenerative changes in the facial nerve without clinical impairment of its function. Nonetheless these changes may have the potential for the development of facial paralysis during COM.

Aged↗
PubMed1984

The aetiological relationship between congenital torticollis and obstetrical paralysis.

A statistical study was done to determine the incidence of congenital torticollis. The aetiological relationship between torticollis and obstetrical paralysis was analysed in an attempt to clarify the possible cause of torticollis. There were forty-three cases of torticollis in the 2,160 babies delivered at the Otsu Red Cross Hospital from 1978 to 1981. The overall incidence of torticollis was 1.9%; 1.2% in cephalic presentations, 6.5% in double breech presentations, 4.2% in footling presentations and 34.0% in single (frank) breech presentations. In addition, forty-three cases of obstetrical paralysis treated in Kyoto University Hospital from 1961 to 1981 were reviewed. Torticollis was found in 26% of the cephalic presentations (6 out of 23) and in 80% of the breech presentations (16 out of 20) respectively. These findings suggest that a foetal posture with both the knees and the cervical spine extended seems to be closely related to the development of torticollis, which indicates that a direct cause may be stretching of the sternocleidomastoid muscle during delivery.

Breech Presentation↗
PubMed1992

Muscle pathology correlates with permanent weakness in hypokalemic periodic paralysis: a case report.

We present a morphological follow-up in a case of familial hypokalemic periodic paralysis with progressive weakness. At age 12 years muscle biopsy revealed mild vacuolar changes. Seventeen years later, after the patient had developed permanent weakness, light and electron microscopy disclosed tubular aggregates in about 15% of the fibers and medium-grade myopathic alterations. We describe correlation of muscle pathology with permanent weakness in hypokalemic periodic paralysis.

Child↗
PubMed1989

Peripheral facial paralysis and HIV infection: report of four African cases and review of the literature.

Four cases of infranuclear facial palsy associated with infection by the human immunodeficiency virus in young heterosexual African patients are reported. Two cases were healthy HIV carriers, one patient manifested AIDS-related complex, and one case fulfilled the CDC criteria for AIDS. Two patients had a typical Bell's palsy, one presented with manifest cephalic Herpes zoster infection and one, who suffered from facial diplegia, could be considered to have a cephalic form of Guillain-Barré syndrome. A review of the literature confirmed that peripheral facial palsy can occur at any stage of HIV infection and in various clinical contexts. In stages I and II of the HIV infection, patients may develop either Bell's palsy or Guillain-Barré syndrome. In stages III and IV, when the cellular immunity has begun to decline, Herpes zoster-related facial paralysis, seventh cranial nerve involvement secondary to meningeal lymphomatosis, and peripheral facial paralysis as one aspect of widespread chronic peripheral neuropathy may also occur.

Acquired Immunodeficiency Syndrome↗
PubMed1984

Malignant parotid gland tumors and facial nerve paralysis.

During the last three decades, 586 cases of parotid gland tumor have been extirpated in our clinic. The tumors were malignant in 170 cases and, of these, facial nerve paralysis was observed at first examination in 59 patients. This paper deals with the retrospective study of these cases and is chiefly concerned with the histological types and facial nerve paralysis.

Facial Paralysis↗
PubMed1986

Effects of botulinum toxin induced muscle paralysis on endocytosis and lysosomal enzyme activities in mouse skeletal muscle.

The effects of botulinum toxin (type A) induced muscle paralysis on endocytosis and lysosomal enzyme activities in skeletal muscle were compared with the effects of surgical denervation. Muscle atrophy, measured as decrease in total muscle protein content, was as large or larger after botulinum toxin treatment as after denervation. Endocytic activity, measured as the in vitro uptake of horseradish peroxidase, and the specific activities of the lysosomal enzymes N-acetyl-beta-D-glucosaminidase and cathepsin D were all increased six days after denervation. Only the specific activity of cathepsin D was increased six days after botulinum toxin poisoning. The uptake of horseradish peroxidase and the specific activity of N-acetyl-beta-D-glucosaminidase were also increased eleven days after poisoning. Transverse sections of eleven days botulinum poisoned muscles from animals injected with horseradish peroxidase showed fibres with dense peroxidase staining similar to those seen in denervated muscle although they seemed to occur less frequently. The results show that increases in endocytic activity and lysosomal enzyme activities may occur in skeletal muscle without the presence of degenerating axons. The differences in effects of surgical denervation and botulinum toxin induced paralysis are discussed in terms of what is known about the mechanism of action of botulinum toxin and the possible functional roles of the two lysosomal enzymes studied.

Animals↗
PubMed1990

Pseudoaneurysm of the cervical internal carotid artery with associated hypoglossal nerve paralysis. Demonstration by CT and angiography.

A case of pseudoaneurysm of the cervical internal carotid artery with associated hypoglossal nerve paralysis resulting from trauma is presented. CT and angiographic manifestations of this pseudoaneurysm and the resulting hypoglossal nerve paralysis are discussed. Correlative CT and angiographic findings of this association have not previously been described in the literature.

Carotid Artery Diseases↗
PubMed1988

Marek's disease virus-induced transient paralysis in chickens: electron microscopic lesions.

A study was made to determine the causative lesion of Marek's disease virus (MDV)-induced transient paralysis (TP) in chickens by comparing the ultrastructure of brain tissue from MDV-infected genetically susceptible and resistant birds. There were numerous intramyelinic vacuoles in the brains of TP-affected birds. Many of these vacuoles contained particulate material compatible with precipitated protein from edema. Astrocyte processes often were distended with similar particulate material. Most intramyelinic vacuoles were either adjacent to the axolemma or within inner myelin lamellae. Myelin sheaths of affected axons, while being displaced, were relatively normal with no vesiculation. Most affected axons were also otherwise normal. Cell processes adjacent to occasional affected axons were distended by degenerating mitochondria, vacuoles, and amorphous material. Some of these processes appeared to be inner loops of oligodendrocyte cytoplasm. The cell bodies of most oligodendrocytes were normal, but a few contained vacuoles similar to those seen in processes adjacent to axons. There were scattered necrotic cells. While most of these could not be specifically identified, some appeared to be oligodendrocytes. Mononuclear inflammatory cells were present both perivascularly and within the parenchyma. Although these cells occasionally contacted myelinated axons and there was myelin phagocytosis, there was no indication that they initiated demyelination. Brain tissue from virus-inoculated resistant birds had perivascular aggregates of mononuclear cells, but there were no intramyelinic vacuoles and few necrotic cells. These findings suggest that intramyelinic vacuolation contributes to the pathogenesis of transient paralysis. Potential pathophysiological mechanisms contributing to the vacuoles, including brain edema and oligodendrocyte injury, are discussed.

Animals↗
PubMed1983

Marek's disease virus-induced transient paralysis: a comparison of lesions in susceptible and resistant lines of chickens.

A study was conducted to determine the causative lesion of Marek's disease virus-induced transient paralysis. Brain histologic lesions were quantitated and compared in genetically resistant and susceptible inbred chickens. Comparisons were made 11 days post inoculation (PI) of virus when clinical signs were evident in susceptible birds and on day 17 PI when these signs had remitted. Clinically-affected birds from the susceptible line on day 11 PI had consistent evidence of neuropil vacuolation compatible with brain edema; two of these birds also had vasculitis. These lesions were absent in both clinically-recovered birds from this line evaluated on day 17 PI and genetically resistant birds studied on day 11 PI. Our findings suggest that the causative lesion of transient paralysis is vasogenic brain edema.

Animals↗
PubMed1998

Hypokalemic thyrotoxic paralysis: a rare cause of tetraparesis with acute onset in Europeans.

We describe a 21-year-old Italian male affected by hypokalemic tetraparesis with acute onset. In the emergency ward, the patient was agitated, with tachycardia (140/min) and systolic hypertension (180/70 mm Hg). He was not able to flex the lower extremities against a light resistance and furthermore, he was hypotonic and without tendon reflexes. One hour later he developed strength deficit of the upper extremities as well. Biochemical analyses revealed severe hypopotassemia (2.1 meg/l). After administration of 140 meq potassium phosphate, the patient began to improve, and 12 h after the onset he was able to walk normally. Successive investigations documented an undiagnosed case of Graves' disease. Thyrotoxic hypokalemic paralysis has been observed almost only in Asians, however, with this case and others reported, we believe that it should be considered as a cause of muscular paralysis also in Caucasians.

Acute Disease↗
PubMed1992

Electromyographic feedback in the treatment of bilateral facial paralysis: a case study.

Electromyographic feedback in the treatment of facial paralysis has been shown to be a useful alternative to surgical procedures. In this paper we report on the partial recovery of a 7-year-old patient with congenital bilateral facial paralysis (Moebius syndrome) that had been considered untreatable by medical specialists. Biofeedback of electromyographic activity was provided together with specific instructions, social reinforcement, and exercises that the patient carried out at home. The rehabilitation training lasted 1 year, during which there was a substantial increase in the electromyographic activity of the muscles on both sides of the face. A follow-up after 1 year of discontinuing the treatment showed that the muscle activity had been maintained and that there was a marked improvement in the patient's mood and facial expression.

Abducens Nerve↗
PubMed1991

Spatial distribution of the Karoo paralysis tick Ixodes rubicundus (Acari: Ixodidae) within a false upper Karoo veld type.

Spatial distribution of the Karoo paralysis tick (Ixodes rubicundus) has been studied in a paralysis enzootic area of the southwestern Orange Free State. Significantly more females than males were collected from the vegetation. Most ticks (99%) used grass as questing sites at a height of approximately 45 cm (range 10-97 cm), which correlates with the size of host animals. No significant differences between the questing height of male and female ticks were evident. The ticks were found on most of the grass species present and, except for the genus Eragrostis, no specific preference was evident. When questing, the capitulum of I. rubicundus is usually (90%) directed towards the ground. Seventy-eight percent of the ticks occurred singly on a specific grassblade or flowerhead. In those cases where two ticks occurred together, no sexual aggregation was evident. Most ticks occurred under or close (mean = 62 cm) to the crown cover of specific shrub or tree species. These plant species were characterized by a dense crown cover with a mat of decaying leaf litter underneath. The preference of the tick for wild olive trees (Olea europaea africana) suggests that, except for the physical characteristics of this tree species, host factors may also be important. Significantly more ticks were distributed on the cooler, more protected southern sides of vegetation in comparison to the northern sides.

Animals↗
PubMed1994

Orbicular synkinesis after facial paralysis: treatment with botulinum toxin.

Involuntary lid closure not rarely accompanies aberrant regeneration of nerve fibers after different types of facial paralysis. 23 patients with such synkinesis were treated with botulinum toxin injections into the orbicularis oculi muscle. After periocular injections all patients showed much improvement: a period of, on the average, 13 symptom-free weeks was followed by a period of minimal symptoms. There were only minor complications. Whenever repeated treatment is necessary, botulinum toxin proves to be an effective therapy for involuntary lid closure after defective healing following facial paralysis.

Adult↗