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At least 1,423 records · Page 79Linked to original sources
PubMed2006

Improved preservation of hearing and facial nerve function in vestibular schwannoma surgery via the retrosigmoid approach in a series of 200 patients.

OBJECT: The aim of this study was to evaluate and present the results of current surgical treatment of vestibular schwannomas (VSs) and to report the refinements in the operative technique. METHODS: The authors performed a retrospective study of 200 consecutive patients who had undergone VS surgery over a 3-year period. Patient records, operative reports, follow-up data, and neuroradiological findings were analyzed. The main outcome measures were magnetic resonance imaging, neurological status, patient complaints, and surgical complications. Complete tumor removal was achieved in 98% of patients. Anatomical preservation of the facial nerve was possible in 98.5% of patients. In patients treated for tumors with extension Classes T1, T2, and T3, the rate of facial nerve preservation was 100%. By the last follow-up examination, excellent or good facial nerve function had been achieved in 81% of the cases. By at least 1 year postsurgery, no patients had total facial palsy. In the patients with preserved hearing, the rate of anatomical preservation of the cochlear nerve was 84%. The overall rate of functional hearing preservation was 51%. There was no surgery-related permanent morbidity in this series of patients. Cerebrospinal fluid leakage was diagnosed in 2% of the patients. The mortality rate was 0%. CONCLUSIONS: The goal of VS treatment should be total removal in one stage and preservation of neurological function, as they determine a patient's quality of life. This goal can be safely and successfully achieved using the retrosigmoid approach.

Adolescent↗
PubMedDate not supplied

Unilateral blepharoptosis with synkinetic movements of the eyelids on horizontal gaze.

A 17-year-old woman with a left congenital ptosis and an alternating esotropia is presented. During horizontal gaze to the right and left, the eyelid of the abducting eye elevated and the eyelid of the adducting eye lowered. There were no synkinetic eyelid movements with contraction of the pterygoid, sternocleidomastoid, or facial muscles. Synkinetic eyelid movements due to aberrant regeneration were unlikely due to absence of previous third nerve palsy. A supranuclear innervational abnormality is proposed to explain the clinical findings.

Abducens Nerve↗
PubMed1989

[Sequelae and transient sequelae-like symptoms in Bell's palsy].

Four symptoms of sequelae of Bell's palsy, such as abnormal synkinesis, facial spasm, contracture, and crocodile's tear were examined with 351 patients with Bell's palsy. As a result, it was seen transient sequelae-like symptoms which disappeared in recovery process. These 4 symptoms were divided into the persistent symptoms which persisted or appeared (sequelae) after 6 months from onset and the transient sequelae-like symptoms which disappeared before 6 months from onset (transient symptoms). The relation between the sequelae and the transient symptoms were examined. Transient facial spasm were shown only in mild cases with early cure, and it was deemed that these had no relation to sequelae. Other transient symptoms were shown in the cases with moderate and severe palsy, and it was deemed that these had a close relation to sequelae. The incidence of sequelae was 19%, and that of transient symptoms was 23%. Therefore, in order to discuss the actual behavior of the sequelae, it is important to investigate the sequelae with rejection of transient symptoms.

Adult↗
PubMed1989

[Prognostication of sequelae in Bell's palsy].

Four symptoms of sequelae (abnormal synkinesis, facial spasm, contracture, and crocodile's tear) which persisted or appeared after 6 months from onset were examined with 351 patients with Bell's palsy. The incidence of sequelae were 2% in the group having score (May-Hosomi's modified method, 90 points method) over 40 points within 1 months after onset. Other hand, the incidence of sequelae were 15% in the group having score under 40 points at 1 weeks from onset, 30% in the group having score under 40 points at 2 weeks, 57% in the group having score under 40 points at 3 weeks, and 76% in the group having score under 40 points at 1 month. From these findings, it was seen that the prognostication with a high accuracy was possible by the score.

Adolescent↗
PubMed1991

[A study on auditory disturbances after microvascular decompression for hemifacial spasm].

After establishing an operation of microvascular decompression by Jannetta in 1975, an improvement rate of hemifacial spasm have increased. However, postoperative hearing deficits, equilibrium disturbances and facial paresis have been described in some publications. Fifty-seven of 119 patients with hemifacial spasm operated from 1982 to 1989, were examined by audiometry before and after operation. In patients with tinnitus at the time of facial spasm and closing eyelids, tinnitus improved almost in many cases. Of 57 patients, 8 (5 with sensorineural hearing loss, 3 with conductive hearing loss) had postoperative hearing impairments in operated ears, and 7 (7 with sensorineural hearing loss) had in the other ears, too. Of 7 patients having sensorineural hearing loss observed for several months, 4 having slight sensorineural hearing loss recovered at the same hearing level before operation. In 2 patients having profound sensorineural hearing loss, however, hearing improvement did not observed in each case.

Adult↗
PubMed1994

[Computerized analysis of facial motions--objective evaluation of facial palsy].

The severity of facial palsy is often diagnosed using a scoring system. However, there have been some problems as to the objectivity and reproducibility of evaluations by this method. To solve these problems, a variety of new methods have been introduced. Compared to the simple scoring method, none of these methods seem to have gained wide-spread application in routine clinical practice. The development of our diagnostic system was inspired by the idea that numerical quantitation of shifting of marks on the face might be possible by means of digital image-processing. Using this method, only marks adhering to the face are extracted, and the shifting position of these marks is quantitatively analyzed. Detailed analysis of the facial movement requires full motion video images. We found that such video images were easily obtainable by application of a Quick Time Movie developed by Apple computer. Twelve healthy subjects served as normal controls. Seven patients were analysed as cases of facial palsy. The facial movements examined in this study consisted of eye-closing and whistling. A total of 20 black marks were used for adherence to the face. The image processing called thresholding leaves only black marks on the face and has made it possible to trace and measure these marks on the face. The shifting positions of the marks moving in accordance with facial movement, from the stationary phase until the maximum stage, were measured and traces were plotted on the coordinate axis. The shifting of the marks adhering to the face was numerically expressed as a trajectory investigation.(ABSTRACT TRUNCATED AT 250 WORDS)

Facial Muscles↗
PubMed1994

Etiology and management of facial palsy.

Palsy of the facial nerve can result in severe debilitation. The physical disfigurement has a disastrous effect on self-image. Asymmetry of facial expression, drooling, and difficulty with speech may occur. Additionally, impaired closure of the eye can result in exposure of the cornea with not only discomfort, but also loss of vision. If the nerve injury is proximal, loss of salivation, lacrimation, and changes in taste can occur. Clearly, an understanding of facial palsy and a framework for management are needed by the clinician who encounters this condition. The recent literature is surveyed for various causes of seventh nerve palsy and for therapeutic modalities available to the physician.

Facial Expression↗
PubMedDate not supplied

[Decreased blink frequency in myotonic dystrophy].

We counted spontaneous eye blink rate in 11 myotonic dystrophy (MD) patients. Seven healthy subjects as well as 10 Parkinson disease (PD) and 7 facio-scapulo-humeral dystrophy (FSH) patients were used as controls. Blink frequency was significantly decreased in MD and PD patients (7.6 +/- 4.9/min in average and 11.0 +/- 7.5/min, respectively), compared with healthy subjects and FSH patients (17.5 +/- 4.3/min and 17.3 +/- 9.9/min, respectively). Normal blink frequency in FSH suggests that the facial muscle weakness is not responsible for decreased blink frequency in MD. This observation is compatible with prolonged R1 latency in blink reflex in MD, suggesting a dysfunction of central mechanism of blink control system as in the case of PD, although there remains a possibility that the myotonia in levator palpebrae muscles disturbs blinking.

Adolescent↗
PubMed1999

[Surgical removal of large cavernous angioma in the pontomedullary junction: a case report].

Recent advances in neuroradiology have enabled us to approach cavernous angioma in the brain stem. A case of large cavernous angioma, which was located in the pontomedullary junction, was removed surgically. A 24-year-old female was admitted with occipitalgia, dizziness, nausea, gait disturbance. On neurologic examination, the patient had right hemiparesis, slight right facial palsy and paresthesia, right hemiparesthesia, dysphagia. T1 weighted Gd enhanced MRI revealed a mixed intensity lesion. These findings were thought to be consistent with a cavernous angioma. Follow up MRI findings demonstrated progressive increase in cavernous angioma. Vertebral angiograms showed a mass sign and a venous angioma in the midline of the pontomedullary junction. Therefore, the operation was performed in an attempt to remove the cavernous angioma through the midline of the fouth ventricle. The operation was performed under monitoring of electromyogram of facial muscle and external ocular muscle. The cavernous angioma was removed totally, and addition neurogical deficits were minimal.

Adult↗
PubMed1999

Emotion processing in three systems: the medium and the message.

In the context of picture viewing, consistent and specific relationships have been found between two emotion dimensions (valence and arousal) and self-report, physiological and overt behavioral responses. Relationships between stimulus content and the emotion-response profile can also be modulated by the formal properties of stimulus presentation such as screen size. The present experiment explored the impact of another presentation attribute, stimulus motion, on the perceived quality of the induced emotion and on its associated physiological response pattern. Using a within-subject design, moving and still versions of emotion-eliciting stimuli were shown to 35 subjects while facial muscle, heart rate, skin conductance, and emotion self-reports were monitored. The impact of motion was dramatic. Self-report and physiological data suggested strongly that motion increased arousal, had little impact on valence, and captured and sustained the subject's attention to the image.

Adult↗
PubMed2000

[A case of motor neuron disease with dementia, presenting motor aphasia as an initial symptom].

We report a case of motor neuron disease (MND) with dementia, presenting motor aphasia as an initial symptom. A 67-year-old man was admitted to our hospital because of speech disturbance slowly progressing for 2 years. On physical examination, he showed no neurological abnormalities except for non-fluent aphasia and increased deep tendon reflexes without laterality. MRI demonstrated bilateral fronto-temporal atrophy, dominating the left hemisphere. This finding was confirmed by surface anatomy scanning (SAS), showing an obvious atrophy in the left inferior frontal gyrus, compared with the right one. SPECT with 123I-IMP revealed some irregular defects in the bilateral frontotemporal region. Because he showed dementia, bulbar palsy with tongue atrophy, weakness of upper extremities and facial muscles, snout reflex, and the atrophy and fasciculation in limbs in addition to motor aphasia soon after the discharge from our hospital, he was diagnosed as having MND with dementia. At age 68, he died of a respiratory failure 3 years after the onset of the disease. MND with dementia seldom shows motor aphasia as an initial symptom. We must include, however, the MND with dementia as an differential diagnosis when we see the patients with progressive aphasia.

Aged↗
PubMed1999

Reading epilepsy in a patient with previous idiopathic focal epilepsy with centrotemporal spikes.

RATIONALE: Reading epilepsy (RE) is a form of reflex epilepsy currently classified as an idiopathic localization-related epilepsy (ILAE, 1989). METHODS: We describe a 30 year-old right-handed male who suffered since the age of 8 from nocturnal partial motor seizures. Clinical features were typical of BECT. We reviewed the EEG recorded at that time which showed centrotemporal spike and waves. He was seizure-free from the age of 12 to the age of 17 when seizures evoked only by reading appeared. No other stimuli provoked seizures. Neurological and neuroradiological (CT and MR) investigations were normal. Baseline video-polygraphic EEG recordings were normal while reading aloud provoked myoclonic jerks in the facial muscles related to bilateral spike and wave discharges. Therapy with carbamazepine and valproic acid strongly reduced seizure frequency. CONCLUSION: Recent papers have debated the difficulties in classifying RE among the generalized or focal syndromes. Literature reports describe an association with RE and juvenile myoclonic epilepsy, supporting the hypothesis of an idiopathic generalized form. We report the first documented case with a clear-cut idiopathic localization-related epilepsy evolving to a primary reading epilepsy.

Adult↗
PubMed2000

Valence-dependent modulation of psychophysiological measures: is there consistency across repeated testing?

The present study used the picture perception paradigm to examine the extent to which three well-documented psychophysiological measures demonstrate consistency across time in response to emotional stimuli. The three measures were the eye-blink startle response and the activation in two facial muscle regions (zygomatic and corrugator). Twenty-seven young women were assessed on two occasions, 2 weeks apart. Whereas activation in the corrugator and zygomatic muscle regions demonstrated the predicted patterns at both assessments (with some attenuation in the zygomatic muscle regions), the startle response had limited consistency across the two assessments. The startle response revealed the predicted linear pattern of valence modulation during the first assessment. During the second assessment, startle magnitude response was a quadratic function of valence ratings and a linear function of arousal ratings. The unexpected pattern of startle response during the second session appeared to be related to the content of the pleasant slides, with action slides generating quadratic valence modulation and erotic slides continuing to exhibit the expected linear valence modulation.

Adult↗