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At least 1,675 records · Page 93Linked to original sources
PubMed1995

Snake bites by the Papuan taipan (Oxyuranus scutellatus canni): paralysis, hemostatic and electrocardiographic abnormalities, and effects of antivenom.

One hundred sixty-six patients with enzyme immunoassay-proven bites by taipans (Oxyuranus scutellatus canni) were studied in Port Moresby, Papua New Guinea. One hundred thirty-nine (84%) showed clinical evidence of envenoming: local signs were trivial, but most developed hemostatic disorders and neurotoxicity. The blood of 77% of the patients was incoagulable and 35% bled spontaneously, usually from the gums. Fifty-one per cent had microscopic hematuria. Neurotoxic signs (ptosis, ophthalmoplegia, bulbar paralysis, and peripheral muscular weakness) developed in 85%. Endotracheal intubation was required in 42% and mechanical ventilation in 37%. Electrocardiographic abnormalities (sinus bradycardia and septal T wave inversion) were found in 52% of a group of 69 unselected patients. Specific antivenom raised against Australian taipan venom was effective in stopping spontaneous systemic bleeding and restoring blood coagulability but, in most cases, it neither reversed nor prevented the evolution of paralysis even when given within a few hours of the bite. However, early antivenom treatment was associated statistically with decreased incidence and severity of neurotoxic signs. The low case fatality rate of 4.3% is attributable mainly to the use of mechanical ventilation, a technique rarely available in Papua New Guinea. Earlier use of increased doses of antivenoms of improved specificity might prove more effective.

Adolescent↗
PubMedDate not supplied

Thyrotoxic periodic paralysis: an overview.

Thyrotoxic periodic paralysis (TPP) is a fairly common manifestation of hyperthyroidism in Asian populations, with an incidence of about 1.9% in thyrotoxic patients, but it is rarely diagnosed among Caucasians and blacks in the Western world. The diagnosis often can be made on the basis of the clinical manifestations alone. Sometimes, periodic paralysis precedes hyperthyroidism or occurs in silent hyperthyroidism. As a result, physicians may easily overlook it even when life-threatening hypokalemia is present. The pathophysiology of this disorder is still not well understood. Correction of the thyrotoxic state is the definitive treatment. Potassium supplementation, propranolol, and spironolactone may be helpful both in the acute state and in preventing attacks.

Humans↗
PubMed2006

[Treatment results of acupuncture in inferior alveolar and lingual nerves sensory paralysis after oral surgery].

The effect of acupuncture in sensory paralysis was evaluated in 43 patients. Thiry-two cases in the study group were after mandibular third molar extraction and 11 cases by postoperative injury of orthognathic surgery. Treatment was performed in four forms: needles only (A), A with moxibustion (AK), electrical needle stimulation (ESA) using LEP 4000 OhmPulser Ra direct current 6 V 5-100 Hz, and ESA+A; exercise therapy was also given 1 or 2 times weekly. There were, however, some variations depending on the patient's conditions. Visual analog scale (VAS) measurement was carried out in addition to the estimation of effectiveness. The group receiving ESA+A seemed to improve better than those receiving other forms of treatment. The results indicated that young patients less than 40 years old tend to improve with fewer treatment times of shorter duration. With respect to the relationship between the effect and the time of starting treatment, we noticed that the earlier the treatment is started, the better the improvement. In summary, the study indicated that acupuncture is useful in treating sensory paralysis.

Acupuncture↗
PubMed1990

Diaphragmatic paralysis following cervical herpes zoster.

A 74-year-old man was found to have a paralysed left hemidiaphragm within four months of the appearance of a typical herpes zoster rash involving his left shoulder and neck. Investigations, including bronchoscopy and computed tomography of the chest, failed to detect a cause for the diaphragmatic paralysis. We believe that the cervical zoster and diaphragmatic paralysis were causally related, a rare but recognised association.

Aged↗
PubMed1996

Avian tick paralysis caused by Ixodes brunneus in the southeastern United States.

Between 1988 and 1994, 16 definitive and 26 presumptive cases of tick paralysis were diagnosed in 10 species of birds from five southeastern states in the USA. All birds had engorged adult female Ixodes brunneus ticks on the head region and were partially paralyzed or dead. Cases occurred in the winter and early spring months, and most birds were passerines found in private yards or near feeders. All stages of I. brunneus feed exclusively on birds, and this species previously has been associated with avian tick paralysis. Little is known concerning the life cycle of this ixodid tick and its impact on wild bird populations.

Animals↗
PubMed1997

Tick paralysis in a red wolf.

A free-ranging male red wolf (Canis rufus) in North Carolina (USA), exhibiting paresis, anorexia and heavy tick infection was diagnosed with tick paralysis. The wolf recovered completely following the removal of all ticks. This is the first record of tick paralysis in the red wolf.

Animals↗
PubMed1996

Surgical simulation of facial paralysis.

We are developing a prototype of a surgical simulation system for restoring facial expression lost in cases of facial paralysis. Correcting facial paralysis requires careful planning of surgery procedures and accurate prediction of the surgical results. So far techniques to perform this task largely relied on the physician's experience, and there were few quantitative data to refer to. The system we propose is finally aimed at helping the surgeon plan the surgery and predict the results. The 3D model of the face used in our system is generated directly from the CT scan of the patient. The face model consists of skin, skull and selected facial muscles based on anatomy. The mass and spring lattice approach is used to give physical attributes to the face model. The present prototype system lets the user directly manipulate graphical representations of facial expression.

Computer Graphics↗
PubMed1999

Chronic aneurysm of the descending thoracic aorta presenting with right pleural effusion and left phrenic paralysis.

A 62-year-old man was admitted to the emergency department with chronic dysphagia and lower back pain. Chest radiography revealed a wide mediastinal shadow and an elevated left diaphragm, which proved to be secondary to left phrenic paralysis. The patient was diagnosed with an aneurysm of the descending thoracic aorta and was admitted to the hospital. After the patient was admitted, the aneurysm ruptured into the right chest. The patient underwent an emergency operation to replace the ruptured segment with a synthetic graft. Postoperative recovery and follow-up were uneventful. This report describes an unusual presentation of a thoracic aortic aneurysm. Hemidiaphragmatic paralysis caused by compression of the phrenic nerve is an unusual complication that, to our knowledge, has not been previously reported.

Aortic Aneurysm, Thoracic↗
PubMed1978

[Permanent atrial paralysis].

A case is described of permanent atrial paralysis in a 68 year old female with diabetes and cirrhosis of the liver. Absence of electrical atrial activity was expected on the standard electrocardiogram, and confirmed by intracavitary electrophysiological investigation which showed the ineffectiveness of stimulation of both the right atrium and the coronary sinus. Recording of the His potentials showed that the resultant rhythm was of supra-ventricular origin. The absence of mechanical atrial activity was confirmed radiographically, on the jugular venogram, on the apexogram, and on the tracings of right atrial and pulmonary capillary pressure. A search was made for muscular or neuromuscular dystrophy which has often been found in association with this arrhythmia, but none was found. There may be an etio-pathological relationship between carbohydrate metabolism and atrial paralysis, as certain authors have suggested.

Aged↗
PubMed1976

Sympathetic disorders in obstetrical paralysis of the newborn.

In addition to the classical description of involvement of the cervical sympathetic in low root lesions (Claude Bernard-Horner syndrome), other sympathetic syndromes have been described accompanying the motor and sensory changes in obstetrical paralysis of the upper limb. Loss of sweat secretion can be deomonstrated by electrical skin resistance tests, and the authors describe their apparatus and method of investigating this in the newborn. Although sweat secretion is often scanty in the newborn, it can be enhanced with appropriate techniques, particularly in the areas richer in sweat glands. This method of investigating sympathetic nerve function has been used to clarify the location of the neurological damage and therefore it is of some value for the prognosis in obstetrical paralysis of the newborn.

Arm↗
PubMed1999

Delayed facial paralysis after stapedotomy using KTP laser.

OBJECTIVE: Delayed facial paralysis after stapes surgery is uncommon and has been reported after traditional, nonlaser techniques for stapedotomy. The purpose of this paper is to inform the reader of the potential risk of delayed facial nerve paralysis associated with the use of the potassium titanyl phosphate (KTP) laser for stapedotomy. Etiologic mechanisms are discussed. STUDY DESIGN: The study was a descriptive study-case report. SETTING: The study was conducted at a university-based otologic practice. PATIENTS: Two patients with otosclerosis and delayed onset facial palsy 5 to 7 days after uncomplicated stapedotomy using the KTP laser were included in the study. INTERVENTION: Potassium titanyl phosphate laser stapedotomy was performed. Patients received treatment of facial palsy with a tapering course of oral steroids. MAIN OUTCOME MEASURE: House-Brackmann facial nerve grade scores were used. RESULTS: Improvement of House-Brackmann facial nerve scores from Grade VI to Grade I-II in one patient, and improvement from Grade IV to Grade I-II in the other was seen. CONCLUSION: The probable etiology of delayed facial palsy is viral neuritis from reactivation of dormant virus within the facial nerve, initiated by thermal stress of the KTP laser. Presentation and resolution of the facial palsy is similar to other types of delayed facial palsy resulting from nonlaser techniques of stapes surgery and other types of middle ear and neurotologic surgeries previously reported.

Facial Nerve↗
PubMed1997

Observation on electromyogram changes in 93 cases of peripheral facial paralysis treated by point-through-point acupuncture.

Bioelectricity of the affected muscles at acute stage, recovery stage and sequel state in 93 cases of peripheral facial paralysis was observed with EMG. Pathological potential or motor potential was found to be reduced to varying degrees in all the affected muscles. After treatment by point-through-point acupuncture, myodynamia recovered fairly rapidly, EMG showed obvious changes, pathological potential decreased, and the normal motor unit potential increased remarkably. Comparative analysis of EMG before and after acupuncture indicated that point-through-point acupuncture had an obvious therapeutic effect on the disease. It was also very significant that EMG was used in diagnosing various stages of peripheral facial paralysis, evaluation of prognosis and guidance in clinical treatment.

Acupuncture Points↗
PubMed1999

Rapid simultaneous comparison system for subjective grading scales grading scales for facial paralysis.

OBJECTIVE: The senior authors developed a computer-assisted rapid, simultaneous comparison system for nine international grading scales for facial paralysis. The purpose of this study is to present the system and to compare the agreement of hand-performed House-Brackmann and Sunnybrook scales, two frequently used scales herein taken as the concurrent criterion test standards, with those like scales done simultaneously in the computed system. STUDY DESIGN: The study design was a prospective concurrent criterion validity study. Test-retest reliability and interobserver agreement were assessed using the kappa statistic (k) for ordinal data and the intraclass correlation coefficient (ICC) for semidimensional data. SETTING: The study was conducted at a university practice. PATIENTS: Ten consecutive consenting subjects with varying degrees of facial paralysis were studied. INTERVENTION: Each subject was measured, in random order, twice by each method by each of two independent observers. MAIN OUTCOME MEASURES: House-Brackmann score, Sunnybrook score, and like-scale scores done simultaneously in the computed system were measured. RESULTS: Agreement between the computed system and hand-performed criterion standards was equal to each scale compared against itself; for the House-Brackmann, agreement was moderate (k = 0.554); for the Sunnybrook, agreement was excellent (ICC = 0.976). CONCLUSIONS: The computed system has the advantage of allowing an examiner to view a rapid, simultaneous display of multiple grading scale scores at a keystroke from one clinical assessment input, obviating the labor of repeating measures by hand.

Adult↗
PubMedDate not supplied

An acute form of transient paralysis induced by highly virulent strains of Marek's disease virus.

A novel syndrome was observed after inoculation of 3-wk-old chickens with highly virulent Marek's disease virus (MDV) strains. This syndrome was characterized by the acute onset of neurologic signs including flaccid paralysis of neck and limbs 9-10 days postinoculation, typically resulting in death 1-3 days after the onset of clinical signs. Most affected birds died, and spontaneous recovery was rare. Few if any gross tissue changes were found. Histologic brain lesions included acute vasculitis with vasogenic edema and perivascular cuffing. The syndrome was influenced by the virus strain and dose and by chicken strain and B haplotype and was prevented by vaccination with turkey herpesvirus. Chickens up to 18 wk of age were susceptible. On the basis of clinical signs and histopathology, the syndrome was determined to be an acute form of transient paralysis (TP); its more acute nature and virtual lack of spontaneous recovery differentiated this syndrome from classical TP. Affected birds were viremic, and brains were positive for viral DNA by polymerase chain reaction assays, but these tests were also positive in inoculated chickens without clinical signs and may have limited value for diagnosis. Although acute TP should occur only rarely in Marek's disease-vaccinated commercial flocks, this syndrome may be important in laboratory studies, where it could interfere with pathogenesis trials. Finally, acute TP appears to be one component in the pathogenesis of the early mortality syndrome, a previously described immunodepressive disease induced by inoculation of 1-day-old chicks with highly virulent MDV.

Animals↗
PubMed2000

Randomized trials of dichlorphenamide in the periodic paralyses. Working Group on Periodic Paralysis.

Although the carbonic anhydrase inhibitors have been used in the treatment of the primary periodic paralyses (PPs), their efficacy has not been demonstrated in double-blind, placebo-controlled trials. Therefore, we tested the efficacy of dichlorphenamide (DCP; Daranide), a potent carbonic anhydrase inhibitor, in the treatment of episodic weakness in the primary PPs. We performed two multicenter, randomized, double-blind, placebo-controlled crossover trials, one involving 42 subjects with hypokalemic periodic paralysis (HypoPP) and the other involving 31 subjects with potassium-sensitive periodic paralysis (PSPP). In each trial, two 8-week treatment periods were separated by an active washout period of at least 9 weeks. The primary outcome variable in the HypoPP trial was the occurrence of an intolerable increase in attack severity or frequency (end point). The primary outcome variable in the PSPP trial was the number of attacks per week. In the HypoPP trial, there were 13 subjects who exhibited a preference (in terms of the end point) for either DCP or placebo, and 11 of these preferred DCP. In the PSPP trial, DCP significantly reduced attack rates relative to placebo. DCP also significantly reduced attack rates relative to placebo in the HypoPP subjects. We conclude that DCP is effective in the prevention of episodic weakness in both HypoPP and PSPP.

Adolescent↗
PubMed1999

[Paralysis of the foot as the first symptom of a herniated thoracic disc].

Herniated thoracic discs are uncommon entities that are difficult to diagnose. They may be associated with a myriad of symptoms, which often delays diagnosis. In general dorsal pain that radiats around the chest or abdomen are found. In case of spinal cord compression signs of thoracal myelopathy are common. This paper describes a patient with a complete paralysis of the left foot as the first symptom of a herniated thoracic disc. After frustrated diagnostic of the lumbar spine, the exact neurological examination showed a sensible cut at the level of D6/7, the MR tomography diagnosed a herniated thoracic disc at the same level. Four months later he was presented again with a plegia of the left foot and a sensible cut at the level D5/6. The MR tomography showed a herniated disc at the level above the spondylodesis. The immediately performed transthoracic disc excision and fusion of D6/7 was followed by complete remission of the plegia and the sensible cut. Four months later we performed a rethoracotomy, disc excision and decompression with a spondylodesis D5/6. The procedure was again followed by complete remission. In case of paralysis of the lower extremities one has to consider a herniated thoracic disc.

Adult↗
PubMed2000

[Periodic hypokalemic paralysis as the manifestation of Graves' disease: clinical and electrophysiological study].

A 30-year-old Vietnamese man experienced severe weakness of four limbs revealing hypokalaemia. Tachycardia and goiter allowed to diagnose a Graves' disease. Thyrotoxic hypokaliemic periodic paralysis is a rare complication of hyperthyroidism in western populations. Electromyogram performed after resolution of the paralysis episodes revealed marked abnormalities of the muscular excitability. Duration of compound muscular action potential was markedly increased after a brief exercise. This increase might indicate a delayed repolarization of muscle fibres.

Adult↗
PubMed2000

[Treatment with Bi-PAP in patients with bilateral diaphragm paralysis].

Two patients with bilateral diaphragmatic paralysis are described. The first case occurred secondary to open chest surgery; the second occurred in a polytraumatized patient. Both were successfully treated with intermittent bi-level positive airway pressure (Bi-PAP). Bilateral diaphragmatic paralysis can be related to a variety of processes, although idiopathic forms also occur. Diagnosis can be difficult and should involve a high level of clinical suspicion. Treatment and prognosis are determined by the underlying disease. Some cases may require the establishment of nighttime support ventilation. Techniques for non-invasive ventilatory assistance such as Bi-PAP can improve symptoms markedly and allow patients to live independently.

Humans↗