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PubMed2006

[Clinical application of electroacupuncture plus chinese medicine in treatment of peripheral facial paralysis].

OBJECTIVE: To probe into the role of electroacupuncture in treatment of peripheral facial paralysis. METHODS: Eighty-six cases were divided into a treatment group (n=45) treated with electroacupuncture plus Chinese medicine, and a control group (n=41) treated with acupuncture plus Chinese medicine. Taiyang (EX-HN 5), Yangbai (GB 14) and other points on the affected side were selected and Chinese medicine modified Qianzheng powder was administrated. Their clinical therapeutic effects were analyzed and evaluated. RESULTS: The effective rate was 97. 8% in the treatment group and 82.9% in the control group with a significant difference between the two groups (P < 0.05). the treatment group being higher than the control group. CONCLUSION: Chinese medicine plus acupuncture combined with electroacupuncture has a better therapeutic effect on peripheral facial paralysis.

Adult↗
PubMedDate not supplied

[Thyrotoxic periodic paralysis and Graves' disease. Description of an HLA-CW7-positive case].

Thyrotoxic periodic paralysis is an uncommon complication of hyperthyroidism, more frequent in Oriental populations and in male than in female subjects. Electron microscopic investigations have shown characteristic degenerative changes of muscle fiber. In this study the sequence of pathophysiologic events proposed by the literature is illustrated and a case of thyrotoxic periodic paralysis in a HLA-CW7 positive patient affected by Graves' disease is reported.

Adult↗
PubMed2006

[Free micro-vascular muscle transplantation for the treatment of late facial paralysis using extensor digitorum brevis and extensor hallucis brevis].

OBJECTIVE: To investigate the result of free vascular transplantation of denervated extensor digitorum brevis and extensor hallucis brevis for the treatment of late facial paralysis. METHODS: From April 2003 to April 2005, 26 cases of facial paralyses were treated by transplantation of denervated extensor digitorum brevis and extensor hallucis brevis. During operation, the ends of the tendons were fixed at ala nasi, middle point of nasal labial fold,oral commissure and chin; the muscle belly were put around the masseter nerve to correct the nasal and oral deformity, microsurgery was applied to anastomose the tarsus lateral vessels to the superficial temporalis vessels or the facial vessels. The result of the operation was evaluated by the Standard of Douglas Harrison and the Paresis Assessment scoring system of Stennert. RESULTS The static appearance was satisfactory in 26 cases after operation, the bilateral oral commissure was symmetry and the dynamic appearance was greatly improved 6 months after operation. Among the 23 cases whose disease history was above 2 years, all could smile naturally and show their teeth symmetrically except 1 case who could only move the oral commissure. Among the 3 cases whose disease history was less than 2 years, one could smile naturally and show his teeth symmetrically, one could smile but could not show his teeth symmetrically, another could move oral commissure but have no motion appearance. The result was evaluated as "+++" according to Standard of Douglas Harrison, accounting for 88% (23/26). Evaluated according to the Paresis Assessment scoring system of Stennert, the difference before operation and after operation was more than 5, accounting for 86% (22/26). CONCLUSION: The free vascular transplantation of denervated extensor digitorum brevis and extensor hallucis brevis can reconstruct the oral appearance for the treatment of late facial paralysis.

Adolescent↗
PubMed2006

Myasthenia gravis accompanied with hypokalemic periodic paralysis.

Myasthenia gravis and hypokalemic periodic paralysis are commonly related with hyperthyroidism but rarely occur together. Here, the authors reported a case of hypokalemic periodic paralysis in a Northeastern Thai woman accompanied with myasthenia gravis. She had motor weakness despite a normal level of serum potassium. Prostigmine test was positive. She dramatically improved after pyridostigmine treatment. Autoantibodies to nicotinic AchR-Ab and dihydropyridine receptor or L-type voltage gated calcium channel were postulated to explain these associated diseases.

Adult↗
PubMed2006

[Respiratory stridency by larynx paralysis. Anusual beginning of miastenia].

A case of severe miastenia beginning with dyspnea, secondary to a bilateral larynx paralysis in aduction is presented. During the evolution of the severe miastenia the affectation of the larynx musculature does not result infrequent, but however, after having realized a bibliographic revision, the infrequency resulting in this disease of the beginning through a bilateral larynx paralysis in aduction was verified. A wide exposition of the clinic case, methods of exploration to obtain the diagnosis of severe miastenia, and the different treatment options actually in use to control these disease, are realized.

Humans↗
PubMedDate not supplied

Facial nerve paralysis following mandibular trauma: a case report.

A strong posteriorly directed force applied to the mandible resulting in fracture, can also displace the mandibular condyle towards the external auditory canal or superiorly against the mandibular fossa, causing its penetration into the middle cranial fossa or even the fracture of the temporal bone. We report the case of a 30-year-old male patient victim of a bicycle accident that developed facial expression muscles paralysis on the left side soon after the trauma. On physical examination he presented left side postauricular ecchymosis, diminished muscular tonus of the left mouth angle and difficulty to close the left eye, he did not present clinical signs of facial fractures. The neurological and CT scan examination revealed fracture of the left temporal bone with total facial expression muscles paralysis. The patient was referred to the neurosurgical team for evaluation and they opted for a conservative treatment. After 3 months the patient showed a marked improvement with almost normal facial expression muscle movements. The trauma dynamics and treatment details are discussed.

Adult↗
PubMed2006

[Ramsay-Hunt syndrome associated to unilateral recurrential paralysis].

Varicella herpes zoster (VZV) virus reactivaction can produce multiple neuropathies of the cranial and cervical region being the peripheral facial paralysys the most common one. We report one case of Ramsay-Hunt syndrome with eruption of vesicles on left auricular pinna and face besides facial palsy which associated to ipsilateral laryngeal or recurrential paralysis nonexisting previously. Our patient was treated by oral aciclovir (800 mg, 5 times daily) for 1 week. 3 months later she returned to Emergencies due to another cause and the ENT exploration showed a recovery in the mobility of the left cord but it persisted the affectation of VII pair, specially the inferior branch or cervicofacial. It is advised that the larynx should be examined in all cases of herpes zoster that involve the head and neck.

Acyclovir↗
PubMed2006

[Glottic measurement and vocal evaluation after three surgical techniques in the treatment of bilateral vocal cord paralysis].

OBJECTIVE: To evaluate postoperative glottic area and vocal quality of three various surgical techniques for treating bilateral vocal cord paralysis, including laser arytenoidectomy (Group A, 24 cases), reinnervation of the posterior cricoarytenoid muscle by phrenic nerve (Group B, 9 cases) and arytenoidectomy accompanying lateral cordopexy by extralaryngeal approach (Woodman's procedure, Group C, 13 cases). METHODS: 46 cases suffered from bilateral recurrent laryngeal nerve injury were included in our study. The pre-postoperative glottic measurement and vocal acoustic parameters were analyzed. RESULTS: The decannulated cases in group A and group B and group C were 22, 8, 13 respectively. The post-operative mean maximal glottic area was (47.2 +/- 7.4) mm2, (78.3 +/- 16.0) mm2, (48.1 +/- 6.5) mm2 respectively. Group B cases glottic area was larger than that of group A and group C (t value were 4.46 and 3.85, P value were 0.000 and 0.001). No significant difference was found between group A and group C (t = 1.68, P = 0.101). After surgery, in group A, 17 cases voice quality was the same compared with that of before surgery, and 7 cases voice quality had become worse; In group B, the voice quality had become better in 5 cases, completely recovered in 1 case, and had not change in 3 cases; In group C, the voice quality had become deteriorated in 10 cases and no change in 3 cases. And in group B, ipsilateral diaphragm paralysis in 9 cases after surgery, whose vital capacity and forced vital capacity had decreased to 72%-84%, 76%-84% of that before the surgery respectively; and the diaphragm mobility had recovered by 35%-76% respectively, while vital capacity and forced vital capacity had become 93%-97%, 91%-98% of that before the surgery. In Group B, all cases' pulmonary function was normal half a year postoperatively. CONCLUSIONS: Reinnervation of the posterior cricoarytenoid muscle by phrenic nerve seems to be best procedure with better post-operative voice and larger glottic area. Although the sufficient airway for decannulation can be acquired in Group A and Group C, but most of patients in Group A had pre-operative vocal level and badly abnormal in Group C.

Adult↗
PubMed2006

[Clinical observation on moxibustion and acupuncture at Zusanli (ST 36) for treatment of refractory facial paralysis].

OBJECTIVE: To observe clinical therapeutic effect of moxibustion and acupuncture at Zusanli (ST 36) on refractory facial paralysis. METHODS: Sixty cases were randomly divided into a test group and a control group, 30 cases in each group. The control group were treated with acupuncture at Hegu (LI 4), Taichong (LR 3), Touwei (ST 8), etc. , and the test group with acupuncture at the same points as those in the control group plus moxibustion and acupuncture at Zusanli (ST 36) with a warm-heat sense transmitting into the depth of the point along the needle body for the patient. RESULTS: The total effective rate of 93.3% in the test group was significantly better than 76.7 in the control group (P < 0.05); in the test group, the total effective rate for the patients with needling sensation propagating along the channel was 100%, which was significantly superior to 80.00% in the patients with no needling sensation propagating along the channel (P < 0.05). CONCLUSION: Moxibustion and acupuncture at Zusanli (ST 36) activating sensation propagating along channel as main way has a better therapeutic effect on refractory facial paralysis.

Acupuncture Points↗
PubMed1991

[Bilateral diaphragmatic paralysis, the cause of acute insufficiency in chronic obstructive bronchopathy. The value of nasal mechanical ventilation].

A 57 year old man with chronic bronchitis sought a consultation for dyspnoea at rest associated with an absolute inability to lie flat. Examination revealed paradoxical respiration and respiratory function testing revealed a mixed ventilation disturbance, which was predominantly obstructive and was aggravated in the dorsal decubitus position. Radiology revealed bilateral diaphragmatic paralysis, which was confirmed on measurement of transdiaphragmatic pressure. The patient benefited from assisted ventilation by the nasal route with an excellent result in both the short and the medium term. Investigation into the cause was negative, in particular there was no evidence of any neuromuscular abnormality. This case recalls the role of the diaphragm in acute respiratory failure and shows the value of mechanical ventilation by the nasal route in the treatment of certain types of diaphragmatic paralysis.

Bronchitis↗
PubMed1991

Thyrotoxic periodic paralysis in a Caucasian man: recognition and diagnosis.

Periodic paralyses are uncommon disorders characterized by episodic muscle weakness, often with hypokalemia. Thyrotoxic periodic paralysis (TPP) is the most common and is rarely seen in the Caucasian population; the relative unfamiliarity of TPP among physicians in the United States may lead to initial errors in diagnosis. This article presents the case of a 25-year-old white man with frequent episodes of skeletal muscle weakness and cramping, associated with profound hypokalemia. Laboratory evaluation demonstrated primary hyperthyroidism, and a diagnosis of TPP was made. The disorder is found more commonly in men between the ages of 20 and 40. Hypokalemia is the most consistent laboratory abnormality, representing a transcellular shift rather than a total body deficit; the exact mechanism is unknown. The exercise test demonstrates distinct electromyographical abnormalities in those with periodic paralysis. The definitive treatment of TPP is establishing a euthyroid state.

Adult↗
PubMed1976

Constant negative pressure in the treatment of diaphragmatic paralysis secondary to birth injury.

A newborn infant with right Erb palsy and diaphragmatic paralysis was treated with CNP for respiratory failure. There was clinical and arterial blood gas improvement. Several months after treatment, respiratory symptoms had disappeared, but fluoroscopy demonstrated persistence of diaphragmatic paralysis. A review of the literature is included. CNP may allow spontaneous recovery while permitting adequate nutrition.

Birth Injuries↗
PubMedDate not supplied

[Isolated sleep paralysis in patients with disorders due to anxiety crisis].

The relationship between isolated sleep paralysis and panic disorder in adults is analyzed in this study. The patients included in this work presented anxiety disorder with agoraphobia and were compared with a group of normal controls. The percentage of patients with sleep paralysis was 40% significantly higher than those encountered in the control group (20%). The existence of this syndrome do not seem to modify the clinical manifestation or severity of panic disorder.

Adult↗
PubMed1991

[Effects of diaphragm plication for phrenic nerve paralysis on respiratory mechanics and diaphragm function].

The purpose of this study is to examine the effects of unilateral diaphragm plication for phrenic nerve paralysis on the respiratory mechanics and diaphragm function. Study 1: We performed thoracotomy (BASELINE), left phrenicotomy (INJURY) and left diaphragm plication (PLICATION) in ten dogs. After chest was closed in each condition, measured were the tidal volume (TV), respiratory rate (f), esophageal and gastric pressure swing (delta Pes, delta Pga), dynamic compliance (Cdyn) the ratio of gastric to esophageal pressure swing (delta Pga/delta Pes) and the work of breathing per liter (WOB/L) under stable spontaneous breathing. Study 2: In eight other left-phrenicotomized dogs, Pdi and fractional shortening of the costal diaphragm during contralateral electrophrenic stimulation were measured before and after plication. After plication TV, delta Pga/delta Pes, Cdyn, Pdi and fractional shortening during stimulation increased significantly, whereas Pes and WOB/L decreased significantly compared with INJURY condition. In conclusion unilateral diaphragm plication after paralysis improves the intact hemidiaphragm contractility and diaphragmatic contribution to breathing.

Animals↗
PubMed1977

Bilateral diaphragmatic paralysis in association with neurogenic disease.

A patient had complete diaphragmatic paralysis and his disease progressed to include systemic neurological deficit. The cause is unknown. Appropriate diagnostic tests are emphasized, and a discussion of potential etiologies with a review of the literature of idiopathic diaphragmatic paralysis is presented.

Brachial Plexus↗
PubMedDate not supplied

[Isolated sleep paralysis in patients with disorders due to anxiety crisis].

The relationship between isolated paralysis and panic disorder in adults is analyzed in this study. The patients included in this work presented anxiety disorder with agoraphobia and were compared with a group of normal controls. The percentage of patients with sleep paralysis was 40% significantly higher than those encountered in the control group (20%). The existence of this syndrome do not seem to modify the clinical manifestation or severity of panic disorder.

Agoraphobia↗
PubMedDate not supplied

[A case of sporadic hypokalemic form of familial periodic paralysis].

A case is reported of sporadic hypokalemic form of periodic paralysis, calling attention to the presence of certain rare signs, that is bilateral facial palsy and speech disturbances. The most modern reports on the aetiology and pathogenesis of periodic paralysis are discussed.

Adult↗
PubMed1990

An outbreak of suspected tick paralysis in one-humped camels (Camelus dromedarius) in the Sudan.

An outbreak of suspected tick paralysis occurred in one-humped camels in Southern Darfur, the Sudan, between latitudes 11-12 degrees N and longitudes 24-25 degrees E, when the camels were herded in tick infested areas. It involved 251 camels of different ages, in ten herds causing 34.3% mortality. The symptoms were incoordination of movements, unsteady gait and recumbency followed by death or recovery. Hyalomma adults and/or Rhipicephalus nymphs and adults were incriminated to be the cause of the disease. Transient paralysis in a guinea pig was produced after experimental feeding of ticks. Removal of the camels from the tick infested areas and treatment against the ectoparasites with Lindane at the concentration of 0.23% contributed to controlling the disease.

Animals↗