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Bells palsy

Ellen H de Moll, Mark G Lebwohl
Melkersson-Rosenthal syndrome (MRS) is a rare syndrome of facial nerve palsy, facial edema, and lingua plicata that can be difficult to treat. We observed a patient with MRS of 4 years' duration that was unsuccessfully treated with multiple therapies. After a variety of diagnoses were considered at outside institutions, including Bell palsy, we diagnosed the patient with MRS based on clinical presentation of the classic triad. Treatment with adalimumab, a tumor necrosis factor α (TNF-α) antibody, showed improvement and relapse-free progress...
February 2018: Cutis; Cutaneous Medicine for the Practitioner
Ramón Medel Jiménez, Juan C Sánchez España, José Visa Nassarre, Eva Ayala Barroso, Alfredo Pueyo Ferrer, Alejandra Tapia Bahamondes, Luz M Vasquez
PURPOSE: To describe our experience and outcomes managing complete third cranial nerve palsy. METHODS: This was a retrospective analysis of the clinical records of 7 consecutive patients treated at our centre for unilateral third nerve palsy over the period 2010-2016. We describe our surgical approach using a frontalis muscle flap to correct the eyelid ptosis associated with medial fixation of the rectus muscle tendon to the orbit to correct the horizontal deviation...
March 15, 2018: Orbit
Pavlos Pavlidis, Rafael J A Cámara, Georgios Kekes, Haralampos Gouveris
OBJECTIVE: Ramsay Hunt syndrome (RHS) and Bell's palsy (BP) are typically known as facial nerve motor syndromes and are primarily unilateral. The aim of this study was to challenge this assertion because both conditions are also known to be associated with viruses that typically affect several nerves. METHODS: Ten participants with RHS, 12 with BP, all clinically unilateral, and 12 healthy controls were prospectively enrolled. Electrogustometric thresholds were measured bilaterally in the areas of the chorda tympani, the glossopharyngeal, and the major petrosal nerve...
March 14, 2018: Annals of Neurology
Eman M Khedr, Noha Abo El-Fetoh, Dina H El-Hammady, Abeer M Ghandour, Khaled Osama, Ahmed F Zaki, Ayman Gamea
OBJECTIVE: Recovery from acute Bell's palsy (BP) is variable and there are few predictors of response. We evaluated the usefulness of a range of neurophysiological parameters to predict outcome in BP. METHODS: Fifty-nine patients (age: 33.7±15.4 years) with acute unilateral BP were recruited within 3-7 days of onset. They were evaluated with electroneurography, facial nerve excitability, and the blink reflex. House-Brackmann (HB) clinical scores were obtained at the same time and three months later...
February 26, 2018: Neurophysiologie Clinique, Clinical Neurophysiology
Selçuk Güneş, Mustafa Çelik, Ceylan Çolak, Burak Olgun
OBJECTIVE: The aim is to investigate the impact of degree of mastoid pneumatization on the affected side of Bell palsy (BP). STUDY DESIGN: Retrospective study in tertiary academic hospital. METHODS: In total, 52 patients who were diagnosed with as BP were included in the study. Each patient was staged using House-Brackmann (HB) staging system. All patients underwent temporal bone computed tomography imaging. House-Brackmann scores, side of the BP, and mastoid pneumatization of all of patients were evaluated in the present study...
February 26, 2018: Journal of Craniofacial Surgery
Alen Sekelj, Davorin Đanić
Lyme borreliosis is a vector-borne infectious disease characterized by three disease stages. In the areas endemic for borreliosis, every acute facial palsy indicates serologic testing and implies specific approach to the disease. Th e aim of the study was to identify and confirm the value of acoustic refl ex and House-Brackman (HB) grading scale as prognostic indicators of facial palsy in neuroborreliosis. Th e study included 176 patients with acute facial palsy divided into three groups based on serologic testing: borreliosis, Bell's palsy, and facial palsy caused by herpes simplex virus type 1 (HSV-1)...
September 2017: Acta Clinica Croatica
Abdulhafeez M Khair, Khalid Ibrahim
Idiopathic (Bell's) palsy is the commonest cause of unilateral facial paralysis in children. Although being idiopathic by definition, possible infectious, inflammatory, and ischemic triggers have been suggested. Bell's palsy is thought to be responsible for up to three-fourths of cases of acute unilateral facial paralysis worldwide. The diagnosis has to be reached after other causes of acute peripheral palsy have been excluded. However, it is rarely described in neonates and young infants. Steroids may have some role in treatment, but antiviral therapies have doubtful evidence of benefit...
January 2018: Oman Medical Journal
Ummer Karadan, Robin George Manappallil, Chellenton Jayakrishnan, Ramesh Naga Supreeth
Isolated facial nerve palsy is a common presentation of Bell's palsy, but rarely seen in pontine lesions. The patient being reported is a middle-aged man who developed isolated facial nerve palsy and was initially treated as Bell's palsy. However, on MRI of the brain, he was found to have pontine haemorrhage. He was managed conservatively and improved. Pontine haemorrhage as an aetiology for isolated facial nerve palsy is a rare scenario, which often goes misdiagnosed and treated as Bell's palsy.
February 5, 2018: BMJ Case Reports
Zeynep Selen Karalok, Birce Dilge Taskin, Zeynep Ozturk, Esra Gurkas, Tuba Bulut Koc, Alev Guven
OBJECTIVE: The objectives of this study were to evaluate the demographic and clinical characteristics, causes, treatment patterns, outcome, and recurrence of childhood peripheral facial palsy. METHODS: We performed a retrospective study of 144 peripheral facial palsy patients, under 18 years old in a tertiary care pediatric hospital. Medical charts were reviewed to analyze the age, gender, side of facial nerve paralysis, family history, cause, grading by the House-Brackmann Facial Nerve Grading Scale (HBS), results of diagnostic tests, therapies, outcomes, and recurrence...
February 9, 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Jaswandi Tushar Pitale, John H Bolte
Background: Cerebral palsy (CP) is a developmental disorder of movement and posture that occurs due to damage to the developing nervous system. As part of therapy, wearable sensors that trigger interactive feedback may provide multi-sensory guidance and motivation. A prototype of a heel-strike real-time feedback system has been developed which records the number of heel strikes during gait and indicates successful heel contact through real-time auditory feedback. The first aim of this feasibility study was to test the prototype accuracy...
2018: Pilot and Feasibility Studies
Tomito Oji, Akiteru Hayashi, Akihiro Ogino, Kiyoshi Onishi
BACKGROUND: Lengthening temporalis myoplasty is a faster and less invasive alternative to free muscle transfer for smile reconstruction. However, it requires a nasolabial fold incision, which leaves a midfacial scar. Based on esthetic considerations, a modified approach, involving an extended lazy-S (parotidectomy) incision instead of a nasolabial fold incision, was developed. METHODS: A cadaveric study involving 10 hemifaces was conducted. From February 2013 to March 2016, the modified lengthening temporalis myoplasty procedure was employed in 10 patients...
February 7, 2018: Journal of Craniofacial Surgery
Piyapa Keawutan, Kristie L Bell, Stina Oftedal, Peter S W Davies, Robert S Ware, Roslyn N Boyd
OBJECTIVE: To compare quality of life (QOL) according to ambulatory status and to investigate association with habitual physical activity (HPA) in children with cerebral palsy (CP) aged 5 years. METHODS: Fifty-eight participants were classified using Gross Motor Function Classification System (GMFCS) as level I = 33, II = 8, III = 6, IV = 3 and V = 8 and assessed for motor function using 66-item Gross Motor Function Measure (GMFM-66). Participants wore an ActiGraph® triaxial accelerometer for 3 days to measure HPA...
January 29, 2018: Research in Developmental Disabilities
Young Min Hah, Sang Hoon Kim, Junyang Jung, Sung Su Kim, Jae Yong Byun, Moon Suh Park, Seung Geun Yeo
OBJECTIVE: This study was designed to evaluate the prognostic value of the blink reflex (BR) test in patients with Bell's palsy (BP) or Ramsay Hunt syndrome (RHS). METHODS: The House-Brackmann (HB) grade of patients diagnosed with BP and RHS was determined at first visit and 3 months later. Final HB grade III-VI was defined as an incomplete recovery. Factors evaluated as prognostic of poor recovery included electroneurography (ENoG) degeneration rate (DR)>90%, and absence of BR...
February 2, 2018: Auris, Nasus, Larynx
Olaf Verschuren, Ana R P Smorenburg, Yvette Luiking, Kristie Bell, Lee Barber, Mark D Peterson
In individuals with cerebral palsy (CP), smaller muscle and atrophy are present at young age. Many people with CP also experience a decline in gross motor function as they age, which might be explained by the loss of muscle mass. The clinical observation of muscle wasting has prompted a comparison with sarcopenia in older adults, and the term accelerated musculoskeletal ageing is often used to describe the hallmark phenotype of CP through the lifespan. However, there has been very little research emphasis on the natural history of ageing with CP and even less with respect to the determinants or prevention of muscle loss with CP...
February 2, 2018: Journal of Cachexia, Sarcopenia and Muscle
B Bianchi, A Varazzani, G Pedrazzi, V Poddi, S Ferrari, B Brevi, A Ferri
BACKGROUND: Eighteen months is usually considered the cutoff time within which recovery of the mimic muscle remains possible using facial nerve cooptation. Few reports on the use of cooptation after this interval have appeared. Purpose of this study is to investigate the feasibility of this procedure also after 22 months. METHODS: Six patients treated via crossfacial nerve grafting between healthy and paralyzed middle and middle-upper facial nerve branches and masseteric cooptation of the main trunk of the paralyzed facial nerve between 20 and 24 months after the onset of palsy were analyzed...
January 30, 2018: Microsurgery
Su Young Jung, Junyang Jung, Jae Yong Byun, Moon Suh Park, Sang Hoon Kim, Seung Geun Yeo
OBJECTIVE: This study investigated the effects metabolic syndrome (MetS) and its factors such as diabetes mellitus (DM), hypertension (HTN), obesity, hypertriglyceridemia (high TG) and low high-density lipoprotein cholesterol (low HDL-C) on the recovery rate of patients with BP. METHODS: The medical records of 124 patients with BP were retrospectively reviewed. Patients were divided into a MetS group and a Non-MetS group according to the diagnostic criteria of MetS, and the demographic and clinical characteristics of the two groups at baseline and six months after BP onset were analyzed...
January 29, 2018: Acta Oto-laryngologica
Maike Kuhn, Kurt-Wolfram Sühs, Manas K Akmatov, Frank Klawonn, Junxi Wang, Thomas Skripuletz, Volkhard Kaever, Martin Stangel, Frank Pessler
BACKGROUND: Varicella zoster virus (VZV) reactivation spans the spectrum from uncomplicated segmental herpes zoster to life-threatening disseminated CNS infection. Moreover, in the absence of a small animal model for this human pathogen, studies of pathogenesis at the organismal level depend on analysis of human biosamples. Changes in cerebrospinal fluid (CSF) metabolites may reflect critical aspects of host responses and end-organ damage in neuroinfection and neuroinflammation. We therefore applied a targeted metabolomics screen of CSF to three clinically distinct forms of VZV reactivation and infectious and non-infectious disease controls in order to identify biomarkers for CNS involvement in VZV reactivation...
January 17, 2018: Journal of Neuroinflammation
Ilyes Berania, Mohamed Awad, Issam Saliba, Jean-Jacques Dufour, Marc-Elie Nader
BACKGROUND: This study aims to assess the effectiveness of delayed facial nerve decompression for Bell's palsy (BP). METHODS: We performed a retrospective case review of all patients having undergone facial nerve decompression for severe refractory BP between 1984 and 2009 at our tertiary referral center. Demographics, timing between onset of symptoms and surgical decompression, degree of facial nerve dysfunction pre- and post-operatively, follow-up length after surgery and postoperative complications were recorded...
January 4, 2018: Journal of Otolaryngology—Head & Neck Surgery
Sultan Şevik Eliçora, Duygu Erdem
OBJECTIVES: Bell's palsy (BP) is defined as an acute facial weakness of unknown cause. Many factors affecting the healing of BP have been identified; 1 factor commonly considered relevant is the presence of type 2 diabetes mellitus. Our aim was to investigate the effects of diabetes on the healing of BP. METHODS: Sixty patients with BP were followed up for 1 to 3 years and were divided into 2 groups, those with and those without type 2 diabetes. All were prescribed prednisone (initially 1 mg/kg per day, with a tapered dose reduction) and acyclovir (200 mg orally every 4 h, 5 times daily, for 5 days)...
December 25, 2017: Canadian Journal of Diabetes
Hiroshi Moriyama, Nobuyuki Mitsukawa, Masahiro Itoh, Naruhito Otsuka
OBJECTIVE: Details regarding the molecular biological features of Bell's palsy have not been widely reported in textbooks. We genetically analyzed facial muscles and clarified these points. MATERIALS AND METHODS: We performed genetic analysis of facial muscle specimens from Japanese patients with severe (House-Brackmann facial nerve grading system V) and moderate (House-Brackmann facial nerve grading system III) dysfunction due to Bell's palsy. Microarray analysis of gene expression was performed using specimens from the healthy and affected sides, and gene expression was compared...
December 14, 2017: Journal of International Advanced Otology
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