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Periodic paralysis

M A Akulov, O R Orlova, T V Tabashnikova, V V Karnaukhov, A S Orlova
Surgical treatment of posterior cranial fossa and cerebellopontine angle tumors is associated with a risk of facial nerve dysfunction. The causes for facial muscle paresis include nerve compression by the tumor, destruction of the nerve structure by the tumor growing from nerve fibers, nerve injury during surgical removal of the tumor, etc. The first 3 months after facial nerve injury are a potential therapeutic window for the use of botulinum toxin type A (BTA). During this period, the drug is introduced both in the healthy side to improve the facial symmetry at rest and during mimetic movements and in the affected side to induce drug-induced ptosis...
2018: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
Hideyuki Yanagi, Hiroto Terashi, Yoshimitsu Takahashi, Katsuyuki Okabe, Katsumi Tanaka, Chu Kimura, Norihiko Ohura, Takahiro Goto, Ichiro Hashimoto, Madoka Noguchi, Junichi Sasayama, Kenichi Shimada, Ayumi Sugai, Mitsuko Tanba, Takeo Nakayama, Ryoji Tsuboi, Junko Sugama, Hiromi Sanada
OBJECTIVE: To clarify the surgical indications and the appropriate perioperative management of ischial pressure ulcers (PUs). METHOD: A two-year prospective, nationwide registry study was carried out across 26 medical institutions in Japan. All participating institutions managed ischial PUs according to the standardisation of total management and surgical application for the refractory decubitus (STANDARDS-I) perioperative protocol. Analysis was conducted on a range of clinically or statistically important variables for the achievement of primary or secondary endpoints: complete wound healing and hospital discharge at three months, and complete wound healing at one month after surgery, respectively...
March 2, 2018: Journal of Wound Care
Ryuichi Azuma, Shimpo Aoki, Tetsushi Aizawa, Masahiro Kuwabara, Tomoharu Kiyosawa
Background: Static reconstruction surgery that tightens the tension of the inferior tarsus, thereby raising the lax lower eyelid, is a common treatment for paralytic ectropion of the lower eyelid. We present one such operative procedure, in which an orbicularis oculi muscle flap was used. Methods: The surgical technique involves partial resection of the tarsus and the skin, as well as a superior-based orbicularis oculi muscle flap that is sutured to the firm tissue present on the Whitnall tubercle...
March 5, 2018: Archives of Plastic Surgery
Andrew D Turner, Monika Dhanji-Rapkova, Karl Dean, Steven Milligan, Mike Hamilton, Julie Thomas, Chris Poole, Jo Haycock, Jo Spelman-Marriott, Alice Watson, Katherine Hughes, Bridget Marr, Alan Dixon, Lewis Coates
At the start of 2018, multiple incidents of dog illnesses were reported following consumption of marine species washed up onto the beaches of eastern England after winter storms. Over a two-week period, nine confirmed illnesses including two canine deaths were recorded. Symptoms in the affected dogs included sickness, loss of motor control, and muscle paralysis. Samples of flatfish, starfish, and crab from the beaches in the affected areas were analysed for a suite of naturally occurring marine neurotoxins of dinoflagellate origin...
February 26, 2018: Toxins
Adam N Master, Daniel S Roberts, Eric P Wilkinson, William H Slattery, Gregory P Lekovic
OBJECTIVE The authors describe their results using an endoscope as an adjunct to microsurgical resection of inferior vestibular schwannomas (VSs) with extension into the fundus of the internal auditory canal below the transverse crest. METHODS All patients who had undergone middle fossa craniotomy for VSs performed by the senior author between September 2014 and August 2016 were prospectively enrolled in accordance with IRB policies, and the charts of patients undergoing surgery for inferior vestibular nerve tumors, as determined either on preoperative imaging or as intraoperative findings, were retrospectively reviewed...
March 2018: Neurosurgical Focus
Manoj Kamal, Geeta Singariya, Om Prakash Suthar, Ashwini S
Acute hypokalemic paralysis is a reversible but potentially lethal clinical condition. We report a case, who developed rapidonset quadriparesis in immediate postoperative period after undergoing right percutaneous nephrolithotomy for bilateral renal stones. On evaluation, she was found to have hypernatremic, hyperchloremic, hypokalemic acidosis. This severe hypokalemia-induced quadriparesis was precipitated by repeated furosemide injections, use of potassium-free fluid as maintenance, intracellular shift due to free water administration in this patient, who had pre-existing distal renal tubular acidosis...
March 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
Emad Kandil, Khuzema Mohsin, Mohammad A Murcy, Gregory W Randolph
OBJECTIVES/HYPOTHESIS: Continuous intraoperative neuromonitoring (CIONM) of the vagus nerve was proposed to obtained frequent repetitive electromyography (EMG) data to recognize early change in intraoperative function of the recurrent laryngeal nerve. We examine our initial experience using this technology. STUDY DESIGN: Retrospective review. METHODS: Data for all patients who underwent neck surgery by a single surgeon at a North American institution over a 5-year period were reviewed...
February 26, 2018: Laryngoscope
YanLi Ma, RuiQing Wang, Yu Zhang, Jiazhen Le, PeiYun Zhuang, Allyson C Pulvermacher
OBJECTIVE: The objective of this study was to provide a theoretical basis for the selection of optimal surgical procedures in ex vivo simulated bilateral vocal fold paralysis (BVFP). STUDY DESIGN: Four surgical stages were sequentially performed on 10 excised canine larynges with simulated BVFP: (1) transverse cordotomy, (2) medial arytenoidectomy, (3) subtotal arytenoidectomy, and (4) total arytenoidectomy. MATERIALS AND METHODS: The sound pressure level, the signal-to-noise ratio, the glottal resistance, the glottal airflow (GF), the maximal glottal area (MGA), and spectrograms were measured after each stage...
February 23, 2018: Journal of Voice: Official Journal of the Voice Foundation
Doreen Fialho, Robert C Griggs, Emma Matthews
The periodic paralyses are a group of skeletal muscle channelopathies characterizeed by intermittent attacks of muscle weakness often associated with altered serum potassium levels. The underlying genetic defects include mutations in genes encoding the skeletal muscle calcium channel Cav 1.1, sodium channel Nav 1.4, and potassium channels Kir 2.1, Kir 3.4, and possibly Kir 2.6. Our increasing knowledge of how mutant channels affect muscle excitability has resulted in better understanding of many clinical phenomena which have been known for decades and sheds light on some of the factors that trigger attacks...
2018: Handbook of Clinical Neurology
Ajai Kumar Singh, Pradeep Kumar Maurya, Dinkar Kulshreshtha, Mayur Deepak Thakkar, Anup Kumar Thacker
OBJECTIVE: Acute neuromuscular weakness related to hypokalemia is a readily treatable disorder associated with diverse aetiologies. In this study we aim to report clinical pattern and biochemical features to identify the different aetiologies of the hypokalemic neuromuscular weakness. METHODS: Retrospective reviews of the medical record were analysed. Evaluation included demography, clinical features, investigations performed to ascertain the aetiologies. All the patients were categorised in to 3 groups; Idiopathic hypokalemic paralysis (IHP), dengue associated hypokalemic paralysis (DHP) and secondary group (SG) which included renal tubular acidosis (RTA- 1 and 2), thyrotoxic periodic paralysis (TPP) and Gitelman's syndrome (GS)...
September 15, 2017: Acta Neurologica Taiwanica
M Coulon, F Schurr, A-C Martel, N Cougoule, A Bégaud, P Mangoni, A Dalmon, C Alaux, Y Le Conte, R Thiéry, M Ribière-Chabert, E Dubois
Pathogens and pesticides are likely to co-occur in honeybee hives, but much remains to be investigated regarding their potential interactions. Here, we first investigated the metabolisation kinetics of thiamethoxam in chronically fed honeybees. We show that thiamethoxam, at a dose of 0.25ng/bee/day, is quickly and effectively metabolised into clothianidin, throughout a 20day exposure period. Using a similar chronic exposure to pesticide, we then studied, in a separate experiment, the impact of thiamethoxam and Chronic bee paralysis virus (CBPV) co-exposure in honeybees...
January 2018: Pesticide Biochemistry and Physiology
Masafumi Kurajoh, Keiko Ohsugi, Miki Kakutani-Hatayama, Takuhito Shoji, Hidenori Koyama
Hypokalemia and hypomagnesemia are frequently observed in patients with chronic alcoholism. However, the involvement of deranged cortisol regulation in patients with those conditions has not been reported. A 63-year-old Japanese male with chronic alcoholism was referred to the Department of Diabetes, Endocrinology and Metabolism for examination and treatment of hypokalemic periodic paralysis. Laboratory findings showed hypokalemia (2.3 mmol/l), as well as a high level of urinary excretion of potassium and hypomagnesemia (1...
February 15, 2018: CEN Case Reports
Maher Barsaoui, Hatem Safi, Walid Said, Med Nabil Nessib
BACKGROUND: Obstetric brachial plexus palsy aredue to elongation of the brachial plexus during delivery by increasing thedistance between the head and shoulder. The majority of paralysis recoverspontaneously, but in some cases, nerve repair is necessary. The timing of thisnerve surgery and criteria for its indication are topics of discussion in theworld literature.The aim of this study is to askdirections and to evaluate the contribution of nerve surgery in improving theprognosis of this disease...
March 2017: La Tunisie Médicale
Yun-Tao Zhao, Hang Zhou, Yumin Cui
Bidirectional ventricular tachycardia (BVT) is a rare ventricular tachyarrhythmia. It is usually regular, demonstrating a beat-to-beat alternation in the QRS frontal axis that varies between -20° to -30° and +110°. The tachycardia rate is typically between 140 and 180 beats/min and the QRS is relatively narrow, with a duration of 120 to 150 ms. The etiology of published BVT cases is most commonly digitalis toxicity and, rarely, herbal aconitine poisoning, hypokalemic periodic paralysis, catecholaminergic polymorphic ventricular tachycardia (CPVT), myocarditis, and Andersen-Tawil syndrome...
January 8, 2018: American Journal of Emergency Medicine
Xu Li, Wenxiang Wang, Yong Zhou, Desong Yang, Jie Wu, Baihua Zhang, Zhining Wu, Jinming Tang
BACKGROUND: This study aimed to propose a new surgical strategy, i.e., the transcervical video-assisted mediastinoscopic lymphadenectomy (VAMLA) with esophagectomy via the left transthoracic approach for patients with esophageal cancer (EC), and to compare the outcomes with those of esophagectomy via the right thoracic approach. METHODS: From December 2014 to March 2016, 49 cases were enrolled in this non-randomized concurrent control study. Twenty-eight patients with EC who underwent transcervical VAMLA with esophagectomy via the left transthoracic approach were assigned into the study group, while 21 EC patients undergoing esophagectomy via the right transthoracic approach during the same period were enrolled into the control group...
February 9, 2018: World Journal of Surgical Oncology
Vincenzo Abbate, Giovanni Dell'Aversana Orabona, Antonio Romano, Fabio Maglitto, Giorgio Iaconetta, Luigi Califano
BACKGROUND: Surgical approaches to the midcheek area are challenging. This area is included between the lower eyelid above, and the upper lip below. The peculiar anatomical location makes it really important for attractiveness, thus the need to obtain a correct balance between the operation's safety and minimally invasive aspect. To the authors' knowledge, this is the first showcase and technical description of a novel minimally invasive endoscopic approach for midcheek mass removal. METHODS: Making 3 incisions in concealed area an endoscopically aided facial dissection was performed to remove a solitary venus malformation of the left midcheek region...
February 7, 2018: Journal of Craniofacial Surgery
Manli Guo, Guowen Zhang, Shaogang Ma, Tie Xu, Yigen Peng
OBJECTIVE To screen for mutations in a Chinese pedigree affected with hypokalemic periodic paralysis. METHODS The proband and nine family members were enrolled for the analysis of CACNA1S and SCN4A gene mutations. Genomic DNA was extracted from peripheral blood samples. The coding regions of the two genes were amplified with PCR and subjected to Sanger sequencing. Potential impact of suspected mutations was predicted with Bioinformatics software. The mutations were also verified among 100 healthy controls. RESULTS The proband and 5 family members (including 5 males and 1 female) had presented with episodes of flaccid paralysis accompanied by low serum potassium...
February 10, 2018: Zhonghua Yi Xue Yi Chuan Xue za Zhi, Zhonghua Yixue Yichuanxue Zazhi, Chinese Journal of Medical Genetics
Christine M Groth, Nicole M Acquisto, Tina Khadem
PURPOSE: Characterize medication practices during and immediately after rapid sequence intubation (RSI) by provider/location and evaluate adverse drug events. MATERIALS AND METHODS: This was a multicenter, observational, cross-sectional study of adult and pediatric intensive care unit and emergency department patients over a 24-h period surrounding first intubation. RESULTS: A total of 404 patients from 34 geographically diverse institutions were included (mean age 58 ± 22 years, males 59%, pediatric 8%)...
January 30, 2018: Journal of Critical Care
Alex Iranzo
Parasomnias and sleep-related movement disorders are important problems in older adults. Sleep paralysis is rare, but may occur in families. In a minority of patients with disorders of arousal, the episodes persist until the age of 70. Zolpidem and other medications may induce sleepwalking and sleep-related eating. Most patients with idiopathic rapid eye movement (REM) sleep behavior disorder eventually develop Parkinson's disease or dementia with Lewy bodies. Anti-IgLON5 disease includes abnormal behaviors in NREM and REM sleep...
March 2018: Sleep Medicine Clinics
Irit Duek, Jacob T Cohen, Ziv Gil
George London was one of the most compelling vocal artists of the early twentieth century. At the age of 47, the great bass-baritone retired from singing. It has been suggested that the premature ending of his operatic career was due to unilateral vocal cord palsy (UVCP). When London retired, the common belief was that this UVCP was caused by viral hepatitis, although there is no evidence to support such an etiology. London's medical records eliminate the possible etiology of a neck neoplasm, and the long period of time between a heart attack he experienced and his diagnosis of UVCP makes a cardiovascular etiology an unlikely causative factor...
January 29, 2018: Rambam Maimonides Medical Journal
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