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Facial palsy treatment

James C Wang, Brittany A Leader, Ryan A Crane, Bernadette L Koch, Matthew M Smith, Stacey L Ishman
Granulomatosis with polyangiitis (GPA, previously known as Wegener's granulomatosis) is an autoimmune systemic small-vessel vasculitis, associated with the presence of anti-neurophil cytoplasmic antibodies with a cytoplasmic staining pattern (c-ANCA). It is characterized by necrotizing granulomas, usually affecting the airways and kidneys. GPA should be considered when patients do not improve despite adequate treatment of otologic symptoms, when patients have unspecific symptoms suggesting systemic disease (e...
April 2018: International Journal of Pediatric Otorhinolaryngology
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
Luciano Mastronardi, Guglielmo Cacciotti, Raffaele Roperto
BACKGROUND: To describe the surgical management and postoperative course of two patients presenting with facial nerve (FN) paralysis as one of the presenting symptoms of small intracanalicular vestibular schwannomas (VS). METHODS: Among 153 patients operated for VS since September 2010 to August 2017, two adult female patients presented with rapidly progressive hearing decrease, vestibular symptoms, and FN paralysis (House-Brackmann grades III and IV, respectively)...
February 26, 2018: Acta Neurochirurgica
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
Ahmed H Qavi, Tasnim F Imran, Zachariah Hasan, Fariha Ilyas
Tuberculous meningitis (TBM) is an infection of the central nervous system (CNS) meninges that carries high morbidity and mortality. It is important to recognize, as patients may present with atypical symptoms. We describe the case of a 31-year-old man with a history of diabetes who presented with a sub-acute onset of right-sided facial weakness and right gaze difficulty with diplopia. History revealed low-grade fever, right-sided headache, fatigue and moderate weight loss for the past several weeks. The patient did not report neck stiffness, rigidity, fever, chills or cough...
December 7, 2017: Curēus
M Sindou, P Mercier
Over the last decades microvascular decompression (MVD) has been established as the curative treatment of the primary Hemifacial Spasm (HFS), proven to be linked in almost all cases to a neurovascular compression of the facial nerve. Because the disease is not life-threatening and MVD not totally innocuous, efficacy and safety have to be weighted before decision taken of indicating surgery. The authors have been charged by the French Speaking Society of Neurosurgery to conduct a detailed evaluation of the probability of relief of the spasm that MVD is able to obtain, together with its potential complications...
February 14, 2018: Neuro-Chirurgie
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
Shang-Fu Hsu, Chen-Chun Lin
RATIONALE: Van Buchem disease (VBD) is a very rare autosomal recessive disease. According to our review of the relevant literature, this article is the first case report of VBD in Taiwan. PATIENT CONCERNS: A 54-year-old woman developed a protruding chin, frontal bossing, and macrocephaly at the age of 40 years. She noted the onset of progressive bilateral visual and hearing impairment at the age of 40 and 45 years, respectively. Intermittent headaches, peripheral facial palsy, recurrent bilateral trigeminal neuralgia, and back pain were also observed since age 40...
December 2017: Medicine (Baltimore)
Vishnu Sri Shanmuganathan, Aumie Kethees, Shu-Hong Chang, Konstantinos Papageorgiou
Purpose: Patients with acute paralytic lagophthalmos are at high risk for ocular surface breakdown due to exposure. External eyelid weights are a temporary solution for paralytic lagophthalmos that aim to reduce exposure and optimize blink excursion. Despite easy application and high efficacy, this product is under-utilized in clinical practice with few physicians employing this treatment adjunct. Results: Ocular surface health was maintained in all patients, and overall aesthetic satisfaction was high...
January 2018: Oxford Medical Case Reports
Ru-Wen Zheng, Di Liu, Tay E Eric, Yan-Zhe Ning, Lu-Lu Chen, Hui Hu, Yi Ren
RATIONALE: Ramsay Hunt syndrome in conjunction with cranial polyneuritis is not extensively documented, and is very easily misdiagnosed. PATIENT CONCERNS: A case of a 53-year-old male with Ramsay Hunt syndrome in conjunction with cranial polyneuritis is presented with early symptoms of vertigo, cephalalgia, and facial palsy, followed by zoster oticus 10 days later. DIAGNOSES: Diagnosis was challenging as this condition presents with multiple neuropathies, and attempting to diagnose based on clinical symptoms was often misleading...
November 2017: Medicine (Baltimore)
Natalie A Kwit, Christina A Nelson, Ryan Max, Paul S Mead
Background: Clinical features of Lyme disease (LD) range from localized skin lesions to serious disseminated disease. Information on risk factors for Lyme arthritis, facial palsy, carditis, and meningitis is limited but could facilitate disease recognition and elucidate pathophysiology. Methods: Patients from high-incidence states treated for LD during 2005-2014 were identified in a nationwide insurance claims database using the International Classification of Diseases, Ninth Revision code for LD (088...
January 2018: Open Forum Infectious Diseases
Dong Sik Chang, Jun Lee, Sun Ae Shin, Ho Yun Lee
Infection caused by Varicella zoster virus (VZV) is a common etiology of acute peripheral facial palsy (APFP). We aimed to assess the clinical significance of detecting VZV DNA from the saliva of patients with APFP. Saliva collected from thirty-six patients with unilateral APFP at initial visit was analyzed to detect VZV DNA by polymerase chain reaction. The House-Brackmann (HB) scale was used to evaluate FP severity on admission day, at week 2, and at weeks 10-12 after start of treatment. Among the 28 patients without rash, VZV DNA was detected in 3 patients (10...
January 10, 2018: Journal of Medical Virology
Mi Jang, Hongyan Liu, Chunfu Dai
OBJECTIVE: To analyze the outcomes of microsurgically treated jugular paragangliomas with control of bleeding from the inferior petrous sinus. STUDY DESIGN: Retrospective patient review. SETTING: A single university hospital. PATIENTS: Forty-three patients with jugular paragangliomas were diagnosed in the past 7 years in our clinic. MAIN OUTCOME MEASURES: Surgical tumor control, intraoperative blood loss, intraoperative management of the facial nerve, and the preoperative and postoperative function of the lower central nerves...
February 2018: Otology & Neurotology
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
John J Halperin
The nervous system is involved in 10-15% of patients infected with B. burgdorferi, B. afzelii and B. garinii. This review will address widespread misconceptions about the clinical phenomenology, diagnostic approach and response to treatment of neuroborreliosis. Areas covered: Improvements in diagnostic testing have allowed better definition of the clinical spectrum of neuroborreliosis, with lymphocytic meningitis and uni- or multifocal inflammation of peripheral/cranial nerves predominating. Despite widespread concern that post-treatment cognitive/behavioral symptoms might be attributable to persisting infection or aberrant inflammation within the central nervous system a large body of evidence indicates this is extremely improbable...
January 2018: Expert Review of Anti-infective Therapy
Yu-Wei Hsu, Jiunn-Tay Lee, Yi-Shu Liao, Shin Nieh, Chun-An Cheng, Chia-Kuang Tsai
PURPOSE: To present a case of salivary gland malignancy initially mimicking Bell's palsy. CASE REPORT: A 75-year-old woman with hypertension visited our neurological outpatient department,complaining of persistent right facial paralysis for more than a year after oral glucocorticoid therapy with recent development of vertigo and unsteady gait. She was previously diagnosed as having Bell's palsy and was prescribed oral glucocorticoid. However, her right facial muscles were still completely paralyzed, with no signs of improvement...
June 15, 2017: Acta Neurologica Taiwanica
Kavita Sachdeva, Aparaajita Upadhyay
The destructive lesions affect midline facial areas causing extensive destruction. These lesions are challenging till date due to peculiarity in presentation and non availability of any single objective test. An attempt has been done to evaluate these different clinical presentations of lesions presenting at a single centre and the challenges faced by us at a tertiary government setup. Prospective study done on 15 patients presenting in department during period of 2006-2016. After a detailed history, hematological and biochemical markers, ESR, radiographical tests, pus culture, C ANCA, CECT PNS and histopathogical evaluation were done...
December 2017: Indian Journal of Otolaryngology and Head and Neck Surgery
Wasan Lafi Alanazi, Nagah Mohamed Abo El-Fetoh, Shahad Lafi Alanazi, Mohammed Abdullah Alkhidhr, Mohammed Abdullah Alanazi, Dounia Saleh Alonazi, Atheer Bader Alanzi, Reem Homoud Alshammari, Mashael Jaza Alshammari, Basmah Abdullah Alanazi, Samiyah Sarhan Alanazi
Background: The term facial palsy generally refers to weakness of the facial muscles, mainly resulting from temporary or permanent damage to the facial nerve. Common causes of facial paralysis include infection or inflammation of the facial nerve, head trauma, head or neck tumor, stroke. Objective: To outline the incidence of several etiologies and the profile of patients with peripheral facial paralysis attending the outpatient clinic of the neurology department in Hospitals of Arar City, Saudi Arabia...
October 2017: Electronic Physician
Luana Antunes Maranha Gatto, Fernando Saurin, Gelson Luis Koppe, Zeferino Demartini
Background: Dural arteriovenous fistulas (DAVF) are unusual intracranial vascular malformations consisting of anomalous connections between meningeal arteries and dural sinuses or the veins that pass through them. They have variable clinical presentation and prognosis, which depend on their location and venous hemodynamics. Treatment is based on the closure of the abnormal connections, which is usually conducted via arterial and/or transvenous endovascular techniques. Case Description: We present a male patient who complained of headaches and left-sided pulsatile tinnitus due to DAVF from the external carotid artery branches draining directly into the ipsilateral sigmoid sinus...
2017: Surgical Neurology International
Ming Xing Liu, Lei Xia, Jun Zhong, Bin Li, Ning Ning Dou, Shi Ting Li
BACKGROUND: Although microvascular decompression (MVD) has been widely accepted as an effective treatment for hemifacial spasm (HFS), some patients may experience delayed relief instead of immediate improvement after the surgery. The need for and timing of repeat MVD has been controversial to date; thus, we conducted the present study with emphasis on those unrelieved patients. METHODS: Between January 2010 and December 2014, 3095 patients with idiopathic HFS were treated with MVD at XinHua Hospital, Shanghai Jiaotong University School of Medicine...
February 2018: World Neurosurgery
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