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Sample records for abducens nerve palsy

  1. Isolated abducens nerve palsy with hyperhomocysteinemia: Association and outcomes

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    Virender Sachdeva

    2013-01-01

    Full Text Available Ischemic abducens nerve palsy usually presents as isolated cranial nerve palsy in the middle aged and elderly patients with known risk factors such as diabetes mellitus, hypertension, dyslipidemia, carotid artery disease, etc., In this report, we describe four patients with isolated abducens nerve palsy who presented with an acute onset diplopia whose detailed history and examination were suggestive of an ischemic etiology. Detailed systemic and laboratory evaluation revealed hyperhomocysteinemia as the only potential risk factor. To the best of our knowledge this is the first report of association of hyperhomocysteinemia and isolated abducens nerve palsy.

  2. Isolated Abducens Nerve Palsy: Update on Evaluation and Diagnosis.

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    Elder, Christopher; Hainline, Clotilde; Galetta, Steven L; Balcer, Laura J; Rucker, Janet C

    2016-08-01

    Abducens nerve palsy is a common clinical finding in neurology practice. In many instances, the origin is obvious and management straightforward; however, the list of possible etiologies and mimics is vast and diverse and diagnostic decisions can be challenging and even controversial. This is especially true when the abducens nerve is affected in isolation, since in the current era of cost-effective medicine, it is critical to accurately diagnose etiologies that may lead to major morbidity or mortality with efficiency. Topics for highlighted updates in this review include management of isolated abducens nerve palsy with a high likelihood of a microvascular ischemic etiology; common imaging pitfalls and current state-of-the-art neuroimaging; and abducens palsy mimics. PMID:27306521

  3. CLIVUS METASTASIS PRESENTING AS ISOLATED ABDUCEN S NERVE PALSY – CASE REPORT

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    Chandrashekhar

    2013-10-01

    Full Text Available ABSTRACT: A 50 year old lady with past history of breast carcinoma surgery presented with progressive diplopia of 15 days duration. Examination revealed paresis of right abducens nerve. Though risk factor like Hypertension was present, patient was ordered MRI which showed Clivus and verte bral metastatic foci highly suggestive of metastasis from breast carcinoma. The patient was referred for radiation therapy. Hence, meticulous neuroophthalmic examination and management is necessary to rule out localised metastasis causing isolated abducens nerve palsy.

  4. Horner's syndrome and contralateral abducens nerve palsy associated with zoster meningitis.

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    Cho, Bum-Joo; Kim, Ji-Soo; Hwang, Jeong-Min

    2013-12-01

    A 55-year-old woman presented with diplopia following painful skin eruptions on the right upper extremity. On presentation, she was found to have 35 prism diopters of esotropia and an abduction limitation in the left eye. Two weeks later, she developed blepharoptosis and anisocoria with a smaller pupil in the right eye, which increased in the darkness. Cerebrospinal fluid analysis showed pleocytosis and a positive result for immunoglobulin G antibody to varicella zoster virus. She was diagnosed to have zoster meningitis with Horner's syndrome and contralateral abducens nerve palsy. After intravenous antiviral and steroid treatments, the vesicular eruptions and abducens nerve palsy improved. Horner's syndrome and diplopia resolved after six months. Here we present the first report of Horner's syndrome and contralateral abducens nerve palsy associated with zoster meningitis.

  5. Abducens nerve palsy as a postoperative complication of minimally invasive thoracic spine surgery: a case report

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    Sandon, Luiz Henrique Dias; Choi, Gun; Park, EunSoo; Lee, Hyung-Chang

    2016-01-01

    Background Thoracic disc surgeries make up only a small number of all spine surgeries performed, but they can have a considerable number of postoperative complications. Numerous approaches have been developed and studied in an attempt to reduce the morbidity associated with the procedure; however, we still encounter cases that develop serious and unexpected outcomes. Case Presentation This case report presents a patient with abducens nerve palsy after minimally invasive surgery for thoracic d...

  6. Paralytic squint due to abducens nerve palsy : a rare consequence of dengue fever

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    Shivanthan Mitrakrishnan C

    2012-07-01

    Full Text Available Abstract Background Dengue fever is an endemic illness in the tropics with early and post infectious complications affecting multiple systems. Though neurological sequelae including mononeuropathy, encephalopathy, transverse myelitis, polyradiculopathy, Guillain-Barre syndrome , optic neuropathy and oculomotor neuropathy have been reported in medical literature, the abducens nerve despite its notoriety in cranial neuropathies in a multitude of condition due to its long intracranial course had not been to date reported to manifest with lateral rectus paralysis following dengue. Case presentation A previously well 29 year old male with serologically confirmed dengue hemorrhagic fever developed symptomatic right lateral rectus palsy during the critical phase of the illness, which persisted into convalescence and post convalescence with proven deficit on Hess screen. Alternate etiologies were excluded by imaging, serology and electrophysiology. Conclusions The authors detail the first reported case of abducens nerve palsy complicating dengue fever in a previously healthy male from Sri Lanka. In a tropical country with endemic dengue infections, dengue related abducens neuropathy may be considered as a differential diagnosis in cases of acquired lateral rectus palsy after dengue fever.

  7. A Rare Neurological Involvement in Sjogrens Syndrome: Abducens Nerve Palsy

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    Yunus Ugan

    2016-05-01

    Full Text Available Sjogren%u2019s syndrome (SS is an autoimmune disorder characterized by lymphocytic infiltration of exocrine organs. Although neurological involvement occurs in approximately one quarter of patients, involvement of cranial nerves is a relatively rare occurrence. Here a rare case of cranial neuropathy related to SS is reported.

  8. The diagnostic yield of neuroimaging in sixth nerve palsy - Sankara Nethralaya Abducens Palsy Study (SNAPS: Report 1

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    Akshay Gopinathan Nair

    2014-01-01

    Full Text Available Aims: The aim was to assess the etiology of sixth nerve palsy and on the basis of our data, to formulate a diagnostic algorithm for the management in sixth nerve palsy. Design: Retrospective chart review. Results: Of the 104 neurologically isolated cases, 9 cases were attributable to trauma, and 95 (86.36% cases were classified as nontraumatic, neurologically isolated cases. Of the 95 nontraumatic, isolated cases of sixth nerve palsy, 52 cases were associated with vasculopathic risk factors, namely diabetes and hypertension and were classified as vasculopathic sixth nerve palsy (54.7%, and those with a history of sixth nerve palsy from birth (6 cases were classified as congenital sixth nerve palsy (6.3%. Of the rest, neuroimaging alone yielded a cause in 18 of the 37 cases (48.64%. Of the other 19 cases where neuroimaging did not yield a cause, 6 cases were attributed to preceding history of infection (3 upper respiratory tract infection and 3 viral illnesses, 2 cases of sixth nerve palsy were found to be a false localizing sign in idiopathic intracranial hypertension and in 11 cases, the cause was undetermined. In these idiopathic cases of isolated sixth nerve palsy, neuroimaging yielded no positive findings. Conclusions: In the absence of risk factors, a suggestive history, or positive laboratory and clinical findings, neuroimaging can serve as a useful diagnostic tool in identifying the exact cause of sixth nerve palsy. Furthermore, we recommend an algorithm to assess the need for neuroimaging in sixth nerve palsy.

  9. Conjugate Gaze Palsies

    Science.gov (United States)

    ... Nerve) Palsy Sixth Cranial Nerve (Abducens Nerve) Palsy Trigeminal Neuralgia Bell Palsy Hemifacial Spasm Glossopharyngeal Neuralgia Hypoglossal Nerve ... Nerve) Palsy Sixth Cranial Nerve (Abducens Nerve) Palsy Trigeminal Neuralgia Bell Palsy Hemifacial Spasm Glossopharyngeal Neuralgia Hypoglossal Nerve ...

  10. Microsurgical anatomy of the abducens nerve.

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    Joo, Wonil; Yoshioka, Fumitaka; Funaki, Takeshi; Rhoton, Albert L

    2012-11-01

    The aim of this study is to demonstrate and review the detailed microsurgical anatomy of the abducens nerve and surrounding structures along its entire course and to provide its topographic measurements. Ten cadaveric heads were examined using ×3 to ×40 magnification after the arteries and veins were injected with colored silicone. Both sides of each cadaveric head were dissected using different skull base approaches to demonstrate the entire course of the abducens nerve from the pontomedullary sulcus to the lateral rectus muscle. The anatomy of the petroclival area and the cavernous sinus through which the abducens nerve passes are complex due to the high density of critically important neural and vascular structures. The abducens nerve has angulations and fixation points along its course that put the nerve at risk in many clinical situations. From a surgical viewpoint, the petrous tubercle of the petrous apex is an intraoperative landmark to avoid damage to the abducens nerve. The abducens nerve is quite different from the other nerves. No other cranial nerve has a long intradural path with angulations and fixations such as the abducens nerve in petroclival venous confluence. A precise knowledge of the relationship between the abducens nerve and surrounding structures has allowed neurosurgeon to approach the clivus, petroclival area, cavernous sinus, and superior orbital fissure without surgical complications. PMID:22334502

  11. An Infant with Benign Isolated Abducens Palsy After Vaccination

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    Celebi Kocaoglu

    2014-02-01

    Full Text Available Benign isolated abducens palsy is a self-improving clinical entity characterized by esotropia and diplopia led by the deficiency of abduction, and accompanied by no other neurological findings. The entity may occur after experiencing minor fever episodes, viral infection. The pathophysiological mechanism of cellular injury remains unclear. Hypotheses involve damage arising from autoimmune mediation or direct viral invasion causing demyelination, localized arteritis or genetic predisposition, which could increase susceptibility to such nerve palsies. Diagnosed with benign isolated abducens palsy, a 19-month-old girl infant admitted to our outpatient clinic with an acute onset of esotropia in the right eye developing two weeks after the vaccination of diphtheria, acellular pertussis, tetanus, inactivated polio and Haemophilus influenzae type b (DTPa-IP-Hib was presented in this report.

  12. A case misdiagnosed as bilateral abducens palsy

    International Nuclear Information System (INIS)

    A 66-year-old male was admitted to our neurosurgical floor because of double vision and gait disturbance. Neurological examinations revealed bilateral 6th nerve palsy with both eyes pointing toward the midline. Initially, using a tentative diagnosis of intracranial mass lesions, especially localized at the base of the skull, computerized tomography of the head, cerebral angiography, orbital venography, and metrizamide CT cisternography were performed; the findings were normal. An orbital CT scan showed an enlargement of the bilateral medial rectus muscles, and the thyroid functions of T3 and T4 and the T3 uptake were all elevated, which was compatible with the diagnosis of Graves' disease. The limitations of both eyeballs were considered to be due not to the 6th nerve palsy, but to the hypertrophy of the bilateral medial rectus muscles. We neurosurgeons should recall Graves' disease as well as intracranial lesions, cerebrovascular disease, and post-traumatic sequelae when examining a patient who presents limitations of external ocular movement. (author)

  13. 电针改善单纯外展神经麻痹性眼球运动障碍的临床分析%Clinical analysis of abducens nerve palsy treated by electroacupuncture

    Institute of Scientific and Technical Information of China (English)

    马朝廷; 杨迎新; 马秋艳; 张丹丹; 赵彦萍; 李喜文

    2015-01-01

    AIM: To observe the clinical curative effect of electroacupuncture connecting Qiuhou ( EX-HN7) and Hegu( LI-4) for eyeball movement disorder caused by acquired simplex abducens nerve palsy. METHODS:Randomly we divided 48 cases(48 eyes) into treatment group(26 cases with 26 eyes) and control group (22 cases with 22 eyes), diagnosed with abducens nerve palsy from March 2012 to March 2015 at ophthalmology department of Beijing hospital of traditional Chinese medicine affiliated to Capital Medical University.Patients in treatment group were treated by electroacupuncture connecting Qiuhou ( EX-HN7) and Hegu ( LI-4), with body acupuncture and acupoints around eye. Control group took methylcobalamin (0.5mg,3 times per day) orally and subcutaneously injection of compound anisodine hydrobromide by the superficial temporal vein (2mL, once a day ) as the treatment. During the treatment, affected eyes of all the patients were covered. The course of treatments was 1mo.The improvement of eye movements was observed. RESULTS:The date of the two groups was comparable at baseline.After 1mo treatments, the eye movement of treatment group was significantly improved from 13.06±2.31mm pre-treatment to 19.35±3.21mm post-treatment, than that of the control group. The difference was statistically significant (t=-5.43, P<0.01).The effective rate of the treatment group was 88.5%, higher than that of the control group (63.6%).The difference was statistically significant (χ2=4.16, P=0.04). CONCLUSION: The electroacupuncture connecting Qiuhou(EX-HN7) and Hegu (LI-4)has certain effects on the treatment of eyeball movement disorder caused by simplex abduction paralysis.It is worth further clinical research.%AIM: To observe the clinical curative effect of electroacupuncture connecting Qiuhou ( EX -HN7 ) and Hegu(LI -4 ) for eyeball

  14. In vitro classical conditioning of abducens nerve discharge in turtles.

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    Keifer, J; Armstrong, K E; Houk, J C

    1995-07-01

    In vitro classical conditioning of abducens nerve activity was performed using an isolated turtle brainstem-cerebellum preparation by direct stimulation of the cranial nerves. Using a delayed training procedure, the in vitro preparation was presented with paired stimuli consisting of a 1 sec train stimulus applied to the auditory nerve (CS), which immediately preceded a single shock US applied to the trigeminal nerve. Conditioned and unconditioned responses were recorded in the ipsilateral abducens nerve. Acquisition exhibited a positive slope of conditioned responding in 60% of the preparations. Application of unpaired stimuli consisting of CS-alone, alternate CS and US, or backward conditioning failed to result in conditioning, or resulted in extinction of CRs. Latencies of CR onset were timed such that they occurred midway through the CS. Activity-dependent uptake of the dye sulforhodamine was used to examine the spatial distribution of neurons labeled during conditioning. These data showed label in the cerebellum and red nucleus during conditioning whereas these regions failed to label during unconditioned responses. Furthermore, the principal abducens nucleus labeled heavily during conditioning. These findings suggest the feasibility of examining classical conditioning in a vertebrate in vitro brainstem-cerebellum preparation. It is postulated that the abducens nerve CR represents a behavioral correlate of a blink-related eye movement. Multiple sites of conditioning are hypothesized, including the cerebellorubral circuitry and brainstem pathways that activate the principal abducens nucleus.

  15. Recurrent isolated abducens nerve paresis associated with persistent trigeminal artery variant.

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    Nakamagoe, Kiyotaka; Mamada, Naomi; Shiigai, Masanari; Shimizu, Kotone; Koganezawa, Tadachika; Tamaoka, Akira

    2012-01-01

    We report a 74-year-old woman who presented with recurrent isolated abducens nerve paresis. Cranial magnetic resonance imaging revealed that the right abducens nerve was sandwiched between the right internal carotid artery and a persistent trigeminal artery (PTA) variant, which might have led to neurovascular compression of the abducens nerve, resulting in abducens nerve damage. Normal variants of PTA, which are cerebellar arteries originating from a precavernous portion of the internal carotid artery, must be carefully observed as such variants can potentially cause a neurovascular compression of the abducens nerve. PMID:22892506

  16. A case of isolated abducens nerve paralysis in maxillofacial trauma

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    Keskin, Elif Seda; Keskin, Ekrem; Atik, Bekir; Koçer, Abdülkadir

    2015-01-01

    Nervus abducens is a pure motor nerve located in the pons. It retracts the eyeball laterally by stimulating rectus lateralis muscle. In case of their paralysis, diplopia and restriction in the eye movements while looking sideways, are seen. Since the same signs are seen due to the muscle entrapment in blowout fractures, its differential diagnosis has importance in terms of the treatment protocol and avoiding unnecessary operations. In this article, we present a 22-year-old male patient who was referred to our department due to the prediagnosis of blowout fracture following maxillofacial trauma. However, he was diagnosed with abducens nerve paralysis after the consultations and analysis and his restriction of movement was resolved via systemic steroid treatment instead of unnecessary operation. PMID:26981484

  17. The cisternal segment of the abducens nerve in man: three-dimensional MR imaging

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    Alkan, Alpay E-mail: aalkan@inonu.edu.tr; Sigirci, Ahmet; Ozveren, M. Faik; Kutlu, Ramazan; Altinok, Tayfun; Onal, Cagatay; Sarac, Kaya

    2004-09-01

    Purpose: The goal of this study was to identify the abducens nerve in its cisternal segment by using three-dimensional turbo spin echo T2-weighted image (3DT2-TSE). The abducens nerve may arise from the medullopontine sulcus by one singular or two separated rootlets. Material and methods: We studied 285 patients (150 males, 135 females, age range: 9-72 years, mean age: 33.3{+-}14.4) referred to MR imaging of the inner ear, internal auditory canal and brainstem. All 3D T2-TSE studies were performed with a 1.5 T MR system. Imaging parameters used for 3DT2-TSE sequence were TR:4000, TE:150, and 0.70 mm slice thickness. A field of view of 160 mm and 256x256 matrix were used. The double rootlets of the abducens nerve and contralateral abducens nerves and their relationships with anatomical structures were searched in the subarachnoid space. Results: We identified 540 of 570 abducens nerves (94.7%) in its complete cisternal course with certainty. Seventy-two cases (25.2%) in the present study had double rootlets of the abducens nerve. In 59 of these cases (34 on the right side and 25 on the left) presented with unilateral double rootlets of the abducens. Thirteen cases presented with bilateral double rootlets of the abducens (4.5%). Conclusion: An abducens nerve arising by two separate rootlets is not a rare variation. The detection of this anatomical variation by preoperative MR imaging is important to avoid partial damage of the nerve during surgical procedures. The 3DT2-TSE as a noninvasive technique makes it possible to obtain extremely high-quality images of microstructures as cranial nerves and surrounding vessels in the cerebellopontine cistern. Therefore, preoperative MR imaging should be performed to detect anatomical variations of abducens nerve and to reduce the chance of operative injuries.

  18. 影响颈内动脉海绵窦瘘患者发生展神经麻痹的相关因素分析%Risk Factor Analysis of Abducens Nerve Palsy Caused by Carotid Cavernous Fistula

    Institute of Scientific and Technical Information of China (English)

    黄小山; 李志平

    2015-01-01

    目的:探讨颈内动脉海绵窦瘘患者发生展神经麻痹的相关影响因素。方法回顾性分析神经外科收治的127例颈内动脉海绵窦瘘患者的临床资料。结果127例患者中展神经麻痹67例,展神经非麻痹患者60例。单因素分析显示:治疗前症状持续时长、瘘口血流量大、颈内盗血、合并颅底骨折或颅高压、经岩上、下引流,是颈内动脉海绵窦瘘患者发生展神经麻痹影响因素,差异有统计学意义(P<0.05)。多因素Logistic 回归分析显示:治疗前症状持续时长(OR=8.449,P<0.05)、瘘口血流量大(OR=6.862,P<0.05)、合并颅底骨折或颅高压(OR=19.375,P<0.05)、经岩上、下引流(OR=3.838,P<0.05)是导致颈内动脉海绵窦瘘患者发生展神经麻痹的独立危险因素。67例展神经麻痹患者中失访3例,展神经完全恢复59例,未完全恢复5例。恢复时间(82.14±12.23)d,85.84%的患者在6个月内恢复。结论治疗前症状持续时长、瘘口血流量大、合并颅底骨折或颅高压、经岩上、下引流是颈内动脉海绵窦瘘患者发生展神经麻痹重要影响因素。多数患者可在6个月内恢复。%Objective To explore the risk factors of abducens nerve palsy caused by carotid cavernous fistula(CCF).Methods The clinical data of 127 patients with CCF in the Department of Neurosurgery form January 2004 to August 2013 were analyzed retrospectively.The factors include gender, age, etiology, duration of symptoms before treatment, accompanying by skull fracture or cerebral edema, fistula side, blood flow of fistula, number of fistula, with or without steal phenomena and venous drainage, were analyzed with univariate analysis and multi-variate binary Logistic regression analysis.Observe the patient’ s prognosis.Results Totally 127 patients, the number of paralysis patients was 67 and non-paralytic patients was 60.The

  19. Abducens Palsy Due to Cerebral Venous Sinus Thrombosis in a Patient with Heart Failure

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    Cem Özgönül; Osman Melih Ceylan; Fatih Mehmet Mutlu

    2015-01-01

    Cerebral venous sinus thrombosis has a wide spectrum of presentation. The clinical manifestation depends on the location of the thrombus, its rate of progression, and the extent of venous collateralization. In this case report, we present the findings of cerebral venous sinus thrombosis presenting with abducens palsy and papilloedema in a patient with heart failure, an unusual etiology for cerebral venous sinus thrombosis. (Turk J Ophthalmol 2015; 45: 179-181)

  20. Risk factors analysis and follow-up of abducens nerve palsy caused by carotid cavernous fistula%颈内动脉海绵窦瘘致外展神经麻痹的影响因素分析及临床随访总结

    Institute of Scientific and Technical Information of China (English)

    崔旭波; 汪求精; 高玉元; 郑涛; 柳亚启; 张炘; 段传志; 李铁林

    2013-01-01

    Objective To explore the risk factors of abducens nerve palsy caused by carotid cavernous fistula (CCF) and follow up their prognosis.Methods One hundred and thirty-nine patients with CCF,admitted to our hospital from January 2000 to August 2012,were chosen in our study and divided into paralysis group and non-paralytic group.The relevant factors,including gender,age,etiology,duration of symptoms before treatment,accompaying by skull fracture or cerebral edema,fistula side,blood flow of fistula,number of fistula,with or without steal phenomena and venous drainage,were retrospectively analyzed with univariate analysis and multivariate binary Logistic regression analysis.And prognosis of patients with abducens nerve palsy (non-paralytic group) were followed up through the outpatient,telephone,Internet and other means.Results In 139 patients,the number of paralysis patients was 67 and non-paralytic patients was 72.The duration of symptoms before treatment (P=0.001,R=4.073,95%CI:1.745-9.510),accompaying by skull fracture or cerebral edema (P=0.009,R=2.829,95%CI:1.294-6.185),blood flow of fistula (P=0.015,R=3.336,95%CI:1.261-8.823) and the inferior or superior petrosal sinus drainage (P=0.001,R=6.791,95%CI:2.129-21.660) were the four independent risk factors.In all,67 paralysis patients were followed; abducens nerve completely restored in 53 and seven did not fully recover.Recovery time lasted for 12-310 d with an average of 88.9 d; 45 patients got recovery within six months,accounting for 84.9%.Conclusion Abducens nerve palsy can be caused by many factors in CCF patients,and the inferior or superior petrosal sinus drainage is the primary risk factors; after CCF being cured,most patients with abducens nerve palsy can fully restore within six months with an average of three months.%目的 探讨颈内动脉海绵窦瘘致外展神经麻痹的影响因素,并对其预后进行临床随访总结. 方法 回顾性收集南方医科大学

  1. Cranial nerve palsies in childhood

    OpenAIRE

    Lyons, C J; Godoy, F; ALQahtani, E

    2015-01-01

    We review ocular motor cranial nerve palsies in childhood and highlight many of the features that differentiate these from their occurrence in adulthood. The clinical characteristics of cranial nerve palsies in childhood are affected by the child's impressive ability to repair and regenerate after injury. Thus, aberrant regeneration is very common after congenital III palsy; Duane syndrome, the result of early repair after congenital VI palsy, is invariably associated with retraction of the g...

  2. Intrinsic properties guide proximal abducens and oculomotor nerve outgrowth in avian embryos.

    Science.gov (United States)

    Lance-Jones, Cynthia; Shah, Veeral; Noden, Drew M; Sours, Emily

    2012-02-01

    Proper movement of the vertebrate eye requires the formation of precisely patterned axonal connections linking cranial somatic motoneurons, located at defined positions in the ventral midbrain and hindbrain, with extraocular muscles. The aim of this research was to assess the relative contributions of intrinsic, population-specific properties and extrinsic, outgrowth site-specific cues during the early stages of abducens and oculomotor nerve development in avian embryos. This was accomplished by surgically transposing midbrain and caudal hindbrain segments, which had been pre-labeled by electroporation with an EGFP construct. Graft-derived EGFP+ oculomotor axons entering a hindbrain microenvironment often mimicked an abducens initial pathway and coursed cranially. Similarly, some EGFP+ abducens axons entering a midbrain microenvironment mimicked an oculomotor initial pathway and coursed ventrally. Many but not all of these axons subsequently projected to extraocular muscles that they would not normally innervate. Strikingly, EGFP+ axons also took initial paths atypical for their new location. Upon exiting from a hindbrain position, most EGFP+ oculomotor axons actually coursed ventrally and joined host branchiomotor nerves, whose neurons share molecular features with oculomotor neurons. Similarly, upon exiting from a midbrain position, some EGFP+ abducens axons turned caudally, elongated parallel to the brainstem, and contacted the lateral rectus muscle, their originally correct target. These data reveal an interplay between intrinsic properties that are unique to oculomotor and abducens populations and shared ability to recognize and respond to extrinsic directional cues. The former play a prominent role in initial pathway choices, whereas the latter appear more instructive during subsequent directional choices. PMID:21739615

  3. Palsies of Cranial Nerves That Control Eye Movement

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    ... Medical News Palsies of Cranial Nerves That Control Eye Movement By Michael Rubin, MDCM NOTE: This is the ... Gaze Palsies Palsies of Cranial Nerves That Control Eye Movement Third Cranial Nerve (Oculomotor Nerve) Palsy Fourth Cranial ...

  4. Intrinsic Properties Guide Proximal Abducens and Oculomotor Nerve Outgrowth in Avian Embryos

    OpenAIRE

    Lance-Jones, Cynthia; Shah, Veeral; Noden, Drew M; Sours, Emily

    2012-01-01

    Proper movement of the vertebrate eye requires the formation of precisely patterned axonal connections linking cranial somatic motoneurons, located at defined positions in the ventral midbrain and hindbrain, with extraocular muscles. The aim of this research was to assess the relative contributions of intrinsic, population-specific properties and extrinsic, outgrowth site-specific cues during the early stages of abducens and oculomotor nerve development in avian embryos. This was accomplished...

  5. Cranial nerve palsies in childhood.

    Science.gov (United States)

    Lyons, C J; Godoy, F; ALQahtani, E

    2015-02-01

    We review ocular motor cranial nerve palsies in childhood and highlight many of the features that differentiate these from their occurrence in adulthood. The clinical characteristics of cranial nerve palsies in childhood are affected by the child's impressive ability to repair and regenerate after injury. Thus, aberrant regeneration is very common after congenital III palsy; Duane syndrome, the result of early repair after congenital VI palsy, is invariably associated with retraction of the globe in adduction related to the innervation of the lateral rectus by the III nerve causing co-contraction in adduction. Clinical features that may be of concern in adulthood may not be relevant in childhood; whereas the presence of mydriasis in III palsy suggests a compressive aetiology in adults, this is not the case in children. However, the frequency of associated CNS abnormalities in III palsy and the risk of tumour in VI palsy can be indications for early neuroimaging depending on presenting features elicited through a careful history and clinical examination. The latter should include the neighbouring cranial nerves. We discuss the impact of our evolving knowledge of congenital cranial dysinnervation syndromes on this field. PMID:25572578

  6. An unusual variant of the abducens nerve duplication with two nerve trunks merging within the orbit: a case report with comments on developmental background.

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    Wysiadecki, Grzegorz; Polguj, Michał; Topol, Mirosław

    2016-07-01

    This study reports the first case of abducens nerve duplication along its entire intracranial course, ending within the orbit. A distinct abducens nerve duplication reaching the common tendinous ring (annulus of Zinn), as well as another split within the intraconal segment of the nerve have been revealed. Additionally, two groups (superior and inferior) of abducens nerve sub-branches to the lateral rectus muscle were visualised using Sihler's stain. The analysed anatomical variation has never been reported before and it seems to be in the middle of the spectrum between the cases of duplication occurring only within the intracranial segments of the abducens nerve found in the literature and those continuing throughout the whole course of the nerve. Abducens nerve duplication may be treated as a relic of early stages of ontogenesis. Such a variant might result from alternative developmental pathways in which axons of the abducens nerve, specific for a given segment of the lateral rectus muscle, run separately at some stage, instead of forming a single stem. PMID:26501961

  7. Isolated trochlear nerve palsy with midbrain hemorrhage

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    Raghavendra S

    2010-01-01

    Full Text Available Midbrain hemorrhage causing isolated fourth nerve palsy is extremely rare. Idiopathic, traumatic and congenital abnormalities are the most common causes of fourth nerve palsy. We report acute isolated fourth nerve palsy in an 18-year-old lady due to a midbrain hemorrhage probably due to a midbrain cavernoma. The case highlights the need for neuroimaging in selected cases of isolated trochlear nerve palsy.

  8. Isolated cranial nerve palsies in multiple sclerosis

    OpenAIRE

    Zadro, Ivana; Barun, Barbara; Habek, Mario; Brinar, Vesna V.

    1997-01-01

    During a 10 year period 24 patients with definite multiple sclerosis with isolated cranial nerve palsies were studied (third and fourth nerve: one patient each, sixth nerve: 12 patients, seventh nerve: three patients, eighth nerve: seven patients), in whom cranial nerve palsies were the presenting sign in 14 and the only clinical sign of an exacerbation in 10 patients. MRI was carried out in 20 patients and substantiated corresponding brainstem lesions in seven patients (...

  9. Multiple nerve palsies in beta thalassaemia major.

    OpenAIRE

    Lamabadusuriya, S. P.

    1989-01-01

    A patient with beta thalassaemia major is described who developed a lower motor neurone facial nerve palsy on the left side, together with a phrenic nerve palsy on the same side, during the course of the illness. This complication has not been reported before in haemoglobinopathies.

  10. Peroneal Nerve Palsy After Cryotherapy.

    Science.gov (United States)

    Collins, K; Storey, M; Peterson, K

    1986-05-01

    In brief: Cryotherapy, a common treatment method for sports injuries, could result in peroneal nerve palsy. In this case a 26-year-old basketball coach who sustained a hamstring strain applied ice circumferentially around his knee on two occasions for one hour each. He subsequently suffered a severe peroneal neuropathy with weakness of the ankle, ankle evertors, and toe dorsiflexors. Electromyographic studies showed axonotmesis three months after the injury. Four months after the injury the patient was still recovering. This case demonstrates the importance of using cryotherapy cautiously. PMID:27442936

  11. A case of possible paraneoplastic neurological syndrome presenting as multiple cranial nerve palsies associated with gallbladder cancer.

    Science.gov (United States)

    Kaido, Misako; Yuasa, Yoshihito; Yamamoto, Tameyoshi; Munakata, Satoru; Tagawa, Naohiro; Tanaka, Keiko

    2016-09-29

    We report the case of a patient who had developed multiple cranial nerve palsies in the course of possible paraneoplastic neurological syndrome (PNS) associated with gallbladder cancer. Twelve days prior to visiting our hospital, a 69-year-old man began experiencing neurological symptoms, beginning with diplopia and progressing to ptosis of the left palpebra and subsequent complete closure of the eye within 8 days. Results of the initial medical examination indicated paresis of left oculomotor (III) and abducens (VI) nerves. MRI of the brain revealed no focal lesion that could have resulted in compression of the affected nerves, while further examination ruled out diabetes mellitus, infection, vasculitis, and other systemic autoimmune diseases as potential causes. Gadolinium-enhanced MRI revealed high intensity located in the oculomotor nerves, and steroid pulse therapy was performed based on the assumption of inflammatory diseases. Although slight improvement was observed with respect to the left extraocular paresis, subsequent emergence of bilateral facial nerve (VII) palsy, right abducens nerve palsy, and right oculomotor nerve palsy occurred in succession. PET/CT performed under suspicion of PNS, confirmed the presence of gallbladder cancer. Surgical extirpation of the cancer occurred 3 months following the appearance of left oculomotor paralysis, after which the patient underwent postoperative chemotherapy. All cranial nerve palsies resolved within 2 months after the operation, and both cancer and PNS have shown no recurrence for over 5 years. Pathological examination of the resected tumor revealed well-differentiated tubular adenocarcinoma showing some signs of epithelial-mesenchymal transition, typically an indicator of a poor prognosis. Nevertheless, lymph node metastasis did not progress beyond N2, and the cancer was completely removed by lymph node dissection. Therefore, the presence of multiple cranial palsies in this patient led to early detection of

  12. Surgical management of third nerve palsy

    Directory of Open Access Journals (Sweden)

    Anupam Singh

    2016-01-01

    Full Text Available Third nerve paralysis has been known to be associated with a wide spectrum of presentation and other associated factors such as the presence of ptosis, pupillary involvement, amblyopia, aberrant regeneration, poor bell′s phenomenon, superior oblique (SO overaction, and lateral rectus (LR contracture. Correction of strabismus due to third nerve palsy can be complex as four out of the six extraocular muscles are involved and therefore should be approached differently. Third nerve palsy can be congenital or acquired. The common causes of isolated third nerve palsy in children are congenital (43%, trauma (20%, inflammation (13%, aneurysm (7%, and ophthalmoplegic migraine. Whereas, in adult population, common etiologies are vasculopathic disorders (diabetes mellitus, hypertension, aneurysm, and trauma. Treatment can be both nonsurgical and surgical. As nonsurgical modalities are not of much help, surgery remains the main-stay of treatment. Surgical strategies are different for complete and partial third nerve palsy. Surgery for complete third nerve palsy may involve supra-maximal recession - resection of the recti. This may be combined with SO transposition and augmented by surgery on the other eye. For partial third nerve, palsy surgery is determined according to nature and extent of involvement of extraocular muscles.

  13. Surgical management of third nerve palsy.

    Science.gov (United States)

    Singh, Anupam; Bahuguna, Chirag; Nagpal, Ritu; Kumar, Barun

    2016-01-01

    Third nerve paralysis has been known to be associated with a wide spectrum of presentation and other associated factors such as the presence of ptosis, pupillary involvement, amblyopia, aberrant regeneration, poor bell's phenomenon, superior oblique (SO) overaction, and lateral rectus (LR) contracture. Correction of strabismus due to third nerve palsy can be complex as four out of the six extraocular muscles are involved and therefore should be approached differently. Third nerve palsy can be congenital or acquired. The common causes of isolated third nerve palsy in children are congenital (43%), trauma (20%), inflammation (13%), aneurysm (7%), and ophthalmoplegic migraine. Whereas, in adult population, common etiologies are vasculopathic disorders (diabetes mellitus, hypertension), aneurysm, and trauma. Treatment can be both nonsurgical and surgical. As nonsurgical modalities are not of much help, surgery remains the main-stay of treatment. Surgical strategies are different for complete and partial third nerve palsy. Surgery for complete third nerve palsy may involve supra-maximal recession - resection of the recti. This may be combined with SO transposition and augmented by surgery on the other eye. For partial third nerve, palsy surgery is determined according to nature and extent of involvement of extraocular muscles. PMID:27433033

  14. Surgical management of third nerve palsy

    Science.gov (United States)

    Singh, Anupam; Bahuguna, Chirag; Nagpal, Ritu; Kumar, Barun

    2016-01-01

    Third nerve paralysis has been known to be associated with a wide spectrum of presentation and other associated factors such as the presence of ptosis, pupillary involvement, amblyopia, aberrant regeneration, poor bell's phenomenon, superior oblique (SO) overaction, and lateral rectus (LR) contracture. Correction of strabismus due to third nerve palsy can be complex as four out of the six extraocular muscles are involved and therefore should be approached differently. Third nerve palsy can be congenital or acquired. The common causes of isolated third nerve palsy in children are congenital (43%), trauma (20%), inflammation (13%), aneurysm (7%), and ophthalmoplegic migraine. Whereas, in adult population, common etiologies are vasculopathic disorders (diabetes mellitus, hypertension), aneurysm, and trauma. Treatment can be both nonsurgical and surgical. As nonsurgical modalities are not of much help, surgery remains the main-stay of treatment. Surgical strategies are different for complete and partial third nerve palsy. Surgery for complete third nerve palsy may involve supra-maximal recession - resection of the recti. This may be combined with SO transposition and augmented by surgery on the other eye. For partial third nerve, palsy surgery is determined according to nature and extent of involvement of extraocular muscles. PMID:27433033

  15. Peripheral nerve involvement in Bell's palsy

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    J. A. Bueri

    1984-12-01

    Full Text Available A group of patients with Bell's palsy were studied in order to disclose the presence of subclinical peripheral nerve involvement. 20 patients, 8 male and 12 female, with recent Bell's palsy as their unique disease were examined, in all cases other causes of polyneuropathy were ruled out. Patients were investigated with CSF examination, facial nerve latencies in the affected and in the sound sides, and maximal motor nerve conduction velocities, as well as motor terminal latencies from the right median and peroneal nerves. CSF laboratory examination was normal in all cases. Facial nerve latencies were abnormal in all patients in the affected side, and they differed significantly from those of control group in the clinically sound side. Half of the patients showed abnormal values in the maximal motor nerve conduction velocities and motor terminal latencies of the right median and peroneal nerves. These results agree with previous reports which have pointed out that other cranial nerves may be affected in Bell's palsy. However, we have found a higher frequency of peripheral nerve involvement in this entity. These findings, support the hypothesis that in some patients Bell's palsy is the component of a more widespread disease, affecting other cranial and peripheral nerves.

  16. Paralytic squint in dengue fever- a report of three cases: Further reports of a rare, once before reported phenomenon of abducens palsy in dengue

    Directory of Open Access Journals (Sweden)

    Mitrakrishnan Shivanthan

    2013-01-01

    Full Text Available With dengue becoming endemic, more complications are being recognized including a variety of neurological complications such as mononeuropathies. Abducens palsy causing paralytic squint has been reported only once previously in medical literature. Demyelinating infective and immune-mediated mechanisms are believed to be the pathogenesis behind mononeuropathies. Neither an effective vaccine against dengue nor proven treatment for dengue neuropathy is currently available. Further studies are needed to elucidate the exact mechanism and develop effective treatment for dengue neuropathy.

  17. Therapeutic results in sixth nerve palsy

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    Pruna Violeta-Ioana

    2015-03-01

    Full Text Available Authors aim to assess through a retrospective study the efficiency of different therapeutic methods used in VIth nerve palsy. 60 patients with VIth nerve palsy, admitted and treated in Oftapro Clinic, were divided into two groups: a group with partial dysfunction (paresis of sixth nerve and a group with the complete abolition of neuromuscular function (VIth nerve palsy. Initial examination included assessment of neuromuscular function, binocular vision and existence of medial rectus muscle contracture (ipsi- and contralateral and contralateral lateral rectus inhibitory palsy. Neuromuscular dysfunction was graded from - 8 (paralysis to 0 (normal abduction. Therapeutic modalities ranged from conservative treatment (occlusion, prism correction, botulinum toxin chemodenervation and surgical treatment: medial rectus recession + lateral rectus resection, in cases of paresis, and transposition procedures (Hummelscheim and full tendon transfer in cases of sixth nerve palsy. Functional therapeutic success was defined as absence of diplopia in primary position, with or without prism correction, and surgical success was considered obtaining orthoptic alignment in primary position or a small residual deviation (under 10 PD. 51 patients had unilateral dysfunction, and 9 patients had bilateral VI-th nerve dysfunction. 8 patients had associated fourth or seventh cranial nerves palsy. The most common etiology was traumatic, followed by tumor and vascular causes. There were 18 cases of spontaneous remission, partial or complete (4-8 months after the onset, and 6 cases enhanced by botulinum toxin chemodenervation. 17 paretic eyes underwent surgery, showing a very good outcome, with restoration of binocular single vision. The procedure of choice was recession of medial rectus muscle, combined with resection of lateral rectus muscle. All patients with sixth nerve palsy underwent surgery, except one old female patient, who refused surgery. Hummelscheim procedure was

  18. Management of peripheral facial nerve palsy.

    Science.gov (United States)

    Finsterer, Josef

    2008-07-01

    Peripheral facial nerve palsy (FNP) may (secondary FNP) or may not have a detectable cause (Bell's palsy). Three quarters of peripheral FNP are primary and one quarter secondary. The most prevalent causes of secondary FNP are systemic viral infections, trauma, surgery, diabetes, local infections, tumor, immunological disorders, or drugs. The diagnosis of FNP relies upon the presence of typical symptoms and signs, blood chemical investigations, cerebro-spinal-fluid-investigations, X-ray of the scull and mastoid, cerebral MRI, or nerve conduction studies. Bell's palsy may be diagnosed after exclusion of all secondary causes, but causes of secondary FNP and Bell's palsy may coexist. Treatment of secondary FNP is based on the therapy of the underlying disorder. Treatment of Bell's palsy is controversial due to the lack of large, randomized, controlled, prospective studies. There are indications that steroids or antiviral agents are beneficial but also studies, which show no beneficial effect. Additional measures include eye protection, physiotherapy, acupuncture, botulinum toxin, or possibly surgery. Prognosis of Bell's palsy is fair with complete recovery in about 80% of the cases, 15% experience some kind of permanent nerve damage and 5% remain with severe sequelae.

  19. Bilateral traumatic paralysis of abducent nerves and clivus fracture: Case Report

    Directory of Open Access Journals (Sweden)

    Calderon-Miranda Willen Guillermo

    2014-12-01

    Full Text Available Clivus fractures are a rare pathology, frecuently associated tohigh power trauma. Such injuries may be associated with vascular and cranial nerves lesions. The abducens nerve is particularly vulnerable to traumatic injuries due to its long intracranial course, since their real origin until the lateral rectus muscle. The unilateral abducens nerve palsy of 1- 2-7% occurs in patients with cranial trauma, bilateral paralysis is rare. We report a patient who presented bilateral abducens nerve palsy associated with a clivus fracture

  20. Prolactinoma presenting with intermittent third nerve palsy.

    OpenAIRE

    Wykes, W N

    1986-01-01

    A patient presented with a painful third nerve palsy. This resolved spontaneously, but recurred several months later. At his second presentation carotid angiography gave normal results, but a high resolution CT scan showed a tumour in the right parasellar region. The serum prolactin was raised at over 22,000 millimicrons/, showing this to be a prolactinoma.

  1. NEONATAL NERVE PALSIES: A CONTEMPORARY OBSTETRIC PERSPECTIVE

    Directory of Open Access Journals (Sweden)

    Daren J. Roberts

    2014-05-01

    Full Text Available Background:Birth trauma and its often incorrect inference of iatrogenic causation has led to unfortunate implications for the affected child, the parents, the obstetrician and the midwife due to unwarranted medico-legal attention in our current litigious society.A more discerning evaluation of neonatal nerve palsies following labour and delivery has led to a better understanding of their aetiology with potentially more appropriate outcomes for all parties involved.

  2. Peripheral facial nerve palsy after therapeutic endoscopy.

    Science.gov (United States)

    Kim, Eun Jeong; Lee, Jun; Lee, Ji Woon; Lee, Jun Hyung; Park, Chol Jin; Kim, Young Dae; Lee, Hyun Jin

    2015-03-01

    Peripheral facial nerve palsy (FNP) is a mononeuropathy that affects the peripheral part of the facial nerve. Primary causes of peripheral FNP remain largely unknown, but detectable causes include systemic infections (viral and others), trauma, ischemia, tumor, and extrinsic compression. Peripheral FNP in relation to extrinsic compression has rarely been described in case reports. Here, we report a case of a 71-year-old man who was diagnosed with peripheral FNP following endoscopic submucosal dissection. This case is the first report of the development of peripheral FNP in a patient undergoing therapeutic endoscopy. We emphasize the fact that physicians should be attentive to the development of peripheral FNP following therapeutic endoscopy.

  3. Skull Base Allergic Fungal Sinusitis with Abducens Palsy in the Third Trimester

    OpenAIRE

    Rassekh, Christopher H.; Kinsella, John B.; Calhoun, Karen H.; Maggio, William W.; Chaljub, Gregory; Gourley, William K.

    1996-01-01

    Allergic fungal sinusitis (AFS) usually follows a slow course, but bone erosion including that of the skull base can be seen. Patients may present with intracranial extension mimicking a cranial base neoplasm. We describe a 21-year-old pregnant female initially seen at 27 weeks gestation with a complete right sixth nerve paralysis. MR imaging showed an apparent nasopharyngeal neoplasm invading both temporal lobes. Further evaluation revealed typical findings of fungal sinusitis on both CT and...

  4. Pseudoradial Nerve Palsy Caused by Acute Ischemic Stroke

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    Hassan Tahir MD

    2016-07-01

    Full Text Available Pseudoperipheral palsy has been used to characterize isolated monoparesis secondary to stroke. Isolated hand nerve palsy is a rare presentation for acute cerebral stroke. Our patient presented with clinical features of typical peripheral radial nerve palsy and a normal computed tomography scan of the head, which, without a detailed history and neurological examination, could have been easily misdiagnosed as a peripheral nerve lesion deferring further investigation for a stroke. We stress the importance of including cerebral infarction as a critical differential diagnosis in patients presenting with sensory-motor deficit in an isolated peripheral nerve pattern. A good history and physical exam can differentiate stroke from peripheral neuropathy as the cause of radial nerve palsy.

  5. Intraneural metastasis of gastric carcinoma leads to sciatic nerve palsy

    Directory of Open Access Journals (Sweden)

    Ichikawa Jiro

    2012-07-01

    Full Text Available Abstract Background Soft tissue metastases, in particular intraneural metastasis, from any carcinomas seldom occur. To our knowledge, no case of sciatic nerve palsy due to intraneural metastasis of gastric carcinoma is reported in the literature. Case presentation A case is reported of a 82-year old woman with sciatic nerve palsy with intraneural metastasis of gastric carcinoma. Although she had undergone partial gastrectomy with T2b, N0, M0 two years ago and primary site was cured, she developed sciatic nerve palsy from the carcinoma metastasis directly to the nerve. Operative resection and Histological examination revealed poorly differentiated adenocarcinoma, the same as her primary site adenocarcinoma. Conclusions Sciatica is usually caused by a herniated disc or spinal canal stenosis. Sciatic nerve palsy may be caused by nondiscogenic etiologies that may be either intrapelvic or extrapelvic. It is important to image the entire course of the nerve to distinguish these etiologies quickly. The longer the nerve compression the less likely a palsy will recover. Surgery is a good intervention that simultaneously obtains a tissue diagnosis and decompresses the nerve.

  6. Sciatic nerve palsy associated with total hip arthroplasty.

    Science.gov (United States)

    Dhillon, M S; Nagi, O N

    1992-01-01

    Six cases of clinically evident sciatic or peroneal nerve palsy occurred in a consecutive series of 380 total hip arthroplasties (THA). An additional eight cases of peroneal nerve palsy due to pressure from Thomas splint or tight bandages were seen. Factors apparently causing nerve palsy were significant lateralization and lengthening in four cases and dislocation of the hip in one case. The cases with neuroapraxia of the peroneal nerve were seen from the third to the fifth day of Thomas splint immobilization. EMG studies were conducted in all six group 1 patients; at the end of one year the results were good in two cases, fair in three cases, and poor in one case. The results suggest that limb lengthening should be limited to 4 cm to minimize this complication. It was also seen that patients with peroneal nerve palsy due to local compression do well, though some are bothered by mild residual dysesthesia over the dorsum of the foot. In contrast, patients with sciatic nerve palsy do not have such a good outlook. PMID:1345646

  7. Correlates of degree of nerve involvement in early Bell's palsy

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    Hsieh Ru-Lan

    2009-06-01

    Full Text Available Abstract Background This study aimed to evaluate the still unknown factors correlating with the degree of nerve involvement in early Bell's palsy. Methods This retrospective chart review study of newly diagnosed cases of Bell's palsy was conducted over a three-year period. Information on age, sex, day of onset, comorbidities, corticosteroid use, and electroneurographic test results were collected. The electroneurographic quotient (amplitude of compound muscle action potential on the affected side divided by that on the healthy side and expressed in percent was used as an index of nerve involvement, with lower quotient indicating more severe disease. Results Data were collected on 563 patients. The mean electroneurographic quotient varied inversely with age (p vs. 40.3%; p = 0.002. There was no correlation between the degree of nerve involvement and sex, season of onset, hypertension, or diabetes. Conclusion The degree of nerve involvement in early Bell's palsy correlates positively with age and negatively with corticosteroid use.

  8. Pontine stroke presenting as isolated facial nerve palsy mimicking Bell's palsy: a case report

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    Saluja Paramveer

    2011-07-01

    Full Text Available Abstract Introduction Isolated facial nerve palsy usually manifests as Bell's palsy. Lacunar infarct involving the lower pons is a rare cause of solitary infranuclear facial paralysis. The present unusual case is one in which the patient appeared to have Bell's palsy but turned out to have a pontine infarct. Case presentation A 47-year-old Asian Indian man with a medical history of hypertension presented to our institution with nausea, vomiting, generalized weakness, facial droop, and slurred speech of 14 hours' duration. His physical examination revealed that he was conscious, lethargic, and had mildly slurred speech. His blood pressure was 216/142 mmHg. His neurologic examination showed that he had loss of left-sided forehead creases, inability to close his left eye, left facial muscle weakness, rightward deviation of the angle of the mouth on smiling, and loss of the left nasolabial fold. Afferent corneal reflexes were present bilaterally. MRI of the head was initially read as negative for acute stroke. Bell's palsy appeared less likely because of the acuity of his presentation, encephalopathy-like imaging, and hypertension. The MRI was re-evaluated with a neurologist's assistance, which revealed a tiny 4 mm infarct involving the left dorsal aspect of the pons. The final diagnosis was isolated facial nerve palsy due to lacunar infarct of dorsal pons and hypertensive encephalopathy. Conclusion The facial nerve has a predominant motor component which supplies all muscles concerned with unilateral facial expression. Anatomic knowledge is crucial for clinical localization. Bell's palsy accounts for around 72% of facial palsies. Other causes such as tumors and pontine infarcts can also present as facial palsy. Isolated dorsal infarct presenting as isolated facial palsy is very rare. Our case emphasizes that isolated facial palsy should not always be attributed to Bell's palsy. It can be a presentation of a rare dorsal pontine infarct as observed

  9. Hemiplegic peripheral neuropathy accompanied with multiple cranial nerve palsy

    Directory of Open Access Journals (Sweden)

    Hirohisa Okuma

    2012-03-01

    Full Text Available A 32-year-old man experienced double vision around January, 2010, followed by weakness of his left upper and lower extremities. Articulation disorders and loss of hearing in his left ear developed, and he was admitted to our hospital on February 14, 2010. Physical examination was normal, and neurological examination showed clear consciousness with no impairment of cognitive function, but with articulation disorders. Olfactory sensation was reduced. Left ptosis and left gaze palsy, complete left facial palsy, perceptive deafness of the left ear, and muscle weakness of the left trapezius muscle were observed. Paresis in the left upper and lower extremities was graded 4/5 through manual muscle testing. Sensory system evaluation revealed complete left-side palsy, including the face. Deep tendon reflexes were slightly diminished equally on both sides; no pathologic reflex was seen. No abnormality of the brain parenchyma, cerebral nerves or cervicothoracolumbar region was found on brain magnetic resonance imaging. On electroencephalogram, alpha waves in the main frequency band of 8 to 9 Hz were recorded, indicating normal findings. Brain single photon emission computed tomography (SPECT scan showed reduced blood flow in the right inner frontal lobe and both occipital lobes. Nerve biopsy (left sural nerve showed reduction of nerve density by 30%, with demyelination. The patient also showed manifestations of multiple cranial nerve disorder, i.e., of the trigeminal nerve, glossopharyngeal nerve, vagus nerve, and hypoglossal nerve. Whole-body examination was negative. Finally, based on ischemic brain SPECT images, spinal fluid findings and nerve biopsy results, peripheral neuropathy accompanied with multiple cranial nerve palsy was diagnosed.

  10. Acute sixth nerve palsy in a young man, beware of the 'red herring'.

    LENUS (Irish Health Repository)

    O'Neill, E C

    2012-02-01

    BACKGROUND: Cranial nerve palsies has several etiologies including vascular insufficiency, neoplasm, trauma and inflammation. Isolated sixth nerve palsy is an extremely rare presenting feature of leukemia. AIM: We describe an unusual ocular presentation of a bilateral progressive sixth nerve palsy in a young male with a preceding head injury. CONCLUSION: Acquired sixth nerve palsies in young adults may be due to trauma but in the absence of a definitive history other systemic processes must be outruled. We describe a case of bilateral sixth nerve palsy in a patient with ALL with no obvious CNS involvement. Potential etiological mechanisms are discussed.

  11. Peroneal palsy after bariatric surgery: is nerve decompresion always necessary?

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    Ana M. Ramos-Leví

    2013-08-01

    Full Text Available We present two patients who underwent successful bariatric surgery and developed peroneal nerve palsy six months after the procedure. This is an unusual complication which determines a significant functional limitation, mainly because of foot drop, and its presence may be a hallmark of excessive and rapid weight loss. We discuss possible pathogenic mechanisms and therapeutic options, and we emphasize the important role of an adequate nutritional management, in order to avoid the need for a surgical nerve decompression.

  12. Hansen's disease and HIV coinfection with facial nerve palsy.

    Science.gov (United States)

    Yadav, Nidhi; Kar, Sumit; Madke, Bhushan; Gangane, Nitin

    2015-01-01

    There are very few published reports of HIV leprosy co infection in India in spite of having a large burden of both leprosy and HIV. Herein we are reporting a case of co-infection of Hansen's disease and HIV with facial nerve palsy. PMID:25883486

  13. Traumatic facial nerve palsy: CT patterns of facial nerve canal fracture and correlation with clinical severity

    Energy Technology Data Exchange (ETDEWEB)

    Seo, Jae Cheol; Kim, Sang Joon; Park, Hyun Min; Lee, Young Suk; Lee, Jee Young [College of Medicine, Dankook Univ., Chonan (Korea, Republic of)

    2002-07-01

    To analyse the patterns of facial nerve canal injury seen at temporal bone computed tomography (CT) in patients with traumatic facial nerve palsy and to correlate these with clinical manifestations and outcome. Thirty cases of temporal bone CT in 29 patients with traumatic facial nerve palsy were analyzed with regard to the patterns of facial nerve canal involvement. The patterns were correlated with clinical grade, the electroneurographic (ENoG) findings, and clinical outcome. For clinical grading, the House-Brackmann scale was used, as follows:grade I-IV, partial palsy group; grade V-VI, complete palsy group. The electroneuronographic findings were categorized as mild to moderate (below 90%) or severe (90% and over) degeneration. In 25 cases, the bony wall of the facial nerve canals was involved directly (direct finding): discontinuity of the bony wall was onted in 22 cases, bony spicules in ten, and bony wall displacement in five. Indirect findings were canal widening in nine cases and adjacent bone fracture in two. In one case, there were no direct or indirect findings. All cases in which there was complete palsy (n=8) showed one or more direct findings including spicules in six, while in the incomplete palsy group (n=22), 17 cases showed direct findings. In the severe degeneration group (n=13), on ENog, 12 cases demonstrated direct findings, including spicules in nine cases. In 24 patients, symptoms of facial palsy showed improvement at follow up evaluation. Four of the five patients in whom symptoms did not improve had spicules. Among ten patients with spicules, five underwent surgery and symptoms improved in four of these; among the five patients not operated on , symptoms did not improve in three. In most patients with facial palsy after temporal bone injury, temporal bone CT revealed direct or indirect facial nerve canal involvement, and in complete palsy or severe degeneration groups, there were direct findings in most cases. We believe that meticulous

  14. [Treatment of idiopathic peripheral facial nerve paralysis (Bell's palsy)].

    Science.gov (United States)

    Meyer, Martin Willy; Hahn, Christoffer Holst

    2013-01-28

    Bell's palsy is defined as an idiopathic peripheral facial nerve paralysis of sudden onset. It affects 11-40 persons per 100,000 per annum. Many patients recover without intervention; however, up to 30% have poor recovery of facial muscle control and experience facial disfigurement. The aim of this study was to make an overview of which pharmacological treatments have been used to improve outcomes. The available evidence from randomized controlled trials shows significant benefit from treating Bell's palsy with corticosteroids but shows no benefit from antivirals.

  15. Neuro-ophthalmological approach to facial nerve palsy.

    Science.gov (United States)

    Portelinha, Joana; Passarinho, Maria Picoto; Costa, João Marques

    2015-01-01

    Facial nerve palsy is associated with significant morbidity and can have different etiologies. The most common causes are Bell's palsy, Ramsay-Hunt syndrome and trauma, including surgical trauma. Incidence varies between 17 and 35 cases per 100,000. Initial evaluation should include accurate clinical history, followed by a comprehensive investigation of the head and neck, including ophthalmological, otological, oral and neurological examination, to exclude secondary causes. Routine laboratory testing and diagnostic imaging is not indicated in patients with new-onset Bell's palsy, but should be performed in patients with risk factors, atypical cases or in any case without resolution within 4 months. Many factors are involved in determining the appropriate treatment of these patients: the underlying cause, expected duration of nerve dysfunction, anatomical manifestations, severity of symptoms and objective clinical findings. Systemic steroids should be offered to patients with new-onset Bell's palsy to increase the chance of facial nerve recovery and reduce synkinesis. Ophthalmologists play a pivotal role in the multidisciplinary team involved in the evaluation and rehabilitation of these patients. In the acute phase, the main priority should be to ensure adequate corneal protection. Treatment depends on the degree of nerve lesion and on the risk of the corneal damage based on the amount of lagophthalmos, the quality of Bell's phenomenon, the presence or absence of corneal sensitivity and the degree of lid retraction. The main therapy is intensive lubrication. Other treatments include: taping the eyelid overnight, botulinum toxin injection, tarsorrhaphy, eyelid weight implants, scleral contact lenses and palpebral spring. Once the cornea is protected, longer term planning for eyelid and facial rehabilitation may take place. Spontaneous complete recovery of Bell's palsy occurs in up to 70% of cases. Long-term complications include aberrant regeneration with

  16. Internuclear Ophthalmoplegia

    Science.gov (United States)

    ... Nerve) Palsy Sixth Cranial Nerve (Abducens Nerve) Palsy Trigeminal Neuralgia Bell Palsy Hemifacial Spasm Glossopharyngeal Neuralgia Hypoglossal Nerve ... Nerve) Palsy Sixth Cranial Nerve (Abducens Nerve) Palsy Trigeminal Neuralgia Bell Palsy Hemifacial Spasm Glossopharyngeal Neuralgia Hypoglossal Nerve ...

  17. Facial nerve palsy due to birth trauma

    Science.gov (United States)

    ... way on both sides while crying No movement (paralysis) on the affected side of the face (from the forehead to the chin in severe ... relieve pressure on the nerve. Infants with permanent paralysis need special therapy.

  18. Cerebral venous thrombosis presenting as multiple lower cranial nerve palsies

    OpenAIRE

    Byju, N.; James Jose; Saifudheen, K; V Abdul Gafoor; P Jithendranath

    2012-01-01

    Cerebral venous thrombosis (CVT) is a well-recognized entity, but its clinical presentation is varied and often mimics many neurological disorders, making it a diagnostic challenge. Cerebral venous thrombosis has a wide spectrum of signs and symptoms, which may evolve suddenly or over weeks. It mimics many neurological conditions such as meningitis, encephalopathy, idiopathic intracranial hypertension, and stroke. Cerebral venous thrombosis presenting as multiple lower cranial nerve palsies, ...

  19. Spontaneous Radial Nerve Palsy Subsequent to Non-Traumatic Neuroma

    OpenAIRE

    Adel Ebrahimpour; Shahram Nazerani; Reza Tavakoli Darestani; Salim Khani

    2013-01-01

    Introduction: Spontaneous radial palsy is a not rare finding in hand clinics. The anatomy of the radial nerve renders it prone to pressure paralysis as often called “Saturday night palsy”. This problem is a transient nerve lesion and an acute one but the case presented here is very unusual in that it seems this entity can also occur as an acute on chronic situation with neuroma formation.Case Presentation: A 61 year-old man presented with the chief complaint of inability to extend the wrist a...

  20. Case of Cytomegalovirus Infection Causing Isolated Oculomotor Nerve Palsy

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    Halil Sen

    2014-06-01

    Full Text Available The third cranial nerve is called the oculomotor nerve. The pathology is revealed by limitation of eye movement inward-up-down, mydriasis, loss of light reflex and ptosis. Oculomotor nerve pathologies are frequently seen in neurology practice and are situations that may be very difficult for differential diagnosis. Differential diagnosis first involves disqualifying intracranial etiologies by imaging because these intracranial etiologies may be situations that can result in death and should be primarily evaluated. If intracranial events are ruled out, generally rarer etiologic reasons with generally difficult differentiation should be researched. Viral infections are among the rare etiological reasons causing 3rd cranial nerve involvement. Our case was a 71-year old female with etiological research due to 3rd cranial nerve palsy. The patient with diabetes-linked immune deficiency was found to have cranial nerve involvement developed secondary to cytomegalovirus (CMV infection. We report this case as 3rd cranial nerve involvement is rarely observed developing linked to CMV infection.

  1. Reaching the limit of the oculomotor plant: 3D kinematics after abducens nerve stimulation during the torsional vestibulo-ocular reflex.

    Science.gov (United States)

    Klier, Eliana M; Meng, Hui; Angelaki, Dora E

    2012-09-19

    Accumulating evidence shows that the oculomotor plant is capable of implementing aspects of three-dimensional kinematics such as Listing's law and the half-angle rule. But these studies have only examined the eye under static conditions or with movements that normally obey these rules (e.g., saccades and pursuit). Here we test the capability of the oculomotor plant to rearrange itself as necessary for non-half-angle behavior. Three monkeys (Macaca mulatta) fixated five vertically displaced targets along the midsagittal plane while sitting on a motion platform that rotated sinusoidally about the naso-occipital axis. This activated the torsional, rotational vestibulo-ocular reflex, which exhibits a zero-angle or negative-angle rule (depending on the visual stimulus). On random sinusoidal cycles, we stimulated the abducens nerve and observed the resultant eye movements. If the plant has rearranged itself to implement this non-half-angle behavior, then stimulation should reveal this behavior. On the other hand, if the plant is only capable of half-angle behavior, then stimulation should reveal a half-angle rule. We find the latter to be true and therefore additional neural signals are likely necessary to implement non-half-angle behavior.

  2. Ulnar nerve palsy due to axillary crutch.

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    Veerendrakumar M

    2001-01-01

    Full Text Available A young lady with residual polio, using axillary crutch since early childhood, presented with tingling, numbness and weakness in ulnar nerve distribution of five months duration. Ulnar motor conduction study revealed proximal conduction block near the axilla, at the point of pressure by the crutch while walking. Distal ulnar sensory conduction studies were normal but proximal ulnar sensory conduction studies showed absence of Erb′s point potential. These findings suggested the presence of conduction block in sensory fibers as well. Proper use and change of axillary crutch resulted in clinical recovery and resolution of motor and sensory conduction block.

  3. MRI of the facial nerve in idiopathic facial palsy

    Energy Technology Data Exchange (ETDEWEB)

    Saatci, I. [Dept. of Radiology, Hacettepe Univ., Hospital Sihhiye, Ankara (Turkey); Sahintuerk, F. [Dept. of Radiology, Hacettepe Univ., Hospital Sihhiye, Ankara (Turkey); Sennaroglu, L. [Dept. of Otolaryngology, Head and Neck Surgery, Hacettepe Univ., Hospital Sihhiye, Ankara (Turkey); Boyvat, F. [Dept. of Radiology, Hacettepe Univ., Hospital Sihhiye, Ankara (Turkey); Guersel, B. [Dept. of Otolaryngology, Head and Neck Surgery, Hacettepe Univ., Hospital Sihhiye, Ankara (Turkey); Besim, A. [Dept. of Radiology, Hacettepe Univ., Hospital Sihhiye, Ankara (Turkey)

    1996-10-01

    The purpose of this prospective study was to define the enhancement pattern of the facial nerve in idiopathic facial paralysis (Bell`s palsy) on magnetic resonance (MR) imaging with routine doses of gadolinium-DTPA (0.1 mmol/kg). Using 0.5 T imager, 24 patients were examined with a mean interval time of 13.7 days between the onset of symptoms and the MR examination. Contralateral asymptomatic facial nerves constituted the control group and five of the normal facial nerves (20.8%) showed enhancement confined to the geniculate ganglion. Hence, contrast enhancement limited to the geniculate ganglion in the abnormal facial nerve (3 of 24) was referred to a equivocal. Not encountered in any of the normal facial nerves, enhancement of other segments alone or associated with geniculate ganglion enhancement was considered to be abnormal and noted in 70.8% of the symptomatic facial nerves. The most frequently enhancing segments were the geniculate ganglion and the distal intracanalicular segment. (orig.)

  4. Clinical observation on common peroneal nerve palsy treated with comprehensive therapy

    Institute of Scientific and Technical Information of China (English)

    杨丽娟

    2014-01-01

    Objective To compare the difference of the clinical efficacy on common peroneal nerve palsy between the comprehensive therapy of electroacupuncture,moxibustion and moving cupping method and western medication.Methods Ninety cases of common peroneal nerve palsy were randomized into a comprehensive therapy group and a western medication group,45 cases in each

  5. A 3-year review of cranial nerve palsies from the University of Port Harcourt Teaching Hospital Eye Clinic, Nigeria

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    Chinyere Nnenne Pedro-Egbe

    2014-01-01

    Conclusion: This is the first study in the literature on ocular cranial nerve palsies in Southern Nigeria. Third and sixth cranial nerve palsies were the most common cases to present to the University of Port Harcourt Teaching Hospital Eye Clinic. There was a statistically significant association to systemic disorders such as hypertension and DM and majority of cases with 6 th cranial nerve palsy.

  6. New Tendon Transfer for Correction of Drop-foot in Common Peroneal Nerve Palsy

    OpenAIRE

    Vigasio, Adolfo; Marcoccio, Ignazio; Patelli, Alberto; Mattiuzzo, Valerio; Prestini, Greta

    2008-01-01

    Common peroneal nerve palsy has been reported to be the most frequent lower extremity palsy characterized by a supinated equinovarus foot deformity and foot drop. Dynamic tendon transposition represents the gold standard for surgical restoration of dorsiflexion of a permanently paralyzed foot. Between 1998 and 2005, we operated on a selected series of 16 patients with traumatic complete common peroneal nerve palsy. In all cases, we performed a double tendon transfer through the interosseous m...

  7. Guillain-Barre Syndrome Presenting With Bilateral Facial Nerve Palsy

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    Soroor INALOO

    2014-01-01

    Full Text Available How to Cite This Article: Inaloo S, Katibeh P. Guillain-Barre Syndrome Presenting With Bilateral Facial Nerve Palsy. Iran J Child Neurol. 2014 Winter;8(1:69-71.ObjectiveThis case study is about an 11-year-old girl with bilateral facial weakness, abnormal taste sensation, and deep tendon reflexes of both knees and ankles were absent. However, the muscle power of the lower and upper extremities across all muscle groups was normal. After 2 days, she developed paresthesia and numbness in the lower extremities. Other neurologic examinations, such as fundoscopic evaluation of the retina were normal with the muscle power of both upper- and lower-extremities intact. A lumbar puncture revealed albumincytological dissociation. EMG and NCV were in favor of Guillain-Barre syndrome, for which IVIG was prescribed and the abnormal sensations in the lower limbs rapidly improved. Bilateral facial diplegia without weakness and paresthesia is a variant of Guillain-Barre syndrome that mostly presents withacute onset, rapid progression with or without limb weakness, paresthesia, and decreased or absent DTR and albumin-cytological dissociation.References:Barbi F, Ariatti A, Funakoshi K, Meacci M, Odaka M, Galassi G. Parvovirus B19 infection antedating Guillain-Barre’ syndrome variant with prominent facial diplegia. J Neurol 2011 Aug; 258(8:1551-2. doi: 10.1007/s00415-011-5949-5. Epub 2011 Feb 15.Yardimci N, Avci AY, Kayhan E, Benli S. Bilateral facial nerve enhancement demonstrated by magnetic resonance imaging in Guillain-Barré syndrome. Neurol Sci 2009 Oct; 30(5:431-3. doi:10.1007/s10072-009-0120-0.Lim TC, Yeo WS, Loke KY, Quek SC. Bilateral facial nerve palsy in Kawasaki disease. Ann Acad Med Singapore 2009; 38(8:737-8.Quintas E, Silva A, Sarmento A. Bilateral facial palsy in a young patient after meningococcal meningitis, associated to herpetic infection. Arq Neuro-Psiquiatr 2009; 67(3a: 712-14.Jain V, Deshmukh A, Gollomp S. Bilateral facial

  8. Facial nerve palsy: Providing eye comfort and cosmesis

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    Alsuhaibani Adel

    2010-01-01

    Full Text Available Development of facial nerve palsy (FNP may lead to dramatic change in the patient′s facial function, expression, and emotions. The ophthalmologist may play an important role in the initial evaluation, and the long-term management of patients with new-onset of FNP. In patients with expected temporary facial weakness, no efforts should be wasted to ensure proper corneal protection. Patients with permanent functional deficit may require combination of surgical procedures tailored to the patient′s clinical findings that may require good eye comfort and cosmesis.

  9. Ulnar nerve palsy after closed forearm fracture: a case report

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    Levent Kucuk

    2012-04-01

    Full Text Available Closed double bone forearm fractures are among the most common fractures of childhood. These fractures often heal without problems with closed reduction and casting. The leading complications are known as malunion and compartment syndrome. The reports about nerve injuries related with these fractures are very limited. We present an eight years old boy who admitted to our hospital with ulnar nerve palsy symptomps three months after his initial trauma. His initial trauma was a simple fall which caused radius and ulna fractures. Radiological assessment showed proper union of the fractures. We performed surgical exploration to the ulnar nerve. We found a trapped and damaged nerve in the fracture region. Even though the rate of complications about nerve injuries are extremely rare in forearm fractures, neurologic examinations should be performed before and after the reduction maneuvers. Neurologic examination will be not only a guide for fracture management but also an important point for medicolegal problems. [Hand Microsurg 2012; 1(1.000: 30-32

  10. Cerebral venous thrombosis presenting as multiple lower cranial nerve palsies.

    Science.gov (United States)

    Byju, N; Jose, James; Saifudheen, K; Gafoor, V Abdul; Jithendranath, P

    2012-10-01

    Cerebral venous thrombosis (CVT) is a well-recognized entity, but its clinical presentation is varied and often mimics many neurological disorders, making it a diagnostic challenge. Cerebral venous thrombosis has a wide spectrum of signs and symptoms, which may evolve suddenly or over weeks. It mimics many neurological conditions such as meningitis, encephalopathy, idiopathic intracranial hypertension, and stroke. Cerebral venous thrombosis presenting as multiple lower cranial nerve palsies, are rarely reported. We describe a pregnant lady who presented with sensorineural deafness of the right ear and paralysis of the 9(th), 10(th), and 12(th) cranial nerves on the right side. She was diagnosed to have thrombosis of the right transverse sinus and sigmoid sinus with extension to the jugular vein and confluence of sinuses. She improved with anticoagulant treatment. PMID:23559730

  11. Cerebral venous thrombosis presenting as multiple lower cranial nerve palsies

    Directory of Open Access Journals (Sweden)

    N Byju

    2012-01-01

    Full Text Available Cerebral venous thrombosis (CVT is a well-recognized entity, but its clinical presentation is varied and often mimics many neurological disorders, making it a diagnostic challenge. Cerebral venous thrombosis has a wide spectrum of signs and symptoms, which may evolve suddenly or over weeks. It mimics many neurological conditions such as meningitis, encephalopathy, idiopathic intracranial hypertension, and stroke. Cerebral venous thrombosis presenting as multiple lower cranial nerve palsies, are rarely reported. We describe a pregnant lady who presented with sensorineural deafness of the right ear and paralysis of the 9 th , 10 th , and 12 th cranial nerves on the right side. She was diagnosed to have thrombosis of the right transverse sinus and sigmoid sinus with extension to the jugular vein and confluence of sinuses. She improved with anticoagulant treatment.

  12. Two Cases of Elderly-Onset Hereditary Neuropathy with Liability to Pressure Palsy Manifesting Bilateral Peroneal Nerve Palsies

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    Norihiko Kawaguchi

    2012-10-01

    Full Text Available Hereditary neuropathy with liability to pressure palsy (HNPP is characterized by recurrent focal neuropathies, which usually become symptomatic in the second or third decade of life. However, clinical phenotypic heterogeneity among patients with HNPP has recently been reported. Certain patients show polyneuropathy-type diffuse nerve injuries, whereas others remain asymptomatic at older ages. We present two cases of elderly-onset bilateral peroneal nerve palsies with diffuse muscle weakness in the lower limbs and glove-and-stocking type sensory disturbance. Both patients were diagnosed with HNPP by genetic analyses that detected deletions of chromosome 17p11.2 in peripheral myelin protein 22 genes. Their clinical courses suggested that the Japanese sitting style termed ‘seiza’, a way of sitting on the floor with the lower legs crossed under the thighs, was a precipitating factor for the bilateral peroneal nerve palsies.

  13. Facial nerve involvement in pseudotumor cerebri.

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    Bakshi S

    1992-07-01

    Full Text Available A woman with history of bifrontal headache, vomiting and loss of vision was diagnosed as a case of pseudotumor cerebri based on clinical and MRI findings. Bilateral abducens and facial nerve palsies were detected. Pseudotumor cerebri in this patient was not associated with any other illness or related to drug therapy. Treatment was given to lower the raised intracranial pressure to which the patient responded.

  14. Transient facial nerve paralysis (Bell's palsy) following administration of hepatitis B recombinant vaccine: a case report.

    Science.gov (United States)

    Paul, R; Stassen, L F A

    2014-01-01

    Bell's palsy is the sudden onset of unilateral transient paralysis of facial muscles resulting from dysfunction of the seventh cranial nerve. Presented here is a 26-year-old female patient with right lower motor neurone facial palsy following hepatitis B vaccination. Readers' attention is drawn to an uncommon cause of Bell's palsy, as a possible rare complication of hepatitis B vaccination, and steps taken to manage such a presentation.

  15. Primary oculomotor nerve palsy due to mild head injury. Report of two cases

    International Nuclear Information System (INIS)

    Two patients with primary oculomotor nerve palsy due to direct mild head injury are reported. They presented with internal ophthalmoplegia, dilated nonreactive pupils, and very mild disturbance in consciousness. Except for the persistent oculomotor nerve palsy, both the patients recovered fully within one week. Neither demonstrated a history that was suggestive of a cause for their oculomotor nerve palsy. Initial CT scans demonstrated localized subarachnoid hemorrhage around the brain stem. One of the patients had sustained a fracture of the anterior clinoid process. As the underlying pathophysiologic mechanism underlying the oculomotor nerve palsy we suspected mild injury to the pupillomotor fibers at the anterior petroclinoidal ligament and that of the pupillary fibers at the posterior petroclinoidal ligament. We speculate that these perforating fibers at the anterior petroclinoidal ligament acted as a fulcrum due to downward displacement of the brainstem at the time of impact. (author)

  16. Resolution of third nerve palsy despite persistent aneurysmal mass effect after flow diversion embolization of posterior communicating artery aneurysms.

    Science.gov (United States)

    Binyamin, Tamar R; Dahlin, Brian C; Waldau, Ben

    2016-09-01

    Posterior communicating artery (PCOM) aneurysms may cause third nerve palsies. The optimal treatment with clipping versus coiling remains controversial. Here we report on two cases of resolution of third nerve palsy after flow diversion embolization of large and giant PCOM aneurysms without adjuvant coil placement. The resolution of third nerve palsy was not preceded by significant shrinkage of the aneurysmal sac on MRI. However, one patient showed resolution of T2-weighted signal abnormalities in the midbrain and mesial temporal lobe despite a similar size of the aneurysm. Therefore, flow diversion embolization of a PCOM aneurysm may resolve oculomotor nerve palsies through decreasing arterial pulsations against the nerve or midbrain. PMID:27183957

  17. Nerve grafting and nerve suture in postoperative facial palsies: A report of 69 cases

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    Karsten Kettel

    1954-12-01

    Full Text Available Since 1939, 260 patients with a peripheral facial palsy have been operated on by me according to Ballance and Duel, and in 61 cases nerve grafting, in 8 nerve suture was performed; 66 of the patients have been re-examined by me, 2 have been operated upon lately and one could not be traced. If a complete facial palsy arises in direct conjunction with surgery or accident the repair should, if possible, be undertaken without delay; if it occurs after an interval of freedom and the continuity of the nerve is unbroken the prognosis on the whole is good. The technique is discussed and the importance of the after-treatment is stressed. The results may be divided into two groups according to the conditions for and the proceeding of the repair, illustrated in tables 1 and 2. Among 52 cases, in which no degeneration of the musc'es had taken place and in which the operation was successfully performed a clinically satisfactory result was obtained in 47 patients. If these conditions are not fulfilled the prospect of a satisfactory result is a priori poor. It must be born in mind that not even the most successful operation will be able to restore function completely.

  18. Partial oculomotor nerve palsy in a 7-year-old child

    Science.gov (United States)

    Israni, Anil; Chakrabarty, Biswaroop; Kumar, Atin; Gulati, Sheffali

    2016-01-01

    Oculomotor nerve palsy can be due to varied causes that include diabetic neuropathy, myasthenia gravis, brainstem infarction, demyelinating conditions, and cerebral aneurysms. Among the aneurysmal causes of oculomotor nerve palsy, aneurysm of the posterior communicating artery has been observed to be the most common. Pupillary dysfunction is considered to be an important feature of aneurysmal oculomotor nerve paresis. A case of a 7-year-old boy with partial oculomotor nerve palsy with pupillary sparing is being reported here, the etiology of which is tortuous and ectatic distal internal carotid artery. This is a rare cause of oculomotor nerve paresis and to the best of our knowledge has not yet been reported in children. Ischemia rather than compression seems to be the most plausible cause in this case.

  19. Characteristics of the perception for unilateral facial nerve palsy.

    Science.gov (United States)

    Mun, Sue Jean; Park, Kyung Tae; Kim, Yoonjoong; Park, Joo Hyun; Kim, Young Ho

    2015-11-01

    Patients with facial nerve palsy (FNP) are actually evaluated by other people rather than doctors or the patients themselves. This study was performed to investigate the characteristics of the perception of unilateral FNP in Korean people. A questionnaire using photographs of four patients with four different grades (House-Brackmann) of FNP was given to two hundred people with no FNP. Subjects of each gender, ranging from 20 to 69 years of age, participated. The questionnaire, showing facial expressions of resting, smiling, whistling, eye closing, and frowning, consisted of questions concerning the identification and the involved side of FNP, the unnatural areas of the face, and the unnaturalness of the facial expressions. The overall identification rate of FNP was 75.0%. The identification rate increased according to the increase in the grade of the patient's FNP (p FNP according to education level. However, the overall detection rate of the involved side was higher in the high-education group (p FNP was lower than the rate of identification of FNP and was significantly low in the middle-aged/elderly and low-education level groups.

  20. Lyme disease in a child presenting with bilateral facial nerve palsy: MRI findings and review of the literature

    Energy Technology Data Exchange (ETDEWEB)

    Vanzieleghem, B.; Lemmerling, M.; Achten, E.; Vanlangenhove, P.; Kunnen, M. [Dept. of Radiology, University Hospital Gent (Belgium); Carton, D.; Matthys, E. [Dept. of Pediatrics, University Hospital Gent (Belgium)

    1998-11-01

    We report a 7-year-old boy with neuroborreliosis presenting with headache and bilateral facial nerve palsy. MRI demonstrated tentorial and bilateral facial and trigeminal nerve enhancement. (orig.) With 1 fig., 22 refs.

  1. An unusual case of isolated sixth cranial nerve palsy in leprosy.

    Science.gov (United States)

    Vaishampayan, Sanjeev; Borde, Priyanka

    2012-08-15

    Cranial nerve involvement is not common in leprosy. The fifth and seventh cranial nerves are the most commonly affected in leprosy. Herein we present a patient with Hansen disease (BL) with type I reaction who developed isolated involvement of the sixth cranial nerve leading to lateral rectus muscle palsy. He responded to timely anti-reactional therapy and it produced a good response. Careful observation of patients with lepra reaction is needed to avoid damage to important organs.

  2. Delayed-onset bilateral abducens paresis after head trauma

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    Pravin Salunke

    2012-01-01

    Full Text Available Bilateral sixth nerve paresis following closed head injury, though rare, is a known entity. However, delayed-onset post-traumatic bilateral abducens paresis is extremely rare. We present two cases. The first patient had onset of bilateral abducens paresis 2 weeks after closed head injury and the second patient after 3 days. The cause in the former was detected to be chronic subdural hematoma and in the latter is speculated to be edema/ischemia due to injury to soft tissue structures housing these nerves. The delayed onset of bilateral abducens paresis following head injury may vary according to the cause. There may be another mechanism of injury apart from direct trauma. Though rare, it needs to be evaluated and may have a treatable cause like elevated intracranial pressure.

  3. Bilateral Cranial IX and X Nerve Palsies After Mild Traumatic Brain Injury

    OpenAIRE

    Yoo, Seung Don; Kim, Dong Hwan; Lee, Seung Ah; Joo, Hye In; Yeo, Jin Ah; Chung, Sung Joon

    2016-01-01

    We report a 57-year-old man with bilateral cranial nerve IX and X palsies who presented with severe dysphagia. After a mild head injury, the patient complained of difficult swallowing. Physical examination revealed normal tongue motion and no uvular deviation. Cervical X-ray findings were negative, but a brain computed tomography revealed a skull fracture involving bilateral jugular foramen. Laryngoscopy indicated bilateral vocal cord palsy. In a videofluoroscopic swallowing study, food resid...

  4. Variant Anterior Digastric Muscle Transfer for Marginal Mandibular Branch of Facial Nerve Palsy

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    Matthew J. Zdilla, DC

    2014-02-01

    Full Text Available Summary: Marginal mandibular branch of facial nerve (MMBFN palsy is a common consequence of head and neck surgeries. MMBFN palsy results in paralysis of muscles which depress the inferior lip. Current management of MMBFN palsy involves ruination of normal neuromuscular anatomy and physiology to restore symmetry to the mouth. The article outlines the possibility to transfer variant anterior digastric musculature to accomplish reanimation of the mouth without adversely affecting normal nonvariant anatomy. The procedure may have the additional cosmetic benefit of correcting asymmetrical muscular bulk in the submental region.

  5. Central pontine myelinolysis presenting as isolated sixth nerve palsy in third trimester of pregnancy

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    Tushar Divakar Gosavi

    2015-01-01

    Full Text Available A 30-year-old primigravida presented with isolated left sixth nerve palsy at 38 weeks gestation. Her MRI showed a lesion consistent with central pontine myelinolysis (CPM. Extensive investigations did not reveal any secondary cause for the CPM. She recovered spontaneously in 2 weeks with complete resolution of her MRI changes. To our knowledge, this is the first report of CPM occurring in third trimester in the absence of identifiable secondary causes and of CPM presenting as an isolated sixth nerve palsy. We discuss the reported causes of CPM in pregnancy, possible pathophysiologic mechanisms involved and the anatomic basis of the unique clinical presentation of sixth nerve palsy in our case.

  6. Central pontine myelinolysis presenting as isolated sixth nerve palsy in third trimester of pregnancy

    Science.gov (United States)

    Gosavi, Tushar Divakar; See, Siew Ju

    2015-01-01

    A 30-year-old primigravida presented with isolated left sixth nerve palsy at 38 weeks gestation. Her MRI showed a lesion consistent with central pontine myelinolysis (CPM). Extensive investigations did not reveal any secondary cause for the CPM. She recovered spontaneously in 2 weeks with complete resolution of her MRI changes. To our knowledge, this is the first report of CPM occurring in third trimester in the absence of identifiable secondary causes and of CPM presenting as an isolated sixth nerve palsy. We discuss the reported causes of CPM in pregnancy, possible pathophysiologic mechanisms involved and the anatomic basis of the unique clinical presentation of sixth nerve palsy in our case. PMID:25745319

  7. Oculomotor nerve palsy associated with bortezomib in a patient with multiple myeloma: a case report

    Directory of Open Access Journals (Sweden)

    Helmy Tarek

    2010-10-01

    Full Text Available Abstract Introduction Bortezomib is a proteasome inhibitor used in the treatment of multiple myeloma. A newly recognized oculomotor nerve palsy related to bortezomib is described. Case presentation A 54-year-old Caucasian woman with immunoglobulin G kappa multiple myeloma on single-agent bortezomib given by intravenous push once weekly developed isolated unilateral partially reversible left sided oculomotor nerve palsy during the first cycle of treatment. All the essential diagnostic tests that were carried out excluded all other possible causes. There was a positive dechallenge-rechallenge test. Management was by withdrawal of bortezomib and empirical dexamethazone. To the best of our knowledge, this is the first report of its kind in the literature. Conclusion This case illustrates the probable association between oculomotor nerve palsy and bortezomib, and generates a hypothesis of whether bortezomib can cross the blood-brain barrier or not.

  8. Central pontine myelinolysis presenting as isolated sixth nerve palsy in third trimester of pregnancy.

    Science.gov (United States)

    Gosavi, Tushar Divakar; See, Siew Ju

    2015-01-01

    A 30-year-old primigravida presented with isolated left sixth nerve palsy at 38 weeks gestation. Her MRI showed a lesion consistent with central pontine myelinolysis (CPM). Extensive investigations did not reveal any secondary cause for the CPM. She recovered spontaneously in 2 weeks with complete resolution of her MRI changes. To our knowledge, this is the first report of CPM occurring in third trimester in the absence of identifiable secondary causes and of CPM presenting as an isolated sixth nerve palsy. We discuss the reported causes of CPM in pregnancy, possible pathophysiologic mechanisms involved and the anatomic basis of the unique clinical presentation of sixth nerve palsy in our case. PMID:25745319

  9. Diagnostic Value of FDG-PET/CT in Laryngeal Nerve Palsy

    DEFF Research Database (Denmark)

    Nielsen, Anne Lerberg; Thomassen, Anders; Hess, Søren;

    2013-01-01

    Aim Paresis of the recurrent laryngeal nerves may be a symptom of malignancy due to the anatomical course of the nerves in the neck and mediastinum. Therefore, FDG-PET/CT may be useful as an ancillary examination for diagnosing malignancy. The Aim was to investigate the frequency of malignant...... findings and the diagnostic yield of FDG-PET/CT in patients presenting with recurrent laryngeal nerve palsy. Materials and Methods We retrospectively included all patients referred for FDGPET/ CT scans with recurrent laryngeal nerve palsy from the Department of ENT Head and Neck Surgery at our hospital...... from January 2011 until March 2013. Scan results were compared to clinical workup including biopsy and pathology results. A scan was considered true positive if PET/CT was suggestive of malignancy along the pathway of the recurrent laryngeal nerves, and this finding was confirmed by biopsy and false...

  10. A guide to the evaluation of fourth cranial nerve palsies.

    Science.gov (United States)

    Lee; Hayman; Beaver; Prager; Kelder; Scasta; Avilla; von Noorden GK; Tang

    1998-12-01

    PURPOSE To devise a cost-effective guide for the evaluation of fourth nerve palsies (FNP). METHODS A review of the pertinent English language literature was performed to devise a guide for the evaluation (including neuroimaging) of FNP. The authors report a retrospective review of imaging studies performed on 206 patients with FNP. RESULTS The literature was used to develop the imaging guide. In the retrospective chart review of 206 patients from two tertiary care centers, 28 patients (13.6%) underwent a computed tomography scan and/or a magnetic resonance scan. Of these patients, five had associated neurological symptoms (non-isolated), one was traumatic, five were congenital, four were vasculopathic, eleven were non-vasculopathic, and two were progressive. Following the recommendations of the imaging guide, the five isolated congenital FNP and the four isolated vasculopathic FNP would not have undergone neuroimaging studies. The total costs of these neuroimaging studies in these nine patients were 19,000 dollars. Four patients in the retrospective review with associated neurological deficits (non-isolated) should have undergone neuroimaging according to the guide, but did not. CONCLUSIONS Although the evaluation of FNP can be difficult, the decision to order neuroimaging can be improved by using an imaging guide. An imaging guide for the evaluation of FNP may allow more appropriate and cost-effective imaging of these patients. Isolated congenital, old traumatic, or vasculopathic FNP do not require neuroimaging studies. Patients with non-isolated FNP should have directed neuroimaging studies based upon the results of clinical examination.

  11. Oculomotor Nerve Palsy as a Rare Presentation and First Sign of Multiple Myeloma.

    Science.gov (United States)

    Panda, Bijnya Birajita; Parija, Sucheta; Mallick, Jyotiranjan; Pujahari, Susanta

    2016-05-01

    Acquired oculomotor nerve palsy has varied aetiologies like vascular (diabetes, heart disease, atherosclerosis and posterior communicating artery aneurysm), space occupying lesions or tumours, inflammation, infection, trauma, demyelinating disease like Multiple sclerosis, autoimmune disorders such as Myasthenia gravis, postoperatively as a complication of neurosurgery, cavernous sinus thrombosis etc. Cranial Nerve palsies as one of the first symptoms of multiple myeloma have been reported sparsely in literature. We report a case of a 60-year-old woman who developed sudden onset right-sided pupil sparing oculomotor nerve palsy along with a tender swelling at right sternoclavicular joint. Cranial and orbital magnetic resonance imaging and cerebrospinal fluid examination demonstrated no abnormalities. Immunological investigations and histopathological analysis of sternoclavicular joint swelling confirmed the diagnosis of IgG type multiple myeloma. After confirmation of diagnosis we started her with appropriate chemotherapy, after which the palsy resolved within one month. The cause of the palsy was probably due to nerve ischemia due to hyper viscosity of the serum. PMID:27437257

  12. Cause of long thoracic nerve palsy: a possible dynamic fascial sling cause.

    Science.gov (United States)

    Hester, P; Caborn, D N; Nyland, J

    2000-01-01

    Long thoracic nerve palsy can result from sudden or repetitive external biomechanical forces. This investigation describes a possible dynamic cause from internal forces. Six fresh cadaveric shoulders (3 female, 3 male, 4 left, 2 right) with full range of motion were systematically dissected to evaluate the anatomic course of the long thoracic nerve. In all specimens a tight fascial band of tissue arose from the inferior aspect of the brachial plexus, extended just superior to the middle scalene muscle insertion on the first rib, and presented a digitation that extended to the proximal aspect of the serratus anterior muscle. With progressive manual abduction and external rotation, the long thoracic nerve was found to "bow-string" across the fascial band. Medial and upward migration of the superior most aspect of the scapula was found to further compress the long thoracic nerve. Previous investigations have reported that nerves tolerate a 10% increase in their resting length before a stretch-induced neuropraxia develops. Previous studies postulated that long thoracic nerve palsy resulted from the tethering effect of the scalenus medius muscle as it actively or passively compressed the nerve; however, similar neuromuscular relationships occur in many other anatomic sites without ill effect. We propose that the cause of long thoracic nerve palsy may be this "bow-stringing" phenomenon of the nerve across this tight fascial band. This condition may be further exacerbated with medial and upward migration of the superior aspect of the scapula as is commonly seen with scapulothoracic dyskinesia and fatigue of the scapular stabilizers. Rehabilitation for long thoracic nerve palsy may therefore benefit from special attention to scapulothoracic muscle stabilization. PMID:10717860

  13. Cranial nerve palsy in Wegener's granulomatosis--lessons from clinical cases

    DEFF Research Database (Denmark)

    Nowack, Rainer; Wachtler, Paul; Kunz, Jürgen;

    2009-01-01

    The problem of diagnosing vasculitic neuropathy is discussed based on case reports of two patients with Wegener's granulomatosis. One patient developed de novo 6(th) nerve palsy as an isolated relapse manifestation and the second patient a sequence of multiple cranial nerve palsies. Brain imaging...... by the overall clinical presentations. Cranial neuropathy may be the first obvious vasculitic manifestation preceding other organ disease, and since single reliable tests for its diagnosis are lacking, a multidisciplinary approach is advocated here to detect vasculitic manifestations in other organs....

  14. Oberlin partial ulnar nerve transfer for restoration in obstetric brachial plexus palsy of a newborn: case report

    Directory of Open Access Journals (Sweden)

    Kawamura Kenji

    2006-09-01

    Full Text Available Abstract An 8 month old male infant with Erb's birth palsy was treated with two peripheral nerve transfers. Except for rapid motor reinnervations, elbow flexion was obtained by an Oberlin's partial ulnar nerve transfer, while shoulder abduction was restored by an accessory-to-suprascapular nerve transfer. The initial contraction of the biceps muscle occurred two months after surgery. Forty months after surgery, elbow flexion reached M5 without functional loss of the ulnar nerve. This case demonstrates an excellent result of an Oberlin's nerve transfer for restoration of flexion of the elbow joint in Erb's birth palsy. However, at this time partial ulnar nerve transfer for Erb's birth palsy is an optional procedure; a larger number of cases will need to be studied for it to be widely accepted as a standard procedure for Erb's palsy at birth.

  15. Post-traumatic acute bilateral facial nerve palsy - a management dilemma

    Directory of Open Access Journals (Sweden)

    Kumar Rakesh

    2015-03-01

    Full Text Available Acute bilateral facial nerve paralysis is a rare clinical entity, and its management remains very controversial (operative or conservative. Here we are presenting a case of acute onset bilateral facial nerve palsy following head injury with bilateral temporal bone fracture with clinico-radiographic contrary. Patient was managed conservatively with complete recovery. By this article, authors want to stress on combining clinical examination and radiological findings for decision making of this rare entity and tried to evaluate the management.

  16. Rare Presentation of Rhino-Orbital-Cerebral Zygomycosis: Bilateral Facial Nerve Palsy

    Directory of Open Access Journals (Sweden)

    Alireza Mohebbi

    2011-01-01

    Full Text Available Rhino-orbital-cerebral zygomycosis afflicts primarily diabetics and immunocompromised individual, but can also occur in normal hosts rarely. We here presented an interesting case of facial nerve palsy and multiple cold abscesses of neck due to rhino-orbital-cerebral zygomycosis in an otherwise healthy man. Although some reports of facial nerve paralysis in conjunction with rhino-orbital-cerebral zygomycosis exist, no case of bilateral complete facial paralysis has been reported in the literature to date.

  17. Orthodromic Transfer of the Temporalis Muscle in Incomplete Facial Nerve Palsy

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    Jae Ho Aum

    2013-07-01

    Full Text Available Background Temporalis muscle transfer produces prompt surgical results with a one-stage operation in facial palsy patients. The orthodromic method is surgically simple, and the vector of muscle action is similar to the temporalis muscle action direction. This article describes transferring temporalis muscle insertion to reconstruct incomplete facial nerve palsy patients.Methods Between August 2009 and November 2011, 6 unilateral incomplete facial nerve palsy patients underwent surgery for orthodromic temporalis muscle transfer. A preauricular incision was performed to expose the mandibular coronoid process. Using a saw, the coronoid process was transected. Three strips of the fascia lata were anchored to the muscle of the nasolabial fold through subcutaneous tunneling. The tension of the strips was adjusted by observing the shape of the nasolabial fold. When optimal tension was achieved, the temporalis muscle was sutured to the strips. The surgical results were assessed by comparing pre- and postoperative photographs. Three independent observers evaluated the photographs.Results The symmetry of the mouth corner was improved in the resting state, and movement of the oral commissure was enhanced in facial animation after surgery.Conclusions The orthodromic transfer of temporalis muscle technique can produce prompt results by applying the natural temporalis muscle vector. This technique preserves residual facial nerve function in incomplete facial nerve palsy patients and produces satisfying cosmetic outcomes without malar muscle bulging, which often occurs in the turn-over technique.

  18. Median Nerve Palsy following Elastic Stable Intramedullary Nailing of a Monteggia Fracture: An Unusual Case and Review of the Literature

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    Surjit Lidder

    2011-01-01

    Full Text Available Monteggia fractures are rare in children, and subtle radial head dislocations, with minor plastic deformation of the ulna, may be missed in up to a third of cases. Complications of Monteggia fractures-dislocations include persistent radial head dislocation, forearm deformity, elbow stiffness, and nerve palsies at the time of presentation. An unusual case of median nerve palsy following elastic stable intramedullary nailing of a type I Monteggia lesion in a 6-year-old girl is presented, and we highlight that, although most nerve palsies associated with a Monteggia fracture-dislocations are treated expectantly in children, early intervention here probably provided the best outcome.

  19. Case Study of Oriental Medicine Treatment with Acupotomy Therapy of the Peroneal Nerve Palsy through Ultrasound Case Report

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    Kim Sungha

    2011-03-01

    Full Text Available Purpose: In order to estimate clinical effects of Oriental Medicine Treatment with acupotomy therapy of Peroneal nerve Palsy. Methods: From 10th June, 2010 to 19th June, 2010, 1 female patient diagnosed as Peroneal nerve Palsy(clinical diagnosed was treated with general oriental medicine therapy (acupuncture, pharmacopuncture,moxibustion, cupping, physical therapy, herbal medication and acupotomy. Results: The patient's left foot drop was remarkably improved. Conclusions: This study demonstrates that oriental medical treatment with acuputomy therapy has notable effect in improving symptoms of peroneal nerve palsy. as though we had not wide experience in this treatment, more research is needed.

  20. Iatrogenic facial nerve palsy "Prevention is better than cure": Analysis of four cases

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    Rakesh Kumar

    2011-01-01

    Full Text Available Iatrogenic facial nerve palsy in mastoid surgery is considered a crime or a taboo in the present scenario of medical science. But one has to accept the fact that every otologist encounters this entity at some point in his/her career. Hence it is of prime importance to be equipped to detect and to manage these cases. The obvious and disfiguring facial deformity it causes makes this a dreaded complication. Our article here discusses our experience in managing four cases of iatrogenic facial palsy. The etiology in all the cases was mastoidectomy for cholesteatoma. The detection of the site and repair was performed by the same surgeon in all cases. The facial nerve was transected completely in three cases, and in one case there was partial loss (>50% of fibers. Cable nerve grafting was utilized in three patients. There was grade 4 improvement in three patients who underwent cable nerve grafting, and one patient had grade 2 recovery after end-to-end anastomosis. A good anatomical knowledge and experience with temporal bone dissection is of great importance in preventing facial nerve injury. If facial nerve injury is detected, it should be managed as early as possible. An end-to-end anastomosis provides better results in final recovery as opposed to cable nerve grafting for facial nerve repair.

  1. Evaluation of Variation in the Course of the Facial Nerve, Nerve Adhesion to Tumors, and Postoperative Facial Palsy in Acoustic Neuroma

    OpenAIRE

    Sameshima, Tetsuro; Morita, Akio; Tanikawa, Rokuya; Fukushima, Takanori; Friedman, Allan H.; Zenga, Francesco; Ducati, Alessandro; Mastronardi, Luciano

    2012-01-01

    Objective To investigate the variation in the course of the facial nerve (FN) in patients undergoing acoustic neuroma (AN) surgery, its adhesion to tumors, and the relationship between such adhesions and postoperative facial palsy.

  2. Intermittent hypoglossal nerve palsy caused by a calcified persistent hypoglossal artery: an uncommon neurovascular compression syndrome.

    Science.gov (United States)

    Meila, Dan; Wetter, Axel; Brassel, Friedhelm; Nacimiento, Wilhelm

    2012-12-15

    Neurovascular compression is assumed to cause symptoms like trigeminal neuralgia, hemifacial spasm and vestibular paroxysmia. We present a patient with recurrent episodes of transient dysarthria due to isolated right hypoglossal nerve (HN) palsy. We describe the first case of a calcified persistent hypoglossal artery (PHA) as the putative cause of a hypoglossal neurovascular compression syndrome. Our patient received a daily low-dose medication of carbamazepine resulting in complete relief of symptoms. In conclusion, PHA is not only an anatomic variation but also a possible cause of a neurovascular compression syndrome leading to intermittent HN palsy. PMID:23020989

  3. An unusual cause of trochlear nerve palsy and brainstem compression

    Directory of Open Access Journals (Sweden)

    Jasmit Singh

    2016-01-01

    Full Text Available Schwannoma originates from the Schwann cells at the Obersteiner-Redlich zone, which marks the junction of central and peripheral myelin of the cranial nerves. Most frequently affected are the vestibular, trigeminal, and facial nerves followed by the lower cranial nerves. Trochlear schwannoma in the absence of neurofibromatosis is a rare entity. The purpose of this report is to serve as a reminder to consider trochlear nerve schwannoma in the list of differential diagnosis of such tumors as the outcome is far better than the intraaxial tumor in that location.

  4. Pituitary apoplexy presenting as isolated third cranial nerve palsy with ptosis : two case reports.

    Science.gov (United States)

    Cho, Won-Jin; Joo, Sung-Pil; Kim, Tae-Sun; Seo, Bo-Ra

    2009-02-01

    Pituitary apoplexy is a clinical syndrome caused by an acute ischemic or hemorrhagic vascular accident involving a pituitary adenoma or an adjacent pituitary gland. Pituitary apoplexy may be associated with a variety of neurological and endocrinological signs and symptoms. However, isolated third cranial nerve palsy with ptosis as the presenting sign of pituitary apoplexy is very rare. We describe two cases of pituitary apoplexy presenting as sudden-onset unilateral ptosis and diplopia. In one case, brain magnetic resonance imaging (MRI) revealed a mass in the pituitary fossa with signs of hemorrhage, upward displacement of the optic chiasm, erosion of the sellar floor and invasion of the right cavernous sinus. In the other case, MRI showed a large area of insufficient enhancement in the anterior pituitary consistent with pituitary infarction or Sheehan's syndrome. We performed neurosurgical decompression via a transsphenoidal approach. Both patients showed an uneventful recovery. Both cases of isolated third cranial nerve palsy with ptosis completely resolved during the early postoperative period. We suggest that pituitary apoplexy should be included in the differential diagnosis of patients presenting with isolated third cranial nerve palsy with ptosis and that prompt neurosurgical decompression should be considered for the preservation of third cranial nerve function. PMID:19274125

  5. Prosthetic ambulation in a paraplegic patient with a transfemoral amputation and radial nerve palsy.

    Science.gov (United States)

    Shin, J C; Park, C; Kim, D Y; Choi, Y S; Kim, Y K; Seong, Y J

    2000-08-01

    Great importance and caution should be placed on prosthetic fitting for a paraplegic patient with an anesthetic residual limb if functional ambulation is to be achieved. The combination of paraplegia with a transfemoral amputation and radial nerve palsy is a complex injury that makes the rehabilitation process difficult. This article describes a case of L2 paraplegia with a transfemoral amputation and radial nerve palsy on the right side. Following the rehabilitation course, the patient independently walked using a walker at indoor level with a transfemoral prosthesis with ischial containment socket, polycentric knee assembly, endoskeletal shank and multiaxis foot assembly and a knee ankle foot orthosis on the sound side. The difficulties of fitting a functional prosthesis to an insensate limb and the rehabilitation stages leading to functional ambulation are reviewed. PMID:10992814

  6. Combined Ipsilateral Oculomotor Nerve Palsy and Contralateral Downbeat Nystagmus in a Case of Cerebral Infarction

    Directory of Open Access Journals (Sweden)

    Kosuke Matsuzono

    2014-04-01

    Full Text Available We report a patient with acute cerebral infarction of the left paramedian thalamus, upper mesencephalon and cerebellum who exhibited ipsilateral oculomotor nerve palsy and contralateral downbeat nystagmus. The site of the infarction was considered to be the paramedian thalamopeduncular and cerebellar regions, which are supplied by the superior cerebellar artery containing direct perforating branches or both the superior cerebellar artery and the superior mesencephalic and posterior thalamosubthalamic arteries. Contralateral and monocular downbeat nystagmus is very rare. Our case suggests that the present downbeat nystagmus was due to dysfunction of cerebellar-modulated crossed oculovestibular fibers of the superior cerebellar peduncle or bilateral downbeat nystagmus with one-sided oculomotor nerve palsy.

  7. Dural carotid cavernous sinus fistula presenting as isolated oculomotor nerve palsy: Case report

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    Şehnaz Arıcı

    2015-04-01

    Full Text Available Indirect (dural carotid cavernous fistula is formed by the connection between meningeal branches of the internal carotid artery and the cavernous sinüs, and low flow circulation with low pressure is occured. Proptosis, ophtalmoplegia, headache, scleral and conjuctival hyperemia expanding around the eyeball can be observed. A forty-eight year old female patient with a background of diabetes mellitus and hypertension was admitted with complaints of double vision. Isolated oculomotor nerve palsy was found in neurological examination and an indirect carotid cavernous fistula was revealed by digital subtraction angiography. Our case with carotid cavernous fistula as a rare cause of isolated oculomotor nerve palsy is worth to be reported.

  8. C5 Nerve root palsies following cervical spine surgery: A review

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    Nancy E Epstein

    2015-01-01

    Full Text Available Background: Cervical C5 nerve root palsies may occur in between 0% and 30% of routine anterior or posterior cervical spine operations. They are largely attributed to traction injuries/increased cord migration following anterior/posterior decompressions. Of interest, almost all studies cite spontaneous resolution of these deficits without surgery with 3-24 postoperative months. Methods: Different studies cite various frequencies for C5 root palsies following anterior or posterior cervical spine surgery. In their combined anterior/posterior series involving C4-C5 level  decompressions, Libelski et al. cited up to a 12% incidence of C5 palsies. In Gu et al. series, C5 root palsies occurred in 3.1% of double-door laminoplasty, 4.5% of open-door laminoplasty, and 11.3% of laminectomy. Miller et al. observed an intermediate 6.9% frequency of C5 palsies followed by posterior cervical decompressions and fusions (PCDF. Results: Gu et al. also identified multiple risk factors for developing C5 palsies following posterior surgery; male gender, ossification of the posterior longitudinal ligament (OPLL, narrower foramina, laminectomy, and marked dorsal spinal cord drift. Miller et al. also identified an average $1918 increased cost for physical/occupational therapy for patients with C5 palsies. Conclusions: The incidence of C5 root deficits for anterior/posterior cervical surgery at C4-C5 was 12% in one series, and ranged up to 11.3% for laminectomies, while others cited 0-30%. Although identification of preoperative risk factors for C5 root deficits may help educate patients regarding these risks, there is no clear method for their avoidance at this time.

  9. Pituitary Apoplexy Presenting as Isolated Third Cranial Nerve Palsy with Ptosis : Two Case Reports

    OpenAIRE

    Cho, Won-Jin; Joo, Sung-Pil; Kim, Tae-Sun; Seo, Bo-Ra

    2009-01-01

    Pituitary apoplexy is a clinical syndrome caused by an acute ischemic or hemorrhagic vascular accident involving a pituitary adenoma or an adjacent pituitary gland. Pituitary apoplexy may be associated with a variety of neurological and endocrinological signs and symptoms. However, isolated third cranial nerve palsy with ptosis as the presenting sign of pituitary apoplexy is very rare. We describe two cases of pituitary apoplexy presenting as sudden-onset unilateral ptosis and diplopia. In on...

  10. Central pontine myelinolysis presenting as isolated sixth nerve palsy in third trimester of pregnancy

    OpenAIRE

    Tushar Divakar Gosavi; Siew Ju See

    2015-01-01

    A 30-year-old primigravida presented with isolated left sixth nerve palsy at 38 weeks gestation. Her MRI showed a lesion consistent with central pontine myelinolysis (CPM). Extensive investigations did not reveal any secondary cause for the CPM. She recovered spontaneously in 2 weeks with complete resolution of her MRI changes. To our knowledge, this is the first report of CPM occurring in third trimester in the absence of identifiable secondary causes and of CPM presenting as an isolated six...

  11. Diagnostic gait pattern of a patient with longstanding left femoral nerve palsy: a case report.

    LENUS (Irish Health Repository)

    Burke, Neil G

    2010-12-01

    The gait pattern of a 35-year-old man with longstanding, left femoral nerve palsy was assessed using 3-dimensional kinematic and kinetic analysis. Stability of his left knee in stance was achieved by manipulating the external moments of the limb so that the ground reaction force passes in front of the knee joint. This compensatory mechanism of locking the knee in extension is reliant on the posterior capsular structures. The patient was managed conservatively and continued to walk without aids.

  12. Transient Femoral Nerve Palsy Complicating “Blind” Transversus Abdominis Plane Block

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    Dimitrios K. Manatakis

    2013-01-01

    Full Text Available We present two cases of patients who reported quadriceps femoris weakness and hypoesthesia over the anterior thigh after an inguinal hernia repair under transversus abdominis plane (TAP block. Transient femoral nerve palsy is the result of local anesthetic incorrectly injected between transversus abdominis muscle and transversalis fascia and pooling around the femoral nerve. Although it is a minor and self-limiting complication, it requires overnight hospital stay and observation of the patients. Performing the block under ultrasound guidance and injecting the least volume of local anesthetic required are ways of minimizing its incidence.

  13. Facial nerve palsy: incidence of different ethiologies in a tertiary ambulatory

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    Atolini Junior, Nédio

    2009-06-01

    Full Text Available Introduction: The ethiologic diferencial diagnostic for facial nerve paralisis is still a challenge and the literature has shown conflictive results concerning its epidemiology. Objective: To outline the incidence of the different ethiologies and the profile of peripheral facial nerve paralysis patients in the otolaryngology ambulatory of the Faculdade de Ciencias Medicas e Biologicas da PUC-SP - campus Sorocaba. Method: The records of 54 patients with facial nerve paralysis seen during the years of 2007 and 2008 were analysed retrospectively. Results: From the 54 patients analysed, 55,5% were male, median age of 40,6 years and had the right side of the face acomitted in 66,6%. Parestesia of the accomited side in 51,85% and increased tears in 66,6% of the patients were observed as associated symptoms. Bell´s palsy was the most frequent ethiology (53,7%, follwed by: traumatic (24%, Ramsay Hunt syndrome (9,2%, Cholesteatoma (5,5%, malignant otitis media (3,7% and acute otits media (3,7%. Three cases of Bell´s palsy during pregancy was also seen in this series. Conclusion: The data found are similiar of the most of the literature, showing that Bell´s palsy is still the most frequent, followed by traumatic causes and others. There is an equilibrium concerning to the gender, with a slight prevalence for males and for the right side of the face.

  14. Superior Oblique Anterior Transposition with Horizontal Recti Recession-Resection for Total Third-Nerve Palsy

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    Muhsin Eraslan

    2015-01-01

    Full Text Available Aims. To report the results of lateral rectus muscle recession, medial rectus muscle resection, and superior oblique muscle transposition in the restoration and maintenance of ocular alignment in primary position for patients with total third-nerve palsy. Methods. The medical records of patients who underwent surgery between March 2007 and September 2011 for total third-nerve palsy were reviewed. All patients underwent a preoperative assessment, including a detailed ophthalmologic examination. Results. A total of 6 patients (age range, 14–45 years were included. The median preoperative horizontal deviation was 67.5 Prism Diopter (PD (interquartile range [IQR] 57.5–70 and vertical deviation was 13.5 PD (IQR 10–20. The median postoperative horizontal residual exodeviation was 8.0 PD (IQR 1–16, and the vertical deviation was 0 PD (IQR 0–4. The median correction of hypotropia following superior oblique transposition was 13.5 ± 2.9 PD (range, 10–16. All cases were vertically aligned within 5 PD. Four of the six cases were aligned within 10 PD of the horizontal deviation. Adduction and head posture were improved in all patients. All patients gained new area of binocular single vision in the primary position after the operation. Conclusion. Lateral rectus recession, medial rectus resection, and superior oblique transposition may be used to achieve satisfactory cosmetic and functional results in total third-nerve palsy.

  15. Unilateral Hypoglossal Nerve Palsy after Use of the Laryngeal Mask Airway Supreme

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    Kenichi Takahoko

    2014-01-01

    Full Text Available Purpose. Hypoglossal nerve palsy after use of the laryngeal mask airway (LMA is an exceptionally rare complication. We present the first case of unilateral hypoglossal nerve palsy after use of the LMA Supreme. Clinical Features. A healthy 67-year-old female was scheduled for a hallux valgus correction under general anesthesia combined with femoral and sciatic nerve blocks. A size 4 LMA Supreme was inserted successfully at the first attempt and the cuff was inflated with air at an intracuff pressure of 60 cmH2O using cuff pressure gauge. Anesthesia was maintained with oxygen, nitrous oxide (67%, and sevoflurane under spontaneous breathing. The surgery was uneventful and the duration of anesthesia was two hours. The LMA was removed as the patient woke and there were no immediate postoperative complications. The next morning, the patient complained of dysarthria and dysphasia. These symptoms were considered to be caused by the LMA compressing the nerve against the hyoid bone. Conservative treatment was chosen and the paralysis recovered completely after 5 months. Conclusion. Hypoglossal nerve injury may occur despite correct positioning of the LMA under the appropriate intracuff pressure. A follow-up period of at least 6 months should be taken into account for the recovery.

  16. Femoral and obturator nerves palsy caused by pelvic cement extrusion after hip arthroplasty.

    Directory of Open Access Journals (Sweden)

    Pawel Zwolak

    2011-05-01

    Full Text Available Cement extrusion into the pelvis with subsequent palsy of the obturator and femoral nerves is a rare entity after hip replacement surgery. Cemented fixation of the acetabular cup has been considered as a safe and reliable standard procedure with very good long term results. We present a case of fifty year old female patient after hip arthroplasty procedure which suffered an obturator and femoral nerve palsy caused by extrusion of bone cement into the pelvis. Postoperative X-rays and CT-scan of the pelvis demonstrated a huge mass consisted of bone cement in close proximity of femoral and obturator nerves. The surgery charts reported shallow and weak bony substance in postero-superior aspect of the acetabulum. This weak bony acetabular substance may have caused extrusion of bone cement during press-fitting of the polyethylene cup into the acetabulum, and the following damage of the both nerves produced by polymerization of bone cement. The bone cement fragment has been surgically removed 3 weeks after arthroplasty. The female patient underwent intensive postoperative physical therapy and electro stimulation which resulted in full recovery of the patient to daily routine and almost normal electromyography results.

  17. Remote therapeutic effect of early nerve transposition in treatment of obstetric al brachial plexus palsy

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Objective: To report a method and remote therape utic effect of early nerve transposition in treatment of obstetrical brachial pl exus palsy.   Methods: From May 1995 to August 1996, 12 patients who had no r ecovery of biceps 3 months after birth were treated with nerve transposition. Ei ght had neuroma at the upper trunk and 4 had rupture or avulsion of the upper tr unk. Mallet test was used to evaluate the results.   Results: The follow-up of 40-52 months showed that excellent and good recovery in functions was found in 75% of the patients and the excellen t rate of phrenic nerve and accessory nerve transposition was 83.3% and 6 6.7% respectively. A complete recovery in shoulder and elbow joint function wa s in 3 patients and Mallet Ⅳ was in 6 patients.   Conclusions: Satisfactory outcome can be obtained by using earl y nerve transposition in treating obstetrical brachial plexus.Paralysis, obstetric; Peripheral nerves; Nerve trans position

  18. Secondary Radial Nerve Palsy after Minimally Invasive Plate Osteosynthesis of a Distal Humeral Shaft Fracture

    Directory of Open Access Journals (Sweden)

    Ursina Bichsel

    2015-01-01

    Full Text Available Minimally invasive plate osteosynthesis is a widely used procedure for the treatment of fractures of the femur and the tibia. For a short time it is also used for the treatment of humeral shaft fractures. Among other advantages, the ambassadors of this technique emphasize the lower risk of nerve injuries when compared to open reduction and internal fixation. We report the case of secondary radial nerve palsy caused by percutaneous fixation of a plate above the antecubital fold. The nerve did not recover and the patient needed a tendon transfer to regain active extension of the fingers. This case points to the importance of adequate exposure of the bone and plate if a humeral shaft fracture extends far distally.

  19. Cranial mononeuropathy VI

    Science.gov (United States)

    ... may reduce the risk by controlling their blood sugar. Alternative Names Abducens paralysis; Abducens palsy; Lateral rectus palsy; Vith nerve palsy; Cranial nerve VI palsy Images Central nervous system and peripheral nervous system References Rucker JC. Cranial ...

  20. Clinical studies of photodynamic therapy for malignant brain tumors: facial nerve palsy after temporal fossa photoillumination

    Science.gov (United States)

    Muller, Paul J.; Wilson, Brian C.; Lilge, Lothar D.; Varma, Abhay; Bogaards, Arjen; Fullagar, Tim; Fenstermaker, Robert; Selker, Robert; Abrams, Judith

    2003-06-01

    In two randomized prospective studies of brain tumor PDT more than 180 patients have been accrued. At the Toronto site we recognized two patients who developed a lower motor neuron (LMN) facial paralysis in the week following the PDT treatment. In both cases a temporal lobectomy was undertaken and the residual tumor cavity was photo-illuminated. The surface illuminated included the temporal fossa floor, thus potentially exposing the facial nerve to the effect of PDT. The number of frontal, temporal, parietal, and occipital tumors in this cohort was 39, 24, 12 and 4, respectively. Of the 24 temporal tumors 18 were randomized to Photofrin-PDT. Of these 18 a temporal lobectomy was carried out exposing the middle fossa floor as part of the tumor resection. In two of the 10 patients where the lobectomy was carried out and the fossa floor was exposed to light there occurred a postoperative facial palsy. Both patients recovered facial nerve function in 6 and 12 weeks, respectively. 46 J/cm2 were used in the former and 130 J/cm2 in the latter. We did not encounter a single post-operative LMN facial plasy in the 101 phase 2 patients treated with Photofrin-PDT. Among 688 supratentorial brain tumor operations in the last decade involving all pathologies and all locations no case of early post-operative LMN facial palsy was identified in the absence of PDT. One further patient who had a with post-PDT facial palsy was identified at the Denver site. Although it is possible that these patients had incidental Bell's palsy, we now recommend shielding the temporal fossa floor during PDT.

  1. Prognostic value of pretreatment and recovery duration of cranial nerve palsy in nasopharyngeal carcinoma

    International Nuclear Information System (INIS)

    The purpose of this study was to evaluate the prognostic value of cranial nerve (CN) palsy in nasopharyngeal carcinoma (NPC) patients. A retrospective analysis was performed on CN involvement using medical records of 178 consecutive patients with histologically diagnosed, non-disseminated NPC. In 178 NPC patients with CN palsy, the 5-year survival rates were as follows: overall survival (OS), 61.0%; disease-specific survival (DSS), 69.6%; local relapse-free survival (LRFS), 75.2%; distant metastasis-free survival (DMFS), 73.4%; and disease-free survival (DFS), 55.3%. Significant differences were observed in the 5-year OS rates between patients with single and multiple CN palsy (69.8% vs. 54.3%; P = 0.033) and the OS rates between patients with different pretreatment durations (68.7% vs. 43.3%, P = 0.007). However, no significant differences were observed in OS, DSS, LRFS and DFS rates between patients with upper and lower CN palsy (P = 0.581, P = 0.792, P = 0.729 and P = 0.212, respectively). The results showed that recovery duration was an independent prognostic factor for OS (HR = 2.485; P < 0.001), DSS (HR = 2.065; P = 0.016), LRFS (HR = 3.051; P = 0.001) and DFS (HR = 2.440; P < 0.001). Recovery duration is an independent prognostic factor for NPC patients with CN palsy and is related to recurrence, which leads to poor survival. Recovery duration requires close surveillance and different treatment regimens

  2. Central Retinal Artery Occlusion and Third Cranial Nerve Palsy Following Nasal Septoplasty

    Directory of Open Access Journals (Sweden)

    G.Nageswar Rao

    2012-10-01

    Full Text Available Background: Postoperative vision loss following routine nasal surgery is an extremely rare and devastating complication. We report a case of unilateral blindness due to central retinal artery occlusion associated with third cranial nerve following septoplasty. Case Report: We report a patient who developed an unusual central retinal artery occlusion with unilateral blindness following nasal surgery under general anesthesia. A 45-year-old man underwent a nasal septal surgery for severe epistaxis. Soon after recovery, the patient noticed loss of vision in his right eye and was unable to lift his upper eyelid. Upon ophthalmic examinations, we determined that he had right-sided third cranial nerve palsy with central retinal artery obstruction and ptosis of right upper eyelid, restriction of ocular movements, and no perception of light in the right eye. Postoperative computerized tomography scan revealed multiple fractures of the left medial orbital wall, including one near the optic canal. Ptosis and ocular defects were recovered partially, but visual loss persisted until the last follow-up. Conclusion: This paper highlights one case of complete unilateral blindness from direct central retinal artery occlusion associated with third cranial nerve palsy following an apparently uneventful septorhinoplasty. Ophthalmologists and otolaryngologists should therefore be aware of the possible occurrence of such complications.

  3. Transient superficial peroneal nerve palsy after anterior cruciate ligament reconstruction

    Directory of Open Access Journals (Sweden)

    Majed Alrowaili

    2016-06-01

    Full Text Available A 19-year-old male subject was diagnosed with medial meniscal, lateral meniscal and anterior cruciate ligament (ACL tear. The symptoms did not subside after 4 months of physical therapy, and he underwent arthroscopic partial medial and lateral meniscectomy and ACL reconstruction. Immediately after the patient woke up from general anesthesia, he started experience loss of sensation in the area of superficial peroneal nerve with inverted dorsiflexion of foot and ankle. Instantly, the bandage and knee brace was removed and a diagnosis of compartment syndrome was ruled out. After eight hours, post-operatively, the patient started receiving physiotherapy. He complained of numbness and tingling in the same area. After 24 h, post-operatively, the patient started to regain dorsiflexion and eversion gradually. Two days after the surgery, the patient exhibited complete recovery of neurological status.

  4. Transient Superficial Peroneal Nerve Palsy After Anterior Cruciate Ligament Reconstruction.

    Science.gov (United States)

    Alrowaili, Majed

    2016-04-26

    A 19-year-old male subject was diagnosed with medial meniscal, lateral meniscal and anterior cruciate ligament (ACL) tear. The symptoms did not subside after 4 months of physical therapy, and he underwent arthroscopic partial medial and lateral meniscectomy and ACL reconstruction. Immediately after the patient woke up from general anesthesia, he started experience loss of sensation in the area of superficial peroneal nerve with inverted dorsiflexion of foot and ankle. Instantly, the bandage and knee brace was removed and a diagnosis of compartment syndrome was ruled out. After eight hours, post-operatively, the patient started receiving physiotherapy. He complained of numbness and tingling in the same area. After 24 h, post-operatively, the patient started to regain dorsiflexion and eversion gradually. Two days after the surgery, the patient exhibited complete recovery of neurological status.

  5. Transient Superficial Peroneal Nerve Palsy After Anterior Cruciate Ligament Reconstruction

    Science.gov (United States)

    2016-01-01

    A 19-year-old male subject was diagnosed with medial meniscal, lateral meniscal and anterior cruciate ligament (ACL) tear. The symptoms did not subside after 4 months of physical therapy, and he underwent arthroscopic partial medial and lateral meniscectomy and ACL reconstruction. Immediately after the patient woke up from general anesthesia, he started experience loss of sensation in the area of superficial peroneal nerve with inverted dorsiflexion of foot and ankle. Instantly, the bandage and knee brace was removed and a diagnosis of compartment syndrome was ruled out. After eight hours, post-operatively, the patient started receiving physiotherapy. He complained of numbness and tingling in the same area. After 24 h, post-operatively, the patient started to regain dorsiflexion and eversion gradually. Two days after the surgery, the patient exhibited complete recovery of neurological status. PMID:27478579

  6. Superior rectus transposition combined with medial rectus recession for Duane syndrome and sixth nerve palsy

    Science.gov (United States)

    Mehendale, Reshma A.; Dagi, Linda R.; Wu, Carolyn; Ledoux, Danielle; Johnston, Suzanne; Hunter, David G.

    2013-01-01

    Objective Vertical rectus transposition (VRT) is used to treat abduction limitation, but new vertical deviations and anterior segment ischemia are concerns. Johnston and Crouch described superior rectus transposition (SRT), a procedure in which only the superior rectus muscle is transposed temporally. We describe our results using augmented temporal SRT with adjustable medial rectus muscle recession (MRc) for treatment of Duane syndrome I (DS) and sixth nerve palsy. Methods Retrospective surgical case review of patients undergoing the SRT procedure. Pre- and post-operative orthoptic measurements were recorded. Minimum follow-up was 6 weeks. Main outcome measures included angle of esotropia in primary position and the angle of head turn. Secondary outcomes included duction limitation, stereopsis, and new vertical deviations. Results The review identified seventeen patients (10 with DS and 7 with sixth nerve palsy). SRT+MRc improved esotropia [from 44 PD to 10.1 PD (p< 0.0001)], reduced abduction limitation [from −4.3 to −2.7 (p<0.0001)] and improved compensatory head posture [from 28°to 4° (p<0.0001)]. Stereopsis was recovered in eight patients (p=0.03). Three patients required a reoperation; one for overcorrection and 2 for undercorrection. A new primary position vertical deviation was observed in 2/7 patients with complex sixth nerve palsy and 0/10 DS patients. No patient described torsional diplopia. Conclusions SRT allows for the option of simultaneous medial rectus recession in patients with severe abduction imitation who require transposition surgery. SRT+MRc improved esotropia, head position, abduction limitation, and stereopsis without inducing torsional diplopia. PMID:22332212

  7. Post Traumatic Delayed Bilateral Facial Nerve Palsy (FNP): Diagnostic Dilemma of Expressionless Face.

    Science.gov (United States)

    Kumar, Rakesh; Mittal, Radhey Shyam

    2015-04-01

    Bilateral facial nerve palsy [FNP] is a rare condition. Mostly it is idiopathic. Post traumatic bilateral FNP is even more rare and having unique neurosurgical considerations. Post traumatic delayed presentation of bilateral FNP is socially debilitating and also having diagnostic challenge. Due to lack of facial asymmetry as present in unilateral facial paralysis, it is difficult to recognize. We are presenting a case of delayed onset bilateral FNP who developed FNP after 12 days of head injury with a brief discussion of its diagnostic dilemma and management along with literature review.

  8. Midbrain hematoma presenting with isolated bilateral palsy of the third cranial nerve in a Moroccan man: a case report

    Directory of Open Access Journals (Sweden)

    El Ouali Ouarda

    2012-07-01

    Full Text Available Abstract Introduction Bilateral third nerve palsy secondary to a hemorrhagic stroke is exceptional. To the best of our knowledge, no similar case has been reported in the literature. Case presentation We describe the case of a 69-year-old Moroccan man who presented with isolated sudden bilateral third nerve palsy. Computed tomography (CT of the brain revealed a midbrain hematoma. The oculomotor function gradually and completely improved over eight months of follow-up. Conclusion Stroke should be included in the differential diagnosis of sudden isolated oculomotor paralysis even when it is bilateral because of the severity of the underlying disease and the importance of its therapeutic implications.

  9. Discrepancy between magnetic resonance imaging and cranial nerve neuropathies associated with the involvement of diffuse large B-cell lymphoma(DLBL)

    OpenAIRE

    Yutaka, TSUTSUMI; Asako, N A K A T A; Souichi,SHIRA TORI; Hiroaki, Y A M ATO; Nobuyuki, EHIRA; Hiroe, K A N A MORI; Takahito, K A W A MURA; Taro, NISHIO; Nobutaka, OGURA

    2007-01-01

    An 83-year-old female developed diffuse large B-cell lymphoma(DLBL) of the left nasal cavity. Complete remission was achieved after two courses of Rituximab and CHOP(R-CHOP) . During the fourth course of R-CHOP, sensory disturbance and palsy of the left face developed. Left trigeminal nerve swelling was observed in magnetic resonance imaging(MRI) followed by double vision in the left eye, and MRI revealed swelling of both trigeminal nerves but not of the abducens nerve. Although the swelling ...

  10. Tardy posterior interosseous nerve palsy resulting from residual dislocation of the radial head in a Monteggia fracture: a case report

    Directory of Open Access Journals (Sweden)

    Lee Kyung-Jae

    2009-11-01

    Full Text Available Abstract Introduction We report an extremely rare case of tardy posterior interosseous nerve palsy that developed 40 years after unreduced anterior dislocation of the radial head in a Monteggia fracture. Case presentation A 46-year-old Asian woman was diagnosed with tardy posterior interosseous nerve palsy resulting from residual dislocation of the radial head in a Monteggia fracture. The patient remembered that she had sustained a fracture to the right elbow when she was 6 years old but could not remember the details of either the injury or its treatment. Intra-operatively, the posterior interosseous nerve was compressed at the radial head, wrapped around the medial side of the radial neck, and ran into the distorted supinator muscle, and was stretched. We therefore excised the radial head and performed neurolysis. The function of the right hand was normal at a follow-up examination 8 months after surgery. Conclusion We theorize that excessive repeated motion with loss of elasticity of surrounding tissues because of long-term dislocation of the radial head may cause delayed posterior interosseous nerve palsy. It is necessary to make an accurate diagnosis and render proper treatment when a Monteggia fracture occurs, making sure that the radial head does not remain dislocated, to avoid possible posterior interosseous nerve palsy due to excessive pronation and supination even several decades later.

  11. [A case presenting with trochlear nerve palsy and segmental sensory disturbance due to circumscribed midbrain and upper pontine hemorrhage].

    Science.gov (United States)

    Ishihara, Kenji; Furutani, Rikiya; Shiota, Jun-ichi; Kawamura, Mitsuru

    2003-07-01

    We describe a patient presenting with trochlear nerve palsy and segmental sensory disturbance due to circumscribed mesencephalic hemorrhage. A 36-year-old man with no past illness visited our hospital complaining of sudden onset of diplopia, dysesthesia of the left face and upper extremity, and acuphenes of the left ear. Neurological examination revealed left trochlear nerve palsy and segmental sensory disturbance of the left side almost above T11 level. Pain and temperature sensation were disturbed, but vibration, joint position, graphesthesia, kinesthesia, and discrimination sensation were spared. Magnetic resonance imaging of the head, performed 7 days after onset, revealed acute to subacute phase hemorrhage at the right inferior colliculus. No abnormalities were identified on cerebral angiography. Symptoms gradually improved with conservative therapy. After about ten weeks, diplopia disappeared and area of sensory disturbance was reduced (disturbance of pain sensation reduced to about T4 level, temperature sensation to about T9). Segmental sensory disturbance usually accompanies spinal cord lesion. However, several cases of similar symptoms following cerebrovascular disease of the brainstem have been reported. Conversely, some reports have indicated that trochlear nerve palsy due to midbrain hemorrhage accompanies sensory disturbance contralateral to the lesion. The nature of sensory disturbance is thus variable. The present case suggests that segmental sensory disturbance might accompany trochlear nerve palsy caused by hemorrhage of the inferior colliculus, as intramedullary fibers of the trochlear nerve and spinothalamic tract are located nearby and somatotopy of the spinothalamic tract is preserved even at the level of the midbrain.

  12. Effects of Electroacupuncture on Facial Nerve Function and HSV-1 DNA Quantity in HSV-1 Induced Facial Nerve Palsy Mice.

    Science.gov (United States)

    Tang, Hongzhi; Feng, Shuwei; Chen, Jiao; Yang, Jie; Yang, Mingxiao; Zhong, Zhendong; Li, Ying; Liang, Fanrong

    2014-01-01

    Acupuncture is a common and effective therapeutic method to treat facial nerve palsy (FNP). However, its underlying mechanism remains unclear. This study was aimed to investigate the effects of electroacupuncture on symptoms and content of HSV-1 DNA in FNP mice. Mice were randomized into four groups, an electroacupuncture treatment group, saline group, model animal group, and blank control group. Electroacupuncture was applied at Jiache (ST6) and Hegu (LI4) in electroacupuncture group once daily for 14 days, while electroacupuncture was not applied in model animal group. In electroacupuncture group, mice recovered more rapidly and HSV-1 DNA content also decreased more rapidly, compared with model animal group. We conclude that electroacupuncture is effective to alleviate symptoms and promote the reduction of HSV-1 in FNP.

  13. Effects of Electroacupuncture on Facial Nerve Function and HSV-1 DNA Quantity in HSV-1 Induced Facial Nerve Palsy Mice

    Directory of Open Access Journals (Sweden)

    Hongzhi Tang

    2014-01-01

    Full Text Available Acupuncture is a common and effective therapeutic method to treat facial nerve palsy (FNP. However, its underlying mechanism remains unclear. This study was aimed to investigate the effects of electroacupuncture on symptoms and content of HSV-1 DNA in FNP mice. Mice were randomized into four groups, an electroacupuncture treatment group, saline group, model animal group, and blank control group. Electroacupuncture was applied at Jiache (ST6 and Hegu (LI4 in electroacupuncture group once daily for 14 days, while electroacupuncture was not applied in model animal group. In electroacupuncture group, mice recovered more rapidly and HSV-1 DNA content also decreased more rapidly, compared with model animal group. We conclude that electroacupuncture is effective to alleviate symptoms and promote the reduction of HSV-1 in FNP.

  14. MRI enhancement of the facial nerve with Gd-DTPA, 2; Investigation of enhanced nerve portions in patients with facial palsy

    Energy Technology Data Exchange (ETDEWEB)

    Yanagida, Masahiro (Kansai Medical School, Moriguchi, Osaka (Japan))

    1993-08-01

    We performed enhanced MRI using Gd-DTPA in 84 patients with facial palsy. After assessing enhancement of the normal facial nerve, we examined enhancement in patients with Bell's palsy and Ramsay Hunt syndrome. In 95% of patients with Bell's palsy, enhancement was obtained in the distal IAC and labyrinthine portions. In 72%, enhancement was significant from the distal IAC portion through the vertical portion. In some of the patients who underwent enhanced MRI twice, increased signal intensity was observed in distal portions such as the vertical portion. In many cases of Ramsay Hunt syndrome, enhancement was seen extensively in the IAC portion through the vertical portion. In the subjects with internal auditory symptoms such as vertigo and tinnitus, enhancement of the IAC portion was seen not only in the facial nerve but also in the vestibular and the cochlear nerves. These results suggest that the vascular permeability of lesions in Bell's palsy may be increased from the distal IAC portion to the vertical portion. Judging from the present findings with Ramsay Hunt syndrome, symptoms related to the enhanced portions suggest that accompanying internal auditory symptoms occur due to inflammation of the IAC portions of cochlear and vestibular nerves. (author).

  15. Management of Synkinesis and Asymmetry in Facial Nerve Palsy: A Review Article

    Directory of Open Access Journals (Sweden)

    Abbasali pourmomeny

    2014-10-01

    Full Text Available Introduction: The important sequelae of facial nerve palsy are synkinesis, asymmetry, hypertension and contracture; all of which have psychosocial effects on patients. Synkinesis due to mal regeneration causes involuntary movements during a voluntary movement. Previous studies have advocated treatment using physiotherapy modalities alone or with exercise therapy, but no consensus exists on the optimal approach. Thus, this review summarizes clinical controlled studies in the management of synkinesis and asymmetry in facial nerve palsy.   Materials and Methods: Case-controlled clinical studies of patients at the acute stage of injury were selected for this review article. Data were obtained from English-language databases from 1980 until mid-2013.   Results: Among 124 articles initially captured, six randomized controlled trials involving 269 patients were identified with appropriate inclusion criteria. The results of all these studies emphasized the benefit of exercise therapy. Four studies considered electromyogram (EMG biofeedback to be effective through neuromuscular re-education.   Conclusion:  Synkinesis and inconsistency of facial muscles could be treated with educational exercise therapy. EMG biofeedback is a suitable tool for this exercise therapy.

  16. Long-Lasting Cranial Nerve III Palsy as a Presenting Feature of Chronic Inflammatory Demyelinating Polyneuropathy

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    Rossella Spataro

    2015-01-01

    Full Text Available We describe a patient with chronic inflammatory demyelinating polyneuropathy (CIDP in which an adduction deficit and ptosis in the left eye presented several years before the polyneuropathy. A 52-year-old man presented with a 14-year history of unremitting diplopia, adduction deficit, and ptosis in the left eye. At the age of 45 a mild bilateral foot drop and impaired sensation in the four limbs appeared, with these symptoms showing a progressive course. The diagnostic workup included EMG/ENG which demonstrated reduced conduction velocity with bilateral and symmetrical sensory and motor involvement. Cerebrospinal fluid studies revealed a cytoalbuminologic dissociation. A prolonged treatment with corticosteroids allowed a significant improvement of the limb weakness. Diplopia and ptosis remained unchanged. This unusual form of CIDP presented as a long-lasting isolated cranial nerve palsy. A diagnostic workup for CIDP should therefore be performed in those patients in which an isolated and unremitting cranial nerve palsy cannot be explained by common causes.

  17. International Federation of Societies for Surgery of the Hand Committee report: the role of nerve transfers in the treatment of neonatal brachial plexus palsy.

    Science.gov (United States)

    Tse, Raymond; Kozin, Scott H; Malessy, Martijn J; Clarke, Howard M

    2015-06-01

    Nerve transfers have gained popularity in the treatment of adult brachial plexus palsy; however, their role in the treatment of neonatal brachial plexus palsy (NBPP) remains unclear. Brachial plexus palsies in infants differ greatly from those in adults in the patterns of injury, potential for recovery, and influences of growth and development. This International Federation of Societies for Surgery of the Hand committee report on NBPP is based upon review of the current literature. We found no direct comparisons of nerve grafting to nerve transfer for primary reconstruction of NBPP. Although the results contained in individual reports that use each strategy for treatment of Erb palsy are similar, comparison of nerve transfer to nerve grafting is limited by inconsistencies in outcomes reported, by multiple confounding factors, and by small numbers of patients. Although the role of nerve transfers for primary reconstruction remains to be defined, nerve transfers have been found to be effective and useful in specific clinical circumstances including late presentation, isolated deficits, failed primary reconstruction, and multiple nerve root avulsions. In the case of NBPP more severe than Erb palsy, nerve transfers alone are inadequate to address all of the deficits and should only be considered as adjuncts if maximal re-innervation is to be achieved. Surgeons who commit to care of infants with NBPP need to avoid an over-reliance on nerve transfers and should also have the capability and inclination for brachial plexus exploration and nerve graft reconstruction. PMID:25936735

  18. Diagnostic pitfall: Adenoid cystic carcinoma of the tongue presenting as an isolated hypoglossal nerve palsy, case report and literature review

    Directory of Open Access Journals (Sweden)

    Wee Hide Elfrida

    2016-01-01

    In malignancies that have a propensity for PI such as ACC, patients may present atypically with nerve palsies. In infiltrative lesions, the primary tumour may not be evident on magnetic resonance imaging. Therefore, to achieve a diagnosis, a high index of suspicion is required. When the diagnosis is in question, deep biopsy and positron emission tomography may be useful.

  19. Tourniquet-Related Iatrogenic Femoral Nerve Palsy after Knee Surgery: Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Juan Mingo-Robinet

    2013-01-01

    Full Text Available Purpose. Tourniquet-induced nerve injuries have been reported in the literature, but even if electromyography abnormalities in knee surgery are frequent, only two cases of permanent femoral nerve palsies have been reported, both after prolonged tourniquet time. We report a case of tourniquet-related permanent femoral nerve palsy after knee surgery. Case Report. We report a case of a 58-year-old woman who underwent surgical treatment of a patella fracture. Tourniquet was inflated to 310 mmHg for 45 minutes. After surgery, patient complained about paralysis of the quadriceps femoris with inability to extend the knee. Electromyography and nerve conduction study showed a severe axonal neuropathy of the left femoral nerve, without clinical remission after several months. Discussion. Even if complications are not rare, safe duration and pressure for tourniquet use remain a controversy. Nevertheless, subtle clinical lesions of the femoral nerve or even subclinical lesions only detectable by nerve conduction and EMG activity are frequent, so persistent neurologic dysfunction, even if rare, may be an underreported complication of tourniquet application. Elderly persons with muscle atrophy and flaccid, loose skin might be in risk for iatrogenic nerve injury secondary to tourniquet.

  20. Femoral nerve palsy caused by ileopectineal bursitis after total hip replacement: a case report

    Directory of Open Access Journals (Sweden)

    Bähr Mathias

    2011-05-01

    Full Text Available Abstract Introduction Infectious ileopectineal bursitis is a rare complication after total hip replacement and is associated mainly with rheumatoid arthritis. The main complications are local swelling and pain, but communication of the inflamed bursa with the joint can occur, leading to subsequent cartilage damage and bone destruction. Case presentation We report a case of a 47-year-old Caucasian woman without rheumatoid arthritis who reported pain and palsy in her left leg almost one year after total hip replacement. She was diagnosed with an ileopectineal bursitis after total hip replacement, leading to femoral nerve palsy. The diagnosis was obtained by thorough clinical examination, the results of focused computed tomography and magnetic resonance imaging. Conclusion To the best of our knowledge, this is the first report of non-infectious ileopectineal bursitis in a patient without rheumatoid arthritis as a complication of total hip replacement. This rare case underlines the importance of proper neurologic examination of persistent conditions after orthopedic intervention in otherwise healthy individuals. We believe this case should be useful for a broad spectrum of medical specialties, including orthopedics, neurology, radiology, and general practice.

  1. Common Peroneal Nerve Palsy with Multiple-Ligament Knee Injury and Distal Avulsion of the Biceps Femoris Tendon

    OpenAIRE

    Takeshi Oshima; Junsuke Nakase; Hitoaki Numata; Yasushi Takata; Hiroyuki Tsuchiya

    2015-01-01

    A multiple-ligament knee injury that includes posterolateral corner (PLC) disruption often causes palsy of the common peroneal nerve (CPN), which occurs in 44% of cases with PLC injury and biceps femoris tendon rupture or avulsion of the fibular head. Approximately half of these cases do not show functional recovery. This case report aims to present a criteria-based approach to the operation and postoperative management of CPN palsy that resulted from a multiple-ligament knee injury in a 22-y...

  2. Outcome of patients presenting with idiopathic facial nerve paralysis (Bell's palsy) in a tertiary centre--a five year experience.

    Science.gov (United States)

    Tang, I P; Lee, S C; Shashinder, S; Raman, R

    2009-06-01

    This is a retrospective study. The objective of this study is to review the factors influencing the outcome of treatment for the patients presented with idiopathic facial nerve paralysis. The demographic data, clinical presentation and management of 84 patients with idiopathic facial nerve paralysis (Bell's palsy) were collected from the medical record office, reviewed and analyzed from 2000 to 2005. Thirty-four (72.3%) out of 47 patients who were treated with oral prednisolone alone, fully recovered from Bell's palsy meanwhile 36 (97%) out of 37 patients who were treated with combination of oral prednisolone and acyclovir fully recovered. The difference was statistically significant. 42 (93.3%) out of 45 patients who presented within three days to our clinic, fully recovered while 28 (71.8%) out of 39 patients presented later then three days had full recovery from Bell's palsy. The difference was statistically significant. The outcome of full recovery is better with the patients treated with combined acyclovir and prednisolone compared with prednisolone alone. The patients who were treated after three days of clinical presentation, who were more than 50 years of age, who had concurrent chronic medical illness and facial nerve paralysis HB Grade IV to VI during initial presentation have reduced chance of full recovery of facial nerve paralysis.

  3. Èlectroneuromyographiс parameters as prognostic criteria in facial nerve palsy outcome

    Directory of Open Access Journals (Sweden)

    N. G. Savitskaya

    2012-01-01

    Full Text Available In the article we present the results of the retrospective clinico-electrophysiological analysis of 182 patients suffering from the idiopathic neuropathy of the facial nerve (Bell`s palsy. The comparison of the most common electromyographical (ENMG predictors of outcomes was made. It was demonstrated that the most sensitive method in the acutest period (less then 5 days is the level of excitability of the nerve, in the acute period (less then 14 days – estimation of M-answer amplitude loss, and from the 21st day – the presence of denervation in muscles. The most specific electromyographical approach to estimate the therapy efficiency is an analysis of the M-answer amplitude and latency. In conclusion, neurologists have the possibility to predict the outcome and to control the therapy efficiency in any period of the disease. The correlation dynamics ÈNMG sensitivity settings – NLN on different dates can be used to determine the volume of ÈNMG – the NLN study depending on the timing for the treatment of patients.

  4. A Case of Death Secondary to Phrenic Nerve Palsy after Huge Mediastinal Teratoma 
Resection in Newborn

    Directory of Open Access Journals (Sweden)

    Yuanda CHENG

    2015-08-01

    Full Text Available Neonatal teratomas, not common in clinical, are often some case reports, female more than male, most are benign. It can occur anywhere of body midline; sacrococcygeal teratoma is the most common and the second most frequent site of extragonadal teratomas is mediastinum. Benign is more commom and malignant is very rarely seen. Completely surgical resection is the main and effective treatment. This review reports a case of neonatal teratoma, which is complicated with a fatal phrenic nerve palsy after surgery.

  5. Pupil-sparing complete third nerve palsy from cryptogenic midbrain stroke in an otherwise-healthy young adult with patent foramen ovale

    Directory of Open Access Journals (Sweden)

    Arif O Khan

    2012-01-01

    Full Text Available Although pupil-sparing in acute unilateral complete third nerve palsy is often a sign of ischemic nerve injury, it is not specific for injury outside of the midbrain. This report documents acute pupil-sparing complete third nerve palsy in an otherwise healthy young adult with patent foramen ovale and associated atrial dilatation who suffered cryptogenic focal midbrain stroke, presumably from a paradoxical embolism. The patent foramen ovale was surgically closed. Over the next several months neurological recovery was complete except for diplopia and relatively comitant hypotropia, which responded well to conventional strabismus surgery.

  6. Foot Drop: Looking Beyond Common Peroneal Nerve Palsy – A Neurophysiology Centre Experience

    LENUS (Irish Health Repository)

    Yap, SM

    2016-04-01

    Foot drop is a complex symptom with a considerable range in aetiology, severity and prognosis. We aim to characterise the aetiologies of foot drop and assess the diagnostic contribution of neurophysiologic testing (NCS\\/EMG). Retrospective review of consecutive referrals of foot drop to the Neurophysiology Department in Cork University Hospital was performed over a two year period (January 2012 to December 2013). Of a total of 59 referrals, common peroneal nerve (CPN) palsy comprised only slightly more than half of cases; 3(5%) have central origin; 3(5%) have motor neuron disease. Six (10%) have diabetes; 7(12%) have cancer; 5(8%) were bilateral. NCS\\/EMG altered initial working diagnosis in 14 out of 52 (27%) cases whereby initial diagnosis was provided. However one-third of all cases revealed additional coexistent pathology in an anatomic location remote to that of the primary diagnosis. Foot drop with central and proximal localisations are important and under recognised. NCS\\/EMG is valuable and also reveals additional pathology which warrants investigation

  7. Sellar Chordoma Presenting as Pseudo-macroprolactinoma with Unilateral Third Cranial Nerve Palsy

    Institute of Scientific and Technical Information of China (English)

    Hai-feng Wang; Hong-xi Ma; Cheng-yuan Ma; Yi-nan Luo; Peng-fei Ge

    2012-01-01

    We described a 61-year-old female with a sellar chordoma,which presented as pseudo-macroprolactinoma with unilateral third cranial nerve palsy.Physical examination revealed that her right upper lid could not be raised by itself,right eyeball movement limited to the abduction direction,right pupil dilated to 4.5 mm with negative reaction to light,and hemianopsia in bitemporal sides.CT scanning showed a hyperdense lesion at sellar region without bone destruction.Magnetic resonance imaging (MRI) revealed the tumor was 2.3 cm×1.8 cm×2.6 cm,with iso-intensity on T1WI,hyper-intensity on T2WI and heterogeneous enhancement on contrast imaging.Endocrine examination showed her serum prolactin level increased to 1,031.49 mlU/ml.The tumor was sub-totally resected via pterional craniotomy under microscope and was histologically proven to be a chordoma.Postoperatively,she recovered uneventfully but ptosis and hemianopsia remained at the 6th month.

  8. Occurrence and severity of upper eyelid skin contracture in facial nerve palsy.

    Science.gov (United States)

    Ziahosseini, K; Venables, V; Neville, C; Nduka, C; Patel, B; Malhotra, R

    2016-05-01

    PurposeTo describe the occurrence and severity of upper eyelid skin contracture in facial nerve palsy (FNP).MethodsWe enroled consecutive patients with unilateral FNP into this study. Patients with previous upper eyelid surgery for either side were excluded. We developed a standardised technique to measure the distance between the upper eyelid margin and the lower border of brow (LMBD). FNP was graded using the Sunnybrook grading scale. Its aetiology, duration, and treatment were noted. Upper and lower marginal reflex distance and lagophthalmos were also noted.ResultsSixty-six patients (mean age 51 years) were included. FNP was owing to a variety of aetiologies. LMBD on the paralytic side was shorter than the normal contralateral side in 47 (71%), equal in 15 (23%), and larger in four (6%) patients. The mean contracture was 3.4 mm (median: 3, range: 1-12) with 11 (17%) patients showing 5 mm or more of skin contracture. The mean LMBD on the paralytic side in all patients was significantly smaller than the contralateral side; 30±3.7 (median: 30; 95% CI 29-31) compared with 32±3.7 (median: 32; 95% CI 32-33), respectively, PFNP. This finding is valuable in directing optimal early management to minimise skin contracture and to caution surgeons against unnecessary upper eyelid skin excision.

  9. Common Peroneal Nerve Palsy with Multiple-Ligament Knee Injury and Distal Avulsion of the Biceps Femoris Tendon

    Directory of Open Access Journals (Sweden)

    Takeshi Oshima

    2015-01-01

    Full Text Available A multiple-ligament knee injury that includes posterolateral corner (PLC disruption often causes palsy of the common peroneal nerve (CPN, which occurs in 44% of cases with PLC injury and biceps femoris tendon rupture or avulsion of the fibular head. Approximately half of these cases do not show functional recovery. This case report aims to present a criteria-based approach to the operation and postoperative management of CPN palsy that resulted from a multiple-ligament knee injury in a 22-year-old man that occurred during judo. We performed a two-staged surgery. The first stage was to repair the injuries to the PLC and biceps femoris. The second stage involved anterior cruciate ligament reconstruction. The outcomes were excellent, with a stable knee, excellent range of motion, and improvement in the palsy. The patient was able to return to judo competition 27 weeks after the injury. To the best of our knowledge, this is the first case report describing a return to sports following CPN palsy with multiple-ligament knee injury.

  10. MEDIAL EPICONDYLE FRACTURE OF THE HUMERUS WITH ULNAR NERVE PALSY OF AN 11-MONTH-OLD INFANT:CASE REPORT

    Institute of Scientific and Technical Information of China (English)

    张楷乐; 张自明; 张菁

    2013-01-01

    <正>To our knowledge,there is no report concerning medial epicondyle fracture of the humerus for infants,the clinical course and treatment outcome of an 11 -month-old boy with such fracture with ulnar nerve palsy was described in this article.Ulnar nerve detection and scar tissue release were performed.The bony fragment was anatomically reduced and fixed with an anchor.The above-elbow wellpadded anterior plastic splint was used postoperatively for 4 weeks.After removing the splint,the motion of hand had no obvious improvement accompanied with claw hand deformity,and nerve transplantation was suggested to the patient’s parent.We would like to remind clinicians of encountering the clinical manifestations to be vigilant for any possibilities.

  11. Laryngeal and phrenic nerve involvement in a patient with hereditary neuropathy with liability to pressure palsies (HNPP).

    Science.gov (United States)

    Cortese, A; Piccolo, G; Lozza, A; Schreiber, A; Callegari, I; Moglia, A; Alfonsi, E; Pareyson, D

    2016-07-01

    Lower cranial and phrenic nerve involvement is exceptional in hereditary neuropathy with liability to pressure palsies (HNPP). Here we report the occurrence of reversible laryngeal and phrenic nerve involvement in a patient with HNPP. The patient recalled several episodes of reversible weakness and numbness of his feet and hands since the age of 30 years. His medical history was uneventful, apart from chronic obstructive pulmonary disease (COPD). At age 44, following severe weight loss, he presented with progressive dysphonia and hoarseness. EMG of cricoarytenoid and thyroarytenoid muscles and laryngeal fibroscopy confirmed vocal cord paralysis. These speech disturbances gradually regressed. Two years later, he reported rapidly worsening dyspnea. Electroneurography showed increased distal latency of the right phrenic nerve and diaphragm ultrasonography documented reduced right hemi-diaphragm excursion. Six months later and after optimization of CODP treatment, his respiratory function had improved and both phrenic nerve conduction and diaphragm excursion were completely restored. We hypothesize that chronic cough and nerve stretching in the context of CODP, together with severe weight loss, may have triggered the nerve paralysis in this patient. Our report highlights the need for optimal management of comorbidities such as CODP as well as careful control of weight in HNPP patients to avoid potentially harmful complications. PMID:27241821

  12. Transient facial nerve paralysis (Bell's palsy following intranasal delivery of a genetically detoxified mutant of Escherichia coli heat labile toxin.

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    David J M Lewis

    Full Text Available BACKGROUND: An association was previously established between facial nerve paralysis (Bell's palsy and intranasal administration of an inactivated influenza virosome vaccine containing an enzymatically active Escherichia coli Heat Labile Toxin (LT adjuvant. The individual component(s responsible for paralysis were not identified, and the vaccine was withdrawn. METHODOLOGY/PRINCIPAL FINDINGS: Subjects participating in two contemporaneous non-randomized Phase 1 clinical trials of nasal subunit vaccines against Human Immunodeficiency Virus and tuberculosis, both of which employed an enzymatically inactive non-toxic mutant LT adjuvant (LTK63, underwent active follow-up for adverse events using diary-cards and clinical examination. Two healthy subjects experienced transient peripheral facial nerve palsies 44 and 60 days after passive nasal instillation of LTK63, possibly a result of retrograde axonal transport after neuronal ganglioside binding or an inflammatory immune response, but without exaggerated immune responses to LTK63. CONCLUSIONS/SIGNIFICANCE: While the unique anatomical predisposition of the facial nerve to compression suggests nasal delivery of neuronal-binding LT-derived adjuvants is inadvisable, their continued investigation as topical or mucosal adjuvants and antigens appears warranted on the basis of longstanding safety via oral, percutaneous, and other mucosal routes.

  13. Evaluation of variation in the course of the facial nerve, nerve adhesion to tumors, and postoperative facial palsy in acoustic neuroma.

    Science.gov (United States)

    Sameshima, Tetsuro; Morita, Akio; Tanikawa, Rokuya; Fukushima, Takanori; Friedman, Allan H; Zenga, Francesco; Ducati, Alessandro; Mastronardi, Luciano

    2013-02-01

    Objective To investigate the variation in the course of the facial nerve (FN) in patients undergoing acoustic neuroma (AN) surgery, its adhesion to tumors, and the relationship between such adhesions and postoperative facial palsy. Methods The subjects were 356 patients who underwent AN surgery in whom the course of the FN could be confirmed. Patients were classified into six groups: ventro-central surface of the tumor (VCe), ventro-rostral (VR), ventro-caudal (VCa), rostral (R), caudal (C), and dorsal (D). Results The FN course was VCe in 185 cases, VR in 137, VCa in 19, R in 10, C in 4, and D in one. For tumors  3.0 cm, there was an increasing tendency for the FN to adhere strongly to the tumor capsule, and postoperative facial palsy was more severe in patients with stronger adhesions. Conclusions The VCe pattern was most common for small tumors. Strong or less strong adhesion to the tumor capsule was most strongly associated with postoperative FN palsy.

  14. A Case Presentation of a Third-Nerve Palsy as a Characteristic of Miller Fisher Syndrome

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    Trennda L. Rittenbach, OD

    2014-07-01

    Full Text Available Background: A rare clinical variant of Guillain-Barre syndrome, known as Miller Fisher syndrome (MFS, is an immunemediated neuropathy classically characterized by a triad consisting of ophthalmoplegia, ataxia, and areflexia.1,2 Although MFS is thought to be a disease of immunological basis, other pathological entities may give rise to the syndrome as well. The diagnosis of MFS relies upon clinical signs, a combination of lab tests including antibody serum, cerebrospinal fluid, and electrophysiological findings. Understanding the clinical course of MFS and its ocular components can aid in the rehabilitation and co-management of these patients. Case Report: A 79-year-old white male presented with a four day onset of double vision and an inability to walk unassisted. An examination revealed a pupil-sparing third-nerve palsy with a left eye ptosis. Due to the patient being in moderate pain throughout his entire body and presenting with an acute onset of symptoms, the patient was sent to the emergency room in the same hospital building. The patient was immediately admitted for evaluation and testing which revealed the diagnosis of MFS. Conclusions: Although a complaint of diplopia can lead to an array of diagnoses, when accompanied by an acute inability to walk, MFS should be on the list of possible causes. Although mostly a self-limiting disease, there is the possibility of progressing to respiratory failure. Knowledge of the syndrome, its clinical course, and prognosis, along with an appropriate evaluation with current laboratory testing, will lead to the proper diagnosis, treatment, and management.

  15. [Invasive aspergillosis of sphenoidal sinus in a patient in Djibouti, revealed by palsy of cranial nerves: a case report].

    Science.gov (United States)

    Crambert, A; Gauthier, J; Vignal, R; Conessa, C; Lombard, B

    2013-05-01

    The authors report a case of invasive aspergillosis of a sphenoid sinus mucocele revealed in a patient with diabetes in Djibouti by homolateral palsy of the 3rd, 4th, 5th and 6th nerves. This rare condition occurs preferentially in immunodeficient subjects. Because of its clinical polymorphism, its diagnosis is difficult and is often not made until complications develop. Endonasal surgery with anatomopathological and mycological examination is both a diagnostic and therapeutic procedure. It must be performed early, to avoid functional or even life-threatening complications. PMID:23803589

  16. An unusual presentation of adenoid cystic carcinoma of the minor salivary glands with cranial nerve palsy: a case study

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    Morris Pierre A

    2007-08-01

    Full Text Available Abstract Background Adenoid Cystic Carcinoma (ACC is a rare tumor entity and comprises about 1% of all malignant tumor of the oral and maxillofacial region. It is slow growing but a highly invasive cancer with a high recurrence rate. Intracranial ACC is even more infrequent and could be primary or secondary occurring either by direct invasion, hematogenous spread, or perineural spread. We report the first case of the 5th and 6th nerve palsy due to cavernous sinus invasion by adenoid cystic carcinoma. Case presentation A 49-year-old African American female presented to the emergency room complaining of severe right-sided headache, photophobia, dizziness and nausea, with diplopia. The patient had a 14 year history migraine headaches, hypertension, and mild intermittent asthma. Physical examination revealed right lateral rectus muscle palsy with esotropia. There was numbness in all three divisions of the right trigeminal nerve. Motor and sensory examination of extremities was normal. An MRI of the brain/brain stem was obtained which showed a large mass in the clivus extending to involve the nasopharynx, pterygoid plate, sphenoid and right cavernous sinuses. Biopsy showed an ACC tumor with a cribriform pattern of the minor salivary glands. The patient underwent total gross surgical resection and radiation therapy. Conclusion This is a case of ACC of the minor salivary glands with intracranial invasion. The patient had long history of headaches which changed in character during the past year, and symptoms of acute 5th and 6th cranial nerve involvement. Our unique case demonstrates direct invasion of cavernous sinus and could explain the 5th and 6th cranial nerve involvement as histopathology revealed no perineural invasion.

  17. Trochlear nerve palsy occurred after percutaneous microsphere compression treatment for trigeminal neuralgia: a clinical analysis

    International Nuclear Information System (INIS)

    Objective: To discuss the possible causes of trochlear never palsy occurred after percutaneous microsphere compression therapy for trigeminal neuralgia in order to improve the operative procedure and reduce the incidence of complications. Methods: Sixteen patients (study group) who developed postoperative trochlear never palsy after microsphere compression therapy for idiopathic trigeminal neuralgia, encountered during the period from June 2001 to June 2010, were enrolled in this study. The clinical data were retrospectively analyzed. The shape of the microsphere which compressed the trigeminal ganglion was observed. Another fifty patients who received microsphere compression therapy and didn't develop postoperative trochlear never palsy, encountered during the period of Jan. 2010-June 2010, were randomly collected as the control group. Results: In all the 16 patients study group the microsphere took the form of the dumbell shape not the ideal 'pear' shape, while the dumbell shape appeared only in 3 patients in the control group. The difference in the frequency of dumbell shape between the two groups was statistically significant (P<0.05). All patients in study group completely recovered from trochlear never palsy after they received neural nourishment therapy. Conclusion: Postoperative trochlear never palsy is caused by inappropriate manipulation, which leads to the protrusion of the microsphere into posterior cranial fossa. In this way, the microsphere presses its wall against the trochlear never and results in never palsy. Proper and careful manipulation can reduce the occurrence of this complication. (authors)

  18. A combination of cranial and peripheral nerve palsies in infectious mononucleosis.

    OpenAIRE

    Mohanaruban, K; Fisher, D J

    1986-01-01

    A 44 year old woman presented with bilateral brachial neuritis and an isolated Bell's palsy. Subsequently she was found to have infectious mononucleosis. The association of cranial and brachial neuropathy has not previously been reported. Without any specific drug therapy she recovered completely within 5 months.

  19. Peripheral (Seventh Nerve Palsy and Multiple Sclerosis: A Diagnostic Dilemma - A Case Report

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    Christian Saleh

    2016-01-01

    Full Text Available During the last decades, only a few cases on the association between peripheral demyelinating diseases and multiple sclerosis (MS have been reported. We describe the case of a young man who was initially diagnosed with Bell's palsy, and only after performing a brain MRI was the diagnosis of MS made. We review the literature and discuss some pitfalls which may lead to missing the diagnosis of MS.

  20. Femoral nerve palsy caused by ileopectineal bursitis after total hip replacement: a case report

    OpenAIRE

    Bähr Mathias; von Gottberg Philipp; Liman Jan; Kermer Pawel

    2011-01-01

    Abstract Introduction Infectious ileopectineal bursitis is a rare complication after total hip replacement and is associated mainly with rheumatoid arthritis. The main complications are local swelling and pain, but communication of the inflamed bursa with the joint can occur, leading to subsequent cartilage damage and bone destruction. Case presentation We report a case of a 47-year-old Caucasian woman without rheumatoid arthritis who reported pain and palsy in her left leg almost one year af...

  1. A rare case of human immunodeficiency virus associated bilateral facial nerve palsy in North India

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    Sanjay Gupta

    2014-10-01

    Full Text Available Human immunodeficiency virus (HIV cases are on the increase in India and worldwide, so are its various complications. Neurological complications are important causes of morbidity and mortality in patients with HIV infection. They can occur at any stage of the disease and can affect any level of the central or peripheral nervous systems. In the literature, several cases of HIV-associated facial paralysis have been reported; however, bilateral facial palsy is rarely reported

  2. Hypoglossal nerve palsy following the robotic thyroidectomy for the papillary thyroid carcinoma: A case report

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    Suk-Won Ahn

    2015-01-01

    Conclusion: Although the robotic surgery is a creative technique and has been known to be safe and effective, the risk of this surgery including traumatic nerve injury should be taken into account before surgery.

  3. Functional and anatomical basis for brain plasticity in facial palsy rehabilitation using the masseteric nerve.

    Science.gov (United States)

    Buendia, Javier; Loayza, Francis R; Luis, Elkin O; Celorrio, Marta; Pastor, Maria A; Hontanilla, Bernardo

    2016-03-01

    Several techniques have been described for smile restoration after facial nerve paralysis. When a nerve other than the contralateral facial nerve is used to restore the smile, some controversy appears because of the nonphysiological mechanism of smile recovering. Different authors have reported natural results with the masseter nerve. The physiological pathways which determine whether this is achieved continue to remain unclear. Using functional magnetic resonance imaging, brain activation pattern measuring blood-oxygen-level-dependent (BOLD) signal during smiling and jaw clenching was recorded in a group of 24 healthy subjects (11 females). Effective connectivity of premotor regions was also compared in both tasks. The brain activation pattern was similar for smile and jaw-clenching tasks. Smile activations showed topographic overlap though more extended for smile than clenching. Gender comparisons during facial movements, according to kinematics and BOLD signal, did not reveal significant differences. Effective connectivity results of psychophysiological interaction (PPI) from the same seeds located in bilateral facial premotor regions showed significant task and gender differences (p < 0.001). The hypothesis of brain plasticity between the facial nerve and masseter nerve areas is supported by the broad cortical overlap in the representation of facial and masseter muscles. PMID:26683008

  4. Functional and anatomical basis for brain plasticity in facial palsy rehabilitation using the masseteric nerve.

    Science.gov (United States)

    Buendia, Javier; Loayza, Francis R; Luis, Elkin O; Celorrio, Marta; Pastor, Maria A; Hontanilla, Bernardo

    2016-03-01

    Several techniques have been described for smile restoration after facial nerve paralysis. When a nerve other than the contralateral facial nerve is used to restore the smile, some controversy appears because of the nonphysiological mechanism of smile recovering. Different authors have reported natural results with the masseter nerve. The physiological pathways which determine whether this is achieved continue to remain unclear. Using functional magnetic resonance imaging, brain activation pattern measuring blood-oxygen-level-dependent (BOLD) signal during smiling and jaw clenching was recorded in a group of 24 healthy subjects (11 females). Effective connectivity of premotor regions was also compared in both tasks. The brain activation pattern was similar for smile and jaw-clenching tasks. Smile activations showed topographic overlap though more extended for smile than clenching. Gender comparisons during facial movements, according to kinematics and BOLD signal, did not reveal significant differences. Effective connectivity results of psychophysiological interaction (PPI) from the same seeds located in bilateral facial premotor regions showed significant task and gender differences (p facial nerve and masseter nerve areas is supported by the broad cortical overlap in the representation of facial and masseter muscles.

  5. Delayed Facial Nerve Palsy After Open Reduction of an Isolated Zygomaticomaxillary Complex Fracture.

    Science.gov (United States)

    Manosalva, Rodolfo E; Dyckman, Damian; Melzer, Jonathan M

    2016-06-01

    Facial nerve paralysis is a devastating complication which can occur after a variety of otolaryngic procedures, including facial trauma repair. The frontal and marginal branches are most often placed at risk. However, facial nerve paralysis is not typically described as a risk in most uncomplicated facial trauma repairs of the zygomaticomaxillary complex (ZMC). In particular, buccal branch injury has not been described in a delayed setting following repair of the ZMC. The authors present a patient of delayed buccal branch paralysis following a simple ZMC repair which has not been previously reported.The diagnosis, clinical course, and management strategies for delayed facial nerve paralysis in the setting of a ZMC repair are discussed. This rare complication after facial trauma repair should be discussed with patients as a possible complication. PMID:27213738

  6. A Comprehensive Guide on Restoring Grasp Using Tendon Transfer Procedures for Ulnar Nerve Palsy.

    Science.gov (United States)

    Diaz-Garcia, Rafael J; Chung, Kevin C

    2016-08-01

    Ulnar nerve paralysis results in classic stigmata, including weakness of grasp and pinch, poorly coordinated flexion, and clawing of digits. Restoration of grasp is a key portion of the reconstructive efforts after loss of ulnar nerve function. Improving flexion at the metacarpophalangeal joint can be done by static and dynamic means, although only the latter can improve interphalangeal extension. Deformity and digital posture are more predictably corrected with surgical intervention. Loss of strength from intrinsic muscle paralysis cannot be fully restored with tendon transfer procedures. Preoperative patient education is paramount to success if realistic expectations are to be met. PMID:27387079

  7. Acute necrosis after Gamma Knife surgery in vestibular schwannoma leading to multiple cranial nerve palsies.

    Science.gov (United States)

    Kapitza, Sandra; Pangalu, Athina; Horstmann, Gerhard A; van Eck, Albert T; Regli, Luca; Tarnutzer, Alexander A

    2016-08-01

    We discuss a rare acute complication after Gamma Knife therapy (Elekta AB, Stockholm, Sweden) in a single patient. A 52-year-old woman presented with vertigo, facial weakness and hearing loss emerging 48hours following Gamma Knife radiosurgery for a right-sided vestibular schwannoma. Neurological examination 6days after symptom onset showed right-sided facial palsy, spontaneous left-beating nystagmus and pathologic head-impulse testing to the right. Pure-tone audiogram revealed right-sided sensorineural hearing loss. A diagnosis of acute vestibulocochlear and facial neuropathy was made. Brain MRI demonstrated focal contrast sparing within the schwannoma, likely related to acute radiation necrosis. Acute multiple cranial neuropathies of the cerebellopontine angle after Gamma Knife treatment should raise suspicion of acute tissue damage within the schwannoma and should result in urgent MRI. Treatment with steroids may be considered based on accompanying swelling and edema. PMID:26947104

  8. Suprascapular nerve palsy after arthroscopic Latarjet procedure: a case report and review of literature.

    Science.gov (United States)

    Sastre, Sergi; Peidro, Lluis; Méndez, Anna; Calvo, Emilio

    2016-02-01

    The Bristow and Latarjet procedures have become popular among orthopaedic surgeons thanks to the development of new instruments that allow the use of arthroscopic techniques to treat cases of glenohumeral instability with bone defects or capsular deficiency. Nonetheless, several complications have been reported after Latarjet procedures, including neurological injuries. This report describes surgical damage to the suprascapular nerve, an unusual complication. Level of evidence Expert opinion, Level V.

  9. Facial Nerve Palsy: An Unusual Presenting Feature of Small Cell Lung Cancer

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    Ozcan Yildiz

    2011-01-01

    Full Text Available Lung cancer is the second most common type of cancer in the world and is the most common cause of cancer-related death in men and women; it is responsible for 1.3 million deaths annually worldwide. It can metastasize to any organ. The most common site of metastasis in the head and neck region is the brain; however, it can also metastasize to the oral cavity, gingiva, tongue, parotid gland and lymph nodes. This article reports a case of small cell lung cancer presenting with metastasis to the facial nerve.

  10. Report of a child with acute herpes zoster ophthalmicus induced partial third nerve palsy

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    AR Suraida

    2015-06-01

    Full Text Available Herpes zoster is a reactivation of the varicella zoster virus (VZV, which may remain dormant in the dorsal root ganglion of the trigeminal nerve for decades after the patient's initial exposure. The ophthalmic branch of the trigeminal nerve, i.e., the innervation to the ocular structures, is one of the most commonly involved dermatomes, giving rise to herpes zoster ophthalmicus (HZO. A 10-year-old indigenous Malaysian girl presented with a complaint of painful blurring of vision in the right eye for one week. It was followed a few days later by cutaneous vesicular eruptions over the right side of her face and nose and drooping of the right upper lid, associated with double vision. In children, the disease usually follows a mild course, resolving without residual damage. However, this child achieved a best corrected visual acuity of only 6/36 in the affected eye due to corneal scarring. The rashes healed by formation of disfiguring keloids over the right nasal area. This is another rarely reported complication of HZO in immunocompetent individuals.

  11. Report of a child with acute herpes zoster ophthalmicus induced partial third nerve palsy

    Institute of Scientific and Technical Information of China (English)

    Suraida AR; Evelyn-Tai LM; Madhusudhan; LK Thavaratnam; Mohtar Ibrahim; Wan Hazabbah WH

    2015-01-01

    Herpes zoster is a reactivation of the varicella zoster virus (VZV), which may remain dormant in the dorsal root ganglion of the trigeminal nerve for decades after the patient's initial exposure. The ophthalmic branch of the trigeminal nerve, i.e., the innervation to the ocular structures, is one of the most commonly involved dermatomes, giving rise to herpes zoster ophthalmicus (HZO). A 10-year-old indigenous Malaysian girl presented with a complaint of painful blurring of vision in the right eye for one week. It was followed a few days later by cutaneous vesicular eruptions over the right side of her face and nose and drooping of the right upper lid, associated with double vision. In children, the disease usually follows a mild course, resolving without residual damage. However, this child achieved a best corrected visual acuity of only 6/36 in the affected eye due to corneal scarring. The rashes healed by formation of disfiguring keloids over the right nasal area. This is another rarely reported complication of HZO in immunocompetent individuals.

  12. [A 74-year-old man with urinary incontinence, right leg weakness and multiple cranial nerve palsies].

    Science.gov (United States)

    Mochizuki, H; Satoh, S; Saikawa, M; Mori, H; Shirai, T; Kondo, T; Mizuno, Y

    1995-02-01

    We report a 74-year-old man with a lung cancer, who developed right leg weakness, neurogenic bladder, and multiple cranial nerve palsies. The patient was well until December of 1992, when he was 74-year-old, when he noted transient double vision; in February of 1993, he noted numb sensation and weakness in his right leg. Later in the same month, he developed overflow incontinence of urine and weakness in his right face. He also noted deafness in his left ear (he had a marked loss of hearing in his right ear since childhood because of otitis media). His weakness in his right leg had progressed, and he was admitted to our service on March 19, 1993. On admission, he was afebrile and BP was 130/50 mmHg. General physical examination was unremarkable. On neurologic examination, he was alert and oriented to all spheres; no dementia was noted nor were detected aphasia, apraxia, and agnosia. His optic fundi were unremarkable; ocular movement appeared normal, however, he complained of diplopia in far vision. Sensation of the face was intact. He had right facial palsy of peripheral type; he was unable to close his right eye, and Bell's phenomenon was observed on attempted eye closure. On the left side, he had facial spasm. He had marked bilateral deafness. He had no dysarthria or dysphagia. The remaining of the cranial nerves were intact. Motor wise, he was unable to stand or walk alone; weakness did not appear to account for his difficulty in gait; manual muscle testing revealed 4/5 weakness in his tibialis anterior muscle, 1/5 in the peroneus longus, 0/5 in his extensor hallucis longus and extensor digitorum longus, all on the right side. Brachioradial and quadriceps femoris reflexes were increased to 3/4; plantar response was equivocal on the right side, and flexor on the left. Sensory examination revealed loss of touch and pain sensation in the L5 and S1 distributions in his right leg: vibration and position sensations were also diminished in his right foot. He had

  13. Case of Behçet's disease complicated by oculomotor nerve palsy associated with internal carotid artery-posterior communicating artery aneurysm.

    Science.gov (United States)

    Yamaoka, Toshifumi; Murota, Hiroyuki; Katayama, Ichiro

    2015-03-01

    Behçet's disease (BD) is a relapsing systemic inflammatory disorder of unknown etiology involving systemic vasculitis. Vasculitis in BD results from the involvement of arteries, veins and blood vessels of all sizes, which leads to the three major manifestations of this condition: venous occlusion, arterial occlusion and aneurysm formation. Therefore, whole-body vascular involvement should always be considered in BD patients. Here, we describe the first appearance of an internal carotid-posterior communicating artery aneurysm, resulting in complete oculomotor nerve palsy in a BD patient. A 44-year-old Japanese man suffered from recurrent episodes of erythema nodosum that had presented on the lower extremities for the past 2 years. His condition was diagnosed as an incomplete type of BD based on relapsing oral and genital ulcers, skin eruptions, such as erythema nodosum and folliculitis, a positive pathergy test and systemic arthralgia. Ten years after his initial clinical presentation, he had manifestations of right-sided ptosis and cyclic dull pain in his right temporal region. Magnetic resonance imaging and angiography revealed a right internal carotid artery-posterior communicating artery aneurysm. Although oculomotor nerve palsy associated with internal carotid artery-posterior communicating artery aneurysm in a BD patient has not been reported previously, our report highlights the fact that this abnormal manifestation should be considered in those with vasculo-BD. PMID:25573207

  14. [The "necktie lasso": a new technique for the simultaneous treatment of Wartenberg's sign and claw deformities in the hand due to ulnar nerve palsy].

    Science.gov (United States)

    Belmahi, A M; Gharib, N E; El Mazouz, S

    2004-08-01

    The "necktie lasso" is a new technique that allows the simultaneous active treatment, of both Wartenberg's sign and claw deformity of the fifth and the fourth digits in the hand with ulnar nerve palsy. The flexor sublimis of the fourth digit is taken by a palmar approach. It is then divided into two strips up to the proximal part of the palm; The radial strip is used as a classical "direct lasso" to treat the claw deformity of the fourth digit; The ulnar strip is wound around the base of the fifth digit by a palmar and dorsal approaches at the level of the proximal phalanx, like a necktie, being medial to its radial pedicle, dorsal and superficial to its extensor apparatus, then lateral to its ulnar pedicle; It is then recovered in the palm and sutured to itself. From September 1998 to April 2003, this technique has been used in eight patients aged between 21 and 35 years old and suffering from post traumatic low ulnar nerve palsy. It was always very effective in dealing with Wartenberg's sign: the active adduction of the fifth digit appearing at the start of flexion. The claw deformity of the fourth and fifth digits was equally actively corrected. No complications are reported in this series. With a mean follow-up of 3 years there was no recurrence of any of the deformities. PMID:15484679

  15. The treatment of spastic cerebral palsy by side to side neurorrhaphy of peripheral nerves%周围神经侧侧缝合治疗痉挛性脑性瘫痪的初步观察

    Institute of Scientific and Technical Information of China (English)

    修先伦; 王宁; 张少成; 祝玉玺; 王季; 王吉波

    2002-01-01

    Objective To discuss a new method and its mechanism for the treatment of spastic cerebral palsy. Methods 6 cases were treated.The injurious nerve trunk was kept abreast of neighbor donor nerve at suitable segement, the epineurium and fascicu of two neighboring area were incised to appear nerve fibers,then side to side anastomosed each other through the epineurium and fascicu. Result All cases were followed up for 4~ 15 months.The spastic limb and deformity of all cases have obvious relieve, 5 cases had no spasm without extra stimulation and have the main function recovered.Conclusion Side to side neurorrhaphy is a new method to treat spastic cerebral palsy.After operation, the spastic muscle could obtain normal never control,thereby,the cervical orientation area was changed.

  16. 颈总动脉交感神经网剥脱术治疗脑性瘫痪的探讨%Discussion of common carotid artery sympathetic nerve net exfoliation therapy treating cerebral palsy

    Institute of Scientific and Technical Information of China (English)

    尹彪中; 李如求; 成顺成

    2002-01-01

    Objective To discuss mechanism of common carotid artery sympathetic nerve net exfoliation therapy treating sequela of cerebral palsy. Methods Examing and assessing before and after operation, curative effect analysis, Wals value assay and 1 year follow up to 124 patients. Result Score of patients in this group reached excellent 1 week after operation, reached good 1 year after operation, Wals value measure P≤ 0.05. Conclusion This operation had an effect on the promotion of mixed type; athetosis type cerebral palsy, upper limb function disorder and malfunction.

  17. 耳源性面神经麻痹的手术治疗%Surgical treatment in otogenic facial nerve palsy

    Institute of Scientific and Technical Information of China (English)

    冯国栋; 高志强; 翟梦瑶; 吕威; 亓放; 姜鸿; 查洋; 沈鹏

    2008-01-01

    objective To study the character of facial nerve palsy due to four difierent auris diseases including chronic otitis media,Hunt syndrome,tumor and physical or chemical factors,and to discuss the principles of the surgical management of otogenic facial nerve palsy.Methods The clinical charaeters of 24 patients with otogenic facial nerve palsy because of the four different auris diseases were retrospectively analyzed,all the cases were performed surgical management from October 1991 to March 2007.Facial nerve function Was evaluated with House-Brackmann(HB) grading system.Results The 24 patients including 10 males and 14 females were analysised,of whom 12 cases due to cholesteatoma,3 cases due to chronic otitis media,3 cases due to Hunt syndrome,2 cases resulted from acute otitis media,2 cases due to Dhysical or chemical factors and 2 cases due to tumor.All cases were treated with operations included facial nerve decompression,lesion resection with facial nerve decompression and lesion resection without facial nerve decompression,I patient'S facial nerve was resected because of the tumor.According to HB grade system,I degree recovery was attained in 4 cases,while Ⅱ degree in 10 cases,Ⅲ degree in 6 cases,Ⅳ degree in 2 cases,V degree in 2 cases and Ⅵ degree in 1 case.Conclusions Removing the lesions completely Was the basic factor to the surgery of otogenie facial palsy,moreover,it was important to have facial nerve decompression soon after lesion removal.%目的 总结由于中耳炎、Hunt综合征、肿瘤及理化损伤4种常见耳源性疾病导致的面神经麻痹手术治疗的经验,增加对手术治疗耳源性面神经麻痹的认识.方法 回顾性分析1991年10月至2007年3月间由于上述4种耳部疾病导致面神经麻痹的24例患者的临床资料.面神经功能评估采用House-Brackman分级.结果 24例患者中男10例,女14例;年龄14~82岁,平均44.5岁.耳部病变包括:胆脂瘤中耳炎12例(其中合并Hunt综合征1

  18. Hypoglossal-facial nerve anastomosis and rehabilitation in patients with complete facial palsy: cohort study of 30 patients followed up for three years.

    Science.gov (United States)

    Dalla Toffola, Elena; Pavese, Chiara; Cecini, Miriam; Petrucci, Lucia; Ricotti, Susanna; Bejor, Maurizio; Salimbeni, Grazia; Biglioli, Federico; Klersy, Catherine

    2014-01-01

    Our study evaluates the grade and timing of recovery in 30 patients with complete facial paralysis (House-Brackmann grade VI) treated with hypoglossal-facial nerve (XII-VII) anastomosis and a long-term rehabilitation program, consisting of exercises in facial muscle activation mediated by tongue movement and synkinesis control with mirror feedback. Reinnervation after XII-VII anastomosis occurred in 29 patients, on average 5.4 months after surgery. Three years after the anastomosis, 23.3% of patients had grade II, 53.3% grade III, 20% grade IV and 3.3% grade VI ratings on the House-Brackmann scale. Time to reinnervation was associated with the final House-Brackmann grade. Our study demonstrates that patients undergoing XIIVII anastomosis and a long-term rehabilitation program display a significant recovery of facial symmetry and movement. The recovery continues for at Hypoglossal-facial nerve anastomosis and rehabilitation in patients with complete facial palsy: cohort study of 30 patients followed up for three years least three years after the anastomosis, meaning that prolonged follow-up of these patients is advisable.

  19. Obstetrical brachial plexus palsy: Can excision of upper trunk neuroma and nerve grafting improve function in babies with adequate elbow flexion at nine months of age?

    Science.gov (United States)

    Argenta, Anne E; Brooker, Jack; MacIssac, Zoe; Natali, Megan; Greene, Stephanie; Stanger, Meg; Grunwaldt, Lorelei

    2016-05-01

    Accepted indications for exploration in obstetrical brachial plexus palsy (OBPP) vary by center. Most agree that full elbow flexion against gravity at nine months of age implies high chance of spontaneous recovery and thus excludes a baby from surgical intervention. However, there are certain movements of the shoulder and forearm that may not be used frequently by the infant, but are extremely important functionally as they grow. These movements are difficult to assess in a baby and may lead to some clinicians to recommend conservative treatment, when this cohort of infants may in fact benefit substantially from surgery. A retrospective review was conducted on all infants managed surgically at the Brachial Plexus Center of a major children's hospital from 2009 to 2014. Further analysis identified five patients who had near-normal AMS scores for elbow flexion but who had weakness of shoulder abduction, flexion, external rotation, and/or forearm supination. In contrast to standard conservative management, this cohort underwent exploration, C5-6 neuroma excision, and sural nerve grafting. Data analysis was performed on this group to look for overall improvement in function. During an average follow-up period of 29 months, all patients made substantial gains in motor function of the shoulder and forearm, without loss of elbow flexion or extension, or worsening of overall outcome. In select infants with brachial plexus injuries but near-normal AMS scores for elbow flexion, surgical intervention may be indicated to achieve the best functional outcome. PMID:26806089

  20. "C3, 4, 5 Keeps the Diaphragm Alive." Is phrenic nerve palsy part of the pathophysiological mechanism in strangulation and hanging? Should diaphragm paralysis be excluded in survived cases?: A review of the literature.

    Science.gov (United States)

    Davies, Susan J

    2010-03-01

    The phrenic nerve arises in the neck. It is formed from C3, C4, and C5 nerve fibers and descends along the anterior surface of the scalenus anterior muscle before entering the thorax to supply motor and sensory input to the diaphragm. Its anatomic location in the neck leaves the nerve vulnerable to traumatic injury. Phrenic nerve injury can arise as a result of transection, stretching or compression of the nerve, and may result in paralysis of the diaphragm. Consequences of diaphragm paralysis include respiratory compromise, gastrointestinal obstruction, and cardiac arrhythmias. There may be serious morbidity and onset of symptoms may be delayed. Cases of diaphragm paralysis occurring as a consequence of neck trauma are documented in the literature. In some cases, the forces involved are relatively minor and include whiplash injury, occurring in minor motor vehicle collisions, chiropractic manipulation, and compression of neck structures, including a case involving external neck compression by industrial machinery. It is concluded that phrenic nerve palsy might be part of the pathophysiological mechanism in strangulation and hanging, and clinical investigation to exclude diaphragm paralysis in survived cases should be considered.

  1. Intramuscular myxoid lipoma in the proximal forearm presenting as an olecranon mass with superficial radial nerve palsy: a case report

    Directory of Open Access Journals (Sweden)

    Hildebrand Kevin A

    2011-07-01

    Full Text Available Abstract Background Extremity lipomas may occur in any location, including the proximal forearm. We describe a case of a patient with an intramuscular lipoma presenting as an unusual posterior elbow mass. Case presentation We discuss the case of a 57-year-old Caucasian man who presented with a tender, posterior elbow mass initially diagnosed as chronic olecranon bursitis. A minor sensory disturbance in the distribution of the superficial radial nerve was initially thought to be unrelated, but was likely caused by mass effect from the lipoma. No pre-operative advanced imaging was obtained because the diagnosis was felt to have already been made. At the time of surgery, a fatty mass originating in the volar forearm muscles was found to have breached the dorsal forearm fascia and displaced the olecranon bursa. Tissue diagnosis was made by histopathology as a myxoid lipoma with no aggressive features. Post-operative recovery was uneventful. Conclusion We present a case of an unusual elbow mass presenting with symptoms consistent with chronic olecranon bursitis, a relatively common condition. The only unexplained pre-operative finding was the non-specific finding of a transient superficial radial nerve deficit. We remind clinicians to be cautious when diagnosing soft tissue masses in the extremities when unexplained physical findings are present.

  2. Bilateral conjugacy of movement initiation is retained at the eye but not at the mouth following long-term unilateral facial nerve palsy.

    Science.gov (United States)

    Coulson, Susan E; O'Dwyer, Nicholas J; Adams, Roger D; Croxson, Glen R

    2006-08-01

    Voluntary eyelid closure and smiling were studied in 11 normal subjects and 11 patients with long-term unilateral facial nerve palsy (FNP). The conjugacy of eyelid movements shown previously for blinks was maintained for voluntary eye closures in normal subjects, with movement onset being synchronous in both eyes. Bilateral onset synchrony of the sides of the mouth was also observed in smiling movements in normal subjects. In FNP patients, initiation of movement of the paretic and non-paretic eyelids was also synchronous, but markedly delayed relative to normal (by 136 ms = 32%). The initiation of bilateral movements at the mouth was similarly delayed, but in contrast to the eyes, it was not synchronous. Central neural processing in the FNP subjects was normal, however, since unilateral movements at the mouth were not delayed. The delays therefore point to considerable additional information processing needed for initiating bilateral facial movements after FNP. The maintenance of bilateral onset synchrony in eyelid closure and its loss in smiling following FNP is an important difference in the neural control of these facial regions. Bilateral conjugacy of eyelid movements is probably crucial for coordinating visual input and was achieved apparently without conscious effort on the part of the patients. Bilateral conjugacy of movements at the sides of the mouth may be less critical for normal function, although patients would very much like to achieve it in order to improve the appearance of their smile. Since the everyday frequency of eyelid movements is considerably greater than that of smiling, it is possible that the preserved eyelid conjugacy in these patients with long-term FNP is merely a product of greater experience. However, if synchrony of movement onset is found to be preserved in patients with acute FNP, then it would suggest that eyelid conjugacy has a privileged status in the neural organisation of the face.

  3. Evaluation of clinically relevant landmarks of the marginal mandibular branch of the facial nerve: A three-dimensional study with application to avoiding facial nerve palsy.

    Science.gov (United States)

    Davies, Joel C; Ravichandiran, Mayoorendra; Agur, Anne M; Fattah, Adel

    2016-03-01

    Injury to the marginal mandibular branch of the facial nerve (MMN) during surgery often results in poor functional and cosmetic outcomes. A line two finger breadths or 2 cm inferior to the border of the mandible is commonly used in planning neck incisions to avoid injury to the MMN. The purpose was to compare the two finger breadth/2 cm landmarks in predicting MMN course, and their accuracy/reliability. Thirty-one cadaveric specimens were scanned to obtain 3D surface topography (FARO® scanner). Four independent raters pinned the inferior border of the mandible and a two finger breadth line and 2cm line below. The location of each pin was digitized (Microscribe™). A preauricular flap was raised, and MMN branches were digitized and modelled (Geomagic®/Maya®) enabling quantification of the accuracy of these landmarks. The location of the two-finger breadth line was variable, spanning 25-51 mm below the inferior border of the mandible (ICC = 0.10). The most inferior MMN branch did not pass below the two-finger breadth line in any specimen, but a narrow clearance zone (≤5 mm) was found in two. In contrast, in 7/31 specimens, the most inferior MMN branch coursed below the 2 cm line and would be at risk of injury. It was concluded that an incision two finger breadths below the inferior border of the mandible could provide safer access than the 2 cm line. After an incision has been placed using the two finger-breadth landmark, caution must be exercised during dissection as branches of the MMN may lie only a few millimeters superior to the incision. PMID:26096443

  4. Cerebral Palsy

    Science.gov (United States)

    Cerebral palsy is a group of disorders that affect a person's ability to move and to maintain balance ... do not get worse over time. People with cerebral palsy may have difficulty walking. They may also have ...

  5. Nerve Transfers for the Restoration of Wrist, Finger, and Thumb Extension After High Radial Nerve Injury.

    Science.gov (United States)

    Pet, Mitchell A; Lipira, Angelo B; Ko, Jason H

    2016-05-01

    High radial nerve injury is a common pattern of peripheral nerve injury most often associated with orthopedic trauma. Nerve transfers to the wrist and finger extensors, often from the median nerve, offer several advantages when compared to nerve repair or grafting and tendon transfer. In this article, we discuss the forearm anatomy pertinent to performing these nerve transfers and review the literature surrounding nerve transfers for wrist, finger, and thumb extension. A suggested algorithm for management of acute traumatic high radial nerve palsy is offered, and our preferred surgical technique for treatment of high radial nerve palsy is provided. PMID:27094891

  6. Clinical Profile of Extraocular Muscle Palsy: A Retrospective Study

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    Suman Adhikari, BOptom

    2013-12-01

    Full Text Available Background: The sixth cranial nerve has been found to be the most commonly affected in previous studies of cranial nerve palsies. This study was carried out to determine the most common nerve involved in extraocular muscle (EOM palsies and the most common cause of EOM palsy in Nepal.Methods: The diagnosed cases of third, fourth, or sixth nerve palsy for 10 years (2000-2010 at the B.P. Koirala Lions Center for Ophthalmic Studies outpatient department were included in the study. A retrospective review of patients’ records was performed, and the causes of EOM palsy were grouped as: vascular, trauma, tumor,aneurysm, undetermined, and others. Recovery of the palsy was evaluated by reviewing the records of the patients who were followed up one month after the initial visit.Results: A total of 838 patients was included in the study. The average patient age was 37 years. The sixth nerve was most commonly affected (n=458, 54.65%, and the most common etiology was undetermined (n=408, 48.68%. Among the cases where the cause of palsy was known, the largest number of patients had trauma (n=188, 16.46%.Conclusion: It was concluded that in Nepal, the most commonly affected cranial nerve is the sixth nerve, in accordance with the other studies done in the past in different parts of the world. Most of the cases of cranial nerve palsy were found to have no specific cause and were not associated with diagnosed systemic disease.

  7. 改良津下法对不可逆桡神经损伤的手功能重建%Modified Tsuge technique for functional reconstruction of hands with radial nerve palsy

    Institute of Scientific and Technical Information of China (English)

    赵炳显; 李炳万; 赵世伟; 邱旭东; 朱春雷

    2010-01-01

    目的 介绍一种改良的桡神经损伤功能重建的方法及其临床效果.方法 从2002年6月起,对12例不可逆的桡神经损伤患者,采用改良津下法进行伸腕、伸指伸拇功能重建.结果 术后12例经2~48个月的随访,根据1994年陈德松等制定的桡神经损伤后肌腱移位术后疗效评定标准评定:优10例,良2例;优良率100%.良的2例中,1例为臂丛神经锐性损伤修复术后8年,移位肌腱肌力略差;另1例为前臂背侧皮肤肌肉神经部分缺损,皮瓣修复术后瘢痕粘连所致.结论 改良津下法肌腱移位术是最合理且简单、疗效满意的术式,可作为桡神经损伤功能重建的理想方法.%Objective To introduce a new method of tendon transfer for treating radial nerve palsy and evaluate the clinical outcomes. Methods Twelve cases of irreversible radial nerve injuries were treated with the modified Tsuge technique to reconstruct the function of wrist, thumb and finger extension since June 2002.Results All 12 cases were follow-up for 2 to 48 months. According to Chen Desong's 1994 criteria for outcome evaluation of tendon transfers in radial nerve palsy, good results were seen in 10 cases and fair results in 2 cases.The overall satisfactory rate was 100%. One of the 2 cases that showed fair results had brachial plexus cut injury and repair 8 years earlier, which yielded weaker donor for tendon transfer. The other case was accompanied by soft tissue defect of the dorsal forearm that required flap coverage and hence postoperative scarring. Conclusion Modified Tsuge tendon transfer is the most suitable, simple and effective method for functional reconstruction in radial nerve palsy.

  8. A case of Klumpke's obstetric brachial plexus palsy following a Cesarean section.

    Science.gov (United States)

    Al-Qattan, Mohammad M; El-Sayed, Amel A F

    2016-09-01

    It is generally thought that Klumpke's palsy is not seen as obstetric injury. The authors present a case of Klumpke's palsy with Horner syndrome following delivery by emergency Cesarean section. Neurolysis and nerve grafting partially corrected the paralysis. PMID:27648266

  9. Facial Nerve Neuroma Management

    OpenAIRE

    Weber, Peter C; Osguthorpe, J. David

    1998-01-01

    Three facial nerve neuromas were identified in the academic year 1994-1995. Each case illustrates different management dilemmas. One patient with a grade III facial nerve palsy had a small geniculate ganglion neuroma with the dilemma of decompression versus resection clear nerve section margins. The second patient underwent facial neuroma resection with cable graft reconstruction, but the permanent sections were positive. The last patient had a massive neuroma in which grafting versus other f...

  10. Clinical efficacy of mouse nerve growth factor and cattle encephalon glycoside and ignotin injection on cerebnal palsy%鼠神经生长因子与脑苷肌肽治疗脑性瘫痪的疗效

    Institute of Scientific and Technical Information of China (English)

    孙兴礼

    2015-01-01

    目的 探讨鼠神经生长因子与脑苷肌肽治疗脑性瘫痪的临床效果.方法 选取郸城县第二人民医院收治的脑性瘫痪患儿80例,随机分为观察组(鼠神经生长因子)与对照组(脑苷肌肽),每组40例.两组患儿均接受常规运动康复训练,观察两组患儿治疗前后发育商(DQ)及治疗期间不良反应发生情况.结果 两组患儿发育商治疗后均显著提高(P<0.05),观察组提高程度明显大于对照组(P<0.05),两组患儿接受治疗期间不良反应发生率比较差异未见统计学意义(P>0.05).结论 鼠神经生长因子治疗脑性瘫痪患儿效果显著,安全性较高.%Objective To investigate the clinical efficacy of mouse nerve growth factor and cattle encephalon glycoside and ignotin injection on cerebral palsy.Methods Eighty cases of cerebral palsy were selected and randomly divided into observation group (treated with mouse nerve growth factor) and control group (treated with cattle encephalon glycoside and ignotin injection),with 40 cases in each group.Both two groups received conventional rehabilitation training.Developmental quotient (DQ) before and after treatment,adverse reactions in the two groups were observed.Results DQ after treatment was significantly improved than before treatment in both two groups,and there was better improvement in observation group than that in control group (P < 0.05).The differences of adverse reactions during treatment in the two groups were not statistically significant (P > 0.05).Conclusions Mouse nerve growth factor has good efficacy and high safety in the treatment of cerebral palsy.

  11. Cerebral Palsy

    Science.gov (United States)

    ... 1 • 2 • 3 For Teens For Kids For Parents MORE ON THIS TOPIC Cerebral Palsy: Keith's Story Physical Therapy I Have Cerebral Palsy. Can I Babysit? Body Image and Self-Esteem Contact Us Print Resources Send to a friend ...

  12. Facial Palsy after Carotid Endarterectomy & Difficult Intubation during Subsequent CABG Surgery: An Impact of the Cranial Nerve Injury on Airway Management

    OpenAIRE

    Won K. Chee

    2015-01-01

    Cranial nerve injuries can occur during carotid endarterectomy from extensive dissection and prolonged retraction. The nerve injuries can impact both the airway reflex and the anatomical contour to cause a difficulty with subsequent airway management for the anesthesiologists. A careful examination of the airway after the carotid procedure is critical for recognizing the subtle signs of cranial nerve injuries.

  13. Paralisia facial periférica bilateral na leucemia linfóide aguda: relato de caso Bilateral peripheric facial nerve palsy in acute linfoid leukemia: a case report

    Directory of Open Access Journals (Sweden)

    Marcos L. Antunes

    2004-04-01

    Full Text Available A mímica facial é fundamental para a expressão e comunicação humana, que são possíveis apenas através da integridade do nervo facial. Sendo assim, a paralisia facial periférica (PFP pode deixar seqüelas estéticas, funcionais e psicológicas. A causa mais comum é a paralisia de Bell (50 a 80%, onde a maioria dos pacientes apresenta manifestação unilateral. O acometimento bilateral simultâneo é raro, sendo a leucemia a neoplasia que com maior freqüência pode resultar nesse tipo de manifestação. A seguir, relatamos o caso de um paciente de dezoito anos de idade apresentando leucemia linfóide aguda (LLA e PFP simultânea, ambas refratárias ao tratamento quimioterápico, culminando com o óbito cinco meses após o início da PFP. Realizou-se considerações importantes sobre a fisiopatologia da PFP na LLA, além de uma revisão da literatura.The facial mimic is very important to the human expression and communication, which depend on the integrity of the facial nerve. So, the peripheric facial palsy (PFP can leave esthetics, functional and psychological sequelae. The more common etiology is Bell's palsy (50 to 80% and most of the patients show a unilateral manifestation. The simultaneous bilateral PFP is rare, and the leukemia is the neoplasia that can often that kind of manifestation. We present a clinical case of an 18-year-old patient with acute lymphoid leukemia and simultaneous bilateral facial palsy, who did not recover after the chemotherapy treatment, and died five months after the initial manifestation of the facial palsy. Important considerations were accomplished about the physiopathology of PFP in acute lymphoid leukemia, besides literature review.

  14. Cerebral palsy - resources

    Science.gov (United States)

    Resources - cerebral palsy ... The following organizations are good resources for information on cerebral palsy : National Institute of Neurological Disorders and Stroke -- www.ninds.nih.gov/disorders/cerebral_palsy/cerebral_palsy. ...

  15. Cerebral Palsy (For Parents)

    Science.gov (United States)

    ... Story" 5 Things to Know About Zika & Pregnancy Cerebral Palsy KidsHealth > For Parents > Cerebral Palsy Print A A ... kids who are living with the condition. About Cerebral Palsy Cerebral palsy is one of the most common ...

  16. Cerebral palsy.

    Science.gov (United States)

    Graham, H Kerr; Rosenbaum, Peter; Paneth, Nigel; Dan, Bernard; Lin, Jean-Pierre; Damiano, Diane L; Becher, Jules G; Gaebler-Spira, Deborah; Colver, Allan; Reddihough, Dinah S; Crompton, Kylie E; Lieber, Richard L

    2016-01-01

    Cerebral palsy is the most common cause of childhood-onset, lifelong physical disability in most countries, affecting about 1 in 500 neonates with an estimated prevalence of 17 million people worldwide. Cerebral palsy is not a disease entity in the traditional sense but a clinical description of children who share features of a non-progressive brain injury or lesion acquired during the antenatal, perinatal or early postnatal period. The clinical manifestations of cerebral palsy vary greatly in the type of movement disorder, the degree of functional ability and limitation and the affected parts of the body. There is currently no cure, but progress is being made in both the prevention and the amelioration of the brain injury. For example, administration of magnesium sulfate during premature labour and cooling of high-risk infants can reduce the rate and severity of cerebral palsy. Although the disorder affects individuals throughout their lifetime, most cerebral palsy research efforts and management strategies currently focus on the needs of children. Clinical management of children with cerebral palsy is directed towards maximizing function and participation in activities and minimizing the effects of the factors that can make the condition worse, such as epilepsy, feeding challenges, hip dislocation and scoliosis. These management strategies include enhancing neurological function during early development; managing medical co-morbidities, weakness and hypertonia; using rehabilitation technologies to enhance motor function; and preventing secondary musculoskeletal problems. Meeting the needs of people with cerebral palsy in resource-poor settings is particularly challenging. PMID:27188686

  17. Spinal accessory nerve schwannomas masquerading as a fourth ventricular lesion

    Directory of Open Access Journals (Sweden)

    Shyam Sundar Krishnan

    2015-01-01

    Full Text Available Schwannomas are benign lesions that arise from the nerve sheath of cranial nerves. The most common schwannomas arise from the 8 th cranial nerve (the vestibulo-cochlear nerve followed by trigeminal and facial nerves and then from glossopharyngeal, vagus, and spinal accessory nerves. Schwannomas involving the oculomotor, trochlear, abducens and hypoglossal nerves are very rare. We report a very unusual spinal accessory nerve schwannoma which occupied the fourth ventricle and extended inferiorly to the upper cervical canal. The radiological features have been detailed. The diagnostic dilemma was due to its midline posterior location mimicking a fourth ventricular lesion like medulloblastoma and ependymoma. Total excision is the ideal treatment for these tumors. A brief review of literature with tabulations of the variants has been listed.

  18. 外周神经电刺激引导下A型肉毒毒素注射在痉挛型脑性瘫痪中的应用%Injection of Botulinum Toxin Type A Guided by Peripheral Nerve Stimulation for Spastic Cerebral Palsy

    Institute of Scientific and Technical Information of China (English)

    邵银进; 吴桂华; 曾康华

    2013-01-01

    Objective To investigate the effects of local injection of Botulinum toxin type A (BTX-A) on spastic cerebral palsy guided by peripheral nerve stimulation. Methods 30 children with spastic cerebral palsy received local multi-point injection of BTX-A guided by peripheral nerve stimulation. They were assessed with modified Ashworth scale (MAS) and Gross Motor Function Assessment Scale (GM-FM-88) before and 1 week, 3 months and 6 months after treatment. Results The scores of MAS decreased significantly 1 week, 3 months and 6 months after treatment (P0.05),3个月和6个月时显著增加(P<0.001)。结论外周神经电刺激引导下BTX-A局部多点注射治疗痉挛型脑瘫疗效显著。

  19. 胫神经缩窄术在治疗脑瘫下肢痉挛肢体中的应用%Neurotomy of the tibial nerve for treatment of spastic lower limbs in cerebral palsy.

    Institute of Scientific and Technical Information of China (English)

    谢轩贵; 李鹏; 蔡德成; 张洪良; 周学斌; 蔡毅骁

    2011-01-01

    Objective To explore indication and approaches of neurotomy of tibial nerve for the treatment of the talipes equinovarus and spastic paralysis in cerebral palsy. Methods A total of 27 cerebral palsy children with 53 spastic lower limbs were diagnosed with clear etiology, spastic muscles with supphed nerves were analyzed in detail, neurotomy of the tibial nerve was performed under microscope, during operation, motor nerve was located with electronic stimuli and monitored with induced electromyocardiogram. The surgical results were analyzed. Results 53 neurotomies of tibial nerve were done in 27 cases of cerebral palsy children with 53 spastic limbs. All patients were followed up from 6 to 15 months ( means 10. 3 months) ,and evaluated with dorsum flex of ankle joint, touching ground of feet, talipes equinovans, random movement improving evaluation and satisfactory grade of the parents. A total of 26 of 27 (96%) neurotomy of the tibial nerve were improved with dorsum flex of ankle at 15 ~ 50 degree,and 16 of 19(84% ) talipes aquinovarus improved chnically. Of 27 feet with surgery, 11 feet (40. 8% ) were in normal position and could touch ground completely, 13 feet (48. 1% ) had 10 degree with ground or could contact ground with external one third of the feet, 3 feet (11.1%) were abnormal. All patients were followed up from 6 to 15 months (means 10. 3 months). During follow-up, the random movement improving rate of spastic lower limbs is 81% (22/27), 7 patients (26%)improved dramatically.Conclusion Neurotomy of tibial nerve is an effective method to treat talipes equinovarus, and can improve the motor activity of spastic lower limbs in cerebral palsy children.%目的 探讨胫神经缩窄术在治疗脑瘫下肢痉挛肢体及矫正内翻马蹄足中的应用及手术效果.方法 2006年9月~2008年12月对27例脑瘫患儿53肢下肢痉挛肢体行胫神经缩窄术,单侧1例,双侧26例.术前详细检查、明确病因,对下肢挛缩肌肉及

  20. DIABETES MELLITUS AND BELL’S PALSY IN IRANIAN POPULATION

    Directory of Open Access Journals (Sweden)

    A. R Karimi-Yazdi

    2008-08-01

    Full Text Available "nDuring last decades many researchers have focused on the conditions associated with Bell's palsy including diabetes mellitus, hypertension, and viral infections. This study was performed to evaluate correlation of diabetes mellitus and Bell's palsy and some relevant features not discussed in the literature in an Iranian population. The presence of diabetes mellitus was evaluated in a total number of 275 subjects (75 patients with Bell's palsy and 200 control subjects. Diabetes mellitus was noted in 10 (13.3% patients with Bell's palsy among which 6 case were diagnosed as new cases of diabetes. Previous history of Bell's palsy was present in 10.67% of the subjects with Bell's palsy. Symptoms of other cranial nerves revealed higher figures in Bell's palsy patients with underlying diabetes. Such studies in developing countries may reveal some unknown features of the disease. This study confirms the correlation of diabetes mellitus and Bell's palsy for the first time in an Iranian population. The results also suggest that diabetic patients with Bell's palsy suffer from more cranial nerve symptoms. We offer screening tests of diabetes as a routine process in the management of Bell's palsy especially in developing countries.

  1. A case of myeloperoxidase anti-neutrophil cytoplasmic antibody (MPO-ANCA)-associated hypertrophic pachymeningitis presenting with multiple cranial nerve palsies and diabetes insipidus.

    Science.gov (United States)

    Yasuda, Ken; Sainouchi, Makoto; Goto, Masahiro; Murase, Nagako; Ohtani, Ryo; Nakamura, Michikazu

    2016-05-31

    A 61-year-old woman developed hearing difficulties and became thirsty after experiencing cold symptoms. A neurological examination revealed a loss of odor sensation, facial palsy, dysphasia, and dysarthria. Vocal cord palsy was observed during pharyngoscopy. Brain magnetic resonance imaging (MRI) showed a thickened pituitary stalk and swelling of the pituitary gland, but no high signal intensity regions were seen in the posterior portion of the pituitary gland. Gadolinium-enhanced MRI demonstrated a thickened dura mater over the anterior cranial fossa. A biopsy specimen of the thickened dura mater showed fibrosis, granulomatous inflammation, and necrotic foci. Blood tests detected myeloperoxidase anti-neutrophil cytoplasmic antibody (MPO-ANCA). The patient's urine osmolarity was low even though she exhibited hypernatremia. We diagnosed her with hypertrophic pachymeningitis associated with MPO-ANCA and diabetes insipidus. The patient received two courses of 5-day high-dose intravenous methylprednisolone (1.0 g/day), and was subsequently administered oral prednisolone, which gradually relieved her symptoms. However, the patient's symptoms recurred despite the high-dose prednisolone treatment. It was difficult to control the patient's symptoms in this case with oral prednisolone monotherapy, but combined treatment with cyclosporine resulted in sustained remission. It is considered that patients with MPO-ANCA-positive hypertrophic pachymeningitis require combination therapy with prednisolone and immunosuppressive agents at an early stage. PMID:27098904

  2. FACIAL PALSY AS FIRST PRESENTATION OF ACUTE LYMPHOBLASTIC LEUKEMIA: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    S. Inaloo

    2008-11-01

    Full Text Available ObjectiveFacial paralysis in children is very often idiopathic and isolated facial nerve palsy, resulting from leukemic infiltration is a rare occurrence. Here we present the case of a 14 year-old boy with acute lymphobastic leukemia, who first presented with isolated right side peripheral facial nerve paralysis and was initially diagnosed with Bell's palsy.ConclusionThe presence of Bell's palsy in young children requires a complete evaluation, keeping in mind the possibility of leptomeningeal disease.Key words: Lymphoblastic Leukemia, Facial nerve palsy, Children.

  3. Modified Tajima technique for reconstruction of thumb opposition after median nerve palsy%高位正中神经麻痹改良津下法重建拇对掌功能

    Institute of Scientific and Technical Information of China (English)

    朱春雷; 李炳万; 赵世伟; 李光; 田东

    2012-01-01

    Objective To introduce the application of extensor digiti minimi tendon transfer(modified Tajima technique)for functional reconstruction of thumb opposition following median nerve palsy.Methods Thumb opponenplasty was done in 11 cases of high median nerve injury with irreversible palsy.Modified Tajima technique was used to transfer the extensor digiti minimi tendon.The proximal band was anchored onto the extensor pollicis longus tendon at the metacarpal neck.The distal band was inserted in the medullary cavity of the proximal phalanx.Results The patients were follow-up for 4 to 38 months with an average of 18.5 months.Thumb opposition was restored in all 11 patients with 100% success rate.The extension of the donor finger was not affected.Conclusion Modified Tajima method is a simple and reliable method to reconstruct thumb opposition function.%目的 介绍应用小指固有伸肌腱(改良津下法)重建拇对掌功能的方法及疗效.方法 对11例高位正中神经不可逆损伤拇对掌功能丧失的患者,采用小指固有伸肌腱双束法移位重建拇对掌功能,近侧束固定于掌骨颈部拇长伸肌肌腱上,远侧束固定于近节指骨髓腔内.结果 术后随访4~ 38个月,平均18.5个月,11例拇对掌功能全部恢复,优良率达100%.供区伸指功能无影响.结论 小指固有伸肌腱改良移位术是合理且简单、疗效满意的术式,可作为拇对掌功能重建的理想方法.

  4. Complete oculomotor palsy caused by persistent trigeminal artery.

    Science.gov (United States)

    Bosco, Domenico; Consoli, Domenico; Lanza, Pier Luigi; Plastino, Massimiliano; Nicoletti, Francesco; Ceccotti, Claudio

    2010-10-01

    Primitive trigeminal artery (PTA) is the most frequent embryonic communication between the carotid and vertebro-basilar system. PTA is a pathophysiology phenomenon which has been implicated as a rare cause of cranial nerve dysfunction. We report the case of a 40-year-old woman who developed a complete oculomotor nerve palsy caused by a persistent ecstatic trigeminal artery. Brain MRI and MRA studies documented a neurovascular conflict between the oculomotor nerve and a PTA. To the best of our knowledge there is no report about complete third cranial nerve palsy NC due to a PTA. A role of this rare vascular condition is discussed. PMID:20552240

  5. Correlation between facial nerve functional evaluation and efficacy evaluation of acupuncture treatment for Bell's palsy%面神经功能评价对针刺治疗贝尔麻痹疗效评估的影响

    Institute of Scientific and Technical Information of China (English)

    周章玲; 李呈新; 姜岳波; 左聪; 蔡云; 王瑞

    2012-01-01

    目的:在针灸治疗贝尔麻痹的过程中,依据面神经麻痹程度进行面神经功能障碍评价分级,并观察该分级与疗效、疗程的关系及在判断预后方面的作用.方法:以面瘫常用运动功能评价量表House-Brackmann量表为准,并对眼裂和唇角设定量标准,治疗前和治疗结束时,根据该量表评分对患者面部瘫痪程度进行面神经功能障碍评估分级,依次分为轻度、中度、中重度、重度功能障碍和完全麻痹5个级别.按患者疾病分期采用针刺对症治疗,不人为设定治疗时程,全程观察,以最终疗效为准.结果:68例病例中,治愈53例,总有效率为97%.5种不同面神经功能障碍之间的治疗效果差异有统计学意义(P<0.01);疗效与病情轻重相关,等级相关分析相关系数为0.423 (P<0.01);其疗程也随着面神经功能障碍级别加重而延长(P<0.01).结论:贝尔麻痹患者存在面神经功能障碍轻重的差别,针灸治疗的效果随着面神经功能障碍的加重而下降,不同级别面神经功能障碍患者治疗所需疗程不同.临床研究中非常有必要对患者进行评估分级后再做观察治疗,并依据病情轻重程度选择不同治疗方法.%OBJECTIVE: To assess and grade facial nerve dysfunction according to the extent of facial paralysis in the clinical course of acupuncture treatment for Bell's palsy, and to observe the interrelationship between the grade, the efficacy and the period of treatment, as well as the effect on prognosis. METHODS: The authors employed the House-Brackmann scale, a commonly used evaluation scale for facial paralysis motor function, and set standards for eye fissure and lips. According to the improved scale, the authors assessed and graded the degree of facial paralysis in terms of facial nerve dysfunction both before and after treatment. The grade was divided into five levels: mild, moderate, moderately severe, severe dysfunction and complete paralysis. The

  6. A Case of Death Secondary to Phrenic Nerve Palsy after Huge Mediastinal Teratoma Resection in Newborn%新生儿纵隔巨大畸胎瘤术后膈神经麻痹致死1例

    Institute of Scientific and Technical Information of China (English)

    程远大; 艾燕; 高阳; 张春芳

    2015-01-01

    Neonatal teratomas, not common in clinical, are otfen some case reports, female more than male, most are benign. It can occur anywhere of body midline; sacrococcygeal teratoma is the most common and the second most frequent site of extragonadal teratomas is mediastinum. Benign is more commom and malignant is very rarely seen. Completely surgical resection is the main and effective treatment. hTis review reports a case of neonatal teratoma, which is complicated with a fatal phrenic nerve palsy atfer surgery.%新生儿畸胎瘤临床上不多见,多为病例报道,女性多于男性,大多数为良性,可发生于身体中线的任何部位,骶尾部为最好发部位,纵隔是性腺以外的第二大好发部位。临床上新生儿畸胎瘤多为良性,恶性少见,外科完整切除是其主要治疗方式。本文报道1例新生儿畸胎瘤,其术后发生致死性膈神经麻痹。

  7. Employees with Cerebral Palsy

    Science.gov (United States)

    ... Resources Home | Accommodation and Compliance Series: Employees with Cerebral Palsy (CP) By Eddie Whidden, MA Preface Introduction Information ... SOAR) at http://AskJAN.org/soar. Information about Cerebral Palsy (CP) What is CP? Cerebral palsy is a ...

  8. Radial Nerve Tendon Transfers.

    Science.gov (United States)

    Cheah, Andre Eu-Jin; Etcheson, Jennifer; Yao, Jeffrey

    2016-08-01

    Radial nerve palsy typically occurs as a result of trauma or iatrogenic injury and leads to the loss of wrist extension, finger extension, thumb extension, and a reduction in grip strength. In the absence of nerve recovery, reconstruction of motor function involves tendon transfer surgery. The most common donor tendons include the pronator teres, wrist flexors, and finger flexors. The type of tendon transfer is classified based on the donor for the extensor digitorum communis. Good outcomes have been reported for most methods of radial nerve tendon transfers as is typical for positional tendon transfers not requiring significant power. PMID:27387076

  9. Quantitative analysis of vascular network of oculogyric nerve nuclei

    Directory of Open Access Journals (Sweden)

    Sladojević Igor

    2011-01-01

    Full Text Available Introduction. Nuclei of oculogyric nerves (principal oculomotor nucleus, trochlear nucleus and abducens nucleus are densely vascularized brain­stem structures. The aim of this study was to determine quantitative characteristics of the vascular network of these nuclei. Material and methods. The study was done on 30 adult brainstems, both male and female, without diagnosed neurological disturbances. Three-millimetrethick stratums were taken in transversal plane and cut in 0.3 micrometer semi-serial sections stained with Mallory method. The images of studied nuclei were taken with „Leica” DM 1000 microscope and „Leica” EC3 digital camera under 400x magnification, and analyzed by ImageJ software with A 100 grid. The statistical analysis was performed by Statistical Package for the Social Sciences software with 5% level of significance. Results. A statistically significant difference was found in the volume and surface density between principal oculomotor nucleus and trochlear nucleus, and between trochlear nucleus and abducens nucleus. No difference was found in the length density. Discussion. The results of this research match the results of studies on characteristics of vascular network of oculogyric nerve nuclei, while the comparison of vascular networks of these nuclei, substantia nigra, vestibulocochlear nuclei and precentral gyrus illustrates differences in quantitative characteristics of blood vessels in these structures. Conclusion. Blood vessels of principal oculomotor nucleus and abducens nucleus have similar dimensions and approximately the same arborization pattern, while vessels of trochlear nucleus have significantly smaller dimensions and density.

  10. Isolated trochlear nerve paralysis due to brainstem ischemia: a case report

    OpenAIRE

    Halit Yaşar; Hakan Tekeli; Tolga Biçer; Kemal Kara

    2013-01-01

    Trochlear neuropathy is the most common isolated cranial nerve palsy which affects the ocular movements. Patients complain of double vision especially during descending stairs or bending. Only 5 % of trochlear nerve palsy is isolated. The most common cause of trochlear nerve palsy is congenital causes. Trauma is the most common reason among acquired causes and ischemia-induced causes are extremely rare. In this article we present a 61-year-old female patient who has an isolated tr...

  11. Immediate Postoperative Bell's Palsy: Viral Etiology or Post-Traumatic Phenomena?

    Directory of Open Access Journals (Sweden)

    Mohammad Ghasem Shams

    2010-12-01

    Full Text Available Introduction: Bell’s palsy is a sudden unilateral paralysis of the facial nerve. Postoperative Bell’s palsy following surgery is rare. It occurs in less than 1% of operations. The hypothesis: We premise that the main cause of immediate postoperative Bell's palsy is latent herpes viruses (herpes simplex virus type 1 and herpes zoster virus, which are reactivated from cranial nerve ganglia. Inflammation of the nerve initially results in a reversible neurapraxia, but ultimately Wallerian degeneration ensues. The palsy is often sudden in onset and evolves rapidly, with maximal facial weakness developing within two days. Associated symptoms of-ten seen in idiopathic Bell’s palsy are tearing problems, hyperacusis and altered taste.Evaluation of the hypothesis: Facial paralysis presenting postoperatively is distressing and poses a diagnostic chal-lenge. A complete interruption of the facial nerve at the sty-lomastoid foramen paralyzes all the muscles of facial expression. Taste sensation may be lost unilaterally and hye-racusis may be present. Idiopathic Bell’s palsy is due to inflammation of the facial nerve in the facial canal. Bell’s palsy may also occur from lesions that invade the temporal bone (carotid body, cholesteatoma, dermoid cyst, acoustic neu-romas. Although traumatic Bell’s palsy cannot be ruled out, it seems logic to postulate that the main cause of immediate postoperative Bell's palsy is latent herpes viruses.

  12. Isolated trochlear nerve paralysis due to brainstem ischemia: a case report

    Directory of Open Access Journals (Sweden)

    Halit Yaşar

    2013-08-01

    Full Text Available Trochlear neuropathy is the most common isolated cranial nerve palsy which affects the ocular movements. Patients complain of double vision especially during descending stairs or bending. Only 5 % of trochlear nerve palsy is isolated. The most common cause of trochlear nerve palsy is congenital causes. Trauma is the most common reason among acquired causes and ischemia-induced causes are extremely rare. In this article we present a 61-year-old female patient who has an isolated trochlear nerve palsy after a brain stem ischemia.

  13. Common questions about Bell palsy.

    Science.gov (United States)

    Albers, Janet R; Tamang, Stephen

    2014-02-01

    Bell palsy is an acute affliction of the facial nerve, resulting in sudden paralysis or weakness of the muscles on one side of the face. Testing patients with unilateral facial paralysis for diabetes mellitus or Lyme disease is not routinely recommended. Patients with Lyme disease typically present with additional manifestations, such as arthritis, rash, or facial swelling. Diabetes may be a comorbidity of Bell palsy, but testing is not needed in the absence of other indications, such as hypertension. In patients with atypical symptoms, magnetic resonance imaging with contrast enhancement can be used to rule out cranial mass effect and to add prognostic value. Steroids improve resolution of symptoms in patients with Bell palsy and remain the preferred treatment. Antiviral agents have a limited role, and may improve outcomes when combined with steroids in patients with severe symptoms. When facial paralysis is prolonged, surgery may be indicated to prevent ocular desiccation secondary to incomplete eyelid closure. Facial nerve decompression is rarely indicated or performed. Physical therapy modalities, including electrostimulation, exercise, and massage, are neither beneficial nor harmful.

  14. Moebius syndrome with Dandy-Walker variant and agenesis of corpus callosum

    Directory of Open Access Journals (Sweden)

    Jomol Sara John

    2013-01-01

    Full Text Available Moebius syndrome is a rare congenital neurological disorder. The most frequent mode of presentation is facial diplegia with bilateral lateral rectus palsy, but there are variations. Here, we report a rare case of Moebius syndrome in a 15-month-old child with unilateral facial palsy, bilateral abducens nerve palsy with Dandy Walker variant, and complete agenesis of corpus callosum.

  15. Cerebral palsy

    International Nuclear Information System (INIS)

    This paper reviews cranial MR findings in patients with cerebral palsy (CP) to clarify and categorize this disorder. The MR images of 40 patients with clinical CP were retrospectively reviewed. All patients suffered either varying spastic plegias, hypotonicity, or choreoathetosis. Concomitantly, the patients suffered from static encephalopathy, developmental delay, and/or microcephaly. Twenty-four patients were born at or near term, 10 were premature, and incomplete birth histories were available in six. The MR images revealed mild to severe degrees of white matter damage in 24 patients (12 term, nine premature, three unknown)

  16. Laser Phototherapy As Modality of Clinical Treatment in Bell's Palsy

    Science.gov (United States)

    Marques, A. M. C.; Soares, L. G. P.; Marques, R. C.; Pinheiro, A. L. B.; Dent, M.

    2011-08-01

    Bell's palsy is defined as a peripheral facial nerve palsy, idiophatic, and sudden onset and is considered the most common cause of this pathology. It is caused by damage to cranial nerves VII, resulting in complete or partial paralysis of the facial mimic. May be associated with taste disturbances, salivation, tearing and hyperacusis. It is diagnosed after ruling out all possible etiologies, because its cause is not fully understood.Some researches shows that herpes virus may cause this type of palsy due to reactivation of the virus or by imunnomediated post-viral nerve demielinization. Physical therapy, corticosteroids and antiviral therapy have become the most widely accepted treatments for Bell's palsy. Therapy with low-level laser (LLLT) may induce the metabolism of injured nerve tissue for the production of proteins associated with its growth and to improve nerve regeneration. The success of the treatment of Bell's palsy by using laser phototherapy isolated or in association with other therapeutic approach has been reported on the literature. In most cases, the recovery occurs without uneventfully (complications), the acute illness is not associated with serious disorders. We will present a clinical approach for treating this condition.

  17. Etiopathogenesis of lower motor neuron facial palsy: Our experience

    Directory of Open Access Journals (Sweden)

    M Venugopal

    2011-01-01

    Full Text Available Introduction : Facial nerve is the seventh cranial nerve having important functions, and hence its paralysis can lead to a great deal of mechanical impairment and emotional embarrassment. Etiopathogenisis of lower motor neuron facial palsy is still a diagnostic challenge and the literature has shown varying results pertaining to the same. This study was designed to sketch out the prevalence of disease causation and the profile of peripheral facial palsy patients presenting to the ENT department at Government Medical College, Kozhikode. Materials and Methods : A prospective study involving 60 patients with facial nerve palsy, presented during the period November 2006 to October 2008, was undertaken. Detailed analysis of etiopathogenesis, age and sex distribution, severity of palsy, anatomical levels and follow up for 1 year was done. Results : Trauma, both iatrogenic and non-iatrogenic, was the most widespread etiology in our study, followed by Bell′s palsy which is described as the commonest cause in world literature. Majority of the patients belonged to the age group of 31-40 years and there was slight male preponderance Non-iatrogenic facial palsy following road traffic accident was common in young males, while females dominated in infectious palsies. Majority of cases reported with grade III palsy, followed by grade IV. High-resolution computed tomography of temporal bone is exceedingly sensitive in delineating facial canal. Conclusions : Data analysis shows similarity with the existing literature except a novel trend towards amplified incidence of trauma surpassing Bell′s palsy. The need for comprehensive history taking, meticulous clinical examination, judicious investigations and appropriate intervention is substantiated by the study.

  18. Isolated Bell’s palsy - An unusual presentation of dengue infection

    Institute of Scientific and Technical Information of China (English)

    Peter S; Malhotra N; Peter P; Sood R

    2013-01-01

    Dengue fever is a very common arthropod – borne infection in tropical countries. Neurological complications in dengue fever are relatively uncommon and among these, isolated cranial neuropathies have been reported only very rarely. We present an unusual neurological complication of Bell’s palsy (lower motor neuron 7 th nerve palsy) associated with dengue infection. To the best of our knowledge, there have been very few documented cases of Flavivirus causing isolated Bell’s palsy.

  19. United Cerebral Palsy

    Science.gov (United States)

    ... be sure to follow us on Twitter . United Cerebral Palsy UCP educates, advocates and provides support services to ... Partners Merz Logo Sprint Relay Copyright © 2015 United Cerebral Palsy 1825 K Street NW Suite 600 Washington, DC ...

  20. Bell's palsy: data from a study of 70 cases.

    Science.gov (United States)

    Cirpaciu, D; Goanta, C M

    2014-01-01

    Bell's palsy is a condition that affects the facial nerve, which is one of the twelve cranial nerves. Its main function is to control all the muscles of the facial expression. It is a unilateral, acute, partial or complete paralysis of the facial nerve. Bell's palsy remains the most common cause of facial nerve paralysis, more often encountered in females aged 17 to 30 years, recurrent in many cases and with poor associations with other pathologic conditions. In modern literature, the suspected etiology could be due to the reactivation of the latent herpes viral infections in the geniculate ganglia, and their subsequent migration to the facial nerve but, favorable outcome by using vasodilators, neurotrophic and corticosteroid therapy was recorded. PMID:25870668

  1. Advances in diagnosis and non-surgical treatment of Bell's palsy

    Institute of Scientific and Technical Information of China (English)

    Yang Zhao; Guodong Feng; Zhiqiang Gao

    2015-01-01

    Bell's palsy is a commonly seen cranial nerve disease and can result in compromised facial appearance and functions. Its etiology, prognosis and treatment are still being debated. This paper is a review of recent development in the understanding of etiology, diagnosis and non-surgical treatment of Bell's palsy.

  2. Bell's Palsy in Children: Role of the School Nurse in Early Recognition and Referral

    Science.gov (United States)

    Gordon, Shirley C.

    2008-01-01

    Bell's palsy is the most common condition affecting facial nerves. It is an acute, rapidly progressing, idiopathic, unilateral facial paralysis that is generally self-limiting and non-life threatening that occurs in all age groups (Okuwobi, Omole, & Griffith, 2003). The school nurse may be the first person to assess facial palsy and muscle…

  3. Cerebral palsy and epilepsy

    OpenAIRE

    Knežević-Pogančev Marija

    2010-01-01

    Introduction. Cerebral palsy is the most common cause of physical disability in early childhood. Epilepsy is known to have a high association with cerebral palsy. All types of epileptic seizures can be seen in patients with cerebral palsy. Complex partial and secondary generalized ones are the most frequent seizure types. In persons with cerebral palsy and mental retardation, the diagnosis of epilepsy presents unique difficulties. Generally they are not able to describe the epileptic ev...

  4. The role of iatrogenic foraminal stenosis from lordotic correction in the development of C5 palsy after posterior laminectomy and fusion

    OpenAIRE

    Blizzard, Daniel J.; Gallizzi, Michael A.; Sheets, Charles; Klement, Mitchell R.; Kleeman, Lindsay T.; Caputo, Adam M.; Eure, Megan; Brown, Christopher R.

    2015-01-01

    Background Post-operative C5 nerve root palsy is a known complication following cervical spine surgery. Although several theories have been proposed, there remains no consensus as to the etiology of the palsies. Multiple pre-operative radiographic measures have been assessed for utility in predicting palsy. The purpose of this study is to evaluate published radiographic parameters as well as specifically evaluate the effect of cervical lordosis in the development of C5 palsy to establish thre...

  5. Facial nerve paralysis in children.

    Science.gov (United States)

    Ciorba, Andrea; Corazzi, Virginia; Conz, Veronica; Bianchini, Chiara; Aimoni, Claudia

    2015-12-16

    Facial nerve palsy is a condition with several implications, particularly when occurring in childhood. It represents a serious clinical problem as it causes significant concerns in doctors because of its etiology, its treatment options and its outcome, as well as in little patients and their parents, because of functional and aesthetic outcomes. There are several described causes of facial nerve paralysis in children, as it can be congenital (due to delivery traumas and genetic or malformative diseases) or acquired (due to infective, inflammatory, neoplastic, traumatic or iatrogenic causes). Nonetheless, in approximately 40%-75% of the cases, the cause of unilateral facial paralysis still remains idiopathic. A careful diagnostic workout and differential diagnosis are particularly recommended in case of pediatric facial nerve palsy, in order to establish the most appropriate treatment, as the therapeutic approach differs in relation to the etiology.

  6. Bell’s palsy: data from a study of 70 cases

    OpenAIRE

    Cirpaciu, D; Goanta, CM

    2014-01-01

    Bell’s palsy is a condition that affects the facial nerve, which is one of the twelve cranial nerves. Its main function is to control all the muscles of the facial expression. It is a unilateral, acute, partial or complete paralysis of the facial nerve. Bell's palsy remains the most common cause of facial nerve paralysis, more often encountered in females aged 17 to 30 years, recurrent in many cases and with poor associations with other pathologic conditions. In modern literature, the suspect...

  7. Acute sciatic neuropathy: "Saturday night palsy"

    Directory of Open Access Journals (Sweden)

    Manigoda Miodrag

    2005-01-01

    Full Text Available This is a case report of 25-year old, unemployed male, admitted to hospital due to acute onset of the left foot drop, subsequent walking difficulty and numbness of the left calf and foot. Symptoms began after prolonged sleep with previous heroin abuse by sniffing. During neurological examination, mild weakness of knee flexors, moderate weakness of plantar flexors and paralysis of foot dorsiflexors, together with hypesthesia of the left calf, foot and fingers, predominantly in the innervation area of common peroneal nerve on the same side, were observed. The electrophysiologic examination revealed predominant involvement of peroneal division within the sciatic nerve, together with recorded conduction block indicating the compression as possible mechanism of nerve injury. The patient was administered corticosteroid therapy during two months, what resulted in almost complete recovery. The peculiarity of this case report is in the presence of the sciatic nerve "Saturday night palsy" with possible effect of former heroin abuse.

  8. Tendon transfer for median nerve palsy

    Directory of Open Access Journals (Sweden)

    K Sridhar

    2011-01-01

    Full Text Available The article describes the approach practiced by the author from 1995. Mainly Hansen′s patients and lower forearm injuries formed the bulk of these. In Opponen′s transfer ECU was used only when others were not available as the wrist developed a tendency to radial deviation even when FCU was acting. PL with palmar aponeurosis as extension was used again in limited cases. The main stay was FDS and EIP. The Guyan′s canal and lower end of ulna were the common pulleys. APB and EPL two slip inserts yielded good results. The approach describes the procedure under three distinct headings of choosing motor, Pulley and insert. Varying combinations of these can be used as per requirement.

  9. Bilateral Facial Nerve Palsy: A Diagnostic Dilemma

    Directory of Open Access Journals (Sweden)

    Sohil Pothiawala

    2012-01-01

    Conclusion. We reinforce the importance of considering the range of differential diagnosis in all cases presenting with bilateral FNP. These patients warrant admission and prompt laboratory and radiological investigation for evaluation of the underlying cause and specific further management as relevant.

  10. ELECTROPHYSIOLOGICAL PROPERTIES OF MORPHOLOGICALLY-IDENTIFIED MEDIAL VESTIBULAR NUCLEUS NEURONS PROJECTING TO THE ABDUCENS NUCLEUS IN THE CHICK EMBRYO

    OpenAIRE

    Gottesman-Davis, Adria; Shao, Mei; Hirsch, June C.; Peusner, Kenna D.

    2010-01-01

    Neurons in the medial vestibular nucleus (MVN) show a wide range of axonal projection pathways, intrinsic firing properties, and responses to head movements. To determine whether MVN neurons participating in the vestibulocular reflexes (VOR) have distinctive electrophysiological properties related to their output pathways, a new preparation was devised using transverse brain slices containing the chicken MVN and abducens nucleus. Biocytin Alexa Fluor was injected extracellularly into the abdu...

  11. The Clinical Study on Bell's Palsy Patients with TCD Measurement

    Directory of Open Access Journals (Sweden)

    Lee Hyun

    2003-06-01

    Full Text Available Objective : This study was carried to make out the connection between cerebral artery blood flow velocity and ischemic theory that presumed the cause of Bell's palsy. Method : We measured cerebral artery blood flow velocity each external carotid artery, internal carotid artery, common carotid artery, siphon, superficial temporal artery by TCD to 20 patients who diagnosed as facial nerve palsy from march 2001 to July 2001 and all objectives devided two groups as palsy side. A group is right side facial nerve palsy and B group is left facial nerve palsy. Results : 1. There is no effective change of blood flow in external carotid artery either A, B group. 2. There is no effective change of blood flow in internal carotid artery either A, B group. 3. There is no effective change of blood flow in common carotid artery either A, B group. 4. There is no effective change of blood flow in siphon artery either A, B group. 5. There is no effective change of blood flow in superficial temporal artery either A, B group.

  12. Common peroneal nerve injuries in knee dislocations: results with one-stage nerve repair and tibialis posterior tendon transfer

    OpenAIRE

    Garozzo, D.; Ferraresi, S.; Buffatti, P.

    2002-01-01

    We report our experience in the treatment of common peroneal nerve (CPN) palsy following knee dislocations: a twelve-year surgical series of 26 patients presenting with a traumatic injury of the lateral sciatic nerve and no spontaneous recovery is reviewed. From 1988 to 1991, we performed nerve surgery alone on 3 patients. Their results were highly disappointing and in none did we observe muscle recovery. Since 1991 nerve surgery was associated with a palliative procedure for 23 patients. Alt...

  13. Incidences of C5 nerve palsy after multi-segmental cervical decompression through different approaches%各种多节段颈椎减压术后颈5神经根麻痹发生率的比较

    Institute of Scientific and Technical Information of China (English)

    孟海亮; 方向义; 郝定均; 王卫东

    2015-01-01

    Objective To investigate the incidence of C5 nerve root palsy after multi-segmental cervical decompression through different approaches. Methods This study was conducted among 375 patients undergoing multi- segmental cervical decompression in anterior corpectomy and fusion fixation, anterior cervical corpectomy and fusion fixation + posterior decompression and fusion fixation, posterior cervical laminectomy decompression, fusion and internal fixation, and posterior laminoplasty and fusion groups. The exclusion criteria included lack of follow- up data, spinal cord injury preventing preoperative or postoperative motor testing, or surgery not involving the C5 level. The incidence of C5 palsy was determined and the potential risk factors C5 palsy were analyzed including age, sex, revision surgery, preoperative weakness, diabetes, smoking, number of levels decompressed, and a history of previous upper extremity surgery. Results Of the 375 patients, 60 patients were excluded and the data of 315 patients were analyzed, including 146 women and 169 men with a mean age of 57.7 years (range 39-72 years). The overall incidence of C5 nerve palsy was 6.03% (19/315) in these patients; in the subgroups receiving different surgeries, the incidence was 8.62%in the cervical road laminectomy and fusion fixation group, 7.79%in the anterior cervical corpectomy and fusion fixation+posterior decompression and fusion and internal fixation, 4.68%in the anterior corpectomy and fusion fixation group, and 3.85%in the posterior laminoplasty and fusion group. No significant difference was found in the incidences among the subgroups, but men were more likely than women to develop cervical nerve root palsy (8.28%vs 3.42%, P<0.05). Conclusion The overall incidence of C5 nerve palsy following postoperative cervical spinal decompression was 6.03%in our cohort. The incidence of C5 nerve palsy did not differ significantly following different cervical decompression surgeries, but the incidence was the

  14. Hereditary neuropathy with liability to pressure palsies: a single-center experience in southern Brazil

    Directory of Open Access Journals (Sweden)

    Paulo José Lorenzoni

    2016-09-01

    Full Text Available The spectrum of clinical and electrophysiological features in hereditary neuropathy with liability to pressure palsies (HNPP is broad. We analyze a series of Brazilian patients with HNPP. Correlations between clinical manifestations, laboratory features, electrophysiological analyze, histological and molecular findings were done. In five cases, more than one episode occurred before diagnosis. Median nerve in the carpal tunnel at the wrist, ulnar nerve in its groove at the elbow, fibular nerve in the head of the fibula at the knee, radial nerve in its groove of the humerus and suprascapular nerve in its notch at the supraspinous fossa were found as focal neuropathies. One patient presented with persistent writer’s cramp after ulnar nerve palsy. Nerve conduction studies showed focal neuropathy in all patients and concomitant generalized symmetrical neuropathy in eight patients. Molecular analysis of the PMP22 gene detected deletion of the 1.5-Mb fragment in all patients.

  15. Hereditary Neuropathy With Liability to Pressure Palsies: A Single-Center Experience in Southern Brazil

    Science.gov (United States)

    Lorenzoni, Paulo José; Kay, Cláudia Suemi Kamoi; Cavalet, Cristiane; Arndt, Raquel C.; Werneck, Lineu Cesar; Scola, Rosana Herminia

    2016-01-01

    The spectrum of clinical and electrophysiological features in hereditary neuropathy with liability to pressure palsies (HNPP) is broad. We analyze a series of Brazilian patients with HNPP. Correlations between clinical manifestations, laboratory features, electrophysiological analyze, histological and molecular findings were done. In five cases, more than one episode occurred before diagnosis. Median nerve in the carpal tunnel at the wrist, ulnar nerve in its groove at the elbow, fibular nerve in the head of the fibula at the knee, radial nerve in its groove of the humerus and suprascapular nerve in its notch at the supraspinous fossa were found as focal neuropathies. One patient presented with persistent writer’s cramp after ulnar nerve palsy. Nerve conduction studies showed focal neuropathy in all patients and concomitant generalized symmetrical neuropathy in eight patients. Molecular analysis of the PMP22 gene detected deletion of the 1.5-Mb fragment in all patients. PMID:27761228

  16. A patient with bilateral facial palsy associated with hypertension and chickenpox: learning points.

    Science.gov (United States)

    Al-Abadi, Eslam; Milford, David V; Smith, Martin

    2010-11-26

    Bilateral facial nerve paralysis is an uncommon presentation and even more so in children. There are reports of different causes of bilateral facial nerve palsy. It is well-established that hypertension and chickenpox causes unilateral facial paralysis and the importance of checking the blood pressure in children with facial nerve paralysis cannot be stressed enough. The authors report a boy with bilateral facial nerve paralysis in association with hypertension and having recently recovered from chickenpox. The authors review aspects of bilateral facial nerve paralysis as well as hypertension and chickenpox causing facial nerve paralysis.

  17. 多节段脊髓型颈椎病经颈后路不同术式治疗后C5神经根麻痹的观察对比%Comparative observation of C5 nerve root palsy after posterior surgical treatment of multilevel cervical spondylotic myelopathy

    Institute of Scientific and Technical Information of China (English)

    贺建军; 梁盾; 陆兴

    2014-01-01

    Objective To compare the incidence of C5 nerve root palsy after laminoplasty and laminectomy with internal fixation for treating multilevel cervical spondylotic myelopathy (MCSM).Methods From January 2008 to August 2012,98 patients with MCSM were treated with laminoplasty (47 patients,group A) or laminectomy (51 patients,group B) with internal fixation.All the patients were followed up for 13-56(26.5 ± 7.9) months.In both groups,Cobb's method was applied to measure cervical lordotic angle,and Ishihara's method was conducted to measure cervical curvature index (CCI) before and after operation.The incidence of C5 nerveroot palsy was recorded and compared.Results The incidence of C5 nerve root palsy in group A was 2.1% (1/47),while 21.6 % (11/51) in group B (x2 =5.430,P < 0.05).The JOA scores in group A and group B before and after operation and improvement rate of JOA scores had no significant difference (P> 0.05).The cervical lordotic angle and CCI in group A and group B before and after operation had no significant difference (P > 0.05).The improvement rate of CCI between two groups had no significant difference (P > 0.05).All of 11 patients with C5 nerve root palsy were group B 1,and other 40 patients were group B2.The improvement rate of CCI in group B1 was significantly higher than that in group B2 [(38.7 ± 18.3)% vs.(22.1 ± 12.1)%](t =1.772,P< 0.05).Conclusions Compared with laminoplasty,laminectomy with internal fixation has a higher incidence of C5 nerve root palsy.The C5 nerve root palsy may be associated with postoperative increase of cervical lordosis angle.Moreover,tethering of the C5 root may he one of its important pathomechanisms.%目的 分析颈后路单开门椎管成形术与椎板切除内固定术治疗多节段脊髓型颈椎病术后C5神经根麻痹的发生率及其原因.方法 2008年1月至2012年8月因多节段脊髓型颈椎病分别接受椎管成形术的患者47例(A组)、接受椎

  18. Midbrain infarction presenting with monocular elevation palsy and ptosis: topographic lesion analysis.

    Science.gov (United States)

    Choi, Yun-Ju; Lee, Seung-Han; Park, Man-Seok; Kim, Byeong C; Kim, Myeong-Kyu

    2015-06-01

    A combination of monocular elevation palsy and ptosis is usually characteristic of an extra-axial lesion of the superior branch of the third nerve. We report an unusual case of monocular elevation palsy and ipsilateral ptosis due to midbrain infarction involving the third nerve fascicle. In addition, we conducted a review of the literature of similar cases and produced an overlay image of the magnetic resonance scans from these reports. The overlapping regions primarily were located in the midbrain between the red nucleus and cerebral peduncle. This correlated with involvement of the lateral portion of the third nerve fascicle containing fibers to the superior rectus and levator palpebrae.

  19. Cerebral Palsy (CP) Quiz

    Science.gov (United States)

    ... Submit Button Past Emails CDC Features Pop Quiz: Cerebral Palsy Language: English Español (Spanish) Recommend on Facebook Tweet ... Sandy is the parent of a child with cerebral palsy and the Board President of Gio’s Garden , a ...

  20. Multiple cranial nerve dysfunction caused by neurosarcoidosis.

    Science.gov (United States)

    Loor, Rivkah G J; van Tongeren, Joost; Derks, Wynia

    2012-01-01

    Neurosarcoidosis is a rare identity and occurs in only 5% to 15% of patients with sarcoidosis. It can manifest in many different ways, and therefore, diagnosis may be complicated. We report a case presented in a very unusual manner with involvement of 3 cranial nerves; anosmia (NI), facial palsy (NVII), and hearing loss (NVIII). When cranial nerve dysfunction occurs, it is very important to take neurosarcoidosis into consideration. PMID:22154016

  1. Isolated long thoracic nerve paralysis - a rare complication of anterior spinal surgery: a case report

    Directory of Open Access Journals (Sweden)

    Ameri Ebrahim

    2009-06-01

    Full Text Available Abstract Introduction Isolated long thoracic nerve injury causes paralysis of the serratus anterior muscle. Patients with serratus anterior palsy may present with periscapular pain, weakness, limitation of shoulder elevation and scapular winging. Case presentation We present the case of a 23-year-old woman who sustained isolated long thoracic nerve palsy during anterior spinal surgery which caused external compressive force on the nerve. Conclusion During positioning of patients into the lateral decubitus position, the course of the long thoracic nerve must be attended to carefully and the nerve should be protected from any external pressure.

  2. Nerve lesioning with direct current

    Science.gov (United States)

    Ravid, E. Natalie; Shi Gan, Liu; Todd, Kathryn; Prochazka, Arthur

    2011-02-01

    Spastic hypertonus (muscle over-activity due to exaggerated stretch reflexes) often develops in people with stroke, cerebral palsy, multiple sclerosis and spinal cord injury. Lesioning of nerves, e.g. with phenol or botulinum toxin is widely performed to reduce spastic hypertonus. We have explored the use of direct electrical current (DC) to lesion peripheral nerves. In a series of animal experiments, DC reduced muscle force by controlled amounts and the reduction could last several months. We conclude that in some cases controlled DC lesioning may provide an effective alternative to the less controllable molecular treatments available today.

  3. 3 dimensional volume MR imaging of intratemporal facial nerve

    Energy Technology Data Exchange (ETDEWEB)

    Seo, Jeong Jin; Kang, Heoung Keun; Kim, Hyun Ju; Kim, Jae Kyu; Jung, Hyun Ung; Moon, Woong Jae [Chonnam University Medical School, Kwangju (Korea, Republic of)

    1994-10-15

    To evaluate the usefulness of 3 dimensional volume MR imaging technique for demonstrating the facial nerves and to describe MR findings in facial palsy patients and evaluate the significance of facial nerve enhancement. We reviewed the MR images of facial nerves obtained with 3 dimensional volume imaging technique before and after intravenous administration of Gadopentetate dimeglumine in 13 cases who had facial paralysis and 33 cases who had no facial palsy. And we analyzed the detectability of ananatomical segments of intratemporal facial nerves and facial nerve enhancement. When the 3 dimensional volume MR images of 46 nerves were analyzed subjectively, the nerve courses of 43(93%) of 46 nerves were effectively demonstrated on 3 dimensional volume MR images. Internal acoustic canal portions and geniculate ganglion of facial nerve were well visualized on axial images and tympanic and mastoid segments were well depicted on oblique sagittal images. 10 of 13 patients(77%) were visibly enhanced along at least one segment of the facial nerve with swelling or thickening, and nerves of 8 of normal 33 cases(24%) were enhanced without thickening or swelling. MR findings of facial nerve parelysis is asymmetrical thickening of facial nerve with contrast enhancement. The 3 dimensional volume MR imaging technique should be a useful study for the evaluation of intratemporal facial nerve disease.

  4. Blink restoration by the functional electrical stimulation in unilateral facial nerve palsy rabbits%功能性电刺激恢复周围性面神经麻痹兔眨眼功能的研究

    Institute of Scientific and Technical Information of China (English)

    薛玉斌; 冯国栋; 丁秀勇; 赵杨; 崔婷婷; 高志强

    2014-01-01

    兔的双侧同步眨眼.%Objective Tocompare the effects of different waveforms and parameters of electrical stimulation to elicit a blink,and construct a functional electrical stimulation (FES) system to restore synchronous blink in unilateral facial nerve palsy (FNP).Methods Firstly,twenty-four rabbits were surgically induced unilateral FNP and were divided into three groups,who received square,sine and triangle pulse wareforms,respectirely.Both the healthy and the paralysis eyelids of the rabbits received pulse train stimulation to produce a blink in both eyes.For each rabbit,twenty-seven combinations of frequencies (25 Hz,50 Hz and 100 Hz) and nine pulse widths (1-9 ms) were stimulated.The threshold amplitude and electric charge to elicit a blink was compared between different waveforms and different parameters.Secondly,a FES system was constructed to treat six surgically induced unilateral FNP rabbit chosen in the twenty-four rabbits,it consisted by an electromyogram (EMG) amplifier module which record the EMG of the healthy muscle,and a stimulator which received the EMG input and output a pulse train stimulation when triggered by the EMG.Results When the carrier frequency of the pulse train was 25 Hz,it was not able to induce a smooth blink.However,when the carrier frequencies were 50 Hz and 100 Hz,a smooth blink could be induced.The voltage required by 100 Hz was lower than 50 Hz,but it cost more electric charge.The amplitude that square waveforms required was far lower than sine and triangle,but the electric charge between the three waveforms was similar.Synchronous blink could be restored in the six unilateral FNP rabbits with the FES system.Conclusions To elicit a blink,square pulse train delivered in 50 Hz is a preferable option.The motion of the healthy eyelids as a source of information for stimulation of the paralyzed sides can restore the synchronous blink in unilateral FNP rabbits.

  5. Unilateral phrenic nerve lesion in Lyme neuroborreliosis

    OpenAIRE

    Djukic Marija; Larsen Jörg; Lingor Paul; Nau Roland

    2013-01-01

    Abstract Background Among a variety of more common differential diagnoses, the aetiology of acute respiratory failure includes Lyme neuroborreliosis. Case presentation We report an 87-years old huntsman with unilateral phrenic nerve palsy as a consequence of Lyme neuroborreliosis. Conclusion Although Lyme neuroborreliosis is a rare cause of diaphragmatic weakness, it should be considered in the differential workup because of its potentially treatable nature.

  6. Diagnosis of Bell palsy with gadolinium magnetic resonance imaging.

    Science.gov (United States)

    Becelli, R; Perugini, M; Carboni, A; Renzi, G

    2003-01-01

    Bell palsy is a condition resulting from a peripheral edematous compression on the nervous fibers of the facial nerve. This pathological condition often has clinical characteristics of no importance and spontaneously disappears in a short time in a high percentage of cases. Facial palsy concerning cranial nerve VII can also be caused by other conditions such as mastoid fracture, acoustic neurinoma, tumor spread to the temporal lobe (e.g., cholesteatoma), neoformation of the parotid gland, Melkersson-Rosenthal syndrome, and Ramsay-Hunt syndrome. Therefore, it is important to adopt an accurate diagnostic technique allowing the rapid detection of Bell palsy and the exclusion of causes of facial paralysis requiring surgical treatment. Magnetic resonance imaging (MRI) with medium contrast of the skull shows a marked increase in revealing lesions, even of small dimensions, inside the temporal bone and at the cerebellopontine angle. The authors present a clinical case to show the important role played by gadolinium MRI in reaching a diagnosis of Bell palsy in the differential diagnosis of the various conditions that determine paralysis of the facial nerve and in selecting the most suitable treatment or surgery to be adopted.

  7. Neural stem cell transplantation for cerebral palsy: nerve repair and safety evaluation%神经干细胞移植治疗脑性瘫痪:神经修复的效果和安全性评估

    Institute of Scientific and Technical Information of China (English)

    刘俊华; 王大斌; 顾教伟; 冯雪连; 郑昆; 赵峰

    2015-01-01

    BACKGROUND:Neural stem cels can repair the damaged brain tissues with potentials of proliferation and differentiation, which become one of the important directions for treating cerebral palsy. OBJECTIVE:To observe the clinical effect and safety of neural stem cel transplantation on the treatment of cerebral palsy in children. METHODS:Neural stem cels were isolated from human embryonic brain and identified by immunofluorescence staining, which were transplanted intravenously into 26 children with cerebral palsy. Children's motor functions were evaluated by gross motor function measure scale and Peabody development motor scale-fine motor scale before treatment, and 3 and 6 months after treatment. Routine blood test and liver-kidney function were detected before and after treatment. Clinical adverse reactions in children with cerebral palsy were monitored. RESULTS AND CONCLUSION:The lost cases were not found during 6 months of folow-up. Specific proteins of neural stem cels were al positive in this study. At 3 and 6 months after transplantation, the A, B, C functional area scores and total score on the gross motor function measure scale were obviously increased (P 0.05). At 3 months after transplantation, the fine motor quotient, grasping subtest and visual-motor integration were not remarkably increased (P > 0.05); these scores, however, were elevated after 6 months with statistical significance (P 0.05);患儿精细运动发育商、抓握能力指数和视觉感知能力指数在细胞移植3个月未见明显提高(P > 0.05),但在移植6个月均有显著提高(P < 0.05,P< 0.01).26例脑瘫患儿细胞移植前后血常规和肝肾功能各项指标均处于正常范围,整个移植治疗过程中未见明显严重不良反应.表明人胚胎脑神经干细胞移植较安全,能改善脑性瘫痪患儿的运动功能,且对粗大运动的治疗起效比精细运动更快.

  8. Nerve biopsy

    Science.gov (United States)

    Biopsy - nerve ... A nerve biopsy is most often done on a nerve in the ankle, forearm, or along a rib. The health care ... feel a prick and a mild sting. The biopsy site may be sore for a few days ...

  9. Imaging the Facial Nerve: A Contemporary Review

    Directory of Open Access Journals (Sweden)

    Sachin Gupta

    2013-01-01

    Full Text Available Imaging plays a critical role in the evaluation of a number of facial nerve disorders. The facial nerve has a complex anatomical course; thus, a thorough understanding of the course of the facial nerve is essential to localize the sites of pathology. Facial nerve dysfunction can occur from a variety of causes, which can often be identified on imaging. Computed tomography and magnetic resonance imaging are helpful for identifying bony facial canal and soft tissue abnormalities, respectively. Ultrasound of the facial nerve has been used to predict functional outcomes in patients with Bell’s palsy. More recently, diffusion tensor tractography has appeared as a new modality which allows three-dimensional display of facial nerve fibers.

  10. Rapid genetic screening of Charcot-Marie-Tooth disease type 1A and hereditary neuropathy with liability to pressure palsies patients

    Institute of Scientific and Technical Information of China (English)

    Xiaobo Li; Kun Xia; Beisha Tang; Ruxu Zhang; Xiaohong Zi; Lin Li; Yajing Zhan; Shunxiang Huang; Jin Li; Xuning Li; Xigui Li; Zhengmao Hu

    2012-01-01

    We used the allele-specific PCR-double digestion method on peripheral myelin protein 22 (PMP22) to determine duplication and deletion mutations in the proband and family members of one family with Charcot-Marie-Tooth disease type 1 and one family with hereditary neuropathy with liability to pressure palsies. The proband and one subclinical family member from the Charcot-Marie-Tooth disease type 1 family had a PMP22 gene duplication; one patient from the hereditary neuropathy with liability to pressure palsies family had a PMP22 gene deletion. Electron microscopic analysis of ultrathin sections of the superficial peroneal nerve from the two probands demonstrated demyelination and myelin sheath hyperplasia, as well as an ‘onion-like’ structure in the Charcot-Marie-Tooth disease type 1A patient. We observed an irregular thickened myelin sheath and ‘mouse-nibbled’-like changes in the patient with hereditary neuropathy with liability to pressure palsies. In the Charcot-Marie-Tooth disease type 1A patient, nerve electrophysiological examination revealed moderate-to-severe reductions in the motor and sensory conduction velocities of the bilateral median nerve, ulnar nerve, tibial nerve, and sural nerve. Moreover, the compound muscle action potential amplitude was decreased. In the patient with hereditary neuropathy with liability to pressure palsies, the nerve conduction velocity of the bilateral tibial nerve and sural nerve was moderately reduced, and the nerve conduction velocity of the median nerve and ulnar nerve of both upper extremities was slightly reduced.

  11. Progressive Supranuclear Palsy

    Science.gov (United States)

    Progressive supranuclear palsy (PSP) is a rare brain disease. It affects brain cells that control the movement of your eyes. This leads to ... speech, vision and swallowing problems. Doctors sometimes confuse PSP with Parkinson's disease or Alzheimer's disease. PSP has ...

  12. Cerebral Palsy Litigation

    OpenAIRE

    Sartwelle, Thomas P.; Johnston, James C.

    2015-01-01

    The cardinal driver of cerebral palsy litigation is electronic fetal monitoring, which has continued unabated for 40 years. Electronic fetal monitoring, however, is based on 19th-century childbirth myths, a virtually nonexistent scientific foundation, and has a false positive rate exceeding 99%. It has not affected the incidence of cerebral palsy. Electronic fetal monitoring has, however, increased the cesarian section rate, with the expected increase in mortality and morbidity risks to mothe...

  13. Rehabilitation in cerebral palsy.

    OpenAIRE

    Molnar, G. E.

    1991-01-01

    Cerebral palsy is the most frequent physical disability of childhood onset. Over the past four decades, prevalence has remained remarkably constant at 2 to 3 per 1,000 live births in industrialized countries. In this article I concentrate on the rehabilitation and outcome of patients with cerebral palsy. The epidemiologic, pathogenetic, and diagnostic aspects are highlighted briefly as they pertain to the planning and implementation of the rehabilitation process.

  14. Birth brachial plexus palsy: a race against time.

    Science.gov (United States)

    Patra, Sambeet; Narayana Kurup, Jayakrishnan K; Acharya, Ashwath M; Bhat, Anil K

    2016-01-01

    A 5-year-old child presented to us with weakness of the left upper limb since birth. With the given history of obstetric trauma and limb examination, a diagnosis of birth brachial plexus palsy was made. Brachial plexus exploration along with microsurgery was performed at the same time which included extrinsic neurolysis of the roots and trunks and nerve transfer for better shoulder external rotation and elbow flexion. Both the movements were severely restricted previously due to co-contractures with the shoulder internal rotators and triceps. The problem of birth brachial plexus palsy is proving to be a global health burden both in developed countries and in developing countries such as India. The lack of awareness among the general public and primary healthcare providers and inadequate orthopaedic and neurosurgeons trained to treat the condition have worsened the prognosis. This case lays stress on the delayed complications in birth brachial palsy and its effective management. PMID:27402656

  15. Nerve transfer in brachial plexus traction injuries

    Directory of Open Access Journals (Sweden)

    Samardžić Miroslav M.

    2003-01-01

    Full Text Available Background. The aim of this study was to analyze the results of nerve transfer to the musculocutaneous and axillary nerves, using some technical modalities such as intercostal, spinal accessory or intraplexal transfer, and on the basis of the results to try to clarify the most common controversies concerning these operations. Methods. The study included 82 patients with brachial plexus traction injuries, who were operated on using various techniques of nerve transfer. The follow-up period was at least two years. The analysis of biceps and deltoid muscles recovery was performed according to the type of the donor nerve. Results. The corresponding rates of recovery for the musculocutaneous and axillary nerves were 46.7% and 68.1% in intercostal nerve transfer, 71.4% and 75% in accessory nerve transfer, 93.1% and 88.8% in nerve transfer of the brachial plexus collateral branches, and 55.5% and 60% in classical intraplexal nerve transfer, respectively. Comparative statistical analysis demonstrated significantly better final outcome and quality of recovery in regional nerve transfers in comparison to the other methods. Conclusion. Our findings suggest that nerve transfer of collateral branches, where possible, (such as in cases with upper or extended upper brachial plexus palsy might be a method of choice, offering better results and quality of recovery.

  16. MR of acoustic neuromas; Relationship to cranial nerves

    Energy Technology Data Exchange (ETDEWEB)

    Suzuki, Masayuki; Takashima, Tsutomu; Kadoya, Masumi; Takahashi, Shiroh; Miyayama, Shiroh; Taira, Sakae; Kashihara, Kengo; Yamashima, Tetsumori; Itoh, Haruhide (Kanazawa Univ. (Japan). School of Medicine)

    1989-08-01

    In this report, the relationship of acoustic neuromas to the adjacent cranial nerves is discussed. On T{sub 1}-weighted images, the trigeminal nerve was detected in all 13 cases. Mild to marked compression of these nerves by the tumors was observed in eight cases. The extent of compression did not always correspond to the clinical symptoms. In four cases with a maximum tumor diameter of 2 cm or less, the 7th and 8th cranial nerves were identified. There was no facial palsy in these patients. Two patients with a tumor diameter of more than 2 cm also had no facial palsy. All patients, including those with small tumors, complained of hearing loss and/or tinnitus. While MR imaging has some limitations, it is an effective imaging modality for showing the relationship between tumors and nerves. (author).

  17. Nanomedicine in cerebral palsy

    Directory of Open Access Journals (Sweden)

    Balakrishnan B

    2013-11-01

    Full Text Available Bindu Balakrishnan,1 Elizabeth Nance,1 Michael V Johnston,2 Rangaramanujam Kannan,3 Sujatha Kannan1 1Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University; Baltimore, MD, USA; 2Department of Neurology and Pediatrics, Kennedy Krieger Institute, Baltimore, MD, USA; 3Department of Ophthalmology, Center for Nanomedicine, Johns Hopkins University, Baltimore, MD, USA Abstract: Cerebral palsy is a chronic childhood disorder that can have diverse etiologies. Injury to the developing brain that occurs either in utero or soon after birth can result in the motor, sensory, and cognitive deficits seen in cerebral palsy. Although the etiologies for cerebral palsy are variable, neuroinflammation plays a key role in the pathophysiology of the brain injury irrespective of the etiology. Currently, there is no effective cure for cerebral palsy. Nanomedicine offers a new frontier in the development of therapies for prevention and treatment of brain injury resulting in cerebral palsy. Nanomaterials such as dendrimers provide opportunities for the targeted delivery of multiple drugs that can mitigate several pathways involved in injury and can be delivered specifically to the cells that are responsible for neuroinflammation and injury. These materials also offer the opportunity to deliver agents that would promote repair and regeneration in the brain, resulting not only in attenuation of injury, but also enabling normal growth. In this review, the current advances in nanotechnology for treatment of brain injury are discussed with specific relevance to cerebral palsy. Future directions that would facilitate clinical translation in neonates and children are also addressed. Keywords: dendrimer, cerebral palsy, neuroinflammation, nanoparticle, neonatal brain injury, G4OH-PAMAM

  18. Optic nerve hypoplasia

    Directory of Open Access Journals (Sweden)

    Savleen Kaur

    2013-01-01

    Full Text Available Optic nerve hypoplasia (ONH is a congenital anomaly of the optic disc that might result in moderate to severe vision loss in children. With a vast number of cases now being reported, the rarity of ONH is obviously now refuted. The major aspects of ophthalmic evaluation of an infant with possible ONH are visual assessment, fundus examination, and visual electrophysiology. Characteristically, the disc is small, there is a peripapillary double-ring sign, vascular tortuosity, and thinning of the nerve fiber layer. A patient with ONH should be assessed for presence of neurologic, radiologic, and endocrine associations. There may be maternal associations like premature births, fetal alcohol syndrome, maternal diabetes. Systemic associations in the child include endocrine abnormalities, developmental delay, cerebral palsy, and seizures. Besides the hypoplastic optic nerve and chiasm, neuroimaging shows abnormalities in ventricles or white- or gray-matter development, septo-optic dysplasia, hydrocephalus, and corpus callosum abnormalities. There is a greater incidence of clinical neurologic abnormalities in patients with bilateral ONH (65% than patients with unilateral ONH. We present a review on the available literature on the same to urge caution in our clinical practice when dealing with patients with ONH. Fundus photography, ocular coherence tomography, visual field testing, color vision evaluation, neuroimaging, endocrinology consultation with or without genetic testing are helpful in the diagnosis and management of ONH. (Method of search: MEDLINE, PUBMED.

  19. Optic nerve hypoplasia.

    Science.gov (United States)

    Kaur, Savleen; Jain, Sparshi; Sodhi, Harsimrat B S; Rastogi, Anju; Kamlesh

    2013-05-01

    Optic nerve hypoplasia (ONH) is a congenital anomaly of the optic disc that might result in moderate to severe vision loss in children. With a vast number of cases now being reported, the rarity of ONH is obviously now refuted. The major aspects of ophthalmic evaluation of an infant with possible ONH are visual assessment, fundus examination, and visual electrophysiology. Characteristically, the disc is small, there is a peripapillary double-ring sign, vascular tortuosity, and thinning of the nerve fiber layer. A patient with ONH should be assessed for presence of neurologic, radiologic, and endocrine associations. There may be maternal associations like premature births, fetal alcohol syndrome, maternal diabetes. Systemic associations in the child include endocrine abnormalities, developmental delay, cerebral palsy, and seizures. Besides the hypoplastic optic nerve and chiasm, neuroimaging shows abnormalities in ventricles or white- or gray-matter development, septo-optic dysplasia, hydrocephalus, and corpus callosum abnormalities. There is a greater incidence of clinical neurologic abnormalities in patients with bilateral ONH (65%) than patients with unilateral ONH. We present a review on the available literature on the same to urge caution in our clinical practice when dealing with patients with ONH. Fundus photography, ocular coherence tomography, visual field testing, color vision evaluation, neuroimaging, endocrinology consultation with or without genetic testing are helpful in the diagnosis and management of ONH. (Method of search: MEDLINE, PUBMED). PMID:24082663

  20. Cranial nerve assessment in cavernous sinus tumors with contrast-enhanced 3D fast-imaging employing steady-state acquisition MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Amemiya, Shiori; Aoki, Shigeki; Ohtomo, Kuni [University of Tokyo, Department of Radiology, Graduate School of Medicine, Bunkyo-ku, Tokyo (Japan)

    2009-07-15

    The purpose of this study is to apply contrast-enhanced 3D fast-imaging employing steady-state acquisition (3D-FIESTA) imaging to the evaluation of cranial nerves (CN) in patients with cavernous sinus tumors. Contrast-enhanced 3D-FIESTA images were acquired from ten patients with cavernous sinus tumors with a 3-T unit. In all cases, the trigeminal nerve with tumor involvement was easily identified in the cavernous portions. Although oculomotor and abducens nerves were clearly visualized against the tumor area with intense contrast enhancement, they were hardly identifiable within the area lacking contrast enhancement. The trochlear nerve was visualized in part, but not delineated as a linear structure outside of the lesion. Contrast-enhanced 3D-FIESTA can be useful in the assessment of cranial nerves in and around the cavernous sinus with tumor involvement. (orig.)

  1. Low Median Nerve Transfers (Opponensplasty).

    Science.gov (United States)

    Chadderdon, Robert Christopher; Gaston, R Glenn

    2016-08-01

    Opposition is the placement of the thumb opposite the fingers into a position from which it can work. This motion requires thumb palmar abduction, flexion, and pronation, which are provided by the abductor pollicis brevis, flexor pollicis brevis (FPB), and opponens pollicis. In the setting of a median nerve palsy, this function is typically lost, although anatomic variations and the dual innervation of the FPB may prevent complete loss at times. There are multiple well described and accepted tendon transfers to restore opposition, none of which have been proven to be superior to the others. PMID:27387078

  2. Iatrogenic Ulnar Nerve Injury post Laceration Suturing – An Unusual Presentation

    Directory of Open Access Journals (Sweden)

    Murali Mothilal

    2013-07-01

    Full Text Available Introduction: Nerve entrapment while suturing a lacerated wound is a complication that is easily avoidable. We report a case low ulnar nerve palsy due to nerve entrapment while suturing a lacerated wound. Case Report: A 48 year old lady came with complaints of pain and a lacerated wound over the dorsomedial aspect of lower third of the left forearm. The lacerated wound was sutured elsewhere one week back. She had fracture of lower third of the ulna which was stabilised with plates and screws using a separate dorsal incision. She developed ulnar claw hand on the third postoperative day. Strength duration curve revealed neurotmesis of ulnar nerve. Ulnar nerve exploration was done and the nerve was found to be ligated at the site of original laceration. The ligature was released and nerve was found to be thinned out at the site. There was no neurological recovery at 5 months follow up and reconstruction procedures in form of tendon tranfer are planned for the patient. Conclusion: This is a case of iatrogenic ulnar nerve palsy which is very rare in our literature. This can be easily avoided if proper care is taken while suturing the primary laceration. A nerve can be mistakenly sutured for a bleeding vein and proper exposure while suturing will be necessary especially at areas where nerves are superficial. Keywords: Iatrogenic, ulnar nerve palsy

  3. MRI of peripheral nerve lesions of the lower limbs

    Energy Technology Data Exchange (ETDEWEB)

    Lacour-Petit, M.C.; Ducreux, D. [Dept. of Neuroradiology, Hopital Bicetre, Kremlin-Bicetre (France); Lozeron, P. [Dept. of Neurology, Hopital Bicetre, Kremlin-Bicetre (France)

    2003-03-01

    Our aim is to illustrate the contribution of MRI to diagnosis of lesions of the lower-limb nerve trunks. We report six patients who had clinical and electrophysiological examination for a peroneal or tibial nerve palsy. MRI of the knee showed in three cases a nonenhancing cystic lesion of the peroneal nerve suggesting an intraneural ganglion cyst, confirmed by histological study in one case. One patient with known neurofibromatosis had an enhancing nodular lesion of the peroneal nerve compatible with a neurofibroma. Two patients had diffuse hypertrophy with high signal on T2-weighted images, without contrast enhancement of the sciatic nerve or its branches. These lesions were compatible with localised hypertrophic neuropathy. In one case, biopsy of the superficial branch of the peroneal nerve showed insignificant axonal degeneration. MRI can provide information about the size and site of the abnormal segment of a nerve before treatment and can be used to distinguish different patterns of focal lesion. (orig.)

  4. MRI of peripheral nerve lesions of the lower limbs

    International Nuclear Information System (INIS)

    Our aim is to illustrate the contribution of MRI to diagnosis of lesions of the lower-limb nerve trunks. We report six patients who had clinical and electrophysiological examination for a peroneal or tibial nerve palsy. MRI of the knee showed in three cases a nonenhancing cystic lesion of the peroneal nerve suggesting an intraneural ganglion cyst, confirmed by histological study in one case. One patient with known neurofibromatosis had an enhancing nodular lesion of the peroneal nerve compatible with a neurofibroma. Two patients had diffuse hypertrophy with high signal on T2-weighted images, without contrast enhancement of the sciatic nerve or its branches. These lesions were compatible with localised hypertrophic neuropathy. In one case, biopsy of the superficial branch of the peroneal nerve showed insignificant axonal degeneration. MRI can provide information about the size and site of the abnormal segment of a nerve before treatment and can be used to distinguish different patterns of focal lesion. (orig.)

  5. HERPES SIMPLEX VIRUS IN SALIVA OF PATIENTS WITH BELL'S PALSY

    Directory of Open Access Journals (Sweden)

    M.H. Harirchian

    2008-04-01

    Full Text Available Acute idiopathic peripheral facial paralysis (Bell's palsy is the most common disorder of the facial nerve. Most patients recover completely, although some have permanent disfiguring facial weakness. Many studies have attempted to identify an infectious etiology for this disease. Although the cause of Bell's palsy remains unknown, recent studies suggest a possible association with Herpes Simplex Virus-1(HSV-1 infection. In this case-control study we investigated the presence of DNA of HSV in the saliva of 26 patients with Bells palsy in first and second weeks of disorder compared to normal population who were matched in sex, age, as well as history of diabetes mellitus, hypertension and labial herpes. In the case group 3 and 7 patients had positive polymerase chain reaction (PCR for HSV in first and second weeks of disease respectively compared to 4 in controls. It means that there was not any relationship between Bell's palsy and HSV in saliva either in first or in second week. Two and 6 of positive results from the sample of first and second weeks were from patients with severe (grade 4-6 Bell's palsy. Although the positive results were more in second week in patient group and more in severe palsies, but a significant relationship between Bell's palsy or its severity and positive PCR for HSV was not detected (P >0.05.

  6. Facial palsy, a disorder belonging to influential neurological dynasty: Review of literature

    Directory of Open Access Journals (Sweden)

    Ujwala R Newadkar

    2016-01-01

    Full Text Available Facial paralysis is one of the common problem leading to facial deformation. Bell′s palsy (BP is defined as a lower motor neuron palsy of acute onset and idiopathic origin. BP is regarded as a benign common neurological disorder of unknown cause. It has an acute onset and is almost always a mononeuritis. The facial nerve is a mixed cranial nerve with a predominant motor component, which supplies all muscles concerned with unilateral facial expression. Knowledge of its course is vital for anatomic localization and clinical correlation. BP accounts for approximately 72% of facial palsies. Almost a century later, the management and etiology of BP is still a subject of controversy. Here, we present a review of literature on this neurologically significant entity.

  7. Facial Palsy, a Disorder Belonging to Influential Neurological Dynasty: Review of Literature.

    Science.gov (United States)

    Newadkar, Ujwala R; Chaudhari, Lalit; Khalekar, Yogita K

    2016-07-01

    Facial paralysis is one of the common problem leading to facial deformation. Bell's palsy (BP) is defined as a lower motor neuron palsy of acute onset and idiopathic origin. BP is regarded as a benign common neurological disorder of unknown cause. It has an acute onset and is almost always a mononeuritis. The facial nerve is a mixed cranial nerve with a predominant motor component, which supplies all muscles concerned with unilateral facial expression. Knowledge of its course is vital for anatomic localization and clinical correlation. BP accounts for approximately 72% of facial palsies. Almost a century later, the management and etiology of BP is still a subject of controversy. Here, we present a review of literature on this neurologically significant entity. PMID:27583233

  8. Facial Nerve Paralysis due to a Pleomorphic Adenoma with the Imaging Characteristics of a Facial Nerve Schwannoma.

    Science.gov (United States)

    Nader, Marc-Elie; Bell, Diana; Sturgis, Erich M; Ginsberg, Lawrence E; Gidley, Paul W

    2014-08-01

    Background Facial nerve paralysis in a patient with a salivary gland mass usually denotes malignancy. However, facial paralysis can also be caused by benign salivary gland tumors. Methods We present a case of facial nerve paralysis due to a benign salivary gland tumor that had the imaging characteristics of an intraparotid facial nerve schwannoma. Results The patient presented to our clinic 4 years after the onset of facial nerve paralysis initially diagnosed as Bell palsy. Computed tomography demonstrated filling and erosion of the stylomastoid foramen with a mass on the facial nerve. Postoperative histopathology showed the presence of a pleomorphic adenoma. Facial paralysis was thought to be caused by extrinsic nerve compression. Conclusions This case illustrates the difficulty of accurate preoperative diagnosis of a parotid gland mass and reinforces the concept that facial nerve paralysis in the context of salivary gland tumors may not always indicate malignancy.

  9. [Treatment of facial nerve paralysis using static suspension methods].

    Science.gov (United States)

    Jovanović, M; Roncević, R; Colić, M; Stojicić, M; Rasulić, L

    2003-01-01

    After the injury of facial nerve, facial muscles are subjected to complex series of biochemical and histological changes, which lead to muscular atrophy if reinnervation is not restored. Facial palsy is very difficult to manage completely. Regardless this fact, the plan of correction has to be directed towards the following: restoration of normal function, normal facial appearance at rest, symmetry in voluntary movements as well as symmetry in involuntary and emotional movements. Static suspension methods were used in our study. All patients had unilateral complete facial nerve palsy but one female patient who experienced the palsy of frontal branch of n.facialis. This method was successfully used to lift the eyebrow, the lid and to improve lagophthalmus on the paralytic side, then the angle and paralytic part of the lip, to reinforce buccal wall of oral cavity as well as to reconstruct new nasolabial fold. The results were satisfactory and permanent. PMID:14619718

  10. Bell’s palsy in a case of Darier’s disease – a rare disease association or coincidental finding?

    Directory of Open Access Journals (Sweden)

    Kritika Pandey

    2016-01-01

    Full Text Available Darier’s disease (DD is a rare acantholytic dyskeratotic autosomal dominant genodermatosis characterized by the presence of warty, brown papules and plaques affecting the seborrhoeic areas. Frequent bacterial, fungal and viral particularly herpes simplex virus (HSV infections complicate DD. Bell’s palsy is an acute onset, idiopathic facial paralysis resulting from a dysfunction anywhere along the peripheral part of the facial nerve. Reactivation of HSV is considered to be the main cause of Bell’s palsy. This case represents, to the best of our knowledge, the first case of DD presenting with Bell’s palsy. This case underlines the importance of recognizing HSV infection in DD.

  11. Bell's palsy before Bell : Evert Jan Thomassen a Thuessink and idiopathic peripheral facial paralysis

    NARCIS (Netherlands)

    van de Graaf, R. C.; IJpma, F. F. A.; Nicolai, J-P A.; Werker, P. M. N.

    2009-01-01

    Bell's palsy is the eponym for idiopathic peripheral facial paralysis. It is named after Sir Charles Bell (1774-1842), who, in the first half of the nineteenth century, discovered the function of the facial nerve and attracted the attention of the medical world to facial paralysis. Our knowledge of

  12. 颈椎管成形微钛板固定与椎板切除内固定后C5神经根麻痹的比较%Comparison of C5 nerve root palsy after laminoplasty with mini-titanium plate fixation and laminectomy with internal fixation

    Institute of Scientific and Technical Information of China (English)

    冯大鹏; 许卫兵; 赵智; 袁亮; 李光灿; 南丰; 李正维

    2015-01-01

    BACKGROUND:Laminoplasty and laminectomy are the most commonly used treatment methods for multilevel cervical spondylotic myelopathy, which is more common in elderly patients. C5 nerve root palsy is the common postoprative complication after posterior cervical repair. OBJECTIVE:To compare the incidence of C5 nerve root palsy after laminoplasty with mini-titanium plate fixation and laminectomy with internal fixation in repair of multilevel cervical spondylotic myelopathy. METHODS:Total y 134 patients with multilevel cervical spondylotic myelopathy from August 2010 to December 2014 were enrol ed, and then divided into laminoplasty group (n=45) and laminectomy group (n=89) owing to different ways of repair. Patients in the laminoplasty group were treated with laminoplasty with mini-titanium plate fixation, and patients in the laminectomy group were treated with laminectomy with internal fixation. C5 nerve root palsy condition after repair was recorded and evaluated. The cervical lordosis angle (Cobb angle) and cervical curvature index were compared. The Japanese Orthopaedic Association score was used for neurological assessment. RESULTS AND CONCLUSION:Al patients in both groups were fol owed up for more than 6 months. There were no significant differences in cervical lordotic angle and cervical curvature index at the first week before and after the treatment between these two groups (P>0.05). The Japanese Orthopaedic Association scores of patients after 6 months of treatment were significantly improved compared with that before treatment in these two groups (P  目的:比较颈椎管成形微钛板固定与椎板切除内固定修复多节段脊髓型颈椎病后C5神经根麻痹的发生率。方法:2010年8月至2014年12月纳入多节段脊髓型颈椎病患者134例,因修复方式不同分为两组,椎管成形组45例接受颈椎管成形微钛板固定,颈板切除组89例接受椎板切除内固定。记录并评估修复后C5神经根麻痹情

  13. MR imaging in Bell's palsy and herpes zoster opticus: correlation with clinical findings

    Energy Technology Data Exchange (ETDEWEB)

    Kwon, Jung Ho; Mo, Jong Hyun; Moon, Sung Hee; Lee, Sang Sun; Park, Yang Hee; Lee, Kyung Hee [National Police Hospital, Seoul (Korea, Republic of); Choi, Ik Joon [Sejong General Hospital, Seoul (Korea, Republic of)

    1998-09-01

    To evaluate the MRI findings of acute facial nerve paralysis in Bell's palsy and herpes zoster opticus, and to correlate these with the clinical findings. We retrowspectively reviewed the MRI findings in six cases of BEll's palsy(BP) and two of herpes zoster oticus(HZO), and compared them with the findings for 30 normal facial nerves. This nerve was considered abnormal when its signal intensity was greater than that of brain parenchyma or the contralateral normal side on Gd-enhanced T1-weighted axial and coronal MR images. We analysed the location and degree of contrast enhancement, interval change, and clinical progression in correlation with House-Brackmann(HB) grade and electroneuronography (ENoG) findings. Fifteen of 30 normal facial nerves(50%) seen on Gd-enhanced MRI were mildly enhanced in the geniculate ganglion, the proximal tympanic, and the proximal mastoid segment of the facial nerve. No enhancement of the internal auditory canal(IAC) or labyrinthine segment of the facial nerve was noted, however. In BP and HZO, Gd-enhanced MR images revealed fair to marked enhancement for more than two segments from the internal auditory canal to the mastoid segment of the facial nerve. During follow-up MRI, enhancement of the facial nerve varied in location and signal intensity, though gradually decreased in intensity approximately eight weeks after the onset of facial nerve palsy. No correlation between clinical HB grade, ENoG, and follow up MRI findings was noted. Except in the internal auditory canal and labyrinthine segment, normal facial nevemay show mild and relatively symmetrical enhancement. In BP and HZO, the facial nerve showed diffuse enhancement from the IAC to the mastoid segment.=20.

  14. MR imaging in Bell's palsy and herpes zoster opticus: correlation with clinical findings

    International Nuclear Information System (INIS)

    To evaluate the MRI findings of acute facial nerve paralysis in Bell's palsy and herpes zoster opticus, and to correlate these with the clinical findings. We retrowspectively reviewed the MRI findings in six cases of BEll's palsy(BP) and two of herpes zoster oticus(HZO), and compared them with the findings for 30 normal facial nerves. This nerve was considered abnormal when its signal intensity was greater than that of brain parenchyma or the contralateral normal side on Gd-enhanced T1-weighted axial and coronal MR images. We analysed the location and degree of contrast enhancement, interval change, and clinical progression in correlation with House-Brackmann(HB) grade and electroneuronography (ENoG) findings. Fifteen of 30 normal facial nerves(50%) seen on Gd-enhanced MRI were mildly enhanced in the geniculate ganglion, the proximal tympanic, and the proximal mastoid segment of the facial nerve. No enhancement of the internal auditory canal(IAC) or labyrinthine segment of the facial nerve was noted, however. In BP and HZO, Gd-enhanced MR images revealed fair to marked enhancement for more than two segments from the internal auditory canal to the mastoid segment of the facial nerve. During follow-up MRI, enhancement of the facial nerve varied in location and signal intensity, though gradually decreased in intensity approximately eight weeks after the onset of facial nerve palsy. No correlation between clinical HB grade, ENoG, and follow up MRI findings was noted. Except in the internal auditory canal and labyrinthine segment, normal facial nevemay show mild and relatively symmetrical enhancement. In BP and HZO, the facial nerve showed diffuse enhancement from the IAC to the mastoid segment.=20

  15. Comparison of Clinical Outcome with Mouse Nerve Growth Factor(NGF) Treatment of Spastic Cerebral Palsy and Non-Spastic Cerebral Palsy%鼠神经生长因子治疗婴幼儿痉挛型脑瘫与非痉挛型脑瘫的临床疗效比较

    Institute of Scientific and Technical Information of China (English)

    卢凤玲; 陈继栋; 李伟明

    2015-01-01

    ObjectiveTo compare NGF treatment outcome in Pediatric spastic and non spastic cerebral palsy.MethodsTotal 60 cases of pediatric cerebal palsy into two groups: spastic and non spastic. Spastic group has 35 cases of age equal or younger than 36 month old; 12 cases of age older than 36 month old. Non -spastic group has 15 cases of age equal or younger than 36 month old; 10 cases age older than 36 month.Both group reveived NGF treatment along with standard physiotherapy : primarily exercise, massage, acupuncture. NGF treatment regimen is 20 times. Total two cycles and one -week break between cycles. The observation of pre and post treatments' GMFM 88 scores.Result①After two treatment regimens, both GMFM 88 scores signoifcantly improve. Statistical signiifcance (P36 month old pediatric patients' MFGF 88 scores signiifcantly improve. Statistical signiifcance (P0.05) indicates the treatments are effective to both groups. Observation bases on Gross Motor Function Measure 88 (GMFM88) scores.ConclusionNGF is a safe and effective treatment for both pedatric spastic and non-spastic cerebral palsy with satisfactory outcomes in two groups.%目的:探讨鼠神经生长因子对治疗痉挛性脑瘫和非痉挛型型脑瘫的疗效比较。方法将60例符合诊断标准及条件的脑瘫患儿按痉挛型及非痉挛型脑瘫分成两组。其中痉挛型脑瘫组35例,包含年龄≤36个月23例和>36个月12例,非痉挛型脑瘫组25例,包含年龄≤36个月15例和>36个月10例。两组均进行常规的综合康复治疗,采用运动治疗为主,配合推拿、按摩、针灸等,同时应用鼠神经生长因子(NGF)20μg(≥9000 AU/支)加注射用水2 mL,肌内注射,每日1次,20次为1个疗程。第1个疗程结束后停药1周再进行第2个疗程,共使用2个疗程。分别观察治疗前和2个疗程结束后,两组粗大运动功能测试量表(GMFM-88)变化情况。结果①两个疗程结束后两组GMFM-88评分均较治疗

  16. Postoperative recovery from posterior communicating aneurysm complicated by oculomotor palsy

    Institute of Scientific and Technical Information of China (English)

    YANG Ming-qi; WANG Shuo; ZHAO Yuan-li; ZHANG Dong; ZHAO Ji-zong

    2008-01-01

    Background Oculomotor palsy is a common complication in patients with posterior communicating aneurysm.This study was conducted to investigate the postoperative recovery of patients with posterior communicating aneurysm complicated with oculomotor palsy and to analyze the factors influencing length of recovery.Methods From 2000 to 2006,148 patients with posterior communicating aneurysm were treated at our hospital,with 74 of them having concurrent unilateral oculomotor palsy.All of the patients underwent craniotomy after the diagnosis by means of whole-brain digital subtraction angiography (DSA).The patients were divided into two groups for observation of postoperative recovery during the follow-up period.Patients in group A were treated with simple pedicle clipping of the aneurysm while patients in group B were treated with pedicle clipping of the aneurysm and decompression of the oculomotor nerve.Results Of the 40 patients in group A.20 underwent surgery within 14 days and completely recovered from oculomotor palsy in 10-40 days.Fourteen patients underwent surgery within 14-30 days.of whom 12 completely recovered within 30-90 days and 2 cases recovered incompletely.The remaining six patients underwent surgery after more than 30 days:of these.four patients recovered completely and two recovered incompletely.Of the 34 cases in group B,15 underwent surgery within 14 days and completely recovered from oculomotor palsy in 10-40 days.Sixteen patients underwent surgery in 14-30 days.of whom 14 completely recovered in 30-90 days and 2 recovered incompletely.The remaining three patients underwent surgery after more than 30 days,of whom two patients recovered completely and one recovered incompletely.Conclusions Early diagnosis and surgical treatment of patients with unilateral oculomotor palsy induced by posterior communicating aneurysm are important to full postoperative recovery of the oculomotor nerve.No correlation was found,however,between decompression of the

  17. Facial nerve paralysis after cervical traction.

    Science.gov (United States)

    So, Edmund Cheung

    2010-10-01

    Cervical traction is a frequently used treatment in rehabilitation clinics for cervical spine problems. This modality works, in principle, by decompressing the spinal cord or its nerve roots by applying traction on the cervical spine through a harness placed over the mandible (Olivero et al., Neurosurg Focus 2002;12:ECP1). Previous reports on treatment complications include lumbar radicular discomfort, muscle injury, neck soreness, and posttraction pain (LaBan et al., Arch Phys Med Rehabil 1992;73:295-6; Lee et al., J Biomech Eng 1996;118:597-600). Here, we report the first case of unilateral facial nerve paralysis developed after 4 wks of intermittent cervical traction therapy. Nerve conduction velocity examination revealed a peripheral-type facial nerve paralysis. Symptoms of facial nerve paralysis subsided after prednisolone treatment and suspension of traction therapy. It is suspected that a misplaced or an overstrained harness may have been the cause of facial nerve paralysis in this patient. Possible causes were (1) direct compression by the harness on the right facial nerve near its exit through the stylomastoid foramen; (2) compression of the right external carotid artery by the harness, causing transient ischemic injury at the geniculate ganglion; or (3) coincidental herpes zoster virus infection or idiopathic Bell's palsy involving the facial nerve.

  18. Dysphagia in cerebral palsy

    OpenAIRE

    Salghetti, Annamaria; Martinuzzi, Andrea

    2013-01-01

    Abstract. Feeding problemsare often present in children with neuromotor impairment: dysphagia is usuallyseen in the most severe form of cerebral palsy and it’s defined as thedifficulty with any of the four phases of swallowing. Clinical consequences aremalnutrition and recurrent chest infections that reduce expected duration andquality of life. In order to prevent these consequences it’s important todetect with clinical and instrumental examinations dysphagia symptoms and totreat them. Clinic...

  19. Nanomedicine in cerebral palsy

    OpenAIRE

    Balakrishnan B; Nance E; Johnston MV; Kannan R; Kannan S

    2013-01-01

    Bindu Balakrishnan,1 Elizabeth Nance,1 Michael V Johnston,2 Rangaramanujam Kannan,3 Sujatha Kannan1 1Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University; Baltimore, MD, USA; 2Department of Neurology and Pediatrics, Kennedy Krieger Institute, Baltimore, MD, USA; 3Department of Ophthalmology, Center for Nanomedicine, Johns Hopkins University, Baltimore, MD, USA Abstract: Cerebral palsy is a chronic childhood disorder that can have diverse etiologies. Injury to the...

  20. Missed ulnar nerve injury and closed forearm fracture in a child

    Institute of Scientific and Technical Information of China (English)

    Batra Amit; Devgan Ashish; Verma Vinit; Singh Raj; Batra Shivani; Magu Narender; Singla Rohit

    2013-01-01

    Ulnar nerve injury in closed fracture of forearm in children is uncommon.Commonly,neurapraxia is the reason for this palsy but other severe injuries or nerve entrapment has been reported in some cases.The importance of diagnosis concerning the types of the nerve injury lies in the fact that they have totally different management.We present a case of ulnar nerve deficit in a child following a closed fracture of the forearm bones.It is imperative to diagnose exact cause of palsy as it forms the basis for treatment.MRI scan can help diagnosis and accordingly guide the management.Simple nerve contusion should be treated conservatively,and exploration with fixation of the fracture should be done in lacerations and entrapments of the nerve.Surgery is not the treatment of choice in cases that could be managed conservatively.

  1. The value of blink reflex and facial nerve conduction in the Bell palsy%瞬目反射和面神经传导检测在Bell麻痹中的运用价值

    Institute of Scientific and Technical Information of China (English)

    张登宇; 薛寿儒

    2011-01-01

    目的:探讨瞬目反射和面神经传导检测在Bell麻痹患者的早期诊断和预后评估中的价值.方法:对39例Bell麻痹患者在病程为3 d(A组)和4~10 d(B组)时分别进行BR(Blink Reflex)、FNC(Facial Nerve Conduction)检测,3个月(C组)后复查.结果:R1﹑R2﹑R2′波缺失者24例预后较差,仅15例患侧较健侧各波延长者预后较好,其中R1/M潜伏期比值提示27例表现为茎乳孔内段损害,7例为外段损害,5例较大范围受累.结论:BR、FNC检测可客观地评价面神经损害的程度及部位,对临床诊断及预后有指导意义.

  2. Combined radial and median nerve injury in diaphyseal fracture of humerus: a case report

    OpenAIRE

    Rohilla Rajesh; Singla Rohit; Magu Narender Kumar; Singh Roop; Devgun Ashish; Mukhopadhyay Reetadyuti; Gogna Paritosh

    2013-01-01

    【Abstract】Radial nerve palsy is the most common neurological involvement in humeral shaft fractures. But combined radial and median nerve injury in a closed dia- physeal fracture of the humerus is rare. Combined injury to both radial and median nerve can cause significant disability. A detailed clinical examination is therefore necessary fol- lowing humeral shaft fractures. We report a patient with closed diaphyseal humeral fracture (AO 12A-2.3) together with radial an...

  3. Middle ear osteoma causing progressive facial nerve weakness: a case report

    OpenAIRE

    Curtis, Kate; Bance, Manohar; Carter, Michael; Hong, Paul

    2014-01-01

    Introduction Facial nerve weakness is most commonly due to Bell’s palsy or cerebrovascular accidents. Rarely, middle ear tumor presents with facial nerve dysfunction. Case presentation We report a very unusual case of middle ear osteoma in a 49-year-old Caucasian woman causing progressive facial nerve deficit. A subtle middle ear lesion was observed on otoscopy and computed tomographic images demonstrated an osseous middle ear tumor. Complete surgical excision resulted in the partial recovery...

  4. The therapy with the large dosage of methylprednisolone for the Bell palsy%大剂量甲基强的松龙冲击治疗面神经炎

    Institute of Scientific and Technical Information of China (English)

    魏新敏; 陆正齐; 蓝瑞琼

    2002-01-01

    @@ Background: The main pathological impairments include edema of facial nerve and different level degeneration of myelin sheath or axis cylinder in Bell's palsy. The prognosis of the disease results from severe degree of the disease and whether treatments are timely or not. The therapy with large dosages of Methylprednisolone (MPS) in vein for Bell's palsy, can relieve local edema,improve nerve conduction,avoid progressive impairments of myeline sheath and axis cylinder and promote repairs of myeline sheath.

  5. Therapeutic interventions in cerebral palsy.

    Science.gov (United States)

    Patel, Dilip R

    2005-11-01

    Various therapeutic interventions have been used in the management of children with cerebral palsy. Traditional physiotherapy and occupational therapy are widely used interventions and have been shown to be of benefit in the treatment of cerebral palsy. Evidence in support of the effectiveness of the neurodevelopmental treatment is equivocal at best. There is evidence to support the use and effectiveness of neuromuscular electrical stimulation in children with cerebral palsy. The effectiveness of many other interventions used in the treatment of cerebral palsy has not been clearly established based on well-controlled trials. These include: sensory integration, body-weight support treadmill training, conductive education, constraint-induced therapy, hyperbaric oxygen therapy, and the Vojta method. This article provides an overview of salient aspects of popular interventions used in the management of children with cerebral palsy. PMID:16391455

  6. Surgical outcomes of lateral approach for jugular foramen schwannoma: postoperative facial nerve and lower cranial nerve functions.

    Science.gov (United States)

    Cho, Yang-Sun; So, Yoon Kyoung; Park, Kwan; Baek, Chung-Hwan; Jeong, Han-Sin; Hong, Sung Hwa; Chung, Won-Ho

    2009-01-01

    The lateral surgical approach to jugular foramen schwannomas (JFS) may result in complications such as temporary facial nerve palsy (FNP) and hearing loss due to the complicated anatomical location. Ten patients with JFS surgically treated by variable methods of lateral approach were retrospectively reviewed with emphasis on surgical methods, postoperative FNP, and lower cranial nerve status. Gross total removal of the tumors was achieved in eight patients. Facial nerves were rerouted at the first genu (1G) in six patients and at the second genu in four patients. FNP of House-Brackmann (HB) grade III or worse developed immediately postoperatively in six patients regardless of the extent of rerouting. The FNP of HB grade III persisted for more than a year in one patient managed with rerouting at 1G. Among the lower cranial nerves, the vagus nerve was most frequently paralyzed preoperatively and lower cranial nerve palsies were newly developed in two patients. The methods of the surgical approach to JFS can be modified depending on the size and location of tumors to reduce injury of the facial nerve and loss of hearing. Careful manipulation and caution are also required for short facial nerve rerouting as well as for long rerouting to avoid immediately postoperative FNP.

  7. CEREBRAL PALSY : ANTENATAL RISK FACTORS

    Directory of Open Access Journals (Sweden)

    Srinivasa Rao

    2015-05-01

    Full Text Available INTRODUCTION: Cerebral palsy (CP is a group of permanent movement disorders that appear in early childhood. Cerebral palsy is caused by abnormal development or damage to the parts of the brain that control movement, balance, and posture. Most often the problems occur during pregnancy; however, they may also occur during childbirth, or shortly after birth. Often the cause is unknown. AIM: To study the different antenatal maternal risk factors associated with cerebral palsy in the study group. MATERIA LS AND METHODS: Retrospective study was done to assess possible associated antenatal risk factors for cerebral palsy. Mothers of 100 cerebral palsy children were selected who are treated in Rani Chandramani Devi Hospital, a Government hospital in Visakhapa tn am, Andhra Pradesh State, India , from 2012 to 2014 and 100 controls, mothers of normal children were studied. Detailed antenatal history was obtained from the mothers of the children in both affected and control group. RESULTS: From the data, we conclude that the association of maternal anaemia with cerebral palsy is 7.3 times higher; association of maternal hypertension with cerebral palsy is 6.6 time higher, association with Pre - eclampsia is 6 times higher; association with Eclampsia is 8.6 times higher ; with antepartum haemorrhage, the association is 8.6 times higher and association of multiple pregnancy with cerebral palsy is 4.8 times higher than with controls. CONCLUSION: From this study of the role of antenatal risk factors, in the occurrence of cer ebral palsy in children it is concluded that the most common risk factor associated with cerebral palsy is the maternal anaemia and the other important risk factors associated being hypertension, pre eclampsia, eclampsia, antepartum haemorrhage and multipl e births.

  8. Facial Nerve Schwannoma of Parotid Gland: Difficulties in Diagnosis and Management

    Directory of Open Access Journals (Sweden)

    Murat Damar

    2016-01-01

    Full Text Available Facial nerve schwannomas (FNS are encapsulated benign tumors arising from Schwann cells of seventh cranial nerve. Most of the facial nerve schwannomas are localized in intratemporal region; only 9% of cases involve a portion of the extratemporal segment. Preoperative diagnosis is often unclear; diagnosis is often made intraoperatively. Management of intraparotid FNS is troublesome because of the facial nerve paralysis. In this report we presented a case of intraparotid schwannoma in a 55-year-old male patient complaining of a painless mass without peripheral facial nerve palsy in left parotid gland. Clinical features, preoperative and intraoperative diagnosis, and difficulties during management are discussed with the review of the literature.

  9. Carotid-cavernous fistula caused by rupture of persistent primitive trigeminal artery trunk aneurysm--case report.

    Science.gov (United States)

    Yoshida, Masahiro; Ezura, Masayuki; Mino, Masaki

    2011-01-01

    A 60-year-old female presented with a carotid-cavernous fistula (CCF) manifesting as left abducens nerve palsy. Left internal carotid digital subtraction angiography showed a persistent primitive trigeminal artery (PPTA) near the CCF. Super-selective angiography showed direct shunt flow between the PPTA trunk aneurysm and the left cavernous sinus. The aneurysm was successfully occluded with detachable coils. The CCF disappeared and the PPTA was preserved. The abducens nerve paralysis had disappeared 6 months later. CCF caused by a PPTA trunk aneurysm is extremely rare. We speculate that the PPTA trunk aneurysm formed and then ruptured due to hemodynamic stress caused by hypoplasia of the basilar artery. PMID:21785245

  10. Progressive Supranuclear Palsy

    Science.gov (United States)

    ... Also, people with PSP show accumulation of the protein tau in affected brain cells, while people with Parkinson’s ... is the accumulation of abnormal deposits of the protein tau in nerve cells in the brain, so that ...

  11. Radiologic finding of facial nerve schwannoma

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Sun Yang; Kim, Dong Ik; Lee, Byung Hee; Chung, Tae Sub [Yonsei Univ. College of Medicine, Seoul (Korea, Republic of)

    1996-03-01

    To analyze the radilologic findings of facial nerve schwannoma. The authors retrospectively reviewed CT and/or MR images and clinical history of eight patients with histologically proven facial nerve schwannama. After classifying this extratemporal and intratemporal types, clinical and radilologic findings were analysed. The most common clinical findings of facial nerve schwannoma were facial nerve palsy and hearing impairment in an intratemporal schwannoma(4/5), and a palpable parotid mass in an extratemporal schwannoma(3/3). On CT, each involved segment of intratemporal schwannomas(five cases) showed characteristic radilologic findings, while extratemporal schwannomas(three cases) showed masses of various types. On MRI, all tumors(two cases) showed hypointensity of T1WI, hyperintensity on T2WI, and strong enhancement on Gd-DTPA enhanced T1WI. Intratemporal facial nerve schwannomas can be easily diagnosed by characteristic clinical and radilologic findings. Extratemporal facial nerve schwannomas show nonspecific findings. However, if the tumor is located between the superficial and the deep lobe of the parotid gland and extends to the posterior portion of the styloid process, then facial nerve schwannoma is strongly suspected.

  12. Managing the child with a diagnosis of Moebius syndrome: more than meets the eye.

    Science.gov (United States)

    McKay, Victoria H; Touil, Leila L; Jenkins, Dagan; Fattah, Adel Y

    2016-09-01

    Moebius syndrome (MBS) is a congenital, non-progressive facial and abducens nerve palsy in the presence of full vertical gaze and may be associated with limb abnormalities and craniofacial dysmorphisms. MBS is now defined as a disorder of rhombencephalic maldevelopment and recent gene discoveries have shown this to be a dominant disorder in a subset of patients. Accurate diagnosis and management by a multidisciplinary team with expertise in congenital facial palsy is paramount. PMID:26868039

  13. Peroneal nerve palsy due to compartment syndrome after facial plastic surgery Paralisia de nervo fibular devido a síndrome compartimental após cirurgia plástica da face

    Directory of Open Access Journals (Sweden)

    Clécio O. Godeiro-Júnior

    2007-09-01

    Full Text Available A 25-year-old white man, right after bilateral rhytidoplasty, presented with agitation, necessiting use of haloperidol. Some hours after, he developed severe pain in his legs and a diagnosis of neuroleptic malignant syndrome (NMS was considered. Even with treatment for NMS he still complained of pain. A diagnosis of lower limb compartment syndrome (CS was done only 12 hours after the initial event, being submitted to fasciotomy in both legs, disclosing very pale muscles, due to previous ischemia. This syndrome was not explained only by facial surgery, his position and duration of the procedure. It can be explained by a sequence of events. He had a history of pain in his legs during physical exercises, usually seen in chronic compartment syndrome. He used to take anabolizant and venlafaxine, not previously related, and the agitation could be related to serotoninergic syndrome caused by interaction between venlafaxine and haloperidol. Rhabdomyolisis could lead to oedema and ischmemia in both anterior leg compartment. This report highlights the importance of early diagnosis of compartment syndrome, otherwise, even after fasciotomy, a permanent disability secondary to peripheral nerve compression could occur.Logo após ritidoplastia bilateral, um jovem de 25 anos apresentou agitação, necessitando uso de haloperidol. Algumas horas após, desenvolveu dor intensa em membros inferiores, e o diagnóstico de síndrome neuroléptica maligna foi considerado. Mesmo com o tratamento para tal, persistiu com dor. Após 12 horas do início do quadro, foi realizado o diagnóstico de síndrome compartimental de membros inferiores e o jovem foi submetido a fasciotomia bilateral. Uma seqüência de eventos desencadeou esta síndrome, já que sua ocorrência dificilmente seria justificada pela cirurgia facial e/ou posição do paciente durante o procedimento. O jovem apresentava previamente dor em membros inferiores aos exercícios, sugerindo a ocorrência de uma s

  14. CEREBRAL PALSY AND MUSIC ACHIEVEMENT

    Directory of Open Access Journals (Sweden)

    Miodrag L. STOSHLJEVIKJ

    2008-12-01

    Full Text Available Pupils with cerebral palsy attend elementary education accordind to a regular and special teaching plan and program. Regular school curriculum was reformed in 1992, while special plan and program has not been changed and adapted according to pupil’s needs and capacities. Music is one of the best means of expressing oneself and plays a very important role in the development of every child, the child with cerebral palsy in particular.In order to test the possibility of pupils with cerebral palsy, with and without mental retardation, to apprehend the actual program content, we have conducted research on musical achievement of children with cerebral palsy. During 2007 a research was carried out, on the sample of 27 pupils with cerebral palsy and mild mental retardation who attended classes in the school “Miodrag Matikj”, and a sample of16 students with cerebral palsy without mental retardation who attended the school “Dr. Dragan Hercog” in Belgrade.Results of the research, as well as analysis of music curriculum content, indicated that the capacities of students with cerebral palsy to carry out the curriculum tasks require special approach and methodology. Therefore, we introduced some proposals to overcome the difficulties in fulfilling music curriculum demands of those pupils. We made special emphasis on the use of computer based Assistive technology which facilitates the whole process to a large extent.

  15. 3D-FT MRI of the facial nerve

    Energy Technology Data Exchange (ETDEWEB)

    Girard, N. (Neuroradiology, Hopital Nord, 13 Marseille (France)); Raybaud, C. (Neuroradiology, Hopital Nord, 13 Marseille (France)); Poncet, M. (Neuroradiology, Hopital Nord, 13 Marseille (France))

    1994-08-01

    Contrast-enhanced 3D-FT MRI of the intrapetrous facial nerve was obtained in 38 patients with facial nerve disease, using a 1.0 T magnet and fast gradient-echo acquisition sequences. Contiguous millimetric sections were obtained, which could be reformatted in any desired plane. Acutely ill patients, were examined within the first 2 months, included: 24 with Bell's palsy and 6 with other acute disorders (Herpes zoster, trauma, neuroma, meningeal metastasis, middle ear granuloma). Six patients investigated more than a year after the onset of symptoms included 3 with congenital cholesteatoma, 2 with neuromas and one with a chronic Bell's palsy. The lesion was found incidentally in two cases (a suspected neurofibroma and a presumed drop metastasis from an astrocytoma). Patients with tumours had nodular, focally-enhancing lesions, except for the leptomeningeal metastasis in which the enhancement was linear. Linear, diffuse contrast enhancement of the facial nerve was found in trauma, and in the patient with a middle ear granuloma. Of the 24 patients with an acute Bell's palsy 15 exhibited linear contrast enhancement of the facial nerve. Three of these were lost to follow-up, but correlation of clinical outcome and contrast enhancement showed that only 4 of the 11 patients who made a complete recovery and all 10 patients with incomplete recovery demonstrated enhancement. Possible explanations for these findings are suggested by pathological data from the literature. 3D-FT imaging of the facial nerve thus yields direct information about the of the nerve condition and defines the morphological abnormalities. It can also demonstrate contrast enhancement which seems to have some prognostic value in acute idiopathic Bell's palsy. (orig.)

  16. Bell's palsy and choreiform movements during peginterferon α and ribavirin therapy

    Institute of Scientific and Technical Information of China (English)

    Sener Barut; Hatice Karaer; Erol Oksuz; Asl Gündodu Eken; Ayse Nazl Basak

    2009-01-01

    Neuropsychiatric side effects of long-term recombinant interferon-α therapy consist of a large spectrum of symptoms. In the literature, cranial neuropathy, especially Bell's palsy, and movement disorders, have been reported much less often than other neurotoxic effects. We report a case of Bell's palsy in a patient with chronic hepatitis C during peginterferon-α and ribavirin therapy. The patient subsequently developed clinically inapparent facial nerve involvement on the contralateral side and showed an increase in choreic movements related to Huntington's disease during treatment.

  17. Prosthodontic Rehabilitation of Patients with Bell’s Palsy: Our Experience

    OpenAIRE

    Rajapur, Anand; Mitra, Nirban; Prakash, V Jeevan; Rah, Sajad Ahmad; Thumar, Sagar

    2015-01-01

    Bell’s palsy is an idiopathic unilateral lower motor neuron paresis or paralysis of the facial nerve of sudden onset. It involves loss of muscular control on the affected side of the face. This paper reports the prosthodontic management of patients with Bell’s palsy and also describes a technique to stabilize the jaw movements in complete denture patients using interim dentures. A 65-year-old male edentulous patient and a 55-year-old female edentulous patient reported to the department of pro...

  18. 针灸在神经修复中的应用%Acupuncture Used in Recurrent of Nerve

    Institute of Scientific and Technical Information of China (English)

    邢海燕

    2012-01-01

      针灸治疗外伤后腓总神经麻痹一例,神经修复良好,功能恢复满意。%  One case of common peroneal nerve palsy which is caused by injury therapied by acupuncture, the recurrent of nerve is good, the return of function is satisfy.

  19. Prevalence of nerve-vessel contact at cisternal segments of the oculomotor nerve in asymptomatic patients evaluated with magnetic resonance images

    Institute of Scientific and Technical Information of China (English)

    WANG Jin; GONG Xiang-yang; SUN Yi; HU Xing-yue

    2010-01-01

    Background Some studies indicated that cases of idiopathic oculomotor nerve palsy can be explained by vascular compression of the oculomotor nerve. Vascular contact with or compression to the cisternal segment of the oculomotor nerve has been reported frequently in asymptomatic individuals. In this study, we retrospectively analyzed the relationship between the oculomotor nerve's cisternal segment and adjacent arteries in asymptomatic patients and the prevalence of this occurrence via magnetic resonance imaging (MRI).Method MRI of bilateral oculomotor nerves in 93 asymptomatic patients were reviewed. The oculomotor nerve-artery relationship was evaluated and classified from levels 1 to 3, representing the degrees of contact on oblique transverse and oblique sagittal reconstructed MRI. Prevalence of the nerve-artery relationship at each level was described. The correlation between the nerve-vessel relationship (levels) and the age was analyzed by Spearman's rank correlation analysis.Results Cisternal segment of the oculomotor nerve did not have contact with any artery (level 1) in 27.4% (51/186) nerves. One hundred nerves made contact with at least one artery (level 2), but their shapes or configurations were not changed; 35 nerves (18.8%) were displaced or distorted due to artery compression (level 3). The posterior cerebral artery had the greatest incidence of making contact with or compressing the cisternal segment of the oculomotor nerve (58.1%). No significant correlation between nerve-vessel relationship (levels) and the age was found in this study. Conclusions Whether oculomotor nerve contact with or compression by one or more arteries is of high prevalence in asymptomatic individuals as evidenced by MRI examination. There is no correlation with individual age. Discretion should be used when making an etiological diagnosis of vascular compression for patients with oculomotor nerve palsy. Further investigation of other causes is warranted.

  20. Pathology and surgery of bell's palsy: A report of 108 cases subjected to the ballance-duel operation

    Directory of Open Access Journals (Sweden)

    Karsten Kettel

    1954-12-01

    Full Text Available The majority of cases of Bell's palsy are due to ischaemia of the facial nerve near the stylomastoid foramen. Following lack of blood supply the nerve loses its power of conduction, and venous stasis arises with ensuing swelling of the nerve, which becomes secondarily compressed within the Fallopian canal. The therapy of choice is medical treatment aiming to relieve the vasoconstriction and maintain the contractility of the muscles. Surgical decompression of the facial nerve is indicated in a limited number of cases, and the results of 108 operations are briefly recorded. Decompression should be performed in both fresh and relapsing palsies if no signs of spontaneous movement are observed after two months of observation. With patients in whom spontaneous recovery has ceased be-fored complete restitution has been obtained, further improvement may be expected from decompression.

  1. Malignant otitis externa with bilateral cranial nerve involvement: Report of a unique case

    Directory of Open Access Journals (Sweden)

    Somnath Saha

    2013-01-01

    Full Text Available Malignant otitis externa is an inflammatory condition caused by pseudomonas infection usually in the elderly diabetics, or an immunosuppressive condition that presents with diffuse otitis externa along with excruciating pain and granulations tissue in the external auditory meatus. Facial paralysis is common along with occasional involvement of other cranial nerves. Case report describing a patient of malignant otitis externa who presented to a tertiary referral hospital of eastern India. This patient had ipsilateral facial and tenth cranial nerve paralysis along with delayed-onset contralateral sixth and twelfth cranial nerve palsy. The patient was treated initially with intravenous anti-pseudomonal antibody followed by tympanic platectomy, facial nerve decompression and medialisation thyroplasty. The contralateral cranial nerve palsy was managed conservatively with partial recovery of function. Malignant otitis externa, though a common disease, may occasionally present with uncommon or unexplained presentations. The management of these cases should be prompt and aggressive and specifically address each of the debilitating complications.

  2. The masseteric nerve: a versatile power source in facial animation techniques.

    Science.gov (United States)

    Bianchi, B; Ferri, A; Ferrari, S; Copelli, C; Salvagni, L; Sesenna, E

    2014-03-01

    The masseteric nerve has many advantages including low morbidity, its proximity to the facial nerve, the strong motor impulse, its reliability, and the fast reinnervation that is achievable in most patients. Reinnervation of a neuromuscular transplant is the main indication for its use, but it has been used for the treatment of recent facial palsies with satisfactory results. We have retrospectively evaluated 60 patients who had facial animation procedures using the masseteric nerve during the last 10 years. The patients included those with recent, and established or congenital, unilateral and bilateral palsies. The masseteric nerve was used for coaptation of the facial nerve either alone or in association with crossfacial nerve grafting, or for the reinnervation of gracilis neuromuscular transplants. Reinnervation was successful in all cases, the mean (range) time being 4 (2-5) months for facial nerve coaptation and 4 (3-7) months for neuromuscular transplants. Cosmesis was evaluated (moderate, n=10, good, n=30, and excellent, n=20) as was functional outcome (no case of impairment of masticatory function, all patients able to smile, and achievement of a smile independent from biting). The masseteric nerve has many uses, including in both recent, and established or congenital, cases. In some conditions it is the first line of treatment. The combination of combined techniques gives excellent results in unilateral palsies and should therefore be considered a valid option.

  3. Bell's Palsy (Beyond the Basics)

    Science.gov (United States)

    ... changes caused by Bell's palsy will affect the appearance of your face, including how you smile. These ... are comfortable with some medical jargon. Patient information: Genital herpes (Beyond the Basics) Patient information: Shingles (Beyond ...

  4. Neurocysticercosis presenting as pseudobulbar palsy

    Directory of Open Access Journals (Sweden)

    Arinaganahalli Subbanna Praveen Kumar

    2014-01-01

    Full Text Available Neurocysticercosis (NCC is the most common helminthic infestation of the central nervous system (CNS and a leading cause of acquired epilepsy worldwide. The common manifestations of NCC are seizures and headache. The NCC as a cause of pseudobulbar palsy is very unusual and not reported yet in the literature. A pseudobulbar palsy can occur in any disorder that causes bilateral corticobulbar disease. The common etiologies of pseudobulbar palsy are vascular, demyelinative, or motor neuron disease. We report a 38-year-old female patient who presented with partial seizures and pseudobulbar palsy. The MRI brain showed multiple small cysts with scolex in both the cerebral hemispheres and a giant intraparenchymal cyst. Our patient responded well to standard treatment of neurocysticercosis and antiepileptics.

  5. Learn More About Cerebral Palsy

    Centers for Disease Control (CDC) Podcasts

    2008-03-30

    This podcast describes the causes, preventions, types, and signs and symptoms of cerebral palsy.  Created: 3/30/2008 by National Center on Birth Defects and Developmental Disabilities.   Date Released: 3/21/2008.

  6. Cerebral palsy: classification and etiology

    OpenAIRE

    Bialik, Gad M.; Givon, Uri

    2004-01-01

    Cerebral palsy (CP), a common condition of abnormalities in the brain, arises early in life. Since the term was first introduced in 1843, many authors have tried to define and classify CP. The most recent definition was released by the American Academy for Cerebral Palsy and Developmental Medicine (AACPDM) in 2005. This article summarizes the latest and familiar classifications of, and etiologies associated with CP.

  7. CEREBRAL PALSY : ANTENATAL RISK FACTORS

    OpenAIRE

    Srinivasa Rao; Vidyullatha; Subbalakshmi

    2015-01-01

    INTRODUCTION: Cerebral palsy (CP) is a group of permanent movement disorders that appear in early childhood. Cerebral palsy is caused by abnormal development or damage to the parts of the brain that control movement, balance, and posture. Most often the problems occur during pregnancy; however, they may also occur during childbirth, or shortly after birth. Often the cause is unknown. AIM: To study the different antenatal maternal risk factors associated with cere...

  8. Bone age in cerebral palsy

    OpenAIRE

    Miranda, Eduardo Régis de Alencar Bona; Palmieri, Maurício D'arc; de Assumpção, Rodrigo Montezuma César; Yamada, Helder Henzo; Rancan, Daniela Regina; Fucs, Patrícia Maria de Moraes Barros

    2013-01-01

    Objective To compare the chronological age and bone age among cerebral palsy patients in the outpatient clinic and its correlation with the type of neurological involvement, gender and functional status. Methods 401 patients with spastic cerebral palsy, and ages ranging from three months to 20 years old, submitted to radiological examination for bone age and analyzed by two independent observers according Greulich & Pyle. Results In the topographic distribution, there was a significant delay (p

  9. MR imaging of cerebral palsy

    Energy Technology Data Exchange (ETDEWEB)

    Saginoya, Toshiyuki [Urasoe General Hospital, Okinawa (Japan); Yamaguchi, Keiichiro; Kuniyoshi, Kazuhide [and others

    1996-06-01

    We evaluated 35 patients with cerebral palsy on the basis of MR imaging findings in the brain. The types of palsy were spastic quadriplegia (n=11), spastic diplegia (n=9), spastic hemiplegia (n=2), double hemiplegia (n=1), athetosis (n=10) and mixed (n=2). Of all patients, 28 (80%) generated abnormal findings. In spastic quadriplegia, although eight cases revealed severe brain damage, two cases showed no abnormal findings in the brain. One of the three had cervical cord compression caused by atlanto-axial subluxation. In spastic diplegia, the findings were divided according to whether the patient was born at term or preterm. If the patient had been born prematurely, the findings showed periventricular leukomalacia and abnormally high intensity in the posterior limbs of the internal capsule on T2-weighted images. MR imaging in spastic hemiplegia revealed cerebral infarction. In the athetoid type, half of all cases showed either no abnormal findings or slight widening of the lateral ventricle. Three cases showed abnormal signals of the basal ganglia. The reason why athetoid-type palsy did not show severe abnormality is unknown. We believe that MR imaging is a useful diagnostic modality to detect damage in the brain in cerebral palsy and plays an important role in the differentiation of cerebral palsy from the spastic palsy disease. (author)

  10. MR imaging of cerebral palsy

    International Nuclear Information System (INIS)

    We evaluated 35 patients with cerebral palsy on the basis of MR imaging findings in the brain. The types of palsy were spastic quadriplegia (n=11), spastic diplegia (n=9), spastic hemiplegia (n=2), double hemiplegia (n=1), athetosis (n=10) and mixed (n=2). Of all patients, 28 (80%) generated abnormal findings. In spastic quadriplegia, although eight cases revealed severe brain damage, two cases showed no abnormal findings in the brain. One of the three had cervical cord compression caused by atlanto-axial subluxation. In spastic diplegia, the findings were divided according to whether the patient was born at term or preterm. If the patient had been born prematurely, the findings showed periventricular leukomalacia and abnormally high intensity in the posterior limbs of the internal capsule on T2-weighted images. MR imaging in spastic hemiplegia revealed cerebral infarction. In the athetoid type, half of all cases showed either no abnormal findings or slight widening of the lateral ventricle. Three cases showed abnormal signals of the basal ganglia. The reason why athetoid-type palsy did not show severe abnormality is unknown. We believe that MR imaging is a useful diagnostic modality to detect damage in the brain in cerebral palsy and plays an important role in the differentiation of cerebral palsy from the spastic palsy disease. (author)

  11. Paresis of cranial nerves III, IV, and VI: clinical manifestation and differential diagnosis.

    Science.gov (United States)

    Carlow, T J

    1989-01-01

    Successful identification of the cranial nerve and ocular muscle responsible for a subjective complaint of diplopia requires an evaluation of the type and character of the double vision and not infrequently the use of a red glass or Maddox rod, especially in incomplete and subtle cases. An isolated third nerve lesion is most commonly seen with a supraclinoid aneurysm (pupil dilated and fixed), vascular disease (pupil spared), and trauma. Mild frontal head trauma and vascular disease are the most common etiologies associated with an isolated fourth nerve paresis. Tumor, vascular disease and trauma should be prime considerations when a patient presents with an isolated sixth nerve paresis. A child's diagnostic possibilities will differ from the adult: third nerve (congenital), fourth nerve (congenital), and sixth nerve (brainstem glioma, postviral or inflammatory). Finally, myasthenia gravis can readily mask or mimic an isolated or mixed cranial nerve palsy. A Tensilon test is always indicated in unexplained diplopia with ophthalmoplegia and normal pupils.

  12. Normal and pathological findings for the facial nerve on magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Al-Noury, K., E-mail: Kalnoury@kau.edu.sa [Department of Otolaryngology, King Abdulaziz University, Jeddah (Saudi Arabia); Lotfy, A. [Radiology Department, King Abdulaziz University Hospital and International Medical Centre, Jeddah (Saudi Arabia)

    2011-08-15

    Aim: To demonstrate the enhanced radiological anatomy and common pathological conditions of the facial nerve by using magnetic resonance imaging (MRI). Materials and methods: A retrospective review of the MRI findings of the facial nerve of 146 patients who visited a tertiary academic referral center was conducted. Results: The radiological anatomy of the facial nerve was well illustrated using MRI, as were most of the common pathological conditions of the facial nerve. Conclusions: Enhancement of the facial nerve in MRI should be correlated with the clinical data. Normal individuals can show enhancement of the tympanic or vertical segments of the facial nerve. Enhancement of the labyrinthine portion of the nerve is almost diagnostic of Bell's palsy. No specific enhancement patterns were observed for tumours or for infections of the middle or external ear. A larger population study is required for the accurate assessment of facial nerve enhancement in multiple sclerosis patients.

  13. Group A Streptococcal Suppurative Arthritis and Osteomyelitis of the Shoulder With Brachial Plexus Palsy in a Newborn.

    Science.gov (United States)

    Dierig, Alexa; Ritz, Nicole; Tacke, Uta; Heininger, Ulrich

    2016-10-01

    Osteoarticular infections in the newborn period are rare. A serious complication is paralysis of the affected extremity resulting from either pain or direct involvement of the nerve. We report a newborn with combined osteomyelitis and suppurative arthritis caused by Streptococcus pyogenes presenting with right brachial plexus palsy. PMID:27622687

  14. Diaphragmatic palsy after cardiac surgical procedures in patients with congenital heart

    Directory of Open Access Journals (Sweden)

    Talwar Sachin

    2010-01-01

    Full Text Available Paralysis of diaphragm on one or, exceptionally, both sides is a common cause of delayed recovery and excessive morbidity following pediatric cardiac surgery. The consequences of this complication after all forms of congenital heart surgery in newborns and young infants can be potentially serious. The impact of diaphragmatic palsy on the physiology after single ventricle palliations is particularly significant. It is necessary for all professionals taking care of children with heart disease to be familiar with the etiology, diagnosis, and management of this condition. Early recognition and prompt management of diaphragmatic palsy can potentially reduce the duration of mechanical ventilation and intensive care in those who develop this complication. This review summarizes the anatomy of the phrenic nerves, reasons behind the occurrence of diaphragmatic palsy, and suggests practical guidelines for management.

  15. Electrophysiological findings in a family with Hereditary Neuropathy and Liability to Pressure Palsies

    Directory of Open Access Journals (Sweden)

    S Khosrawi

    2005-05-01

    Full Text Available Hereditary neuropathy with liability to pressure palsies is an autosomal dominant and demyelinative peripheral neuropathy which characterized by reversible episodes of sensorimotor deficits after neural compression injuries. Their clinical hallmarks are recurrent and painless focal neuropathies maintly preceded by minor trauma or compression at entrapment sites of peripheral nerves. We describe multiple compression mononeuropathies in an individual who presented with left sided ulnar palsy after drilling for a period of 8 hours and report neurophysiologic findings in two clinically asymptomatic family members. We believe that this entity may be clinically and neurophysiologically underdiagnosed by orthopaedic surgeons and electromyographers. Electrophysiological abnormalities can be detected even in asymptomatic patients and it should be considered in differential diagnosis of patients with atypical presentations of compression neuropathies. Key Words: Hereditary Neuropathy with liability to Pressure Palsies- Electrodiagnostic tests

  16. Monocular Elevation Deficiency - Double Elevator Palsy

    Science.gov (United States)

    ... Español Condiciones Chinese Conditions Monocular Elevation Deficiency/ Double Elevator Palsy En Español Read in Chinese What is monocular elevation deficiency (Double Elevator Palsy)? Monocular Elevation Deficiency, also known by the ...

  17. Ganglioneuromas involving the hypoglossal nerve and the vagus nerve in a child: Surgical difficulties.

    Science.gov (United States)

    Bakshi, Jaimanti; Mohammed, Abdul Wadood; Lele, Saudamini; Nada, Ritambra

    2016-02-01

    Ganglioneuromas are benign tumors that arise from the Schwann cells of the autonomic nervous system. They are usually seen in the posterior mediastinum and the paraspinal retroperitoneum in relation to the sympathetic chain. In the head and neck, they are usually related to the cervical sympathetic ganglia or to the ganglion nodosum of the vagus nerve or the hypoglossal nerve. We describe what we believe is the first reported case of multiple ganglioneuromas of the parapharyngeal space in which two separate cranial nerves were involved. The patient was a 10-year-old girl who presented with a 2-year history of a painless and slowly progressive swelling on the left side of her neck and a 1-year history hoarseness. She had no history of relevant trauma or surgery. Intraoperatively, we found two tumors in the left parapharyngeal space-one that had arisen from the hypoglossal nerve and the other from the vagus nerve. Both ganglioneuromas were surgically removed, but the affected nerves had to be sacrificed. Postoperatively, the patient exhibited hypoglossal nerve and vocal fold palsy, but she was asymptomatic. In addition to the case description, we discuss the difficulties we faced during surgical excision.

  18. Korioamnionitis sebagai Faktor Risiko Terjadinya Palsi Serebral

    OpenAIRE

    Lubis, Siska Mayasari

    2010-01-01

    Cerebral palsy affects motion, muscle strength, balance, and coordination. Despite improvements in perinatal medicine, the prevalence of cerebral palsy has increased over the last 2 decades, and the etiology of cerebral palsy remains poorly understood. Evidence suggests that 70-80% of cases are due to prenatal factors, and that birth asphyxia plays a relatively minor role. A number of studies have assessed the relationship between chorioamnionitis and cerebral palsy in infants. Multicenter co...

  19. Cutaneous nerve entrapment syndrome

    Institute of Scientific and Technical Information of China (English)

    DongFuhui

    2004-01-01

    The cutaneous nerve entrapment syndrome is named that, the cutaneous nerve's functional disorder caused by some chronic entrapment, moreover appears a series of nerve's feeling obstacle,vegetative nerve function obstacle, nutrition obstacle, even motor function obstacle in various degree.

  20. Nerve biopsy (image)

    Science.gov (United States)

    Nerve biopsy is the removal of a small piece of nerve for examination. Through a small incision, a sample ... is removed and examined under a microscope. Nerve biopsy may be performed to identify nerve degeneration, identify ...

  1. Neuroevolutional Approach to Cerebral Palsy and Speech.

    Science.gov (United States)

    Mysak, Edward D.

    Intended for cerebral palsy specialists, the book emphasizes the contribution that a neuroevolutional approach to therapy can make to habilitation goals of the child with cerebral palsy and applies the basic principles of the Bobath approach to therapy. The first section discusses cerebral palsy as a reflection of disturbed neuro-ontogenisis and…

  2. Large oculomotor nerve schwannoma - Rare entity: A case report with review of literature

    Directory of Open Access Journals (Sweden)

    L Pavan Kumar

    2014-01-01

    Full Text Available Schwannomas commonly arise from peripheral nerves. Intracranial schwannomas are comparatively rare and are seen commonly as vestibular tumors. Oculomotor nerve schwannomas are extremely rare tumors, these are usually symptomatic. A 29 year aged male presented with diplopia and blurring of vision in left eye and found to have an extra-axial lesion at left cavernous sinus involving oculomotor nerve. The excised tumor showed classic morphology of a schwannoma. Postoperatively patient developed complete oculomotor nerve palsy. The tumor recurred after 2 years. It was re-excised followed by radiotherapy.

  3. Occipital Condyle Fracture With Isolated Unilateral Hypoglossal Nerve Palsy

    OpenAIRE

    Yoon, Jin Won; Lim, Oh Kyung; Park, Ki Deok; Lee, Ju Kang

    2014-01-01

    Occipital condyle fractures (OCFs) with selective involvement of the hypoglossal canal are rare. OCFs usually occur after major trauma and combine multiple fractures. We describe a 38-year-old man who presented with neck pain and a tongue deviation to the right side after a traffic accident. Severe limitations were detected during active and passive range of neck motion in all directions. A physical examination revealed a normal gag reflex and normal mobility of the palate, larynx, and should...

  4. Treatment of the spasticity in children with cerebral palsy.

    Science.gov (United States)

    Meholjić-Fetahović, Ajsa

    2007-11-01

    Botulinum toxin is a natural purified protein and one of the strongest biological poisons--neurotoxin. It is produced by the bacterium Clostridium botulinum. Its medical usage started in USA in 1981 and in Europe in 1992. There are seven different immune types of the toxin: A, B, C1, D, E, F and G. Toxin types A and B are used to decrease muscular spasticity. Botulinum toxin prevents the formation of acetylcholine from cholinergic nerve tissues in muscles, which in the end irreversibly destroys neuromuscular synapses. It is called temporary local chemodenervation. It does not affect the synthesis of acetylcholine. As it affects neuromuscular bond it also affects one of the symptoms of cerebral palsy--spasticity. Decreasing the spasticity of children with cerebral palsy leads to the improvement of conscious movements, muscles are less toned, passive mobility is improved, orthosis tolerance is also improved, and the child is enabled to perform easier and better motor functions such as crawling, standing and walking. Since the action of Botulinum toxin is limited to 2-6 months, new neural collaterals are formed and neuromuscular conductivity is reestablished which in the end once again develops a muscular spasm. This leads to a conclusion that botulinum toxin should again be applied into spastic muscles. It is very important for good effect of Botulinum toxin to set the goals of the therapy in advance. The goals include improvement of a function, prevention of contractions and deformities, ease of care and decrease of pain for children with cerebral palsy. After application of botulinum toxin, it is necessary to perform adequate and intensive physical treatment with regular monitoring of effects. This work shows a case of a boy with spastic form of cerebral palsy. After being rehabilitated using Vojta therapy and Bobath concept and the conduct of certain physical procedures, botulinum toxin is administered into his lower limbs' muscles and kinesiotherapy is

  5. Causes of Acquired Vocal Cord Palsy in Indian Scenario.

    Directory of Open Access Journals (Sweden)

    Swapna Sebastian

    2012-10-01

    Full Text Available Vocal cord paresis or paralysis occurs due to lesion in the vagus nerve. Vocal cord paralysis can lead to dysphonia as well as dysphagia which lead the patient to frustration and emotional problems. The literature available on the etiology and the problems faced by them in Indian population is very scanty. Hence a prospective study was done on 41 Patients with vocal cord palsy who were referred to the Department of ENT for voice assessment and management from March 1st 2012 till 1st August 2012. The medical and surgical reports were examined. They were evaluated by an otorhinolaryngologist, and a Speech Language Pathologist. Diagnosis was made based on video stroboscopic findings. We also examined voice-related quality of life (V-RQOL outcomes in these patients. In this study, endo-tracheal intubation (15/41; 36.5% was the major cause of vocal cord palsy. The second major cause for vocal cord palsy in our study was surgical trauma (iatrogenic which constituted 26.8% (11/41, out of which thyroidectomy contributed to 81.81% (9/11 and cardiac surgery (Coronary Artery Bypass Grafting (CABG contributed to 18.18% (2/11. Neurological problems caused 14.63% (6/41 of the total cases. Non-surgical trauma constituted 9.75% (4/41 of the total patients. Left recurrent laryngeal nerve paralysis was found as a complication of heart disease in 7.3%(3/41. Tuberculosis of lungs and cancer of lungs accounted to be the rarest causes. Hoarseness of voice was the most common symptom with associated dysphagia in a few. The voice related quality of life of these patients was found to be poor. They were found to have problems in the social-emotional domain and physical functioning domain.

  6. Prednisolone and acupuncture in Bell's palsy: study protocol for a randomized, controlled trial

    Directory of Open Access Journals (Sweden)

    Wang Kangjun

    2011-06-01

    Full Text Available Abstract Background There are a variety of treatment options for Bell's palsy. Evidence from randomized controlled trials indicates corticosteroids can be used as a proven therapy for Bell's palsy. Acupuncture is one of the most commonly used methods to treat Bell's palsy in China. Recent studies suggest that staging treatment is more suitable for Bell's palsy, according to different path-stages of this disease. The aim of this study is to compare the effects of prednisolone and staging acupuncture in the recovery of the affected facial nerve, and to verify whether prednisolone in combination with staging acupuncture is more effective than prednisolone alone for Bell's palsy in a large number of patients. Methods/Design In this article, we report the design and protocol of a large sample multi-center randomized controlled trial to treat Bell's palsy with prednisolone and/or acupuncture. In total, 1200 patients aged 18 to 75 years within 72 h of onset of acute, unilateral, peripheral facial palsy will be assessed. There are six treatment groups, with four treated according to different path-stages and two not. These patients are randomly assigned to be in one of the following six treatment groups, i.e. 1 placebo prednisolone group, 2 prednisolone group, 3 placebo prednisolone plus acute stage acupuncture group, 4 prednisolone plus acute stage acupuncture group, 5 placebo prednisolone plus resting stage acupuncture group, 6 prednisolone plus resting stage acupuncture group. The primary outcome is the time to complete recovery of facial function, assessed by Sunnybrook system and House-Brackmann scale. The secondary outcomes include the incidence of ipsilateral pain in the early stage of palsy (and the duration of this pain, the proportion of patients with severe pain, the occurrence of synkinesis, facial spasm or contracture, and the severity of residual facial symptoms during the study period. Discussion The result of this trial will assess the

  7. Overview of pediatric peripheral facial nerve paralysis: analysis of 40 patients.

    Science.gov (United States)

    Özkale, Yasemin; Erol, İlknur; Saygı, Semra; Yılmaz, İsmail

    2015-02-01

    Peripheral facial nerve paralysis in children might be an alarming sign of serious disease such as malignancy, systemic disease, congenital anomalies, trauma, infection, middle ear surgery, and hypertension. The cases of 40 consecutive children and adolescents who were diagnosed with peripheral facial nerve paralysis at Baskent University Adana Hospital Pediatrics and Pediatric Neurology Unit between January 2010 and January 2013 were retrospectively evaluated. We determined that the most common cause was Bell palsy, followed by infection, tumor lesion, and suspected chemotherapy toxicity. We noted that younger patients had generally poorer outcome than older patients regardless of disease etiology. Peripheral facial nerve paralysis has been reported in many countries in America and Europe; however, knowledge about its clinical features, microbiology, neuroimaging, and treatment in Turkey is incomplete. The present study demonstrated that Bell palsy and infection were the most common etiologies of peripheral facial nerve paralysis.

  8. Electromyography: prognosis and evaluation of the efficiency of therapy for Bell's palsy

    Directory of Open Access Journals (Sweden)

    N G Savitskaya

    2011-01-01

    Full Text Available The paper presents the results of clinical and electromyographic studies in 182 patients with idiopathic facial neuropathy (BellXs palsy. The most commonly studied parameters of electroneuromyography (ENMG were compared to determine a good or poor prognosis for recovery. The most sensitive parameters were shown to be nerve excitability threshold in the acutest period (up to 5 days, M-response amplitude fall

  9. Association of Bell's Palsy with Hepatitis E Virus Infection: A Rare Entity

    OpenAIRE

    Ashish K. Jha; Nijhawan, Sandeep; Nepalia, Subhash; Suchismita, Arya

    2012-01-01

    Hepatitis E virus (HEV) infection is a common cause of acute hepatitis in India and other developing countries. The data regarding the neurologic manifestation of HEV infection are limited. The neurologic disorders including Guillain–Barré syndrome, polyradiculopathy, neuralgic amyotrophy, encephalitis, bilateral brachial neuritis, ataxia/proximal myopathy, and acute transverse myelitis have been described. Bell's palsy and other cranial nerve involvement in hepatitis A virus (HAV) and HEV in...

  10. Bilateral Abducent Palsy in Leptospirosis- An Eye Opener to a Rare Neuro Ocular Manifestation: A Case Report

    Directory of Open Access Journals (Sweden)

    Mahadevaiah Mahesh

    2015-11-01

    Full Text Available Leptospirosis, a disease of great significance in tropical countries, presents commonly as a biphasic illness with acute febrile episode in the first phase followed by a brief afebrile period and then by the second phase of fever with or without jaundice and renal failure. However, it has varied manifestations and unusual clinical features ascribed to immunological phenomena can occur due to the additional involvement of pulmonary, cardiovascular, and neurological systems. Among the various neurological features, aseptic meningitis is the most common myeloradiculopathy, myelopathy, cerebellar dysfunction, transverse myelitis, Guillain-Barre syndrome, optic neuritis, peripheral neuropathy are also described. Cranial neuropathy involving facial nerve is a rare, but known neurological manifestation. Sixth nerve palsy in neuroleptospirosis has so far not been reported. We hereby present the occurrence of bilateral abducent nerve palsy in a patient with leptospirosis.

  11. Zolpidem in Progressive Supranuclear Palsy

    Directory of Open Access Journals (Sweden)

    Sandip K. Dash

    2013-01-01

    Full Text Available Progressive supranuclear palsy (PSP is a progressive neurodegenerative disorder, characterized by motor symptoms, postural instability, personality changes, and cognitive impairment. There is no effective treatment for this disorder. Reduced neurotransmission of GABA in the striatum and globus pallidus may contribute to the symptoms of motor and cognitive symptoms seen in PSP. Zolpidem is a GABA agonist of the benzodiazepine subreceptor BZ1. Here a nondiabetic, normotensive case of PSP is (Progressive Supranuclear Palsy described, which showed improvement in swallowing, speech, and gaze paresis after zolpidem therapy and possible mechanism of actions are discussed. However, more trials are needed with large number of patients to confirm the effectiveness of zolpidem in progressive supranuclear palsy.

  12. Facial nerve neurinoma presenting as middle cranial fossa and cerebellopontine angle mass : a case report.

    Directory of Open Access Journals (Sweden)

    Devi B

    2000-10-01

    Full Text Available Facial nerve neurinomas are rare. The tumours arising from the geniculate ganglion may grow anteriorly and superiorly and present as a mass in the middle cranial fossa. Only a few cases of facial nerve neurinomas presenting as middle cranial fossa mass have so far been reported. These tumours present with either long standing or intermittent facial palsy along with cerebellopontine angle syndrome.

  13. Surgical trainees neuropraxia? An unusual case of compression of the lateral cutaneous nerve of the forearm.

    LENUS (Irish Health Repository)

    Seoighe, D M

    2010-09-01

    Compression of the lateral cutaneous nerve of the forearm is an uncommon diagnosis but has been associated with strenuous upper limb activity. We report the unique case of a 32-year-old male orthopaedic trainee who suffered this nerve palsy as a result of prolonged elbow extension and forearm pronation while the single assistant during a hip resurfacing procedure. Conservative measures were sufficient for sensory recovery to be clinically detectable after 12 weeks.

  14. Operative treatment with nerve repair can restore function in patients with traction injuries in the brachial plexus

    DEFF Research Database (Denmark)

    Stiasny, Jerzy; Birkeland, Peter

    2015-01-01

    INTRODUCTION: Brachial plexus injuries are usually a result of road traffic accidents and a cause of severe disability that typically affects young adult males. In 2010, a national centre was established for referral of these cases from Danish trauma centres. In this paper, we report on our...... or transfers for nerve repairs based on the pattern of nerve injury seen intraoperatively. RESULTS: Overall, 24 patients were operated, and 12 patients were included in the outcome analysis. The six patients with upper brachial plexus palsies all regained shoulder function and useful elbow flexion. Of the six...... patients with complete brachial plexus palsies, four regained shoulder function, while only one regained useful elbow function, and this was after nerve transfers. CONCLUSION: Operative treatment provides satisfactory results in patients with upper brachial plexus palsies, while improvement is warranted...

  15. Lifetime costs of cerebral palsy

    DEFF Research Database (Denmark)

    Kruse, Marie; Michelsen, Susan Ishøy; Flachs, Esben Meulengracht;

    2009-01-01

    This study quantified the lifetime costs of cerebral palsy (CP) in a register-based setting. It was the first study outside the US to assess the lifetime costs of CP. The lifetime costs attributable to CP were divided into three categories: health care costs, productivity costs, and social costs....... The population analyzed was retrieved from the Danish Cerebral Palsy Register, which covers the eastern part of the country and has registered about half of the Danish population of individuals with CP since 1950. For this study we analyzed 2367 individuals with CP, who were born in 1930 to 2000 and were alive...

  16. CEREBRAL PALSY AND MUSIC ACHIEVEMENT

    OpenAIRE

    Miodrag L. STOSHLJEVIKJ; EMINOVIKJ Fadilj N.; NIKIKJ Radmila M.; Gordana I. ACHIKJ; Sanela R. PACIKJ

    2015-01-01

    Pupils with cerebral palsy attend elementary education accordind to a regular and special teaching plan and program. Regular school curriculum was reformed in 1992, while special plan and program has not been changed and adapted according to pupil’s needs and capacities. Music is one of the best means of expressing oneself and plays a very important role in the development of every child, the child with cerebral palsy in particular.In order to test the possibility of pupils with cerebral pal...

  17. Contemporary management of Bell palsy.

    Science.gov (United States)

    Jowett, Nate; Hadlock, Tessa A

    2015-04-01

    Bell palsy (BP) is the most common diagnosis in acute and chronic facial palsy. Although most patients fully recover, more than one-quarter will have residual dysfunction. Of these, nearly half will demonstrate severe limitations in facial expression. Though significant attention has been paid to acute management and prognosis, a paucity of literature exists addressing management of the long-term sequelae of BP. This article describes contemporary use of physical therapy, injectables, and static and dynamic surgical procedures in facial reanimation of acute and chronic BP. PMID:25958893

  18. Facial nerve neuromas: MR imaging. Report of four cases

    Energy Technology Data Exchange (ETDEWEB)

    Martin, N. (G.H. Pitie-Salpetriere, 75 - Paris (France). Dept. of Neuroradiology); Sterkers, O. (Hospital Beaujon, Clichy (France). Dept. of Otorhinolaryngology); Mompoint, D.; Nahum, H. (Hopital Beaujon, Clichy (France). Dept. of Radiology)

    1992-02-01

    Four cases of facial nerve neuroma were evaluated by computed tomographic (CT) scan and magnetic resonance imaging (MRI). The extension of the tumor in the petrous bone or the parotid gland was well defined by MRI in all cases. CT scan was useful to demonstrate bone erosions and the relation of the tumor to inner ear structures. In cases of progressive facial palsy, CT and MRI should be combined to detect a facial neuroma and to plan the surgical approach for tumor removal and nerve grafting. (orig.).

  19. Schwannoma of the 6th nerve: case report and review of the literature

    Institute of Scientific and Technical Information of China (English)

    Xin Li; Jingjun Li; Jing Li; Zhen Wu

    2015-01-01

    Introduction: Schwannomas of the 6th nerve are extremely rare.Only 22 cases of intracranial schwannomas of the 6th cranial nerve pathologically confirmed have been reported.Case Presentation: Here, we report a case of a 14-year-old girl who presented with isolated progressive 6th nerve palsy.A cisternal type of schwannomawas found from neuro-imaging.Subtotal removal of the tumor was performed by a routine left subtemporal craniotomy with an petrosectomy.The attachment to the 6th nerve was found.After surgery, the patient's 6th nerve palsy remained.Histological images revealed a cellular schwannoma.Then the classification, clinical presentation, diagnosis, operation, stereotactic radiosurgery are reviewed.Conclusions: The location and the attachment to the 6th nerve is the key for diagnosis.Most cases are treated surgically.It looks like it is not easy to completely remove for CA type because of invasion of the cavernous sinus or firm adherence to the nerves.The 6th nerve function seldom completely recovered postoperatively.The direction of further research is to improve the diagnosis and therapy to have better nerve recovery.

  20. Combined radial and median nerve injury in diaphyseal fracture of humerus: a case report

    Directory of Open Access Journals (Sweden)

    Rohilla Rajesh

    2013-12-01

    Full Text Available 【Abstract】Radial nerve palsy is the most common neurological involvement in humeral shaft fractures. But combined radial and median nerve injury in a closed dia- physeal fracture of the humerus is rare. Combined injury to both radial and median nerve can cause significant disability. A detailed clinical examination is therefore necessary fol- lowing humeral shaft fractures. We report a patient with closed diaphyseal humeral fracture (AO 12A-2.3 together with radial and median nerve palsy, its management and review of the literature. As the patient had two nerves involved, surgical exploration was planned. Fracture was reduced and fixed with a 4.5 mm narrow dynamic compres- sion plate. There was no external injury to both radial and median nerves on surgical exploration. Neurological reco- very started at 3 weeks’ follow-up. Complete recovery was seen at 12 weeks. Careful clinical examination is of the ut- most importance in early diagnosis of combined nerve injuries, which allows better management and rehabilitation of the patient. Key words: Humeral fractures; Radial nerve; Me- dian nerve; Diaphyses; Paralysis

  1. 颈总动脉周围交感神经网剥脱切除术治疗脑性瘫痪患儿的效果及对其认知功能的影响%Effect of excision of peripheral sympathetic nerve network in common carotid artery in children with cerebral palsy and its effect on their cognitive function

    Institute of Scientific and Technical Information of China (English)

    赵家鹏; 王家勤; 常崇旺; 王玉峰; 马世江; 冯宇飞

    2015-01-01

    Objective To explore the clinical effect of excision of peripheral sympathetic nerve network in common carotid artery on children with cerebral palsy (CP)and the effect on their cognitive function. Methods A ret-rospective study method was admitted to preschool children with CP in 69 cases in Center of Brain Disease,the Third Hospital Affiliated to Xinxiang Medical University from July 2008 to August 2014, the common carotid artery sympathetic with the surrounding network stripping off resection treatment of 43 cases ( surgery group) ,without the use of surgery in the treatment of children with 26 cases ( no operation group) . The muscle tension improved, movement to improve the ability of 2 groups before and after treatment 6 months were detected and compared. Developmental quotient ( DQ) ,intelligence quotient ( IQ) ,bilateral middle cerebral artery ( MCA) hemodynamic index difference were deter-mined between 2 groups before and after treatment 6 months. Results After treatment 6 months,the muscle tension score and walking ability score of the surgery group were significantly better than those of no operation group [(2. 2± 1. 1) scores vs (4. 5±0. 6)scores,(3. 5±0. 7) scores vs (2. 7±0. 8) scores,all P<0. 05],and significantly improved compared with before treatment[(4. 8±0. 6)scores,(2. 2±0. 9)scores,all P<0. 05]. After treatment 6 months,the IQ score,fine motor, social adaptation, personal social, language score and MCA mean velocity ( MV ) , peak velocity ( PV) ,resistance index ( RI) ,pulsatility index ( PI) determination value of the surgery group were significantly higher than those of no operation group and before treatment (all P<0. 05). Conclusions Excision of peripheral sympathetic nerve network on common carotid artery has a good clinical effect in the treatment of CP , and can significantly improve the cognitive function of children with CP .%目的:探讨颈总动脉周围交感神经网剥脱切除术治疗脑性瘫痪( CP )患儿的临床

  2. Embodying Investigations of Cerebral Palsy

    DEFF Research Database (Denmark)

    Martiny, Kristian Møller Moltke

    The main question of Kristian Martiny’s dissertation is: how do we help persons living with the brain damage, cerebral palsy (CP)? This question is as complex and difficult to answer as any healthcare question. Martiny argues that we need to ‘open up’ how we do ( cognitive ) science in order...

  3. A Case of Multiple Sclerosis Presented with 5th, 6th and 7th Cranial Nerve Paralysis

    Directory of Open Access Journals (Sweden)

    Almila Sarıgül

    2015-04-01

    Full Text Available A 36-year-old female patient was admitted to our clinic with complaints of numbness in hands, double vision, and inability to close her left eye. Her physical examination revealed horizontal diplopia, underactivity of the left lateral rectus muscle, left peripheral facial paralysis, and trigeminal sensorial neuropathy. The magnetic resonance imaging revealed hyperintense lesions, which were compatible with multiple sclerosis (MS. Therefore, systemic steroid treatment (1000 mg/day intravenous methylprednisolone for 5 days, 1 mg/ kg/day oral prednisolone, reduced slowly was administered to the patient. Within five weeks, her symptoms were regressed, and no recurrence was observed during the follow-up period of 4 years. As this case proves, MS can present with cranial nerve palsies in addition to many other different neurological symptoms. Although 5th nerve palsy is the most common cranial nerve palsy detected in MS patients, 7th and 6th nerve involvement are rarely reported in the literature. MS should always be considered in the differential diagnosis of cranial nerve palsies especially in young patients. (Turk J Ophthalmol 2015; 45: 81-3

  4. Temperament of premature infants with cerebral palsy

    OpenAIRE

    Ryu, Hyo Jeong; Don Kim, Kyoung

    2015-01-01

    [Purpose] The purpose of this study was to examine the infant temperaments of children with cerebral palsy due to premature birth. [Subjects and Methods] Data were collected through questionnaires sent to 118 mothers of infants diagnosed with cerebral palsy due to premature birth. [Results] Different infant temperament scores were obtained according to the degrees of disability, type of palsy, birth weights, gestational age, and periods of hospitalization in an NICU; however, the differences ...

  5. Parental age, genetic mutation, and cerebral palsy.

    OpenAIRE

    Fletcher, N A; Foley, J

    1993-01-01

    Parental age and birth order were studied in 251 patients with cerebral palsy. No parental age or birth order effects were observed in spastic quadriplegia or diplegia, but a paternal age effect was detected in those with athetoid/dystonic cerebral palsy and congenital hemiplegia. These observations indicate that some cases of athetoid/dystonic or hemiplegic cerebral palsy might arise by fresh dominant genetic mutation.

  6. Cerebral palsy in very low birthweight infants.

    OpenAIRE

    Cooke, R W

    1990-01-01

    Eighty one very low birthweight survivors with cerebral palsy were matched with controls by sex, gestational age, and place of birth. Using discriminant analysis, the perinatal profiles for infants with cerebral palsy and their controls were shown to differ significantly. When infants with various types of cerebral palsy were analysed with their controls the discriminating variables differed. Diplegic infants could be differentiated from controls on antenatal variables alone, but significant ...

  7. Evaluation measures for children with cerebral palsy

    OpenAIRE

    Sršen, Katja Groleger

    2013-01-01

    Abstract. Cerebral palsy is a well-recognized neurodevelopmental condition. The most recentdefinition describes cerebral palsy as a group of disorders of movement andposture, causing activity limitation. An important step in the process of(re)habilitation is evaluation of functional abilities of an individual. To beas accurate as possible in the evaluation of functioning, proper measurementinstruments have to be used. There are many different measurement tools forchildren with cerebral palsy,...

  8. Epilepsy in children with cerebral palsy

    OpenAIRE

    Bruck Isac; Antoniuk Sérgio Antônio; Spessatto Adriane; Bem Ricardo Schmitt de; Hausberger Romeu; Pacheco Carlos Gustavo

    2001-01-01

    OBJECTIVE: To describe the prevalence and characteristics of epilepsy in patients with cerebral palsy in a tertiary center. METHODS: a total of 100 consecutive patients with cerebral palsy were retrospectively studied. Criteria for inclusion were follow-up period for at least 2 years. Types and incidence of epilepsy were correlated with the different forms of cerebral palsy. Other factors associated with epilepsy such as age of first seizure, neonatal seizures and family history of epilepsy w...

  9. Health-related quality of life in 794 patients with a peripheral facial palsy using the FaCE Scale: a retrospective cohort study.

    NARCIS (Netherlands)

    Kleiss, I.J.; Hohman, M.H.; Susarla, S.M.; Marres, H.A.M.; Hadlock, T.A.

    2015-01-01

    OBJECTIVES: To describe the health-related quality of life of patients visiting a tertiary referral centre for facial palsy, and to analyse factors associated with health-related quality of life, using the FaCE Scale instrument. DESIGN: Retrospective cohort study. SETTING: The Facial Nerve Center at

  10. Hereditary Neuropathy with Liability to Pressure Palsy: A Recurrent and Bilateral Foot Drop Case Report

    Directory of Open Access Journals (Sweden)

    Filipa Flor-de-Lima

    2013-01-01

    Full Text Available Hereditary neuropathy with liability to pressure palsy is characterized by acute, painless, recurrent mononeuropathies secondary to minor trauma or compression. A 16-year-old boy had the first episode of right foot drop after minor motorcycle accident. Electromyography revealed conduction block and slowing velocity conduction of the right deep peroneal nerve at the fibular head. After motor rehabilitation, he fully recovered. Six months later he had the second episode of foot drop in the opposite site after prolonged squatting position. Electromyography revealed sensorimotor polyneuropathy of left peroneal, sural, posterior tibial, and deep peroneal nerves and also of ulnar, radial, and median nerves of both upper limbs. Histological examination revealed sensory nerve demyelination and focal thickenings of myelin fibers. The diagnosis of hereditary neuropathy with liability to pressure palsy was confirmed by PMP22 deletion of chromosome 17p11.2. He started motor rehabilitation and avoidance of stressing factors with progressive recovery. After one-year followup, he was completely asymptomatic. Recurrent bilateral foot drop history, “sausage-like” swellings of myelin in histological examination, and the results of electromyography led the authors to consider the diagnosis despite negative family history. The authors highlight this rare disease in pediatric population and the importance of high index of clinical suspicion for its diagnosis.

  11. Backpack palsy: A rare complication of backpack use in children and young adults - A new case report.

    Science.gov (United States)

    Rose, Katy; Davies, Anne; Pitt, Matthew; Ratnasinghe, Didi; D'Argenzio, Luigi

    2016-09-01

    Backpack palsy is a well-recognised, albeit rare, complication of carrying backpacks. Although it has been mostly described in cadets during strenuous training, sporadic cases of brachial nerve impairment have been reported in children and young adults. Here we reported the case of a 15-year-old girl who presented with a left-side brachial palsy with axonal denervation of C5C7 motor roots following a school challenge for the Duke of Edinburgh Award. Her symptoms began soon after starting the challenge and included weakness of shoulder abduction and elevation, as well as forearm, wrist and fingers extension. After 6 months of physiotherapy her motor function was completely restored. Backpack palsy can sometimes present in children and young adults. This disorder should be taken in consideration when planning for daily, as well as more challenging, physical activities in these age groups. PMID:27252125

  12. Genetic factors for nerve susceptibility to injuries-lessons from PMP22 deifciency

    Institute of Scientific and Technical Information of China (English)

    Jun Li

    2014-01-01

    Genetic factors may be learnt from families with gene mutations that render nerve-injury sus-ceptibility even to ordinary physical activities. A typical example is hereditary neuropathy with liability to pressure palsies (HNPP). HNPP is caused by a heterozygous deletion of PMP22 gene. PMP22 deficiency disrupts myelin junctions (such as tight junction and adherens junctions), leading to abnormally increased myelin permeability that explains the nerve susceptibility to injury. This ifnding should motivate investigators to identify additional genetic factors contribut-ing to nerve vulnerability of injury.

  13. Bell Palsy and Acupuncture Treatment

    Directory of Open Access Journals (Sweden)

    Betul Battaloglu Ižnanc

    2013-08-01

    A 22-year-old female patient, a midwifery student, had treatment with corticosteroid and antiviral agents as soon as Bell Palsy (BP was diagnosed (House-Breckman stage 6. Six weeks later, patient didn’t recover, while in House-Breckman stage 3, acupuncture was perfomed and local and distal acupoints were used with ears, body and face. Ear acupuncture point was used two times with detection. In the course of six sessions body and face points were stimulated by electroacupuncture. After ten acupuncture treatments, the subjective symptoms and the facial motion on the affected side improved. There was an spotting ecchymosis the ST2 points on. The symmetry of the face is a determinant of facial charm and influences interpersonal attraction for adults, children and pregnant women. Medical options for the sequelae of BP are limited. Acupuncture’s effectively in Bell palsy patients’ should be shown with more clinical and electrophysiological studies.

  14. Cerebral palsy and congenital malformations

    DEFF Research Database (Denmark)

    Garne, Ester; Dolk, Helen; Krägeloh-Mann, Inge;

    2007-01-01

    AIM: To determine the proportion of children with cerebral palsy (CP) who have cerebral and non-cerebral congenital malformations. METHODS: Data from 11 CP registries contributing to the European Cerebral Palsy Database (SCPE), for children born in the period 1976-1996. The malformations were...... classified as recognized syndromes, chromosomal anomalies, cerebral malformations or non-cerebral malformations. Prevalence of malformations was compared to published data on livebirths from a European database of congenital malformations (EUROCAT). RESULTS: Overall 547 out of 4584 children (11.9%) with CP...... were reported to have a congenital malformation. The majority (8.6% of all children) were diagnosed with a cerebral malformation. The most frequent types of cerebral malformations were microcephaly and hydrocephaly. Non-cerebral malformations were present in 97 CP children and in further 14 CP children...

  15. Cerebral Palsy: A Dental Update

    OpenAIRE

    Sehrawat, Nidhi; Marwaha, Mohita; Bansal, Kalpana; Chopra, Radhika

    2014-01-01

    ABSTRACT Special and medically compromised patients present a unique population that challenges the dentist’s skill and knowledge. Providing oral care to people with cerebral palsy (CP) requires adaptation of the skills we use everyday. In fact, most people with mild or moderate forms of CP can be treated successfully in the general practice setting. This article is to review various dental considerations and management of a CP patient. How to cite this article: Sehrawat N, Marwaha M, Bansal ...

  16. Baclofen in Spastic Cerebral Palsy

    OpenAIRE

    J Akhundian

    2002-01-01

    To evaluate the effect of oral baclofen in spastic cerebral palsy (cp), we studied 40 children with different clinical types of spastic cp. Half of these children served as control group and the others received oral baclofen. All of them were treated with physiotherapy under equal conditions for 6 weeks. We used two methods, modified Ashworth scale and range of motion for evaluation. At the end of therapy we found a significant improvement in the baclofen group compared to control group. As a...

  17. Cerebral palsy in preterm infants

    OpenAIRE

    Demeši-Drljan Čila; Mikov Aleksandra; Filipović Karmela; Tomašević-Todorović Snežana; Knežević Aleksandar; Krasnik Rastislava

    2016-01-01

    Background/Aim. Cerebral palsy (CP) is one of the leading causes of neurological impairment in childhood. Preterm birth is a significant risk factor in the occurrence of CP. Clinical outcomes may include impairment of gross motor function and intellectual abilities, visual impairment and epilepsy. The aim of this study was to examine the relationships among gestational age, type of CP, functional ability and associated conditions. Methods. The sample size w...

  18. Early nerve damage in leprosy: An electrophysiological study of ulnar and median nerves in patients with and without clinical neural deficits

    Directory of Open Access Journals (Sweden)

    Husain Sajid

    2007-01-01

    Full Text Available Background: Peripheral nerve trunk involvement in leprosy is very common. However, by the time it becomes clinically manifest, the damage is quite advanced. If the preclinical nerve damage can be detected early, the deformities and disabilities can be prevented to a large extent. Aims: To assess the electrophysiological functions of the ulnar and median nerve trunks in cases of clinically manifest leprosy with and without manifest nerve damage at different durations of nerve damage. Materials and Methods: Electrophysiological functions of ulnar and median nerves were studied in leprosy patients, both normal and at different stages of disease and damage. PB cases, having disease for six months or less, without neurological symptoms and clinically normal appearing nerve. Statistical Methods: Mean was taken of different values. The changes in values of different parameters were expressed as percentage change with reference to the control values (increase or decrease. Results: Reduced nerve conduction velocities and changes in latency and amplitude were observed. Changes in sensory nerve conduction were more pronounced. Sensory latencies and amplitude changes were more severe than motor latencies and amplitudes in cases with manifest muscle palsies. Changes in MB cases were less marked. Conclusions: Further studies are needed to identify parameters likely to be helpful in the diagnosis of early nerve damage.

  19. Combined radial and median nerve injury in diaphyseal fracture of humerus: a case report

    Institute of Scientific and Technical Information of China (English)

    Rajesh Rohilla; Rohit Singla; Narender Kumar Magu; Roop Singh; Ashish Devgun; Reetadyuti Mukhopadhyay; Paritosh Gogna

    2013-01-01

    Radial nerve palsy is the most common neurological involvement in humeral shaft fractures.But combined radial and median nerve injury in a closed diaphyseal fracture of the humerus is rare.Combined injury to both radial and median nerve can cause significant disability.A detailed clinical examination is therefore necessary following humeral shaft fractures.We report a patient with closed diaphyseal humeral fracture (AO 12A-2.3) together with radial and median nerve palsy,its management and review of the literature.As the patient had two nerves involved,surgical exploration was planned.Fracture was reduced and fixed with a 4.5 mm narrow dynamic compression pla te.There was no external injury to both radial and median nerves on surgical exploration.Neurological recovery started at 3 weeks' follow-up.Complete recovery was seen at 12 weeks.Careful clinical examination is of the utmost importance in early diagnosis of combined nerve injuries,which allows better management and rehabilitation of the patient.

  20. Assistive technology for people with cerebral palsy

    OpenAIRE

    Zupan, Anton; Jenko, Mojca

    2013-01-01

    Abstract. Assistive technology includes equipment, devicesand software solutions that increase functional capabilities of people withdisabilities and improve the quality of their lives. The article presentsassistive technology for people with cerebral palsy. These are mobility aidsthat enable people with cerebral palsy independent walking. For those whocannot walk, proper seating is very important. People, who cannot propel manualwheelchair, can control electric wheelchair with various contro...

  1. Ataxic cerebral palsy and genetic predisposition.

    OpenAIRE

    Miller, G.

    1988-01-01

    It was calculated that in the 962 family members of 36 patients with ataxic cerebral palsy there were 75 (8%) with a history of neurodevelopmental disorder and 31 (3%) with a major congenital malformation. This was not significantly greater than expected, and does not support the hypothesis of a genetic non-Mendelian role in the aetiology of ataxic cerebral palsy.

  2. Mobility Experiences of Adolescents with Cerebral Palsy

    Science.gov (United States)

    Palisano, Robert J.; Shimmell, Lorie J.; Stewart, Debra; Lawless, John J.; Rosenbaum, Peter L.; Russell, Dianne J.

    2009-01-01

    The purpose of this study was to describe how youth with cerebral palsy experience mobility in their daily lives using a phenomenological approach. The participants were 10 youth with cerebral palsy, 17 to 20 years of age, selected using purposeful sampling with maximum variation strategies. A total of 14 interviews were completed. Transcripts…

  3. Phrenic nerve paralysis during cryoballoon ablation for atrial fibrillation: a comparison between the first- and second-generation balloon

    NARCIS (Netherlands)

    Casado-Arroyo, R.; Chierchia, G.B.; Conte, G.; Levinstein, M.; Sieira, J.; Rodriguez-Manero, M.; Giovanni, G.; Baltogiannis, Y.; Wauters, K.; Asmundis, C. de; Sarkozy, A.; Brugada, P.

    2013-01-01

    BACKGROUND: Phrenic nerve palsy (PNP) is the most frequently observed complication during cryoballoon ablation (CB; Arctic Front, Medtronic, MN) occurring in roughly 7%-9% of the cases. The new second-generation cryoballoon ablation Arctic Front Advance (CB-A) (Arctic Front) has recently been launch

  4. Recurrent laryngeal nerve pathology in spasmodic dysphonia.

    Science.gov (United States)

    Bocchino, J V; Tucker, H M

    1978-08-01

    Since it was first described in 1871, spasmodic (spastic) dysphonia has been considered a disease of psychogenic origin. Unsupported theories of possible organic etiology have appeared sporadically in the literature. In 1976 sectioning of the recurrent laryngeal nerve for patients with this disease was reported with resultant improvement in voice production. This was attempted because the spasmodic dysphonic has, in effect, already compensated vocal cords bilaterally. It was reasoned, therefore, that if one of these was paralyzed the patient would immediately be converted to a state approximating that of well-compensated unilateral vocal cord paralysis which situation, as is well known, usually carries with it a fairly good voice. A controlled study to evaluate the efficacy of this surgical approach has been undertaken at the Cleveland Clinic during the past year. In an attempt to elucidate the possible organic etiology of spasmodic dysphonia, a section of nerve was removed in every case and examined by both light and electron microscopy. Special stains for myelin were also used on the light microscopy specimens. Demyelinization has been found in most of the cases examined by electron microscopy. Possible correlation between this disease entity and other cranial nerve syndromes of unknown etiology is noted. Such conditions as trigeminal neuralgia, glossopharyngeal neuralgia, belpharospasm, hemifacial spasm, and even possibly Bell's palsy may exhibit a similar etiology.

  5. Delayed presentation of traumatic facial nerve (CN VII) paralysis.

    Science.gov (United States)

    Napoli, Anthony M; Panagos, Peter

    2005-11-01

    Facial nerve paralysis (Cranial Nerve VII, CN VII) can be a disfiguring disorder with profound impact upon the patient. The etiology of facial nerve paralysis may be congenital, iatrogenic, or result from neoplasm, infection, trauma, or toxic exposure. In the emergency department, the most common cause of unilateral facial paralysis is Bell's palsy, also known as idiopathic facial paralysis (IFP). We report a case of delayed presentation of unilateral facial nerve paralysis 3 days after sustaining a traumatic head injury. Re-evaluation and imaging of this patient revealed a full facial paralysis and temporal bone fracture extending into the facial canal. Because cranial nerve injuries occur in approximately 5-10% of head-injured patients, a good history and physical examination is important to differentiate IFP from another etiology. Newer generation high-resolution computed tomography (CT) scans are commonly demonstrating these fractures. An understanding of this complication, appropriate patient follow-up, and early involvement of the Otolaryngologist is important in management of these patients. The mechanism as well as the timing of facial nerve paralysis will determine the proper evaluation, consultation, and management for the patient. Patients with total or immediate paralysis as well as those with poorly prognostic audiogram results are good candidates for surgical repair.

  6. Hereditary Neuropathy with Liability to Pressure Palsies Masked by Previous Gunshots and Tuberculosis

    Directory of Open Access Journals (Sweden)

    Martin Gencik

    2015-01-01

    Full Text Available Objectives. Although hereditary neuropathy with liability to pressure palsies (HNPP presents with a distinct phenotype on history, clinical exam, and nerve conduction studies, it may be masked if diagnostic work-up suggests other causes. Case Report. In a 37-year-old male with pseudoradicular lumbar pain, neurological exam revealed sore neck muscles, peripheral facial nerve palsy, right anacusis and left hypoacusis, hemihypesthesia of the right face, mild distal quadriparesis, diffuse wasting, and generally reduced tendon reflexes. He had a history of skull fracture due to a gunshot behind the right ear and tuberculosis for which he had received adequate treatment for 3 years; MRI revealed a disc prolapse at C6/7 and Th11/12. Nerve conduction studies were indicative of demyelinating polyneuropathy with conduction blocks. Despite elevated antinuclear antibodies and elevated CSF-protein, HNPP was diagnosed genetically after having excluded vasculitis, CIDP, radiculopathy, and the side effects of antituberculous treatment. Conclusions. HNPP may manifest with mild, painless, distal quadriparesis. The diagnosis of HNPP may be blurred by a history of tuberculosis, tuberculostatic treatment, hepatitis, and the presence of elevated CSF-protein.

  7. Hereditary Neuropathy with Liability to Pressure Palsies Masked by Previous Gunshots and Tuberculosis

    Science.gov (United States)

    Gencik, Martin; Finsterer, Josef

    2015-01-01

    Objectives. Although hereditary neuropathy with liability to pressure palsies (HNPP) presents with a distinct phenotype on history, clinical exam, and nerve conduction studies, it may be masked if diagnostic work-up suggests other causes. Case Report. In a 37-year-old male with pseudoradicular lumbar pain, neurological exam revealed sore neck muscles, peripheral facial nerve palsy, right anacusis and left hypoacusis, hemihypesthesia of the right face, mild distal quadriparesis, diffuse wasting, and generally reduced tendon reflexes. He had a history of skull fracture due to a gunshot behind the right ear and tuberculosis for which he had received adequate treatment for 3 years; MRI revealed a disc prolapse at C6/7 and Th11/12. Nerve conduction studies were indicative of demyelinating polyneuropathy with conduction blocks. Despite elevated antinuclear antibodies and elevated CSF-protein, HNPP was diagnosed genetically after having excluded vasculitis, CIDP, radiculopathy, and the side effects of antituberculous treatment. Conclusions. HNPP may manifest with mild, painless, distal quadriparesis. The diagnosis of HNPP may be blurred by a history of tuberculosis, tuberculostatic treatment, hepatitis, and the presence of elevated CSF-protein. PMID:26640726

  8. Progressive supranuclear palsy: new concepts

    Directory of Open Access Journals (Sweden)

    Orlando Graziani Povoas Barsottini

    2010-12-01

    Full Text Available Progressive supranuclear palsy (PSP is a distinctive form of neurodegenerative disease which affects the brainstem and basal ganglia. Patients present supranuclear ophthalmoplegia, postural instability and mild dementia. PSP is defined neuropathologically by the accumulation of neurofibrillary tangles in the subthalamic nucleus, pallidum, red nucleus, substantia nigra, striatum, pontine tegmentum, oculomotor nucleus, medulla and dentate nucleus. Over the last decade many lines of investigations have helped refine PSP in many aspects and it is the purpose of this review to help neurologists identify PSP, to better understand its pathophysiology and to provide a more focused, symptom-based treatment approach.

  9. Report of 121 Cases of Bell's Palsy Referred to the Emergency Department

    Directory of Open Access Journals (Sweden)

    Behzad Zohrevandi

    2014-03-01

    Full Text Available Introduction: According to the high incidence of Bell's palsy (IFP and lack of clinical data regarding different aspects of disease, the present study investigated 121 Iranian patients with peripheral facial paralysis referred to the emergency department. Methods: In this retrospective study, all patients with peripheral facial paralysis, referred to the emergency department of Poursina hospital, Rasht, Iran, from August 2012 to August 2013, were enrolled. For all patients with diagnosis of Bell's palsy variables such as age, sex, occupation, clinical symptoms, comorbid disease, grade of paralysis, and the severity of the facial palsy were reviewed and analyzed using STATA version 11.0. Results: A total of 121 patients with peripheral facial paralysis were assessed with a mean age of 47.14±18.45 years (52.9% male. The majority of patients were observed in the summer (37.2% and autumn (33.1% and the recurrence rate was 22.3%. The most common grades of nerve damage were IV and V based on House- Brackman grading scale (47.1%. Also, the most frequent signs and symptoms were ear pain (43.8%, taste disturbance (38.8%, hyperacusis (15.7% and increased tearing (11.6%. There were not significant correlations between the severity of palsy with age (p= 0.08, recurrence rate (p=0.18, season (p=0.9, and comorbid disease including hypertension (p=0.18, diabetes (p=0.29, and hyperlipidemia (p=0.94. The patients with any of following symptoms such as ear pain (p<0.001, taste disturbance (p<0.001, increased tearing (p=0.03, and Hyperacusis (p<0.001 have more severe palsy. Conclusion: There was equal gender and occupational distribution, higher incidence in fourth decade of life, higher incidence in summer and autumn, higher grade of nerve damage (grade V and VI, and higher incidence of ear pain and taste disturbance in patients suffered from IFP. Also, there was significant association between severity of nerve damage and presence of any simultaneous symptoms. 

  10. Aerobic training in children with cerebral palsy.

    Science.gov (United States)

    Nsenga, A L; Shephard, R J; Ahmaidi, S; Ahmadi, S

    2013-06-01

    Rehabilitation is a major goal for children with cerebral palsy, although the potential to enhance cardio-respiratory fitness in such individuals remains unclear. This study thus compared current cardio-respiratory status between children with cerebral palsy and able-bodied children, and examined the ability to enhance the cardio-respiratory fitness of children with cerebral palsy by cycle ergometer training. 10 children with cerebral palsy (Gross Motor Function Classification System levels I and II) participated in thrice-weekly 30 min cycle ergometer training sessions for 8 weeks (mean age: 14.2±1.9 yrs). 10 additional subjects with cerebral palsy (mean age: 14.2±1.8 yrs) and 10 able-bodied subjects (mean age: 14.1±2.1 yrs) served as controls, undertaking no training. All subjects undertook a progressive cycle ergometer test of cardio-respiratory fitness at the beginning and end of the 8-week period. Cardio-respiratory parameters [oxygen intake V˙O2), ventilation V ˙ E) and heart rate (HR)] during testing were measured by Cosmed K4 b gas analyzer. The children with cerebral palsy who engaged in aerobic training improved their peak oxygen consumption, heart rate and ventilation significantly (pchildren with cerebral palsy can benefit significantly from cardio-respiratory training, and such training should be included in rehabilitation programs.

  11. 肌筋膜经线选穴法针刺治疗对脑性瘫痪模型大鼠神经细胞再生及运动功能恢复的影响%Effects of Acupuncture Based on Acupoint Selection of Myofascial Meridians Perspective on Regeneration of Nerve Cells and Recov-ery of Motor Function in Rats with Cerebral Palsy

    Institute of Scientific and Technical Information of China (English)

    徐冬晨; 杨江; 喻斌; 李达玲; 韩新民

    2014-01-01

    目的:探讨基于肌筋膜经线的选穴法针刺治疗对脑瘫模型大鼠神经细胞再生及运动功能恢复的影响。方法健康21日龄雄性Sprague-Dawley大鼠20只,分成对照组、针刺1组、针刺2组和假手术组,对照组、针刺1组和针刺2组采用左侧颈总动脉结扎结合低氧环境制作脑瘫模型。针刺1组接受传统针刺疗法,针刺2组接受基于肌筋膜经线的选穴法针刺治疗。各组于针刺开始后第3、7、14天行BBB评分、斜板试验;第14天用5-溴脱氧尿核苷(BrdU)标记检测左脑运动皮层和纹状体的细胞增殖情况。结果第7天和第14天针刺2组的BBB评分恢复明显优于针刺1组和对照组(P<0.01),第3、7、14天针刺2组斜板支撑能力均较对照组升高(P≤0.05);第14天针刺2组运动皮层BrdU含量较针刺1组升高(P<0.05)。结论基于肌筋膜经线的选穴法针刺治疗能有效促进脑瘫模型神经细胞再生和运动功能的改善,且优于传统针刺疗法。%Objective To investigate the effects of acupuncture based on acupoint selection of myofascial meridians perspective on the regeneration of nerve cells and recovery of motor function in rats with cerebral palsy. Methods 20 healthy 21-day-old male Sprague-Dawley rats were divided into control group, acupuncture groups 1 (receiving traditional acupuncture) and 2 (receiving acupuncture based on acu-point selection of myofascial meridians perspective), and sham group. The control group and the acupuncture groups were subjected to liga-tion of left carotid artery (ischemia) and then put into a hypoxic environment. They were assessed with Basso-Beattie-Bresnahan (BBB) Scale and inclined plane test 3 d, 7 d and 14 d after the beginning of acupuncture. And 5-bromo-2'-deoxyuridine (BrdU) was used to label S-phase cells in the left striaturn and motor cortex in each group 14 d after the beginning of acupuncture. Results The BBB scores improved more in the acupuncture group

  12. Validation of a cerebral palsy register

    DEFF Research Database (Denmark)

    Topp, Monica Wedell; Langhoff-Roos, J; Uldall, P

    1997-01-01

    OBJECTIVES: To analyse completeness and validity of data in the Cerebral Palsy Register in Denmark, 1979-1982. METHODS: Completeness has been assessed by comparing data from The Danish National Patient Register (DNPR) with the cases included in the Cerebral Palsy Register (CPR). Agreement between......, but gestational age was subject to a systematic error, and urinary infections in pregnancy (kappa = 0.43) and placental abruption (kappa = 0.52) were seriously under-reported in the CPR. CONCLUSIONS: Completeness of the Cerebral Palsy Register in Denmark, 1979-1982, has been assessed to maximal 85%, emphasizing...

  13. Trends in birth prevalence of cerebral palsy.

    OpenAIRE

    Pharoah, P O; Cooke, T.; Rosenbloom, I; Cooke, R W

    1987-01-01

    A register of children with cerebral palsy born in the period 1966-77 to mothers resident in the Mersey region was compiled from several different data sources. There were 685 cases, with a male:female ratio of 1.4:1. The birth prevalence of cerebral palsy ranged from 1.18 to 1.97 per 1000 live births each year, with a mean of 1.51 per 1000 live births. There was no discernible trend in overall prevalence, but there was a highly significant upward trend in the prevalence of cerebral palsy amo...

  14. Unusual presentation of hereditary neuropathy with liability to pressure palsies

    Directory of Open Access Journals (Sweden)

    Andary Michael T

    2008-01-01

    Full Text Available Abstract Background Hereditary neuropathy with liability to pressure palsies (HNPP is an autosomal-dominant painless peripheral neuropathy characterized by episodes of repeated focal pressure neuropathies at sites of entrapment/compression, with a considerable variability in the clinical course. Electrodiagnostic and genetic testing are important in the diagnostic evaluation of these patients. Case presentation We report an unusual HNPP phenotype, five compression neuropathies in four nerves in a patient with bilateral hand numbness. A 42-year-old female, presented with acute bilateral paresthesias and weakness in her hands after starting yoga exercises requiring hyperextension of her hands at the wrists. Her presentation was complicated by: a a remote history of acute onset foot drop and subsequent improvement, b previous diagnoses of demyelinating peripheral neuropathy, possibly Charcot-Marie-Tooth disease, and c exposure to leprosy. Electrodiagnostic testing showed 5 separate compression neuropathies in 4 nerves including: severe left and right ulnar neuropathies at the wrist, left and right median neuropathies at the wrist and left ulnar neuropathy at the elbow. There was a mild generalized, primarily demyelinating, peripheral polyneuropathy. Based on the clinical suspicion and electrodiagnostic findings, consistent with profound demyelination in areas of compression, genetic analysis was done which identified a deletion of the PMP-22 gene consistent with HNPP. Conclusion HNPP can present with unusual phenotypes, such as 5 separate mononeuropathies, bilateral ulnar and median neuropathies at the wrists and ulnar neuropathy at the elbow with mild peripheral demyelinating polyneuropathy associated with the PMP-22 gene deletion.

  15. Nerve conduction velocity

    Science.gov (United States)

    ... to measure the speed of the nerve signals. Electromyography (recording from needles placed into the muscles) is ... Often, the nerve conduction test is followed by electromyography (EMG). In this test, needles are placed into ...

  16. Common peroneal nerve dysfunction

    Science.gov (United States)

    ... toe-out movements Tests of nerve activity include: Electromyography (EMG, a test of electrical activity in muscles) Nerve ... Peroneal neuropathy. In: Preston DC, Shapiro BE, eds. Electromyography and Neuromuscular Disorders . 3rd ed. Philadelphia, PA: Elsevier; ...

  17. Effects of electrical stimulation in early Bells palsy on facial disability index scores

    Directory of Open Access Journals (Sweden)

    P. Alakram

    2011-02-01

    Full Text Available Recovery following facial nerve palsy is variable. Physiotherapists try  to restore  function  in  patients  with  Bell’s  palsy.  The  choice  of treatment modality  depends  on  the  stage  of  the  condition.  Although limited  evidence  exists  for  the  use  of  electrical  stimulation  in  the acute  stage  of  Bell’s  palsy, some physiotherapists in South Africa have been applying this modality. This study examined the effects of electrical stimulation on functional recovery from  Bell’s palsy using the Facial Disability Index, a tool that documents recovery from the patients’ perspective. A two group pre-test post-test experimental design comprising of 16 patients with Bell’s Palsy of less than 30 days duration was utilized. Patients with a clinical diagnosis of Bell’s Palsy were systematically allocated to the control and experimental groups. Patients (n=16 were pre-tested and post-tested using the Facial Disability Index. Both groups were treated with heat, massage, exercises and given a home program. The experimental group also received electrical stimulation. The FDI of the control group improved between 17, 8% and 95, 4% with a mean of 52, 8%. The improvement in the experimental group ranged between 14, 8% and 126% with a mean of 49, 8%. Certain clinical residuals persisted in a mild form in both groups on discharge from the study.  The effects of electrical stimulation as used in this study during the acute phase of Bell’s palsy, quantified as the FDI was clinically but not statistically significant. A larger sample size, longer stimulation time or both should be investigated.

  18. MR findings of cerebral palsy

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Sang Hum; Chang, Seung Kuk; Cho, Mee Young; Park, Dong Woo; Kim, Jong Deok; Eun, Choong Ki [Pusan Paik Hospital, Pusan (Korea, Republic of)

    1994-11-15

    To evaluate the MR findings of brain damage in cerebral palised patients and to correlate it with gestational age and the time of damage. A retrospective analysis was performed in 40 patients who underwent MR scanning for evaluation of brain lesion in clinically diagnosed cerebral palsy. Authors classified the patients into two groups as premature and full-term and compared MR findings of the two groups. Abnormal MR findings were noted in 28 cases (70%). Five out of 6 patients who had been born prematurely showed isolate periventricular white matter lesions. Twenty-three out of 34 patients who had been born at full-term showed abnormal MR findings. Of these 23 patients, migration anomalies in 7 patients, isolate periventricular white matter lesions in 3 patients, and other combined periventricular subcortical white matter and deep gray matter lesions in 14 patients were seen. At least, 10 patients(43%) of full term group showed abnormal MRI findings reflecting intrauterine brain damage and all 5 patients of premature group showed isolate periventricular white matter lesions suggesting immaturity of brain. MRI is thought to be very useful in the assessment of brain damage for the patients with cerebral palsy by recognizing the location of the lesion and estimating the time of damage.

  19. MR findings of cerebral palsy

    International Nuclear Information System (INIS)

    To evaluate the MR findings of brain damage in cerebral palised patients and to correlate it with gestational age and the time of damage. A retrospective analysis was performed in 40 patients who underwent MR scanning for evaluation of brain lesion in clinically diagnosed cerebral palsy. Authors classified the patients into two groups as premature and full-term and compared MR findings of the two groups. Abnormal MR findings were noted in 28 cases (70%). Five out of 6 patients who had been born prematurely showed isolate periventricular white matter lesions. Twenty-three out of 34 patients who had been born at full-term showed abnormal MR findings. Of these 23 patients, migration anomalies in 7 patients, isolate periventricular white matter lesions in 3 patients, and other combined periventricular subcortical white matter and deep gray matter lesions in 14 patients were seen. At least, 10 patients(43%) of full term group showed abnormal MRI findings reflecting intrauterine brain damage and all 5 patients of premature group showed isolate periventricular white matter lesions suggesting immaturity of brain. MRI is thought to be very useful in the assessment of brain damage for the patients with cerebral palsy by recognizing the location of the lesion and estimating the time of damage

  20. A large dumbbell glossopharyngeal schwannoma involving the vagus nerve: a case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Zhao Hongyu

    2008-10-01

    Full Text Available Abstract Introduction Schwannoma arising from the glossopharyngeal nerve is a rare intracranial tumor. Fewer than 40 cases have been reported. Accurate pre-operative diagnosis and optimal treatment are still difficult. Case presentation We present one case of schwannoma originating from the ninth cranial nerve with palsies of the trigeminal nerve, facial-acoustic nerve complex, and vagus nerve in addition to ninth nerve dysfunction. Magnetic resonance imaging showed tumors located in the cerebellopontine angle with extracranial extension via the jugular foramen, with evident enhancement on post-contrast scan. Surgical management single-staged with the help of gamma knife radiosurgery achieved total removal. Conclusion Glossopharyngeal schwannoma is devoid of clinical symptoms and neurological signs. High resolution magnetic resonance imaging may play a key role as an accurate diagnostic tool. A favorable option of approach and appropriate planning of surgical strategy should be the goal of operation for this benign tumor.

  1. Optic Nerve Pit

    Science.gov (United States)

    ... Conditions Frequently Asked Questions Español Condiciones Chinese Conditions Optic Nerve Pit What is optic nerve pit? An optic nerve pit is a ... may be seen in both eyes. How is optic pit diagnosed? If the pit is not affecting ...

  2. Herpes Simplex Virus-1 and Bell's Palsy

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2008-05-01

    Full Text Available The association between herpes simplex virus-1 (HSV-1 infection and Bell palsy was determined in 47 children studied at Children's Hospital at Montefiore, Bronx, NY. Swabs of saliva and conjunctiva were taken for PCR testing.

  3. Hereditary neuropathy with liability to pressure palsies in a Turkish patient (HNPP): a rare cause of entrapment neuropathies in young adults.

    Science.gov (United States)

    Celik, Yahya; Kilinçer, Cumhur; Hamamcioğlu, M Kemal; Balci, Kemal; Birgili, Bariş; Cobanoğlu, Sebahattin; Utku, Ufuk

    2008-01-01

    Hereditary neuropathy with liability to pressure palsies (HNPP) is an autosomal dominant nerve disease usually caused by 1,5 Mb deletion on chromosome 17p11.2.2-p12, the region where the PMP-22 gene is located. The patients with HNPP usually have relapsing and remitting entrapment neuropathies due to compression. We present a 14-year-old male who had acute onset, right-sided ulnar nerve entrapment at the elbow. He had electrophysiological findings of bilateral ulnar nerve entrapments (more severe at the right side) at the elbow and bilateral median nerve entrapment at the wrist. Genetic tests of the patient demonstrated deletions in the 17p11.2 region. The patient underwent decompressive surgery for ulnar nerve entrapment at the elbow and completely recovered two months after the event. Although HNPP is extremely rare, it should be taken into consideration in young adults with entrapment neuropathies.

  4. PHYSIOTHERAPY MANAGEMENT FOR PROGRESSIVE SUPRA NUCLEAR PALSY

    OpenAIRE

    P. Keerthi Chandra Shekhar.; A. Anitha kumari,; Chennupati. Ashok Chakravarthi

    2013-01-01

    Background:An elderly patient with disturbances in gait, impaired balance, difficulty moving the eyes andhistory of frequent falls are not commonly seen in physiotherapy referral cases. Progressive supranuclear palsy(PSP) is relatively uncommon and is the most frequently occurring form of Atypical Parkinsonism withcardinalfeatures of vertical gaze palsy, gait instability with frequent falls. However, because the initialclinical featuresoften resemble Parkinson’s disease (PD) many patients are...

  5. Joubert syndrome labeled as hypotonic cerebral palsy

    OpenAIRE

    Dekair, Lubna H.; Kamel, Hussein; El-Bashir, Haitham O.

    2014-01-01

    Joubert syndrome (JS) is a rare autosomal recessive disorder with cerebellar vermis hypoplasia and complex brainstem malformation. The diagnosis of cases can be difficult as the presentation can be similar to cases of cerebral palsy. We present a case of JS in an 18-month-old girl who presented to pediatric rehabilitation with a diagnosis of hypotonic cerebral palsy and abnormal eye movements. The brain MRI confirmed the typical brain malformations.

  6. Tongue mobility in patients with cerebral palsy

    OpenAIRE

    Živković Zorica; Golubović Slavica

    2012-01-01

    Background/Aim. In children with cerebral palsy speech is a big problem. Speech of these children is more or less understandable, depending on the degree of reduced mobility of articulatory organs. Reduced mobility is affected by inability to control facial grimacing and poor muscle strength when performing targeted movements. The aim of this study was to determine the mobility of tongue in patients with cerebral palsy. Methods. The study included a sample of 34 children - patients with...

  7. Ocular problems in children with cerebral palsy

    OpenAIRE

    Esra Ayhan Tuzcu; Fatmagül Başarslan; Cahide Yılmaz; Seçil Arıca; Nilgün Üstün; Özgür İlhan; Mesut Coşkun; Uğurcan Keskin

    2012-01-01

    The aim of this study is to evaluate eye problemsin children with cerebral palsy in our region.Materials and Methods: 90 patients which was diagnosedas cerebral palsy, treated and followed up in PediatricNeurology Department of Mustafa Kemal University,were included to this study. The history was taken, anda physical examination was performed to determine theetiology of the disease and type of SP. All of the patientswere underwent a detailed ophthalmological examinationincluding visual acuity...

  8. PRETERM BIRTH ASSOCIATION WITH CEREBRAL PALSY

    OpenAIRE

    Srinivasa Rao; Vidyullatha; Subbalakshmi

    2015-01-01

    INTRODUCTION: Cerebral palsy ( CP ) is a group of permanent movement disorders that appear in early childhood. Preterm birth is the birth of baby before 37 completed weeks, a full term birth is birth at 37 to 42 weeks of gestation . AIM: To show the extent of association of preterm deliveries as a risk factor in development of cerebral palsy. MATERIALS AND METHODS: This r etrospective cohort study wa...

  9. Assessment of the hand in cerebral palsy

    OpenAIRE

    Praveen Bhardwaj; S Raja Sabapathy

    2011-01-01

    Cerebral palsy is the musculoskeletal manifestation of a nonprogressive central nervous system lesion that usually occurs due to a perinatal insult to the brain. Though the cerebral insult is static the musculoskeletal pathology is progressive. Some patients with cerebral palsy whose hands are affected can be made better by surgery. The surgical procedures as such are not very technically demanding but the assessment, decision-making, and selecting the procedures for the given patient make th...

  10. Optic nerve oxygenation

    DEFF Research Database (Denmark)

    Stefánsson, Einar; Pedersen, Daniella Bach; Jensen, Peter Koch;

    2005-01-01

    at similar levels of perfusion pressure. The levels of perfusion pressure that lead to optic nerve hypoxia in the laboratory correspond remarkably well to the levels that increase the risk of glaucomatous optic nerve atrophy in human glaucoma patients. The risk for progressive optic nerve atrophy in human...... glaucoma patients is six times higher at a perfusion pressure of 30 mmHg, which corresponds to a level where the optic nerve is hypoxic in experimental animals, as compared to perfusion pressure levels above 50 mmHg where the optic nerve is normoxic. Medical intervention can affect optic nerve oxygen......-oxygenase inhibitor, indomethacin, which indicates that prostaglandin metabolism plays a role. Laboratory studies suggest that carbonic anhydrase inhibitors might be useful for medical treatment of optic nerve and retinal ischemia, potentially in diseases such as glaucoma and diabetic retinopathy. However, clinical...

  11. Optic nerve oxygenation

    DEFF Research Database (Denmark)

    Stefánsson, Einar; Pedersen, Daniella Bach; Jensen, Peter Koch;

    2005-01-01

    at similar levels of perfusion pressure. The levels of perfusion pressure that lead to optic nerve hypoxia in the laboratory correspond remarkably well to the levels that increase the risk of glaucomatous optic nerve atrophy in human glaucoma patients. The risk for progressive optic nerve atrophy in human......The oxygen tension of the optic nerve is regulated by the intraocular pressure and systemic blood pressure, the resistance in the blood vessels and oxygen consumption of the tissue. The oxygen tension is autoregulated and moderate changes in intraocular pressure or blood pressure do not affect...... glaucoma patients is six times higher at a perfusion pressure of 30 mmHg, which corresponds to a level where the optic nerve is hypoxic in experimental animals, as compared to perfusion pressure levels above 50 mmHg where the optic nerve is normoxic. Medical intervention can affect optic nerve oxygen...

  12. Forty-two cases of Bell's palsy in pregnancy treated with acupuncture and moving cupping therapy%针刺配合走罐治疗妊娠 Bell麻痹42例

    Institute of Scientific and Technical Information of China (English)

    邵素菊; 冯罡; 任重

    2010-01-01

    @@ Bell's palsy is manifested chiefly as deviation of eye and mouth to the one side,which refers to peripheral facial paralysis due to non-specific inflammation of facial nerve in stylomastoid foramen,in the category of"deviation of eye and mouth"in Chinese medicine.

  13. Bell's palsy before Bell: Cornelis Stalpart van der Wiel's observation of Bell's palsy in 1683.

    Science.gov (United States)

    van de Graaf, Robert C; Nicolai, Jean-Philippe A

    2005-11-01

    Bell's palsy is named after Sir Charles Bell (1774-1842), who has long been considered to be the first to describe idiopathic facial paralysis in the early 19th century. However, it was discovered that Nicolaus Anton Friedreich (1761-1836) and James Douglas (1675-1742) preceded him in the 18th century. Recently, an even earlier account of Bell's palsy was found, as observed by Cornelis Stalpart van der Wiel (1620-1702) from The Hague, The Netherlands in 1683. Because our current knowledge of the history of Bell's palsy before Bell is limited to a few documents, it is interesting to discuss Stalpart van der Wiel's description and determine its additional value for the history of Bell's palsy. It is concluded that Cornelis Stalpart van der Wiel was the first to record Bell's palsy in 1683. His manuscript provides clues for future historical research.

  14. Gd-DTPA enhancement of the facial nerve in Ramsay Hunt's syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Kato, Tsutomu; Yanagida, Masahiro; Yamauchi, Yasuo (Kansai Medical School, Moriguchi, Osaka (Japan)) (and others)

    1992-10-01

    A total of 21 MR images in 16 Ramsay Hunt's syndrome were evaluated. In all images, the involved side of peripheral facial nerve were enhanced in intensity after Gd-DTPA. However, 2 cases had recovered facial palsy when MR images were taken. Nine of 19 cases with the enhancement of internal auditory canal portion had vertigo or tinnitus. Thus, it was suggested that the enhancement of internal auditory canal portion and clinical feature are closely related. (author).

  15. An Unusual Case of Neuralgic Amyotrophy Presenting with Bilateral Phrenic Nerve and Vocal Cord Paresis

    OpenAIRE

    Holtbernd, F.; Zehnhoff-Dinnesen, A. am; Duning, T.; Kemmling, A.; Ringelstein, E.B.

    2011-01-01

    Background Neuralgic amyotrophy (brachial plexus neuropathy, brachial plexus neuritis, or Parsonage-Turner syndrome) is an uncommon inflammatory condition typically characterized by acute and severe shoulder pain followed by paresis with muscle weakness and atrophy of the upper limb or shoulder girdle. We report an unusual clinical manifestation of neuralgic amyotrophy, namely bilateral phrenic nerve palsy with concomitant laryngeal paresis. Case Report A 55-year-old male presented with ortho...

  16. Genetics of Progressive Supranuclear Palsy

    Directory of Open Access Journals (Sweden)

    Sun Young Im

    2015-09-01

    Full Text Available Progressive supranuclear palsy (PSP is a neurodegenerative syndrome that is clinically characterized by progressive postural instability, supranuclear gaze palsy, parkinsonism and cognitive decline. Pathologically, diagnosis of PSP is based on characteristic features, such as neurofibrillary tangles, neutrophil threads, tau-positive astrocytes and their processes in basal ganglia and brainstem, and the accumulation of 4 repeat tau protein. PSP is generally recognized as a sporadic disorder; however, understanding of genetic background of PSP has been expanding rapidly. Here we review relevant publications to outline the genetics of PSP. Although only small number of familial PSP cases have been reported, the recognition of familial PSP has been increasing. In some familial cases of clinically probable PSP, PSP pathologies were confirmed based on NINDS neuropathological diagnostic criteria. Several mutations in MAPT, the gene that causes a form of familial frontotemporal lobar degeneration with tauopathy, have been identified in both sporadic and familial PSP cases. The H1 haplotype of MAPT is a risk haplotype for PSP, and within H1, a sub-haplotype (H1c is associated with PSP. A recent genome-wide association study on autopsyproven PSP revealed additional PSP risk alleles in STX6 and EIF2AK3. Several heredodegenerative parkinsonian disorders are referred to as PSP-look-alikes because their clinical phenotype, but not their pathology, mimics PSP. Due to the fast development of genomics and bioinformatics, more genetic factors related to PSP are expected to be discovered. Undoubtedly, these studies will provide a better understanding of the pathogenesis of PSP and clues for developing therapeutic strategies.

  17. Cerebral palsy in preterm infants

    Directory of Open Access Journals (Sweden)

    Demeši-Drljan Čila

    2016-01-01

    Full Text Available Background/Aim. Cerebral palsy (CP is one of the leading causes of neurological impairment in childhood. Preterm birth is a significant risk factor in the occurrence of CP. Clinical outcomes may include impairment of gross motor function and intellectual abilities, visual impairment and epilepsy. The aim of this study was to examine the relationships among gestational age, type of CP, functional ability and associated conditions. Methods. The sample size was 206 children with CP. The data were obtained from medical records and included gestational age at birth, clinical characteristics of CP and associated conditions. Clinical CP type was determined according to Surveillance of Cerebral Palsy in Europe (SCPE and topographically. Gross motor function abilities were evaluated according to the Gross Motor Function Classification System (GMFCS. Results. More than half of the children with CP were born prematurely (54.4%. Statistically significant difference was noted with respect to the distribution of various clinical types of CP in relation to gestational age (p < 0.001. In the group with spastic bilateral CP type, there is a greater proportion of children born preterm. Statistically significant difference was noted in the functional classification based on GMFCS in terms of gestational age (p = 0.049, children born at earlier gestational age are classified at a higher GMFCS level of functional limitation. The greatest percentage of children (70.0% affected by two or more associated conditions was found in the group that had extremely preterm birth, and that number declined with increasing maturity at birth. Epilepsy was more prevalent in children born at greater gestational age, and this difference in distribution was statistically significant (p = 0.032. Conclusion. The application of antenatal and postnatal protection of preterm children should be a significant component of the CP prevention strategy. [Projekat Ministarstva nauke Republike

  18. The effect of the photobiomodulation in the treatment of Bell's palsy: clinical experience

    Science.gov (United States)

    Colombo, Fabio; Marques, Aparecida Maria C.; Carvalho, Carolina M.; Paraguassu, Gardenia M.; de Sousa, José A. C.; Magalhaes, Edival; Cangussu, Maria Cristina T.; de A. Reis, Silvia Regina; Pinheiro, Antonio Luiz B.

    2012-03-01

    The Bell's palsy (G51) consists of a unilateral face paralysis that sudden begins with unknown cause and can result in complete mimic loss or partial paralysis of the face. Damage to the VII cranial nerve can be found in the pathology, promoting mussel's inactivity. The light Photobiomodulation (LPBM) has presented ability of rush the tissue repair, favoring the regeneration of neural structures. The present study aimed to assess the effectiveness use of the 780nm laser and 850nm LED (light-emitting diode) in the treatment of the face paralysis. Were evaluated 14 patients that suffer of Bell's palsy whom were submitted to the light administration, on the Laser Clinic of the UFBA between 2005 and 2010. The treatment was performed by infrared Laser in 11 patients (78.57%), and by LED in 3 patients (21.42%). At the end of the 12 sections, 11 patients (78.57%) had presented themselves cure or with substantial improvement of the initial picture, however 3 patients (21.42%) dealt with infra-red Laser λ780nm had not evolution. The light presented as an effective method for the treatment of Bell's palsy, but the association with the physiotherapy and medications is important.

  19. The effects of deefferentation without deafferentation on functional connectivity in patients with facial palsy

    Directory of Open Access Journals (Sweden)

    Carsten M. Klingner

    2014-01-01

    Full Text Available Cerebral plasticity includes the adaptation of anatomical and functional connections between parts of the involved brain network. However, little is known about the network dynamics of these connectivity changes. This study investigates the impact of a pure deefferentation, without deafferentation or brain damage, on the functional connectivity of the brain. To investigate this issue, functional MRI was performed on 31 patients in the acute state of Bell's palsy (idiopathic peripheral facial nerve palsy. All of the patients performed a motor paradigm to identify seed regions involved in motor control. The functional connectivity of the resting state within this network of brain regions was compared to a healthy control group. We found decreased connectivity in patients, mainly in areas responsible for sensorimotor integration and supervision (SII, insula, thalamus and cerebellum. However, we did not find decreased connectivity in areas of the primary or secondary motor cortex. The decreased connectivity for the SII and the insula significantly correlated to the severity of the facial palsy. Our results indicate that a pure deefferentation leads the brain to adapt to the current compromised state during rest. The motor system did not make a major attempt to solve the sensorimotor discrepancy by modulating the motor program.

  20. Gastrostomy tube feeding of children with cerebral palsy

    DEFF Research Database (Denmark)

    Dahlseng, Magnus O; Andersen, Guro L; DA Graca Andrada, Maria;

    2012-01-01

    To compare the prevalence of gastrostomy tube feeding (GTF) of children with cerebral palsy (CP) in six European countries.......To compare the prevalence of gastrostomy tube feeding (GTF) of children with cerebral palsy (CP) in six European countries....

  1. Granulomatosis with polyangiitis and facial palsy: Literature review and insight in the autoimmune pathogenesis.

    Science.gov (United States)

    Iannella, Giannicola; Greco, Antonio; Granata, Guido; Manno, Alessandra; Pasquariello, Benedetta; Angeletti, Diletta; Didona, Dario; Magliulo, Giuseppe

    2016-07-01

    Granulomatosis with polyangiitis (GPA) is an autoimmune systemic necrotizing small-vessel vasculitis associated with the presence of anti-neutrophil cytoplasmic antibodies (ANCA). Oto-neurological manifestations of ANCA-associated vasculitis according to PR3-ANCA positivity and MPO-ANCA positivity are usually reported. Facial nerve palsy is usually reported during the clinical course of the disease but it might appear as the presenting sign of GPA. Necrotizing vasculitis of the facial nerve 'vasa nervorum' is nowadays the most widely accepted etiopathogenetic theory to explain facial damage in GPA patients. A central role for PR3-ANCA in the pathophysiology of vasculitis in GPA patients with oto-neurological manifestation is reported. GPA requires prompt, effective management of the acute and chronic manifestations. Once the diagnosis of GPA has been established, clinicians should devise an appropriate treatment strategy for each individual patient, based on current clinical evidence, treatment guidelines and recommendations.

  2. Brachial plexus palsy caused by halo traction before posterior correction in patients with severe scoliosis

    Institute of Scientific and Technical Information of China (English)

    QIAN Bang-ping; QIU Yong; WANG Bin; YU Yang; ZHU Ze-zhang

    2007-01-01

    Objective: To explore the clinical features and treatment results of brachial plexus palsy caused by halo traction before posterior correction in patients with severe scoliosis.Methods: A total of 300 cases of severe scoliosis received halo traction before posterior correction in our department from July 1997 to November 2004. Among them, 7 cases were complicated with brachial plexus palsy.The average Cobb angle was 110° (range, 90°-135°).Diagnoses were made as idiopathic scoliosis in 1 case,congenital scoliosis in 3 cases, and neuromuscular scoliosis in 3 cases. Additionally, diastematomyelia and tethered cord syndrome were found in 3 cases and thoracolumbar kyphosis in 2 cases. Weight of traction was immediately reduced when the patient developed any abnormal neurological symptoms in the upper extremity, and rehabilitation training was undertaken. Simultaneously,neurotrophic pharmacotherapy was applied, and the neurological function restoration of the upper limbs and the recovery time were documented.Results: Traction was used for an average of 3.5 weeks (range, 2-6 weeks) before spinal fusion for these 7 patients. The average traction weight was 8 kg, which was 19% on average (range, 13%-26%) of the average body weight (40.2 kg). These 7 patients had long and thin body configuration with a mean height of 175 cm. The duration between symptoms of brachial plexus paralysis and the diagnosis was 1-3 hours. All of these 7 patients presented various degrees of numbness in the ulnar side of the hand and forearm. Median nerve paresis was found in 3 cases and ulnar nerve paresis in 4 cases. Complete recovery of the neurological function had been achieved by the end of three months.Conclusions: The clinical features of brachial plexus palsy caused by halo traction include median nerve paresis,ulnar nerve paralysis, and numbness in the ulnar side of the hand and forearm, which may be due to the injury of the inferior part of the brachial plexus, i.e. , damage of Cs and

  3. Unusual Clinical Presentation of Ethylene Glycol Poisoning: Unilateral Facial Nerve Paralysis

    Directory of Open Access Journals (Sweden)

    Eray Eroglu

    2013-01-01

    Full Text Available Ethylene glycol (EG may be consumed accidentally or intentionally, usually in the form of antifreeze products or as an ethanol substitute. EG is metabolized to toxic metabolites. These metabolites cause metabolic acidosis with increased anion gap, renal failure, oxaluria, damage to the central nervous system and cranial nerves, and cardiovascular instability. Early initiation of treatment can reduce the mortality and morbidity but different clinical presentations can cause delayed diagnosis and poor prognosis. Herein, we report a case with the atypical presentation of facial paralysis, hematuria, and kidney failure due to EG poisoning which progressed to end stage renal failure and permanent right peripheral facial nerve palsy.

  4. Peripheral nerve injuries in weight training: sites, pathophysiology, diagnosis, and treatment.

    Science.gov (United States)

    Lodhia, Keith R; Brahma, Barunashish; McGillicuddy, John E

    2005-07-01

    Direct trauma, compression caused by muscle hypertrophy or other soft tissue changes, or excessive stretching of a peripheral nerve in the upper extremity may lead to uncommon-but potentially serious-complications. Clinicians are seeing more of these injuries as weight training, power lifting, bodybuilding, cross-training, and general physical conditioning with weights become more popular. Symptoms of pain, weakness, paresthesia, or palsy; physical exam findings; electromyography; and nerve conduction studies are used to make the diagnosis. Most conditions respond well to conservative measures, such as rest from the offending exercise and correction of poor technique, but surgery may be required for complete clinical resolution in severe cases.

  5. Imaging the trigeminal nerve

    Energy Technology Data Exchange (ETDEWEB)

    Borges, Alexandra [Radiology Department, Instituto Portugues de Oncologia Francisco Gentil, Centro de Lisboa, Rua Prof. Lima Basto, 1093, Lisboa (Portugal)], E-mail: borgalexandra@gmail.com; Casselman, Jan [Department of Radiology, A. Z. St Jan Brugge and A. Z. St Augustinus Antwerpen Hospitals (Belgium)

    2010-05-15

    Of all cranial nerves, the trigeminal nerve is the largest and the most widely distributed in the supra-hyoid neck. It provides sensory input from the face and motor innervation to the muscles of mastication. In order to adequately image the full course of the trigeminal nerve and its main branches a detailed knowledge of neuroanatomy and imaging technique is required. Although the main trunk of the trigeminal nerve is consistently seen on conventional brain studies, high-resolution tailored imaging is mandatory to depict smaller nerve branches and subtle pathologic processes. Increasing developments in imaging technique made possible isotropic sub-milimetric images and curved reconstructions of cranial nerves and their branches and led to an increasing recognition of symptomatic trigeminal neuropathies. Whereas MRI has a higher diagnostic yield in patients with trigeminal neuropathy, CT is still required to demonstrate the bony anatomy of the skull base and is the modality of choice in the context of traumatic injury to the nerve. Imaging of the trigeminal nerve is particularly cumbersome as its long course from the brainstem nuclei to the peripheral branches and its rich anastomotic network impede, in most cases, a topographic approach. Therefore, except in cases of classic trigeminal neuralgia, in which imaging studies can be tailored to the root entry zone, the full course of the trigeminal nerve has to be imaged. This article provides an update in the most recent advances on MR imaging technique and a segmental imaging approach to the most common pathologic processes affecting the trigeminal nerve.

  6. Imaging the trigeminal nerve

    International Nuclear Information System (INIS)

    Of all cranial nerves, the trigeminal nerve is the largest and the most widely distributed in the supra-hyoid neck. It provides sensory input from the face and motor innervation to the muscles of mastication. In order to adequately image the full course of the trigeminal nerve and its main branches a detailed knowledge of neuroanatomy and imaging technique is required. Although the main trunk of the trigeminal nerve is consistently seen on conventional brain studies, high-resolution tailored imaging is mandatory to depict smaller nerve branches and subtle pathologic processes. Increasing developments in imaging technique made possible isotropic sub-milimetric images and curved reconstructions of cranial nerves and their branches and led to an increasing recognition of symptomatic trigeminal neuropathies. Whereas MRI has a higher diagnostic yield in patients with trigeminal neuropathy, CT is still required to demonstrate the bony anatomy of the skull base and is the modality of choice in the context of traumatic injury to the nerve. Imaging of the trigeminal nerve is particularly cumbersome as its long course from the brainstem nuclei to the peripheral branches and its rich anastomotic network impede, in most cases, a topographic approach. Therefore, except in cases of classic trigeminal neuralgia, in which imaging studies can be tailored to the root entry zone, the full course of the trigeminal nerve has to be imaged. This article provides an update in the most recent advances on MR imaging technique and a segmental imaging approach to the most common pathologic processes affecting the trigeminal nerve.

  7. Mastoiditis and Gradenigo’s Syndrome with anaerobic bacteria

    Directory of Open Access Journals (Sweden)

    Jacobsen Chris

    2012-09-01

    Full Text Available Abstract Background Gradenigo’s syndrome is a rare disease, which is characterized by the triad of the following conditions: suppurative otitis media, pain in the distribution of the first and the second division of trigeminal nerve, and abducens nerve palsy. The full triad may often not be present, but can develop if the condition is not treated correctly. Case presentation We report a case of a 3-year-old girl, who presented with fever and left-sided acute otitis media. She developed acute mastoiditis, which was initially treated by intravenous antibiotics, ventilation tube insertion and cortical mastoidectomy. After 6 days the clinical picture was complicated by development of left-sided abducens palsy. MRI-scanning showed osteomyelitis within the petro-mastoid complex, and a hyper intense signal of the adjacent meninges. Microbiological investigations showed Staphylococcus aureus and Fusobacterium necrophorum. She was treated successfully with intravenous broad-spectrum antibiotic therapy with anaerobic coverage. After 8 weeks of follow-up there was no sign of recurrent infection or abducens palsy. Conclusion Gradenigo’s syndrome is a rare, but life-threatening complication to middle ear infection. It is most commonly caused by aerobic microorganisms, but anaerobic microorganisms may also be found why anaerobic coverage should be considered when determining the antibiotic treatment.

  8. Clinical Practice Guideline of Acupuncture for Bell's Palsy

    Directory of Open Access Journals (Sweden)

    Xi Wu

    2016-10-01

    Full Text Available Backgroud: Acupuncture is common used for Bell's palsy in clinic, however, recent systematic reviews all shows that there is no sufficient evidence to support the effectiveness of acupuncture for Bell's palsy because ofthe poor quality and heterogeneity. It's urgently necessary to develop a guideline of acupuncture for Bell's palsy based on principles of evidence-based medicine to optimize acupuncture treating, standardize outcomes evaluating and to improve the quality of acupuncture for patients with Bell's palsy under general circumstances.

  9. Masseteric-facial nerve transposition for reanimation of the smile in incomplete facial paralysis.

    Science.gov (United States)

    Hontanilla, Bernardo; Marre, Diego

    2015-12-01

    Incomplete facial paralysis occurs in about a third of patients with Bell's palsy. Although their faces are symmetrical at rest, when they smile they have varying degrees of disfigurement. Currently, cross-face nerve grafting is one of the most useful techniques for reanimation. Transfer of the masseteric nerve, although widely used for complete paralysis, has not to our knowledge been reported for incomplete palsy. Between December 2008 and November 2013, we reanimated the faces of 9 patients (2 men and 7 women) with incomplete unilateral facial paralysis with transposition of the masseteric nerve. Sex, age at operation, cause of paralysis, duration of denervation, recipient nerves used, and duration of follow-up were recorded. Commissural excursion, velocity, and patients' satisfaction were evaluated with the FACIAL CLIMA and a questionnaire, respectively. The mean (SD) age at operation was 39 (±6) years and the duration of denervation was 29 (±19) months. There were no complications that required further intervention. Duration of follow-up ranged from 6-26 months. FACIAL CLIMA showed improvement in both commissural excursion and velocity of more than two thirds in 6 patients, more than one half in 2 patients and less than one half in one. Qualitative evaluation showed a slight or pronounced improvement in 7/9 patients. The masseteric nerve is a reliable alternative for reanimation of the smile in patients with incomplete facial paralysis. Its main advantages include its consistent anatomy, a one-stage operation, and low morbidity at the donor site.

  10. PRETERM BIRTH ASSOCIATION WITH CEREBRAL PALSY

    Directory of Open Access Journals (Sweden)

    Srinivasa Rao

    2015-04-01

    Full Text Available INTRODUCTION: Cerebral palsy ( CP is a group of permanent movement disorders that appear in early childhood. Preterm birth is the birth of baby before 37 completed weeks, a full term birth is birth at 37 to 42 weeks of gestation . AIM: To show the extent of association of preterm deliveries as a risk factor in development of cerebral palsy. MATERIALS AND METHODS: This r etrospective cohort study was conducted by eliciting history from the mothers of 99 cerebral palsy children who w ere treated in Rani Chandra Mani Devi Hospital, Visakhapatnam, Andhra Pradesh, India. De tailed history was taken from the mothers of 99 cerebral palsy children who were treated in this hospital. History regarding the period of gestation at which the child was born (preterm or full term, any previous history of pre - term delivery or abortions, was obtained from the mothers and the data analyzed . RESULTS: From this study it was observed the proportional association of pre - term births to cerebral palsy is 33 out 99 i.e., about 33.33%, Of these 33 cerebral palsy children highest association being with birth at 28 wks gestation (51 %. This study also shows th at the mothers with a previous history of preterm delivery have 14.4 times higher risk of subsequent pre term delivery; those with previous history of abortions have 5.7 times risk of pre - term delivery than mothers without such history. CONCLUSION: From th is study it was concluded that the pre - term birth plays a major role as a risk factor in the development of cerebral palsy with mothers having previous pre term delivery and previous abortions adding further to this risk.

  11. Recurrent oculomotor palsy due to haemorrhage in pituitary adenoma.

    OpenAIRE

    Mohanty, S.

    1980-01-01

    Haemorrhage in pituitary adenoma is an unusual cause of recurrent oculomotor palsy. Three episodes of right oculomotor palsy are reported from a patient having haemorrhage in pituitary adenoma. Early operation and decompression of haemorrhagic pituitary adenoma should be performed so that vision may be preserved and recovery of oculomotor palsy be assured.

  12. MRI enhancement of the facial nerve with Gd-DTPA, 1; Experimental study on the enhancement mechanism used in viewing vascular permeability of the facial nerve

    Energy Technology Data Exchange (ETDEWEB)

    Yanagida, Masahiro (Kansai Medical School, Moriguchi, Osaka (Japan))

    1993-08-01

    Although there have recently been numerous reports of enhanced MRI in patients with facial palsy, the mechanism of enhancement remains largely unknown. In the present study, animal models with experimentally induced facial paralysis were prepared, and the vascular permeabilities of normal and damaged facial nerves were assessed using Evans blue albumin (EBA) as a tracer. The Gd-DTPA contents in normal and compressively damaged facial nerves were also investigated. In the normal intratemporal facial nerve, EBA remained in the vessels, and did not leak into the endoneurium. In contrast, vascular permeability was very high in the epineurium and the geniculate ganglion which showed leakage of large amounts of EBA from vessels. At the site of compression in the damaged nerve, EBA leakage was also seen in the endoneurism, indicating accentuated vascular permeability. This accentuation of vascular permeability shifted toward the distal side. However, no EBA leakage was seen on the side proximal to the site of compression. Significantly higher Gd-DTPA contents were obtained in the facial nerve on the paralytic side than in that on the normal side (p<0.001). As for differences between the distal and proximal sides, the distal side had a significantly higher Gd-DTPA content (p<0.01). Assessment of vascular permeability with EBA revealed accentuated vascular permeability on the side distal to the site of compression. These results showed the presence of a blood nerve barrier (BNB) in the facial nerve. Furthermore, the present findings suggest that the enhancement of the facial nerve on the affected side is caused by BNB destruction due to nerve damage and subsequent Gd-DTPA leakage from the vessels. Furthermore, it is suggested that the facial nerve enhancement appears to occur mainly on the distal side of the damaged portion of the nerve. (author).

  13. "All that palsies is not Bell's" - The need to define Bell's palsy as an adverse event following immunization

    NARCIS (Netherlands)

    Rath, Barbara; Linder, Thomas; Cornblath, David; Hudson, Michael; Fernandopulle, Rohini; Hartmann, Katharina; Heininger, Ulrich; Izurieta, Hector; Killion, Leslie; Kokotis, Pangiotis; Oleske, James; Vajdy, Michael; Wong, Virginia

    2007-01-01

    Bell's palsy has been reported as an adverse event following immunization (AEFI). Review of the published literature reveals that several characteristics have been used to describe Bell's palsy, which differ significantly from author to author. Evidently, the definition of "Bell's palsy" remains con

  14. 贝尔麻痹患者早期瞬目反射、面神经电图的改变及其与面神经功能损害的关系%Relationship among Characteristic of Blink Reflex, Facial Nerve Electroneurography and Functional Lesion at the Early Stage of Bell's Palsy

    Institute of Scientific and Technical Information of China (English)

    余青云; 洪铭范; 程静

    2014-01-01

    目的:探讨贝尔麻痹患者早期瞬目反射、面神经电图的改变及其与面神经功能损害相关性。方法对25例贝尔麻痹早期患者进行瞬目反射与面神经电图检测,比较其阳性率,并分别根据其检测结果分为轻-中度损害、重度损害;同时按House-Blackmann(H-B)面神经功能评价分级标准进行面瘫程度评估,Ⅰ级为正常,Ⅱ~Ⅲ级为轻-中度、Ⅳ~Ⅵ级为重度。结果H-B面瘫分级评估,轻-中度面瘫占44%,重度面瘫占56%。瞬目反射检测阳性率达100%,其中轻-中度损害占28%,重度损害占72%;瞬目反射检测与H-B面瘫分级评估一致(P>0.05)。面神经电图检测阳性率52%,其中轻-中度损害占44%,重度损害占8%,与H-B面瘫分级评估不一致(P0.05). The positive rate of electroneurography was 52%, with the proportion of mild-moderate damage was 44%and severe damage was 8%, which was inconsistent with H-B scale evaluation (P<0.05). Conclusion Blink reflex is preferable to electroneurography in evaluating facial paralysis degree at the early stage of Bell's palsy.

  15. Nerve damage in leprosy: An electrophysiological evaluation of ulnar and median nerves in patients with clinical neural deficits: A pilot study

    Directory of Open Access Journals (Sweden)

    Sumit Kar

    2013-01-01

    Full Text Available Background : Leprosy involves peripheral nerves sooner or later in the course of the disease leading to gross deformities and disabilities. Sadly, by the time it becomes clinically apparent, the nerve damage is already quite advanced. However, if the preclinical damage is detected early in the course of disease, it can be prevented to a large extent. Materials and Methods: We conducted an electrophysiological pilot study on 10 patients with clinically manifest leprosy, in the Dermatology Department of Mahatma Gandhi Institute of Medical Sciences, Sewagram. This study was done to assess the nerve conduction velocity, amplitude and latency of ulnar and median nerves. Results and Conclusion: We found reduced conduction velocities besides changes in latency and amplitude in the affected nerves. Changes in sensory nerve conduction were more pronounced. Also, sensory latencies and amplitude changes were more severe than motor latencies and amplitude in those presenting with muscle palsies. However, further studies are going on to identify parameters to detect early nerve damage in leprosy.

  16. A rare case of Moebius sequence

    Directory of Open Access Journals (Sweden)

    Abhishek Kulkarni

    2012-01-01

    Full Text Available We report a case of an 18-year-old male who presented with watering and inability to close the left eye completely since 6 months and inability to move both eyes outward and to close the mouth since childhood. Ocular, facial, and systemic examination revealed that the patient had bilateral complete lateral rectus and bilateral incomplete medial rectus palsy, left-sided facial nerve paralysis, thickening of lower lip and inability to close the mouth, along with other common musculoskeletal abnormalities. This is a typical presentation of Moebius syndrome which is a very rare congenital neurological disorder characterized by bilateral facial and abducens nerve paralysis. This patient had bilateral incomplete medial rectus palsy which is suggestive of the presence of horizontal gaze palsy or occulomotor nerve involvement as a component of Moebius sequence.

  17. Hereditary neuropathy with liability to pressure palsies (HNPP) in a toddler presenting with toe-walking, pain and stiffness.

    Science.gov (United States)

    Lönnqvist, Tuula; Pihko, Helena

    2003-12-01

    The typical clinical presentation of hereditary neuropathy with liability to pressure palsies is an adult-onset recurrent, painless monoparesis. Electrophysiological abnormalities--decreased nerve conduction velocities and delayed distal latencies--can be detected even in asymptomatic patients. We describe a toddler, who presented with asymmetric toe walking, painful cramps and stiffness in the legs. He had calf hypertrophy, brisk tendon reflexes and bilateral Babinski signs and the electrophysiological examination was normal. The unlikely diagnosis of hereditary neuropathy with liability to pressure palsies was reached 5 years later, when the boy started to complain of episodic numbness and weakness in the upper extremities. His father, paternal aunt and grandmother had similar symptoms, but they had never been investigated. The typical 1.5 Mb deletion on chromosome 17p11.2-12 was found in our patient and his affected relatives. PMID:14678806

  18. Anatomical Study of the Ulnar Nerve Variations at High Humeral Level and Their Possible Clinical and Diagnostic Implications

    Science.gov (United States)

    Guru, Anitha; Kumar, Naveen; Ravindra Shanthakumar, Swamy; Patil, Jyothsna; Nayak Badagabettu, Satheesha; Aithal Padur, Ashwini; Nelluri, Venu Madhav

    2015-01-01

    Background. Descriptive evaluation of nerve variations plays a pivotal role in the usefulness of clinical or surgical practice, as an anatomical variation often sets a risk of nerve palsy syndrome. Ulnar nerve (UN) is one amongst the major nerves involved in neuropathy. In the present anatomical study, variations related to ulnar nerve have been identified and its potential clinical implications discussed. Materials and Method. We examined 50 upper limb dissected specimens for possible ulnar nerve variations. Careful observation for any aberrant formation and/or communication in relation to UN has been carried out. Results. Four out of 50 limbs (8%) presented with variations related to ulnar nerve. Amongst them, in two cases abnormal communication with neighboring nerve was identified and variation in the formation of UN was noted in remaining two limbs. Conclusion. An unusual relation of UN with its neighboring nerves, thus muscles, and its aberrant formation might jeopardize the normal sensori-motor behavior. Knowledge about anatomical variations of the UN is therefore important for the clinicians in understanding the severity of ulnar nerve neuropathy related complications. PMID:26246909

  19. Anatomical Study of the Ulnar Nerve Variations at High Humeral Level and Their Possible Clinical and Diagnostic Implications

    Directory of Open Access Journals (Sweden)

    Anitha Guru

    2015-01-01

    Full Text Available Background. Descriptive evaluation of nerve variations plays a pivotal role in the usefulness of clinical or surgical practice, as an anatomical variation often sets a risk of nerve palsy syndrome. Ulnar nerve (UN is one amongst the major nerves involved in neuropathy. In the present anatomical study, variations related to ulnar nerve have been identified and its potential clinical implications discussed. Materials and Method. We examined 50 upper limb dissected specimens for possible ulnar nerve variations. Careful observation for any aberrant formation and/or communication in relation to UN has been carried out. Results. Four out of 50 limbs (8% presented with variations related to ulnar nerve. Amongst them, in two cases abnormal communication with neighboring nerve was identified and variation in the formation of UN was noted in remaining two limbs. Conclusion. An unusual relation of UN with its neighboring nerves, thus muscles, and its aberrant formation might jeopardize the normal sensori-motor behavior. Knowledge about anatomical variations of the UN is therefore important for the clinicians in understanding the severity of ulnar nerve neuropathy related complications.

  20. The hip in cerebral palsy.

    Science.gov (United States)

    Bleck, E E

    1980-01-01

    Orthopedic surgery can alleviate the hip flexion, adduction, and medial rotation deformities of the hip and improve the function and appearance of gait. To accomplish this, however, careful examination and prudence in the operative procedure to avoid overdoing and overcorrecting are important. Orthopedic surgery can prevent subluxation and dislocation of the hip before the age of seven years, and consequently repetitive radiographic examinations of the hip in children who have spastic paralysis of the hip musculature should be a routine procedure. Subluxation and dislocation of the hip, when established, can be successfully treated with orthopedic surgical procedures. Physicians must keep in mind that the spastic paralysis of cerebral palsy originates in the brain, and therefore the spasticity cannot be eliminated. The best that can be done is to weaken or remove some muscles as deforming forces and to achieve compromises for continued function. The goal should be optimal independence for the child and adolescent during development, and freedom from pain with deteriorating function due to degenerative arthritis in the adult. PMID:7360505

  1. Peripheral nerve disease

    Institute of Scientific and Technical Information of China (English)

    1992-01-01

    920745 Experimental reconstruction of in-trinsic hand muscle function by anteriorinterosseous nerve transference. HUANGGang(黄钢), et al. Dept Orthopaedics, GeneralHosp, PLA, Beijing, 100853. Natl, Med J Chin1992; 72(5): 269-272. The anterior interosseous nerve was transferred

  2. Comparison of the Efficacy of Combination Therapy of Prednisolone-Acyclovir with Prednisolone Alone in Bell’s Palsy

    Directory of Open Access Journals (Sweden)

    Ali KHAJEH

    2015-06-01

    Full Text Available How to Cite This Article: Khajeh A, Fayyazi A, Soleimani Gh, Miri-Aliabad Gh, Shaykh Veisi S, Khajeh B. Comparison of the Efficacy ofCombination Therapy of Prednisolone-Acyclovir with Prednisolone Alone in Bell’s Palsy. Iran J Child Neurol. Spring 2015; 9(2:17-20.AbstractObjectiveBell’s palsy is a rapid onset, usually, unilateral paralysis of the facial nerve that causes significant changes in an individual’s life such as a decline in personal, social, and educational performance. This study compared efficacy of combined prednisolone and acyclovir therapy with prednisolone alone.Materials & MethodsThis study is a randomized controlled trial conducted on 43 Children (2–18 years old with Bell’s palsy. The first group of 23 patients was treated with prednisolone and the remaining patients were treated with a combination of prednisolone and acyclovir. The required data were extracted, using an informational form based on the House-Brackmann Scale, which grades facial nerve paralysis. The data were analyzed with Mann-Whitney test using SPSS version 16.ResultsThe mean age of the first and second group were 8.65 ± 5.07 and 8.35 ± 4.92 years, respectively, (p=0.84. Sixty one percent and 39% of patients in the first group, and 45% and 55% of patients in the second group were male and female, respectively. No significant differences exist between the groups in terms of age and gender. The rate of complete recovery was 65.2% in group I and 90% in the group II (p=0.04.ConclusionThe results of this study showed that the combined prednisolone and acyclovir therapy of patients with Bell’s palsy is far more effective than treatment with prednisolone alone. Actually, age and gender had no impact on the rate of recovery.

  3. Electrophsiological study in the prognosis of Bell palsy%电生理检测对贝耳麻痹患者的预后评估

    Institute of Scientific and Technical Information of China (English)

    鲍海平; 常宇; 毛艺芳; 尹琳; 高政

    2003-01-01

    AIM:To estimate the prognosis of Bell palsy.METHODS: Blink reflex (BR), electromyography(EMG),motor latency(ML) and amplitude (AMP) of facial nerve were performed in 42 patients with Bell's palsy.The patients were followed about half a year.RESULTS: (1)When 1 of the 3R waves related with the ill side existed or appeared in 3 weeks after onset,97% patients could recover completely.The recovery time was related to the time of the occurrence of R wave.(2) When 1 of the 3 R waves appeared in the 4th week, 60% patients could recover completely.When none of the 3 waves appeared after the 4th week,100% patients could not recover completely.EMG showed spontaneous activities in 3 of the 6 patients in the 4th week.(3) Motor latency and amplitude of facial nerve were examined when the illness stopped developing.All patients had normal latencies.5 patients' amplitudes reduced more than 90% . 3 of the 5 patients did not appear the related R waves after the 4th week.CONCLUSION:BR might provide the early sign of good prognosis of Bell's palsy. BR together with EMG and ML and AMP of facial nerve might provide the later sign of poor prognosis.

  4. Excitability properties of motor axons in adults with cerebral palsy

    Directory of Open Access Journals (Sweden)

    Cliff S. Klein

    2015-06-01

    Full Text Available Cerebral Palsy (CP is a permanent disorder caused by a lesion to the developing brain that significantly impairs motor function. The neurophysiological mechanisms underlying motor impairment are not well understood. Specifically, few have addressed whether motoneuron or peripheral axon properties are altered in CP, even though disruption of descending inputs to the spinal cord may cause them to change. In the present study, we have compared nerve excitability properties in seven adults with CP and fourteen healthy controls using threshold tracking techniques by stimulating the median nerve at the wrist and recording the compound muscle action potential (CMAP over the abductor pollicis brevis. The excitability properties in the CP subjects were found to be abnormal. Early and late depolarizing and hyperpolarizing threshold electrotonus was significantly larger (i.e., fanning out, and resting current-threshold (I/V slope was smaller, in CP compared to control. In addition resting threshold and rheobase tended to be larger in CP. According to a modeling analysis of the data, an increase in leakage current under or through the myelin sheath, i.e., the Barrett-Barrett conductance (GBB, combined with a slight hyperpolarization of the resting membrane potential, best explained the group differences in excitability properties. There was a trend for those with greater impairment in gross motor function to have more abnormal axon properties. The findings indicate plasticity of motor axon properties far removed from the site of the lesion. We suspect that this plasticity is caused by disruption of descending inputs to the motoneurons at an early age around the time of their injury.

  5. Maternal Infections during Pregnancy and Cerebral Palsy

    DEFF Research Database (Denmark)

    Miller, Jessica; Pedersen, Lars Henning; Streja, Elani;

    2013-01-01

    BACKGROUND: Cerebral palsy (CP) is a common motor disability in childhood. We examined the association between maternal infections during pregnancy and the risk of congenital CP in the child. METHODS: Liveborn singletons in Denmark between 1997 and 2003 were identified from the Danish National...... the Danish Cerebral Palsy Registry. Adjusted hazard ratio (HR) and 95% confidence interval (CI) were estimated by Cox proportional hazard models. RESULTS: Of the 440 564 singletons with follow-up data, 840 were diagnosed with congenital CP. Maternal genito-urinary tract infections (HR 2.1, 95% CI 1.4, 3...

  6. Education and employment prospects in cerebral palsy

    DEFF Research Database (Denmark)

    Michelsen, Susan Ishøy; Uldall, Peter; Kejs, Anne Mette T;

    2005-01-01

    Parents and paediatric neurologists need information on the long-term social prognosis of children with cerebral palsy (CP). No large population-based study has been performed on this topic. On 31 December 1999, to find predictors in childhood of subsequent education and employment, 819...... participants with CP born between 1965 and 1978 (471 males; mean age 28y 10 mo, SD 4y, range 21 to 35y) in the Danish Cerebral Palsy Registry were compared with 4406 controls without CP born between 1965 and 1978 (2546 males; mean age 28y 10 mo, SD 4y, range 21 to 35y). Diagnostic subtypes of the 819...

  7. Epidemiology of cerebral palsy in Southern Denmark

    DEFF Research Database (Denmark)

    Frøslev-Friis, Christina; Dunkhase-Heinl, Ulrike; Andersen, Johnny Dohn Holmgren;

    2015-01-01

    INTRODUCTION: The aim of this study was to describe the prevalence, subtypes, severity and neuroimaging findings of cerebral palsy (CP) in a cohort of children born in Southern Denmark. Risk factors were analysed and aetiology considered. METHODS: A population-based cohort study covering 17...... prevention of CP is possible if the numbers of preterm births and multiple pregnancies can be reduced. FUNDING: The Danish Cerebral Palsy Follow-up Programme is supported by the foundation "Ludvig og Sara Elsass Fond". TRIAL REGISTRATION: 2008-58-0034....

  8. Biological and artificial nerve conduit for repairing peripheral nerve defect

    Institute of Scientific and Technical Information of China (English)

    Xuetao Xie; Changqing Zhang

    2006-01-01

    OBJECTIVE: Recently, with the development of biological and artificial materials, the experimental and clinical studies on application of this new material-type nerve conduit for treatment of peripheral nerve defect have become the hotspot topics for professorial physicians.DATA SOURCES: Using the terms "nerve conduits, peripheral nerve, nerve regeneration and nerve transplantation" in English, we searched Pubmed database, which was published during January 2000 to June 2006, for the literatures related to repairing peripheral nerve defect with various materials. At the same time, we also searched Chinese Technical Scientific Periodical Database at the same time period by inputting" peripheral nerve defect, nerve repair, nerve regeneration and nerve graft" in Chinese.STUDY SELECTION: The materials were firstly selected, and literatures about study on various materials for repairing peripheral nerve defect and their full texts were also searched. Inclusive criteria: nerve conduits related animal experiments and clinical studies. Exclusive criteria: review or repetitive studies.DATA EXTRACTION: Seventy-nine relevant literatures were collected and 30 of them met inclusive criteria and were cited.DATA SYNTHESTS: Peripheral nerve defect, a commonly seen problem in clinic, is difficult to be solved. Autogenous nerve grafting is still the gold standard for repairing peripheral nerve defect, but because of its application limitation and possible complications, people studied nerve conduits to repair nerve defect. Nerve conduits consist of biological and artificial materials.CONCLUSION: There have been numerous reports about animal experimental and clinical studies of various nerve conduits, but nerve conduit, which is more ideal than autogenous nerve grafting, needs further clinical observation and investigation.

  9. What is cerebral palsy - new advances in treatment of cerebral palsy?

    OpenAIRE

    Perat, Milivoj Veličković

    2013-01-01

    Abstract. Cerebral palsy is the most frequent motorimpairment in childhood. In many countries, its prevalence is predicted toincrease. There are an estimated 15 million people with cerebral palsy aroundthe world and more than half of them are mentally retarded and one third haveepilepsy. It should be seen that it is more than merely a motor disorder. Therecan be problems of development, perceptual-cognitive impairment, social andfunctional problems of daily living, emotional and behavioural p...

  10. Neurophysiological approach to disorders of peripheral nerve

    DEFF Research Database (Denmark)

    Crone, Clarissa; Krarup, Christian

    2013-01-01

    Disorders of the peripheral nerve system (PNS) are heterogeneous and may involve motor fibers, sensory fibers, small myelinated and unmyelinated fibers and autonomic nerve fibers, with variable anatomical distribution (single nerves, several different nerves, symmetrical affection of all nerves...

  11. Stem cells and related factors involved in facial nerve function regeneration.

    Science.gov (United States)

    Nelke, Kamil H; Łuczak, Klaudiusz; Pawlak, Wojciech; Łysenko, Lidia; Gerber, Hanna

    2015-01-01

    The facial nerve (VII) is one of the most important cranial nerves for head and neck surgeons. Its function is closely related to facial expressions that are individual for every person. After its injury or palsy, its functions can be either impaired or absent. Because of the presence of motor, sensory and parasympathetic fibers, the biology of its repair and function restoration depends on many factors. In order to achieve good outcome, many different therapies can be performed in order to restore as much of the nerve function as possible. When rehabilitation and physiotherapy are not sufficient, additional surgical procedures and therapies are taken into serious consideration. The final outcome of many of them is discussable, depending on nerve damage etiology. Stem cells in facial nerve repair are used, but long-term outcomes and results are still not fully known. In order to understand this therapeutic approach, clinicians and surgeons should understand the immunobiology of nerve repair and regeneration. In this review, potential stem cell usage in facial nerve regeneration procedures is discussed. PMID:26400886

  12. Intratemporal facial nerve neuromas and their mimics: CT and MR findings

    Energy Technology Data Exchange (ETDEWEB)

    Han, Moon Hee; Chang, Kee Hyun; Lee, Kyung Hwan; Cha, Sang Hoon; Kim, Chong Sun [Seoul National University College of Medicine, Seoul (Korea, Republic of); Kim, Sang Joon [Chungang Gil General Hospital, Seoul (Korea, Republic of)

    1992-05-15

    CT and MR findings of nine cases with intra temporal facial nerve neuromas were described and compared with CT findings of 3 cases with facial nerve palsy and facial nerve canal erosion which may mimic facial nerve neuroma. The tympanic segment of the facial nerve was involved in 8 cases, mastoid segment in 7 cases and labyrinthine segment in 5 cases. The lesions were easily diagnosed with high resolution CT with bone algorithms by showing the expansion of bony structures along the course of the facial nerves. In 4 cases with large vertical segment tumors, extensive destruction of mastoid air cells and external auditory canals posed difficulty in making a diagnosis. Two out of 5 cases with labyrinthine segment involvement were presented as middle cranial fossa masses. MRI with enhancement was performed in 4 cases and was useful in characterizing the lesion as a tumor with its superior sensitivity to enhancement. Three cases of facial neuroma-mimicking lesion including post-inflammatory peri neural thickening, peri neural extension from parotid adenoid cystic carcinoma, and congenita; cholesteatoma showed irregular erosion or mild expansion of the facial nerve canal which may be helpful for differential diagnosis from neuromas.

  13. Changes in nerve microcirculation following peripheral nerve compression

    Institute of Scientific and Technical Information of China (English)

    Yueming Gao; Changshui Weng; Xinglin Wang

    2013-01-01

    Following peripheral nerve compression, peripheral nerve microcirculation plays important roles in regulating the nerve microenvironment and neurotrophic substances, supplying blood and oxygen and maintaining neural conduction and axonal transport. This paper has retrospectively analyzed the articles published in the past 10 years that addressed the relationship between peripheral nerve compression and changes in intraneural microcirculation. In addition, we describe changes in different peripheral nerves, with the aim of providing help for further studies in peripheral nerve microcirculation and understanding its protective mechanism, and exploring new clinical methods for treating peripheral nerve compression from the perspective of neural microcirculation.

  14. Parental infertility and cerebral palsy in children

    DEFF Research Database (Denmark)

    Zhu, Jin Liang; Hvidtjørn, Dorte; Basso, Olga;

    2010-01-01

    Children born after in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) have been reported to have a higher risk of cerebral palsy (CP), perhaps due to the higher frequency of preterm birth, multiple births or vanishing embryo in the pregnancies. However, it has been suggested...

  15. Early identification and intervention in cerebral palsy

    DEFF Research Database (Denmark)

    Herskind, Anna; Greisen, Gorm; Nielsen, Jens Bo

    2015-01-01

    Infants with possible cerebral palsy (CP) are commonly assumed to benefit from early diagnosis and early intervention, but substantial evidence for this is lacking. There is no consensus in the literature on a definition of 'early', but this review focuses on interventions initiated within...

  16. Social integration of adults with cerebral palsy

    DEFF Research Database (Denmark)

    Michelsen, Susan Ishøy; Uldall, Peter; Hansen, Thomas;

    2006-01-01

    Social integration and independence is the ultimate goal of habilitation and social support for patients with cerebral palsy (CP). Having a partner and having children provide support for social integration of adults with or without a disability. We studied 416 participants with CP born between...

  17. Spasticity in Children with Cerebral Palsy?

    DEFF Research Database (Denmark)

    Willerslev-Olsen, Maria

    ) and passive stiffness (changes in the elastic properties of muscles) of ankle joint muscles at rest, during gait and in relation to gait training in children with cerebral palsy (CP). In study I we found that reflex mediated stiffness is difficult to distinguish clinically from changes in passive muscle...

  18. Thyroxine Level of Children with Cerebral Palsy

    Institute of Scientific and Technical Information of China (English)

    Zhang Jie

    2000-01-01

    Objective:To investigate the thyroxine level of Children with cerebral palsy so as to understand thd changes of their nevous endocrine. Methods:Radioimmunoassay was applied to 57 Children with cerebral palsy and 108 normal children.The serum level of tridothyronine(T3), thyroxine(T4)free tridothyronine(FT3),free thyroxin(FT4),and thyroid stimulating hormone(TSH) were measured for those children in the moming and and in condition without any food Rsults: (1)Chiidren with cerebral palsy all showed low T3 values.The difference of T3 value between CP children and norrmal children was significant (P<0.001). (2)Results from groups with difference ages:the CP toddler′s age group also showed low T4 and FT4 values The difference of T4 and FT4 values between the toddler′s age CP childrengroup and the toddler′s age normal children group tegted was significant (CP<0.01 for T4, P <0. 05 for FT4): Conclusion:The tlyroxine level of children with cerebral palsy showed lower values compared to normal children, especisly, the low T3 values were significant.

  19. Rare copy number variation in cerebral palsy

    OpenAIRE

    McMichael, Gai; Girirajan, Santhosh; Moreno-De-Luca, Andres; Gecz, Jozef; Shard, Chloe; Nguyen, Lam Son; Nicholl, Jillian; Gibson, Catherine; Haan, Eric; Eichler, Evan; Martin, Christa Lese; MacLennan, Alastair

    2013-01-01

    Recent studies have established the role of rare copy number variants (CNVs) in several neurological disorders but the contribution of rare CNVs to cerebral palsy (CP) is not known. Fifty Caucasian families having children with CP were studied using two microarray designs. Potentially pathogenic, rare (

  20. Pharmacological treatment in Dyskinetic Cerebral Palsy

    OpenAIRE

    Allori P; Pasquinelli A; Varrella A

    2012-01-01

    Evaluation of the effect of Levo-Sulpiride, Trazodone and combined treatment in 46 subjects affected by pure and mixed forms of Dyskinetic Cerebral Palsy. The results were assessed according to "Neuromotor Disorders Assessment Scale" (Papini et al, 1995, 1998; Allori et al 2006).

  1. Pretend Play of Children with Cerebral Palsy

    Science.gov (United States)

    Pfeifer, Luzia Iara; Pacciulio, Amanda Mota; dos Santos, Camila Abrao; dos Santos, Jair Licio; Stagnitti, Karen Ellen

    2011-01-01

    Background and Purpose: Evaluate self-initiated pretend play of children with cerebral palsy. Method: Twenty preschool children participated in the study. Pretend play ability was measured by using the child-initiated pretend play assessment culturally adapted to Brazil. Results: There were significant negative correlations between the children's…

  2. Gait Stability in Children with Cerebral Palsy

    Science.gov (United States)

    Bruijn, Sjoerd M.; Millard, Matthew; van Gestel, Leen; Meyns, Pieter; Jonkers, Ilse; Desloovere, Kaat

    2013-01-01

    Children with unilateral Cerebral Palsy (CP) have several gait impairments, amongst which impaired gait stability may be one. We tested whether a newly developed stability measure (the foot placement estimator, FPE) which does not require long data series, can be used to asses gait stability in typically developing (TD) children as well as…

  3. Epidemiology of Cerebral Palsy in the Netherlands

    NARCIS (Netherlands)

    M.J. Wichers (Marc Jan)

    2011-01-01

    textabstractChildren with cerebral palsy (CP) and their families often make strong demands on diagnostic, therapeutic, technical and social facilities. Prevalence estimates are needed to improve treatment and services. As recent Dutch data are not available, the present study aimed to assess the pop

  4. Cerebral palsy: the first three years.

    Science.gov (United States)

    Hoffer, M M; Koffman, M

    1980-09-01

    The orthopedic surgeion should be an integral part of a medical team for evaluation and treatment of young children with cerebral palsy. Surgical procedures in this first three years of life are usually limited to the adductor releases about the hip. Stretching and plastic splints about the ankle and knee followed by ankle-foot orthoses are frequently effective in correction of deformity.

  5. Seizure and unilateral facial nerve paralysis in a newborn with Dandy-Walker malformation – A case report

    Directory of Open Access Journals (Sweden)

    Subhajit Bhakta

    2014-01-01

    Full Text Available The Dandy-Walker syndrome (DWS is a rare posterior fossa malformation. It can have a varied presentation depending on the age. A newborn presenting with neonatal seizure along with unilateral facial nerve palsy is rather a rare presentation of DWS and very few such cases were reported in the past. We are reporting a case of a newborn male baby presenting with neonatal seizure within 48 hrs of birth along with right sided LMN type facial nerve palsy which on due course of investigation revealed as a case of Dandy–Walker malformation. Journal of College of Medical Sciences-Nepal, 2013, Vol-9, No-1, 48-51 DOI: http://dx.doi.org/10.3126/jcmsn.v9i1.9673

  6. High Ulnar Nerve Injuries: Nerve Transfers to Restore Function.

    Science.gov (United States)

    Patterson, Jennifer Megan M

    2016-05-01

    Peripheral nerve injuries are challenging problems. Nerve transfers are one of many options available to surgeons caring for these patients, although they do not replace tendon transfers, nerve graft, or primary repair in all patients. Distal nerve transfers for the treatment of high ulnar nerve injuries allow for a shorter reinnervation period and improved ulnar intrinsic recovery, which are critical to function of the hand. PMID:27094893

  7. Diabetic Nerve Problems

    Science.gov (United States)

    ... at the wrong times. This damage is called diabetic neuropathy. Over half of people with diabetes get ... you change positions quickly Your doctor will diagnose diabetic neuropathy with a physical exam and nerve tests. ...

  8. Damaged axillary nerve (image)

    Science.gov (United States)

    Conditions associated with axillary nerve dysfunction include fracture of the humerus (upper arm bone), pressure from casts or splints, and improper use of crutches. Other causes include systemic disorders that cause neuritis (inflammation of ...

  9. Sacral nerve stimulation.

    Science.gov (United States)

    Matzel, K E; Stadelmaier, U; Besendörfer, M

    2004-01-01

    The current concept of recruiting residual function of an inadequate pelvic organ by electrostimulation involves stimulation of the sacral spinal nerves at the level of the sacral canal. The rationale for applying SNS to fecal incontinence was based on clinical observations of its effect on bowel habits and anorectal continence function in urologic patients (increased anorectal angulation and anal canal closure pressure) and on anatomic considerations: dissection demonstrated a dual peripheral nerve supply of the striated pelvic floor muscles that govern these functions. Because the sacral spinal nerve site is the most distal common location of this dual nerve supply, stimulating here can elicit both functions. Since the first application of SNS in fecal incontinence in 1994, this technique has been improved, the patient selection process modified, and the spectrum of indications expanded. At present SNS has been applied in more than 1300 patients with fecal incontinence limited.

  10. Diabetes and nerve damage

    Science.gov (United States)

    Diabetic neuropathy; Diabetes - neuropathy; Diabetes - peripheral neuropathy ... In people with diabetes, the body's nerves can be damaged by decreased blood flow and a high blood sugar level. This condition is ...

  11. Degenerative Nerve Diseases

    Science.gov (United States)

    Degenerative nerve diseases affect many of your body's activities, such as balance, movement, talking, breathing, and heart function. Many of these diseases are genetic. Sometimes the cause is a medical ...

  12. Optic nerve oxygen tension

    DEFF Research Database (Denmark)

    la Cour, M; Kiilgaard, Jens Folke; Eysteinsson, T;

    2000-01-01

    To investigate the influence of acute changes in intraocular pressure on the oxygen tension in the vicinity of the optic nerve head under control conditions and after intravenous administration of 500 mg of the carbonic anhydrase inhibitor dorzolamide.......To investigate the influence of acute changes in intraocular pressure on the oxygen tension in the vicinity of the optic nerve head under control conditions and after intravenous administration of 500 mg of the carbonic anhydrase inhibitor dorzolamide....

  13. Ischemic and hemorrhagic brain stem lesions mimicking diabetic ophthalmoplegia.

    Science.gov (United States)

    Fujioka, T; Segawa, F; Ogawa, K; Kurihara, T; Kinoshita, M

    1995-05-01

    Two patients with diabetes mellitus, one of them with an isolated third cranial nerve palsy and the other with an isolated sixth cranial nerve palsy, are presented. MRI investigations including diffusion-weighted MRI revealed a small ischemic brain stem lesion in the former and a small hemorrhagic brain stem lesion in the latter. In the former case wallerian degeneration of the nerve fascicle within the mesencephalon was also detected. These cases indicate that vascular accidents of the brain stem may masquerade as fascicular or infranuclear disturbance of the oculomotor or abducens nerve; therefore, it is important to include brain stem lesions into the differential diagnosis of isolated ophthalmoplegia. Thorough investigation by MRI including diffusion-weighted MRI is helpful for correct diagnosis. PMID:7656493

  14. A RARE CASE OF SCHWANNOMA OF TRIGEMINAL NERVE WITH INTRAORBITAL EXTENSION

    Directory of Open Access Journals (Sweden)

    Shruti S.

    2015-10-01

    Full Text Available Schwannomas, also known as neurilemmomas, are benign peripheral nerve sheath tumors. Trigeminal schwannomas are rare intracranial tumors. Here, we report a 35 - year - old female presenting with an axial proptosis of right eyeball with right - sided III, IV and VI cranial nerve palsy. Her best corrected visual acuity in the right eye was perception of light absent and in the left eye was 20/20. MRI scan revealed a large right - sided heterogeneous, extra - axial middle cranial fossa mass that extended to the intraconal space of right orbit. A diagnosis of intracranial trigeminal nerve schwannoma with right orbital extension was made. Successful surgical excision of the mass with preservation of the surrounding tissues and orbital exenteration was done. Post - operative period was uneventful.

  15. Inherited focal, episodic neuropathies: hereditary neuropathy with liability to pressure palsies and hereditary neuralgic amyotrophy.

    Science.gov (United States)

    Chance, Phillip F

    2006-01-01

    Hereditary neuropathy with liability to pressure palsies (HNPP; also called tomaculous neuropathy) is an autosomal-dominant disorder that produces a painless episodic, recurrent, focal demyelinating neuropathy. HNPP generally develops during adolescence, and may cause attacks of numbness, muscular weakness, and atrophy. Peroneal palsies, carpal tunnel syndrome, and other entrapment neuropathies may be frequent manifestations of HNPP. Motor and sensory nerve conduction velocities may be reduced in clinically affected patients, as well as in asymptomatic gene carriers. The histopathological changes observed in peripheral nerves of HNPP patients include segmental demyelination and tomaculous or "sausage-like" formations. Mild overlap of clinical features with Charcot-Marie-Tooth (CMT) disease type 1 (CMT1) may lead patients with HNPP to be misdiagnosed as having CMT1. HNPP and CMT1 are both demyelinating neuropathies, however, their clinical, pathological, and electrophysiological features are quite distinct. HNPP is most frequently associated with a 1.4-Mb pair deletion on chromosome 17p12. A duplication of the identical region leads to CMT1A. Both HNPP and CMT1A result from a dosage effect of the PMP22 gene, which is contained within the deleted/duplicated region. This is reflected in reduced mRNA and protein levels in sural nerve biopsy samples from HNPP patients. Treatment for HNPP consists of preventative and symptom-easing measures. Hereditary neuralgic amyotrophy (HNA; also called familial brachial plexus neuropathy) is an autosomal-dominant disorder causing episodes of paralysis and muscle weakness initiated by severe pain. Individuals with HNA may suffer repeated episodes of intense pain, paralysis, and sensory disturbances in an affected limb. The onset of HNA is at birth or later in childhood with prognosis for recovery usually favorable; however, persons with HNA may have permanent residual neurological dysfunction following attack(s). Episodes are often

  16. Bell's palsy: A Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Tashika Kushraj

    2014-06-01

    Full Text Available Bell's palsy is considered as a disease of exclusion. It is a form of lower motor neuron paralysis affecting the facial muscles. Rapid onset of paralysis causes panic to the patients. For speedy recovery, correct diagnosis and early treatment are crucial. Here a case of Bell's palsy is reported and the literature on Bell's palsy is reviewed. [Cukurova Med J 2014; 39(3.000: 581-588

  17. DIABETES MELLITUS AND BELL’S PALSY IN IRANIAN POPULATION

    OpenAIRE

    A. R Karimi-Yazdi; A Vasheghani-Farahani; Sadeghi, M.; S. M Sadr-Hoseini; A. A Sazgar; M. A Harirchian; N. S Alirezaie

    2008-01-01

    "nDuring last decades many researchers have focused on the conditions associated with Bell's palsy including diabetes mellitus, hypertension, and viral infections. This study was performed to evaluate correlation of diabetes mellitus and Bell's palsy and some relevant features not discussed in the literature in an Iranian population. The presence of diabetes mellitus was evaluated in a total number of 275 subjects (75 patients with Bell's palsy and 200 control subjects). D...

  18. Familial Recurrence of Cerebral Palsy with Multiple Risk Factors

    OpenAIRE

    Lawrence P. Richer; Dower, Nancy A.; Norma Leonard; Chan, Alicia K. J.; Robertson, Charlene M. T.

    2012-01-01

    The recurrence of cerebral palsy in the same family is uncommon. We, however, report on two families with two or more affected siblings. In both families, numerous potential risk factors were identified including environmental, obstetric, and possible maternal effects. We hypothesize that multiple risk factors may lead to the increased risk of recurrence of cerebral palsy in families. Intrinsic and maternal risk factors should be investigated in all cases of cerebral palsy to properly counsel...

  19. Accessibility of mental health care for adults with cerebral palsy

    OpenAIRE

    Pihlaja, Kimmo; Päivärinta, Paula

    2014-01-01

    The purpose of this thesis is to describe the accessibility in mental health care from the point of view of an adult with cerebral palsy. The theoretical framework of this thesis is constructed from the related literature and previous studies closely linked to the topic. Research was done to clarify the concepts of disability, cerebral palsy, and mental health. The research showed cerebral palsy as a multidimensional physical disability which may include different types of accompanying im...

  20. The importance of phrenic nerve preservation and its effect on long-term postoperative lung function after pneumonectomy

    DEFF Research Database (Denmark)

    Kocher, Gregor J; Poulson, Jannie Lysgaard; Blichfeldt-Eckhardt, Morten Rune;

    2015-01-01

    OBJECTIVES: The importance of phrenic nerve preservation during pneumonectomy remains controversial. We previously demonstrated that preservation of the phrenic nerve in the immediate postoperative period preserved lung function by 3-5% but little is known about its long-term effects. We, therefore......%). In the remaining 2 patients, diaphragmatic motion was already paradoxical before the nerve block. We found no significant difference on dynamic lung function values (FEV1 'before' 1.39 ± 0.44 vs FEV1 'after' 1.38 ± 0.40; P = 0.81). CONCLUSIONS: Induction of a temporary diaphragmatic palsy did not significantly...... influence dynamic lung volumes in mid- to long-term pneumonectomy patients, suggesting that preservation of the phrenic nerve is of greater importance in the immediate postoperative period after pneumonectomy....

  1. Clinical characteristics and cerebrospinal fluid parameters in patients with peripheral facial palsy caused by Lyme neuroborreliosis compared with facial palsy of unknown origin (Bell's palsy

    Directory of Open Access Journals (Sweden)

    Hagberg Lars

    2011-08-01

    Full Text Available Abstract Background Bell's palsy and Lyme neuroborreliosis are the two most common diagnoses in patients with peripheral facial palsy in areas endemic for Borrelia burgdorferi. Bell's palsy is treated with corticosteroids, while Lyme neuroborreliosis is treated with antibiotics. The diagnosis of Lyme neuroborreliosis relies on the detection of Borrelia antibodies in blood and/or cerebrospinal fluid, which is time consuming. In this study, we retrospectively analysed clinical and cerebrospinal fluid parameters in well-characterised patient material with peripheral facial palsy caused by Lyme neuroborreliosis or Bell's palsy, in order to obtain a working diagnosis and basis for treatment decisions in the acute stage. Methods Hospital records from the Department of Infectious Diseases, Sahlgrenska University Hospital, for patients with peripheral facial palsy that had undergone lumbar puncture, were reviewed. Patients were classified as Bell's palsy, definite Lyme neuroborreliosis, or possible Lyme neuroborreliosis, on the basis of the presence of Borrelia antibodies in serum and cerebrospinal fluid and preceding erythema migrans. Results One hundred and two patients were analysed; 51 were classified as Bell's palsy, 34 as definite Lyme neuroborreliosis and 17 as possible Lyme neuroborreliosis. Patients with definite Lyme neuroborreliosis fell ill during the second half of the year, with a peak in August, whereas patients with Bell's palsy fell ill in a more evenly distributed manner over the year. Patients with definite Lyme neuroborreliosis had significantly more neurological symptoms outside the paretic area of the face and significantly higher levels of mononuclear cells and albumin in their cerebrospinal fluid. A reported history of tick bite was uncommon in both groups. Conclusions We found that the time of the year, associated neurological symptoms and mononuclear pleocytosis were strong predictive factors for Lyme neuroborreliosis as a

  2. [Biophysics of nerve excitation].

    Science.gov (United States)

    Kol'e, O R; Maksimov, G V

    2010-01-01

    The studies testifying to the presence of the interrelation between the physiological functions of the organism and physical and chemical processes in nerves are discussed. Changes in some physical and chemical parameters observed both upon elicited rhythmic exaltation of nerves and during the spontaneous rhythmic activity of neurons are analyzed. Upon rhythmic exaltation, a complex of physical and chemical processes is triggered, and reversible structural and metabolic rearrangements at the subcellular and molecular levels occur that do not take place during the generation of a single action potential. Thus, only in conditions of rhythmic exaltation of a nerve, it is possible to reveal those processes that provide exaltation of nerves in the organism. The future possibilities of the investigations combining the biophysical and physiological approaches are substantiated. Characteristic changes in physicochemical parameters are observed in nerves during the generation of a series of action potentials of different frequency and duration ("frequency dependence") under normal physiological conditions, as well as in extreme situations and in nerve pathology. The structural and metabolic rearrangements are directly related to the mode of rhythmic exaltation and proceed both in the course of rhythmic exaltation and after its termination. Participation and the basic components of the nervous fulcrum (an axon, Shwan cell, myelin, subcellular organelles) in the realization of rhythmic exaltation is shown. In the coordination of all processes involved in rhythmic exaltation, the main role is played by the systems of redistribution and transport of intercellular and endocellular calcium. The idea is put forward that myelin of nerve fibers is not only an isolator, but also an "intercellular depot" of calcium and participates in the redistribution of different ions. Thus, the rhythmic excitation is of great importance in the realization of some physiological functions, the

  3. Decompression of the facial nerve in cases of hemifacial spasm

    Directory of Open Access Journals (Sweden)

    Karsten Kettel

    1954-12-01

    Full Text Available Among 11 patients a complete cure was obtained in one case, a fair result in 4 cases, while in 6 cases the effect of the operation has only been temporary and full recurrence has taken place. Even if decompression has thus resulted in a few recoveries and improvements, the results in the majority of cases have been disappointing. Everything points to hemifacial spasm being due to a disorder of the lower motor neuron. Intracranial lesions in the vicinity of the facial nerve are known to have resulted in irritation and spasm. It may be perfectly true that the majority of cases of hemifacial spasm are due to a lesion, the nature of which may vary, in the Fallopian canal near the stylomastoid foramen, not least the postparalytic following Bell's palsy. But the disappointing results of decompression seems to indicate that at the time of operation irreparable damage to the nerve has in the majority of cases been already done. Consequently I gave up decompression in cases of hemifacial spasm some years ago. Good results from injections of alcohol into the nerve have been reported13 but I prefer selective sections of the branches to the muscles involved as described by German and Greenwood8.

  4. Dog sciatic nerve gap repaired by artificial tissue nerve graft

    Institute of Scientific and Technical Information of China (English)

    GU Xiaosong; ZHANG Peiyun; WANG Xiaodong; DING Fei; PENG Luping; CHENG Hongbing

    2003-01-01

    The feasibility of repairing dog sciatic nerve damage by using a biodegradable artificial tissue nerve graft enriched with neuroregenerating factors is investigated. The artificial nerve graft was implanted to a 30 mm gap of the sciatic nerve damage in 7 dogs. The dogs with the same nerve damage that were repaired by interposition of the autologous nerve or were given no treatment served as control group 1 or 2, respectively. The observations include gross and morphological observations, immune reaction, electrophysiological examination, fluorescence tracing of the neuron formation and the number of the neurons at the experimental sites, etc. Results showed that 6 months after the implantation of the graft, the regenerated nerve repaired the damage of the sciatic nerve without occurrence of rejection and obvious inflammatory reaction in all 7 dogs, and the function of the sciatic nerve recovered with the nerve conduction velocity of (23.91±11.35)m/s. The regenerated neurons and the forming of axon could be observed under an electron microscope. This proves that artificial tissue nerve graft transplantation can bridge the damaged nerve ends and promote the nerve regeneration.

  5. CT findings in patients with cerebral palsy

    Energy Technology Data Exchange (ETDEWEB)

    Konno, K. (Akita Univ. (Japan))

    1982-01-01

    Clinical findings and CT findings in 73 cases of cerebral palsy were studied. The causes of cerebral palsy were presumed to be as follows: abnormal cerebral development (36%), asphyxial delivery (34%), and immature delivery (19%), etc. CT findings were abnormal in 58% of the 73 cases, 83% of the spastic tetraplegia patients and all of the spastic hemiplegia patients showed abnormal CT findings. All the patients with spastic monoplegia presented normal CT findings. In 75% of the spastic hemiplegia cases, the CT abnormalities were due to cerebral parenchymal abnormality such as porencephaly and regional low absorption. In cases of spastic tetraplegia, cerebral parenchymal abnormality was found only in 10%. Cortical atrophy was found only in 15 of the 73 cases, whereas central atrophy was found in 36 cases.

  6. CT findings in patients with cerebral palsy

    International Nuclear Information System (INIS)

    Clinical findings and CT findings in 73 cases of cerebral palsy were studied. The causes of cerebral palsy were presumed to be as follows: abnormal cerebral development (36%), asphyxial delivery (34%), and immature delivery (19%), etc. CT findings were abnormal in 58% of the 73 cases, 83% of the spastic tetraplegia patients and all of the spastic hemiplegia patients showed abnormal CT findings. All the patients with spastic monoplegia presented normal CT findings. In 75% of the spastic hemiplegia cases, the CT abnormalities were due to cerebral parenchymal abnormality such as porencephaly and regional low absorption. In cases of spastic tetraplegia, cerebral parenchymal abnormality was found only in 10%. Cortical atrophy was found only in 15 of the 73 cases, whereas central atrophy was found in 36 cases. (Ueda, J.)

  7. Education and employment prospects in cerebral palsy

    DEFF Research Database (Denmark)

    Michelsen, Susan Ishøy; Uldall, Peter; Kejs, Anne Mette T;

    2005-01-01

    Parents and paediatric neurologists need information on the long-term social prognosis of children with cerebral palsy (CP). No large population-based study has been performed on this topic. On 31 December 1999, to find predictors in childhood of subsequent education and employment, 819...... participants with CP born between 1965 and 1978 (471 males; mean age 28y 10 mo, SD 4y, range 21 to 35y) in the Danish Cerebral Palsy Registry were compared with 4406 controls without CP born between 1965 and 1978 (2546 males; mean age 28y 10 mo, SD 4y, range 21 to 35y). Diagnostic subtypes of the 819...... participants with CP were: 31% hemiplegia, 43% diplegia, 18% tetraplegia, and 8% other types. Level of motor impairment with respect to walking ability was: 62% able to walk without assistance, 21% with assistance, and 16% not able to walk (for 1% of study children walking ability was not known). Relevant...

  8. Neuromuscular ultrasound of cranial nerves.

    Science.gov (United States)

    Tawfik, Eman A; Walker, Francis O; Cartwright, Michael S

    2015-04-01

    Ultrasound of cranial nerves is a novel subdomain of neuromuscular ultrasound (NMUS) which may provide additional value in the assessment of cranial nerves in different neuromuscular disorders. Whilst NMUS of peripheral nerves has been studied, NMUS of cranial nerves is considered in its initial stage of research, thus, there is a need to summarize the research results achieved to date. Detailed scanning protocols, which assist in mastery of the techniques, are briefly mentioned in the few reference textbooks available in the field. This review article focuses on ultrasound scanning techniques of the 4 accessible cranial nerves: optic, facial, vagus and spinal accessory nerves. The relevant literatures and potential future applications are discussed.

  9. Possibilities of applying the method of radiofrequency (RFthermal destruction to correct spasticity in childrenwith cerebral palsy

    Directory of Open Access Journals (Sweden)

    Alexey Vasilievich Zvozil

    2015-03-01

    Full Text Available For the treatment of focal spasticity in the TurnerInstitute we developed and applied the approach toreduce spasticity in children with cerebral palsy byapplying the method of radiofrequency thermal de-struction of peripheral nerves and muscle motorpoints. This method is based on the effect of heatrelease during the passage through biological tissueof radiofrequency currents. The procedure was totally performed in 112 patients aged 1,2 to 14 yearsold with a level of spasticity over 3 points on a scaleAshworth. In order to reduce hypertonia of femuradductors, the target for RF ablation was obturatornerve; we targeted on the motor point of the gastrocnemius muscle in equinus, to reduce forearm flexorhypertonia we targeted on the musculo-cutaneousnerve, flexor muscles of the hand we intervened on their motor points. A positive result was maintained at follow-up of 6 months to one year in all patients, maximum - 2 years. The obtained results are preliminary and subject to further statistical processing, but they are quite comparable with the results of the use of type A botulinum toxin preparations. The proposed method of treatment is minimally invasive, virtually devoid of the risk of postoperative complications, can cut one stage spasticity in the muscles of various motor segments in children with cerebral palsy of great age range, including children up to 2 years old.

  10. LMN Facial Palsy in Pregnancy: An Opportunity to Predict Preeclampsia—Report and Review

    Directory of Open Access Journals (Sweden)

    Vani Aditya

    2014-01-01

    Full Text Available Facial paralysis is the most frequent unilateral cranial nerve pathology affecting pregnant population 2 to 4 times more often than the nonpregnant population. There exists an association with preeclampsia but this has largely been overlooked. Clinicians often dismiss it for idiopathic palsy as seen in the present case. A 30-year-old woman, Gravida 4, Para 3, presented at 26 weeks pregnancy with complaints of facial weakness, blurring of vision, altered taste sensation, increased noise sensitivity for 1 month, headache since 18 days, and vomiting since 2­3 days. Her pulse was 90/min, BP was 170/120, and RR was 18/min. Uterus was 18 weeks size and proteinuria++ was present. Ultrasonography revealed a 26 weeks fetus, severe bradycardia, and absent liquor. HELLP syndrome was diagnosed after investigations. Six units of fresh frozen plasma were transfused. An informed decision for termination of pregnancy was made. She delivered a 450 gram stillborn. The third stage was complicated with postpartum hemorrhage but it was managed successfully. Women with Bell’s palsy during pregnancy should be evaluated critically as in some it may precede preeclampsia which has serious maternal and fetal implications. Therefore, these women should be in regular followup of the obstetrician.

  11. [Measurement of external pressure of peroneal nerve tract coming in contact with lithotomy leg holders using pressure distribution measurement system BIG-MAT®].

    Science.gov (United States)

    Mizuno, Ju; Namba, Chikara; Takahashi, Toru

    2014-10-01

    We investigated external pressure on peroneal nerve tract coming in contact with two kinds of leg holders using pressure distribution measurement system BIG- MAT® (Nitta Corp., Osaka) in the lithotomy position Peak contact (active) pressure at the left fibular head region coming in contact with knee-crutch-type leg holder M® (Takara Belmont Corp., Osaka), which supports the left popliteal fossa, was 78.0 ± 26.4 mmHg. On the other hand, peak contact pressure at the left lateral lower leg region coming in contact with boot-support-type leg holder Bel Flex® (Takara Belmont Corp., Osaka), which supports the left lower leg and foot was 26.3±7.9 mmHg. These results suggest that use of knee-crutch-type leg holder is more likely to induce common peroneal nerve palsy at the fibular head region, but use of boot-support-type leg holder dose not easily induce superficial peroneal nerve palsy at the lateral lower leg region, because capillary blood pressure is known to be 32 mmHg. Safer holders for positioning will be developed to prevent nerve palsy based on the analysis of chronological change in external pressure using BIG-MAT® system during anesthesia.

  12. Sociopragmatic skills in children with cerebral palsy

    OpenAIRE

    Kenda, Nataša

    2013-01-01

    Communication is one of the most important means that enables us life in society. My thesis is therefore dedicated to the use of language among people or pragmatics. I am mainly interested in special features in communication and pragmatics in children with cerebral palsy. In the theoretical introduction, I firstly presented the characteristics of communication and the process of language development of children in the early years of age. Special attention is paid to pragmatics, its deve...

  13. Neonatal brachial plexus palsy: a permanent challenge

    Directory of Open Access Journals (Sweden)

    Carlos Otto Heise

    2015-09-01

    Full Text Available Neonatal brachial plexus palsy (NBPP has an incidence of 1.5 cases per 1000 live births and it has not declined despite recent advances in obstetrics. Most patients will recover spontaneously, but some will remain severely handicapped. Rehabilitation is important in most cases and brachial plexus surgery can improve the functional outcome of selected patients. This review highlights the current management of infants with NBPP, including conservative and operative approaches.

  14. EVALUATION OF NEUROIMAGING IN CEREBRAL PALSY

    OpenAIRE

    S.H. Hasanpour avanji

    2008-01-01

    ObjectiveCerebral palsy (CP), a common static motor neurological disorder of childhood with wide spectrum of underlying etiologies, can be demonstrated with different neuro imaging techniques. We undertook this study to investigate the diagnosis of intracranial lesions in children with CP and its correlation between clinical deficits and neuroradiological findings.Materials and methodsIn this prospective hospital-based study, the data of 120 patients with CP, aged below 18 years, referring to...

  15. Maternal Risk Factors for Congenital Cerebral Palsy

    OpenAIRE

    Streja, Elani

    2012-01-01

    Congenital Cerebral Palsy (CP) is the most common physical disability in children. In spite of major advances in medical technology, the etiology of CP is still not well understood. There is growing evidence that brain damage leading to CP development occurs during pregnancy and that maternal phenotype contributes to this intrauterine environment. We hypothesized that maternal factors such as infections, smoking, comorbidities and genetics can increase the risk of CP in children. Additionally...

  16. Cancer mortality in cerebral palsy in California

    OpenAIRE

    Day, Steven,; Brooks, Jordan; Strauss, David; Shumway, Sharon; Shavelle, Robert; Kush, Scott; Sasco, Annie

    2008-01-01

    Exposure to lifestyle, occupational, and environmental risk factors for cancer are undoubtedly different in cerebral palsy (CP) than in the general population, and these differences and others may result in a specific pattern of cancer mortality in CP. Objective: To study the cancer mortality of CP in California. Study group: 40,482 CP cases (contributing 357,928 person-years) among 210,155 persons having received annual evaluations from the California Department of Developmental Services ove...

  17. Lever arm dysfunction in cerebral palsy gait

    OpenAIRE

    Theologis, Tim

    2013-01-01

    Skeletal structures act as lever arms during walking. Muscle activity and the ground reaction against gravity exert forces on the skeleton, which generate torque (moments) around joints. These lead to the sequence of movements which form normal human gait. Skeletal deformities in cerebral palsy (CP) affect the function of bones as lever arms and compromise gait. Lever arm dysfunction should be carefully considered when contemplating treatment to improve gait in children with CP.

  18. Hand Functioning in Children with Cerebral Palsy

    OpenAIRE

    Arnould, Carlyne; Bleyenheuft, Yannick; Thonnard, Jean-Louis

    2014-01-01

    Brain lesions may disturb hand functioning in children with cerebral palsy (CP), making it difficult or even impossible for them to perform several manual activities. Most conventional treatments for hand dysfunction in CP assume that reducing the hand dysfunctions will improve the capacity to manage activities (i.e., manual ability, MA). The aim of this study was to investigate the directional relationships (direct and indirect pathways) through which hand skills influence MA in children wit...

  19. Epidemiology of Cerebral Palsy in the Netherlands

    OpenAIRE

    Wichers, Marc Jan

    2011-01-01

    textabstractChildren with cerebral palsy (CP) and their families often make strong demands on diagnostic, therapeutic, technical and social facilities. Prevalence estimates are needed to improve treatment and services. As recent Dutch data are not available, the present study aimed to assess the population prevalence of CP in the Netherlands. A representative Dutch area with 1.2 million inhabitants of which 172,000 were born between 1977 and 1988 was studied. To ascertain the children with CP...

  20. Visual Impairments in Children with Cerebral Palsy

    OpenAIRE

    Alimović, Sonja

    2012-01-01

    Cerebral palsy (CP) is the neurological developmental disorder mainly affecting motor abilities. Considering the high rate of associated impairments even the definition of CP is revised and changed. Visual impairment is one of the most common associated impairment. Unfortunately, it is often unrecognized and considered to be a normal consequence of motor problems. Sense of sight is most important for early child development, motivation, learning through imitation. It is, therefore, indispensa...

  1. Rehabilitation Outcomes of Children with Cerebral Palsy

    OpenAIRE

    Yalcinkaya, Ebru Yilmaz; Caglar, Nil Sayıner; Tugcu, Betul; Tonbaklar, Aysegul

    2014-01-01

    [Purpose] To evaluate the results of Bobath-based rehabilitation performed at a pediatric cerebral palsy (CP) inpatient clinic. [Subjects and Methods] The study subjects were 28 children with CP who were inpatients at a pediatric service. Inclusion criteria were: being an inpatient of our hospital aged 2–12 with a diagnosis of CP; having one permanent primary caregiver; and the caregiver having no medical or psychotic problems. All of the patients received Bobath treatment for 1 hour per day,...

  2. Chronic conditions in adults with cerebral palsy

    OpenAIRE

    Peterson, MD; Ryan, JM; Hurvitz, EA; E Mahmoudi

    2015-01-01

    Adults with cerebral palsy (CP) represent a growing population whose health status and healthcare needs are poorly understood.1 Mortality records reveal that death due to ischemic heart disease and cancer is higher among adults with CP;2 however, there have been no national surveillance efforts to track disease risk in this population. We examined estimates of chronic conditions in a population-representative sample of adults with CP.

  3. Kinematic Deviations In Children With Cerebral Palsy

    OpenAIRE

    Sangeux, Morgan; ARMAND, Stéphane

    2015-01-01

    In gait analysis, a large portion of the work consists in finding the underlying causes of the abnormal movement observed during walking. The patient’s kinematics of walking is compared to that of typically developed children and the deviations are further analysed. Over the years, clinicians have observed multiple-joints kinematics deviations that were frequent in children with cerebral palsy and devised gait patterns in order to group patients and support management algorithms. However, the...

  4. Hip and Spine in Cerebral Palsy

    OpenAIRE

    Persson-Bunke, Måns

    2015-01-01

    Abstract Background: Children with cerebral palsy (CP) have an increased risk of scoliosis, contractures including windswept hip deformity (WS), and hip dislocation. In 1994, a follow-up program and registry for children and adolescents with CP (CPUP) was initiated in Sweden to allow the early detection and prevention of hip dislocations and other musculoskeletal deformities. Purpose: To analyze the prevalence of scoliosis and WS in children with CP and to study the effect of CPUP. To e...

  5. Trends of Cerebral Palsy in Rajasthan, India

    OpenAIRE

    Sumeet Goel; Nisha Ojha

    2015-01-01

    The aim of this study was to determine the incidence of etiological factor and clinical features of children with cerebral palsy (CP) in Rajasthan. Five dissertations done in the Post Graduate Department of Pediatrics Ay., National Institute of Ayurveda, Jaipur with diagnosed case of spastic CP, from year 2010 to 2014 were included in the study. Age, sex, etiological factors, clinical classifications, and epidemiological characteristics as well as the problems associated with CP were analysed...

  6. Hand functioning in children with cerebral palsy

    OpenAIRE

    CarlyneArnould; YannickBleyenheuft; Jean-LouisThonnard

    2014-01-01

    Brain lesions may disturb hand functioning in children with cerebral palsy (CP), making it difficult or even impossible for them to perform several manual activities. Most conventional treatments for hand dysfunction in CP assume that reducing the hand dysfunctions will improve the capacity to manage activities (i.e., manual ability, MA). The aim of this study was to investigate the directional relationships (direct and indirect pathways) through which hand skills influence MA in children wit...

  7. Hummingbird sign in progressive supranuclear palsy disease

    Directory of Open Access Journals (Sweden)

    Sanjay Pandey

    2012-01-01

    Full Text Available Progressive supranuclear palsy (PSP is characterized by slowness, rigidity, bradykinesia, repeated falls, downgaze limitation and dementia. Midbrain atrophy on magnetic resonance imaging is highly suggestive of PSP and is described as "hummingbird sign". This sign is very helpful in differentiating PSP patients from those with Parkinson′s disease. We hereby report a 72-year-old female case of PSP primarily diagnosed with Parkinson′s disease.

  8. Foot Deformities in Patients with Cerebral Palsy

    OpenAIRE

    E Ameri; A. Yeganeh

    2007-01-01

    Introduction & Objective: In patients with cerebral palsy (CP) the most common presentation is lower extremity deformity specially foot deformity. Inability to ambulation is the one of the most important disabilities, that dependent to the variety of factors such as severity of disease, kind of CP, etc. This study was aimed to assess prevalence of kinds of foot deformity in CP and communication between kind of CP and foot deformity and another hand inability to ambulation.Materials & Methods...

  9. Occupational therapy for children with cerebral palsy.

    OpenAIRE

    Steultjens, E.M.J.; Dekker, J.; Bouter, L.M.; Nes, J.C.M. van de; Lambregts, B.L.M.; Ende, C.H.M. van den

    2003-01-01

    Objectives: The object of our systematic review, therefore, was to determine whether OT interventions improve functional abilities and social participation in children with cerebral palsy. Criteria for considering Studies for this Review: Types of studies: Studies with one of the following designs will be entered in the review. 1) Randomised controlled clinical trial (RCT): An experiment in which investigators randomly allocate eligible people into treatment and control groups. Cross-over tri...

  10. Narrative ability in children with cerebral palsy.

    OpenAIRE

    Holck, Pernille; Dahlgren Sandberg, Annika; Nettelbladt, Ulrika

    2011-01-01

    In a previous study a group of children with cerebral palsy (CP) were found to have considerable difficulties with narratives, performing several standard deviations below the criteria for the Information score of the Bus Story Test (BST). To examine in depth the performance of children with CP and a control group with typically developing (TD) children on a narrative task, in order to search for possible underlying causes to the problems in the CP group. The results of the BST for 10 childre...

  11. Birthweight specific trends in cerebral palsy.

    OpenAIRE

    Pharoah, P O; Cooke, T.; Cooke, R W; Rosenbloom, L

    1990-01-01

    A register of infants with cerebral palsy born to mothers resident in the Mersey region from 1967-84 has been maintained using various sources of information. A total of 1056 patients are registered of whom 331 (31%) have hemiplegia or mixed hemiplegia, 236 (22%) have diplegias or mixed diplegia, and 369 (35%) have quadriplegia or mixed quadriplegia. The remainder have dyskinetic or dystonic forms except for seven, who are unclassified. There has been no significant change in the prevalence o...

  12. Dietary Practices in Saudi Cerebral Palsy Children

    OpenAIRE

    Al-Hammad, Nouf S.

    2015-01-01

    Objectives: To determine the dietary practices of Saudi cerebral palsy (CP) children. Methods: A self-administered questionnaire was used to collect the following information from parents of CP children: demographics, main source of dietary information, frequency of main meals, foods/drinks used for main meals and in-between-meals. Results: Parents of 157 CP children participated. Parents were divided into three, while children were divided into two age groups. The main sources of dietary inf...

  13. A Case of Apoplexy Attack-Like Neuropathy due to Hereditary Neuropathy with Liability to Pressure Palsies in a Patient Diagnosed with Chronic Cerebral Infarction.

    Science.gov (United States)

    Hachisuka, Akiko; Matsushima, Yasuyuki; Hachisuka, Kenji; Saeki, Satoru

    2016-06-01

    Hereditary neuropathy with liability to pressure palsies is an inherited disease associated with the loss of a copy of the PMP22 gene. The condition leads to mononeuropathy due to compression and easy strangulation during daily life activities, resulting in sudden muscle weakness and sensory disturbance, and displaying symptoms similar to cerebrovascular diseases. We report the case of an 80-year-old man with left paralysis due to chronic cerebral infarction. His medical history indicated remarkable recovery from about 4 months after the onset of left hemiplegia with predominant involvement of the fingers. Despite subsequent recurrent monoplegia of the upper or lower limbs, brain magnetic resonance imaging consistently revealed only previous cerebral infarction in the right corona radiata without new lesions. Medical examination showed reduced deep tendon reflexes in his extremities on both the healthy and hemiplegic sides. Nerve conduction studies showed delayed conduction at the bilateral carpal and cubital tunnels and near the right caput fibulae. Genetic analysis revealed loss of a copy of the PMP22 gene. Thus, he was diagnosed with a cerebral infarction complicated by hereditary neuropathy with liability to pressure palsies. Stroke patients develop sudden muscle weakness and sensory disturbance. However, if such patients have no hyperactive deep tendon reflexes and show atypical recovery of paralysis that does not correspond to findings of imaging modalities, nerve conduction studies and genetic analysis may be necessary, considering the complication of hereditary neuropathy with liability to pressure palsies. PMID:27080157

  14. OBSERVATION ON EFFECT OF POINT INJECTION AS THE MAIN TREATMENT FOR OBSTETRIC BRACHIAL PLEXUS PALSY

    Institute of Scientific and Technical Information of China (English)

    L(U) Zhong-li; ZHANG Man; LI Hui-jie; JIA Wei

    2006-01-01

    Objective: To discuss the best way of treatment for obstetric brachial plexus palsy (OBPP).Method: The 102 cases of OBPP were randomized into two groups: the observation group (51 cases) and the control group (51 cases). The observation group was treated by point injection with nerve growth factor (NGF), acupuncture, and moxibustion. The control group was treated by acupuncture and moxibustion. Result: The result was compared after two courses of treatment. The curative rate of observation group was 35.3% and that of control group 11. 8%. The curative and remarkably effective rate was 78.4% and 43.2%respectively. In the two-two comparison, the difference was significant (P < 0.01 ). Conclusion: The effect of NGF point injection as the main treatment for OBPP was good, worth spreading.

  15. PHYSIOTHERAPY MANAGEMENT FOR PROGRESSIVE SUPRA NUCLEAR PALSY

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    P. Keerthi Chandra Shekhar.

    2013-06-01

    Full Text Available Background:An elderly patient with disturbances in gait, impaired balance, difficulty moving the eyes andhistory of frequent falls are not commonly seen in physiotherapy referral cases. Progressive supranuclear palsy(PSP is relatively uncommon and is the most frequently occurring form of Atypical Parkinsonism withcardinalfeatures of vertical gaze palsy, gait instability with frequent falls. However, because the initialclinical featuresoften resemble Parkinson’s disease (PD many patients are referred for rehabilitation services withthe wrongdiagnosis as PD. The progression of the symptoms in PSP is much faster than in PD and there is no cure oreffective medication to manage PSP. We describe a case of 59 years old male, patient who was referred tophysiotherapy department for asymmetric limb apraxia, markedly impaired balance and frequent falls duringtransitional movements. Two years before the patient was diagnosis as PD and later the patient was re-diag-nosed as PSP based on the progression of the disease. The patient was rehabilitated using coordination exer-cises and reciprocal rhythmic movements to reduce rigidity, transfer training exercises for balance,gait trainingusing weights strapped to ankles in parallel bar and visual tracking exercises. The exercises wereprogrammedfor 1 ½ hours a day, 5 days a week, for 8 weeks. After 15 weeks there was improvement in gait and balance ofthe patient with decrease in fall incidence on a Progressive Supranuclear Palsy Rating Scale (PSPRS.

  16. Nerve canals at the fundus of the internal auditory canal on high-resolution temporal bone CT

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    Ji, Yoon Ha; Youn, Eun Kyung; Kim, Seung Chul [Sungkyunkwan Univ., School of Medicine, Seoul (Korea, Republic of)

    2001-12-01

    To identify and evaluate the normal anatomy of nerve canals in the fundus of the internal auditory canal which can be visualized on high-resolution temporal bone CT. We retrospectively reviewed high-resolution (1 mm thickness and interval contiguous scan) temporal bone CT images of 253 ears in 150 patients who had not suffered trauma or undergone surgery. Those with a history of uncomplicated inflammatory disease were included, but those with symptoms of vertigo, sensorineural hearing loss, or facial nerve palsy were excluded. Three radiologists determined the detectability and location of canals for the labyrinthine segment of the facial, superior vestibular and cochlear nerve, and the saccular branch and posterior ampullary nerve of the inferior vestibular nerve. Five bony canals in the fundus of the internal auditory canal were identified as nerve canals. Four canals were identified on axial CT images in 100% of cases; the so-called singular canal was identified in only 68%. On coronal CT images, canals for the labyrinthine segment of the facial and superior vestibular nerve were seen in 100% of cases, but those for the cochlear nerve, the saccular branch of the inferior vestibular nerve, and the singular canal were seen in 90.1%, 87.4% and 78% of cases, respectiveIy. In all detectable cases, the canal for the labyrinthine segment of the facial nerve was revealed as one which traversed anterolateralIy, from the anterosuperior portion of the fundus of the internal auditory canal. The canal for the cochlear nerve was located just below that for the labyrinthine segment of the facial nerve, while that canal for the superior vestibular nerve was seen at the posterior aspect of these two canals. The canal for the saccular branch of the inferior vestibular nerve was located just below the canal for the superior vestibular nerve, and that for the posterior ampullary nerve, the so-called singular canal, ran laterally or posteolateralIy from the posteroinferior aspect of

  17. Efficacy of acupuncture and moxibustion in treating Bell's palsy:a multicenter randomized controlled trial in China

    Institute of Scientific and Technical Information of China (English)

    李瑛; 梁繁荣; 余曙光; 李常度; 胡玲香; 周东; 袁秀丽; 李怡; 夏晓红

    2004-01-01

    Background Bell's palsy involves acute facial paralysis due to inflammation of the facial nerve. Acupuncture and moxibustion (acu-moxi) is beneficial in treating facial palsy. In order to verify the efficacy of acu-moxi on Bell's palsy, a randomized single-blind, multicenter clinical trial was performed.Methods A total of 480 patients from four clinical centers were involved in this trial, of whom 439 completed the trial and 41 did not. All patients were randomly assigned to either the control group or to one of two treatment groups. The control group was treated with prednisone, vitamin B1, vitamin B12, and dibazole; the treatment groups were treated either with acu-moxi alone or in combination with prednisone, Vitamin B1, vitamin B12, and dibazole. Symptoms and signs, the House-Brackmann scale, and facial disability index (FDI) scores were assessed and determined both pre- and post-treatment to evaluate the effectiveness of the treatment methods.Results The characteristics of the control and two treatment groups were comparable without statistically significant differences before treatment. There were significant differences between the control and treatment groups after treatment (χ2=15.265, P=0.018). According to evaluations based on the House-Brackmann scale and FDI scores, the effectiveness of treatment in the two treatment groups was better than in the control group and was most effective in patients receiving acu-moxi treatment alone (Z=-2.827, P=0.005). Conclusion The efficacy of acu-moxi treatment for Bell's palsy is verified scientifically.

  18. Clinical Observation of Combined Acupuncture and Medications in Treating 90 Cases of Facial Palsy

    Institute of Scientific and Technical Information of China (English)

    WU Chun-huan; XIAO Yuan-chun

    2008-01-01

    @@ Peripheral facial palsy, namely Bell palsy, is one ofthe common diseases in the department ofacupuncture. Facial palsy, popularly called wry mouthand eye, is primarily manifested by the motormalfunction of the muscles of the expression on theaffected side. The author adopted combinedacupuncture and medications to treat 90 cases offacial palsy from June 2005 to June 2007, andattained good effects. It is now reported as follows.

  19. Manual muscle test at C5 palsy onset predicts the likelihood of and time to C5 palsy resolution.

    Science.gov (United States)

    Macki, Mohamed; Alam, Ridwan; Kerezoudis, Panagiotis; Gokaslan, Ziya; Bydon, Ali; Bydon, Mohamad

    2016-02-01

    The primary objective of this study was to identify time to and prognostic factors of C5 palsy resolution. All patients over a 7 year period who experienced C5 palsy following a posterior decompression and instrumented fusion surgery were retrospectively reviewed. C5 palsy resolution was defined as a recovery of deltoid muscle function equal to or greater than the preoperative condition as defined by the manual muscle test (MMT). Of the 511 patients who met the selection criteria, 8.6% (n=44) experienced C5 palsy. MMT information was available for 43 patients; 81.4% (n=35) had full resolution from their condition. Of the 35 patients who resolved, the median MMT score at onset was 3-. Following a discrete-time proportional hazards model, the hazards of C5 palsy resolution increased by 19% for every one-grade increase in MMT score at symptom onset (hazard ratio [HR]=1.19, p=0.005). Moreover, males displayed a 71% lower hazard of resolution than females (HR=0.29, p=0.003). Following an adjusted Kaplan-Meier analysis, the median time to C5 palsy resolution was between 6 months and 1 year. In a multiple linear regression, a lower MMT score at the onset of C5 palsy predicted a longer time to C5 palsy resolution (coefficient=-0.19, p=0.003). Time to C5 palsy onset was not statistically associated with hazards of palsy resolution (p=0.381) or time to resolution (p=0.121). A higher MMT score at the onset of C5 palsy statistically significantly predicted a higher chance of resolution and a shorter recovery time. Female sex was also associated with a higher hazard of resolution.

  20. Lateral rectus palsy following coronary angiography and percutaneous coronary intervention

    Science.gov (United States)

    Nicholson, Luke; Jones, Ruth; Hughes, David S

    2014-01-01

    We present a rare case of unilateral lateral rectus palsy following an elective coronary angiography and percutaneous coronary intervention in a 78-year-oldwoman. Ophthalmoplegia following coronary angiography is extremely rare and this is the first case of a unilateral lateral rectus palsy following the procedure. PMID:24536054