A case of atypical progressive supranuclear palsy

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Spaccavento S

2013-12-01

Full Text Available Simona Spaccavento, Marina Del Prete, Angela Craca, Anna Loverre IRCCS Salvatore Maugeri Foundation, Cassano Murge, Bari, Italy Background: Progressive supranuclear palsy (PSP is a neurodegenerative extrapyramidal syndrome. Studies have demonstrated that PSP can present clinically as an atypical dementing syndrome dominated by a progressive apraxia of speech (AOS and aphasia. Aim: We aimed to investigate the clinical presentation of PSP, using a comprehensive multidimensional evaluation, and the disease response to various pharmacological treatments. Methods: A 72-year-old right-handed male, with 17 years education, who first presented with aphasia, AOS, depression, apathy, and postural instability at 69 years; a complete neuropsychological evaluation, tapping the different cognitive domains, was performed. Results: Testing revealed a moderate global cognitive deficit (Mini-Mental State Examination test score =20, low memory test scores (story recall, Rey’s 15-word Immediate and Delayed Recall, and poor phonemic and semantic fluency. The patient’s language was characterized by AOS, with slow speech rate, prolonged intervals between syllables and words, decreased articulatory accuracy, sound distortions, and anomia. Behavioral changes, such as depression, anxiety, apathy, and irritability, were reported. The neurological examination revealed supranuclear vertical gaze palsy, poor face miming, and a mild balance deficit. Magnetic resonance imaging showed only widespread cortical atrophy. Single photon emission computed tomography demonstrated left > right frontotemporal cortical abnormalities. After 6 months, a further neuropsychological assessment showed a progression in cognitive deficits, with additional attention deficits. The patient reported frequent falls, but the neurological deficits remained unchanged. Neuroimaging tests showed the same brain involvement. Conclusion: Our case highlights the heterogeneity of the clinical features in

Postural imbalance and falls in PSP correlate with functional pathology of the thalamus.

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Zwergal, A; la Fougère, C; Lorenzl, S; Rominger, A; Xiong, G; Deutschenbaur, L; Linn, J; Krafczyk, S; Dieterich, M; Brandt, T; Strupp, M; Bartenstein, P; Jahn, K

2011-07-12

To determine how postural imbalance and falls are related to regional cerebral glucose metabolism (PET) and functional activation of the cerebral postural network (fMRI) in patients with progressive supranuclear palsy (PSP). Sixteen patients with PSP, who had self-monitored their frequency of falls, underwent a standardized clinical assessment, posturographic measurement of balance during modified sensory input, and a resting [¹⁸F]FDG-PET. In addition, patients performed an fMRI paradigm using mental imagery of standing. Results were compared to healthy controls (n = 16). The frequency of falls/month in patients (range 1-40) correlated with total PSP rating score (r = 0.90). Total sway path in PSP significantly correlated with frequency of falls, especially during modulated sensory input (eyes open: r = 0.62, eyes closed: r = 0.67, eyes open/head extended: r = 0.84, eyes open/foam-padded platform: r = 0.87). Higher sway path values and frequency of falls were associated with decreased regional glucose metabolism (rCGM) in the thalamus (sway path: r = -0.80, falls: r = -0.64) and increased rCGM in the precentral gyrus (sway path: r = 0.79, falls: r = 0.64). Mental imagery of standing during fMRI revealed a reduced activation of the mesencephalic brainstem tegmentum and the thalamus in patients with postural imbalance and falls. The new and clinically relevant finding of this study is that imbalance and falls in PSP are closely associated with thalamic dysfunction. Deficits in thalamic postural control get most evident when balance is assessed during modified sensory input. The results are consistent with the hypothesis that reduced thalamic activation via the ascending brainstem projections may cause postural imbalance in PSP.

PspF-binding domain PspA1-144 and the PspA·F complex: New insights into the coiled-coil-dependent regulation of AAA+ proteins.

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Osadnik, Hendrik; Schöpfel, Michael; Heidrich, Eyleen; Mehner, Denise; Lilie, Hauke; Parthier, Christoph; Risselada, H Jelger; Grubmüller, Helmut; Stubbs, Milton T; Brüser, Thomas

2015-11-01

Phage shock protein A (PspA) belongs to the highy conserved PspA/IM30 family and is a key component of the stress inducible Psp system in Escherichia coli. One of its central roles is the regulatory interaction with the transcriptional activator of this system, the σ(54) enhancer-binding protein PspF, a member of the AAA+ protein family. The PspA/F regulatory system has been intensively studied and serves as a paradigm for AAA+ enzyme regulation by trans-acting factors. However, the molecular mechanism of how exactly PspA controls the activity of PspF and hence σ(54) -dependent expression of the psp genes is still unclear. To approach this question, we identified the minimal PspF-interacting domain of PspA, solved its structure, determined its affinity to PspF and the dissociation kinetics, identified residues that are potentially important for PspF regulation and analyzed effects of their mutation on PspF in vivo and in vitro. Our data indicate that several characteristics of AAA+ regulation in the PspA·F complex resemble those of the AAA+ unfoldase ClpB, with both proteins being regulated by a structurally highly conserved coiled-coil domain. The convergent evolution of both regulatory domains points to a general mechanism to control AAA+ activity for divergent physiologic tasks via coiled-coil domains. © 2015 John Wiley & Sons Ltd.

Characteristics of Nonmotor Symptoms in Progressive Supranuclear Palsy

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Ruwei Ou

2016-01-01

Full Text Available Objectives. To explore the clinical correlates of nonmotor symptoms (NMS in progressive supranuclear palsy (PSP and their differences from healthy controls and patients with Parkinson’s disease (PD. Methods. Twenty-seven PSP patients, 27 age- and gender-matched healthy controls (HC, and 27 age- and gender-matched PD patients were included for this case-control study. NMS were assessed using the Nonmotor Symptoms Scale (NMSS, including 9 domains. Results. All PSP patients reported NMS. The frequency and severity of “sleep/fatigue,” “mood/apathy,” “attention/memory,” “gastrointestinal,” “sexual dysfunction,” and “miscellaneous” domains in PSP group were significantly higher than those in HC group (P<0.05. The frequency of “mood/apathy,” “attention/memory,” and “sexual dysfunction” domains and the severity of “attention/memory” and “gastrointestinal” domains in PSP group were significantly higher than those in PD group (P<0.05. The “attention/memory” domain in PSP had a significant but weak-to-moderate correlation with age (R=0.387, P=0.046 and onset age (R=0.406, P=0.036. Conclusions. NMS are common in PSP patients. Patients with PSP seem to be subjected to more frequent and severe specific NMS compared to healthy aging subjects and PD patients. Older PSP patients and late-onset patients are likely to be subjected to cognitive decline.

Utility and accuracy of perceptual voice and speech distinctions in the diagnosis of Parkinson's disease, PSP and MSA-P.

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Miller, Nick; Nath, Uma; Noble, Emma; Burn, David

2017-06-01

To determine if perceptual speech measures distinguish people with Parkinson's disease (PD), multiple system atrophy with predominant parkinsonism (MSA-P) and progressive supranuclear palsy (PSP). Speech-language therapists blind to patient characteristics employed clinical rating scales to evaluate speech/voice in 24 people with clinically diagnosed PD, 17 with PSP and 9 with MSA-P, matched for disease duration (mean 4.9 years, standard deviation 2.2). No consistent intergroup differences appeared on specific speech/voice variables. People with PD were significantly less impaired on overall speech/voice severity. Analyses by severity suggested further investigation around laryngeal, resonance and fluency changes may characterize individual groups. MSA-P and PSP compared with PD were distinguished by severity of speech/voice deterioration, but individual speech/voice parameters failed to consistently differentiate groups.

Impaired perception of surface tilt in progressive supranuclear palsy.

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Marian L Dale

Full Text Available Progressive supranuclear palsy (PSP is characterized by early postural instability and backward falls. The mechanisms underlying backward postural instability in PSP are not understood. The aim of this study was to test the hypothesis that postural instability in PSP is a result of dysfunction in the perception of postural verticality.We gathered posturography data on 12 subjects with PSP to compare with 12 subjects with idiopathic Parkinson's Disease (PD and 12 healthy subjects. Objective tests of postural impairment included: dynamic sensory perception tests of gravity and of surface oscillations, postural responses to surface perturbations, the sensory organization test of postural sway under altered sensory conditions and limits of stability in stance.Perception of toes up (but not toes down surface tilt was reduced in subjects with PSP compared to both control subjects (p≤0.001 standing, p≤0.007 seated and subjects with PD (p≤0.03 standing, p≤0.04 seated. Subjects with PSP, PD and normal controls accurately perceived the direction of gravity when standing on a tilting surface. Unlike PD and control subjects, subjects with PSP exerted less postural corrective torque in response to toes up surface tilts.Difficulty perceiving backward tilt of the surface or body may account for backward falls and postural impairments in patients with PSP. These observations suggest that abnormal central integration of sensory inputs for perception of body and surface orientation contributes to the pathophysiology of postural instability in PSP.

Neck Vibration Proprioceptive Postural Response Intact in Progressive Supranuclear Palsy unlike Idiopathic Parkinson’s Disease

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Stefan Kammermeier

2017-12-01

Full Text Available Progressive supranuclear palsy (PSP and late-stage idiopathic Parkinson’s disease (IPD are neurodegenerative movement disorders resulting in different postural instability and falling symptoms. IPD falls occur usually forward in late stage, whereas PSP falls happen in early stages, mostly backward, unprovoked, and with high morbidity. Postural responses to sensory anteroposterior tilt illusion by bilateral dorsal neck vibration were probed in both groups versus healthy controls on a static recording posture platform. Three distinct anteroposterior body mass excursion peaks (P1–P3 were observed. 18 IPD subjects exhibited well-known excessive response amplitudes, whereas 21 PSP subjects’ responses remained unaltered to 22 control subjects. Neither IPD nor PSP showed response latency deficits, despite brainstem degeneration especially in PSP. The observed response patterns suggest that PSP brainstem pathology might spare the involved proprioceptive pathways and implies viability of neck vibration for possible biofeedback and augmentation therapy in PSP postural instability.

CSF neurofilament light chain and phosphorylated tau 181 predict disease progression in PSP.

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Rojas, Julio C; Bang, Jee; Lobach, Iryna V; Tsai, Richard M; Rabinovici, Gil D; Miller, Bruce L; Boxer, Adam L

2018-01-23

To determine the ability of CSF biomarkers to predict disease progression in progressive supranuclear palsy (PSP). We compared the ability of baseline CSF β-amyloid 1-42 , tau, phosphorylated tau 181 (p-tau), and neurofilament light chain (NfL) concentrations, measured by INNO-BIA AlzBio3 or ELISA, to predict 52-week changes in clinical (PSP Rating Scale [PSPRS] and Schwab and England Activities of Daily Living [SEADL]), neuropsychological, and regional brain volumes on MRI using linear mixed effects models controlled for age, sex, and baseline disease severity, and Fisher F density curves to compare effect sizes in 50 patients with PSP. Similar analyses were done using plasma NfL measured by single molecule arrays in 141 patients. Higher CSF NfL concentration predicted more rapid decline (biomarker × time interaction) over 52 weeks in PSPRS ( p = 0.004, false discovery rate-corrected) and SEADL ( p = 0.008), whereas lower baseline CSF p-tau predicted faster decline on PSPRS ( p = 0.004). Higher CSF tau concentrations predicted faster decline by SEADL ( p = 0.004). The CSF NfL/p-tau ratio was superior for predicting change in PSPRS, compared to p-tau ( p = 0.003) or NfL ( p = 0.001) alone. Higher NfL concentrations in CSF or blood were associated with greater superior cerebellar peduncle atrophy (fixed effect, p ≤ 0.029 and 0.008, respectively). Both CSF p-tau and NfL correlate with disease severity and rate of disease progression in PSP. The inverse correlation of p-tau with disease severity suggests a potentially different mechanism of tau pathology in PSP as compared to Alzheimer disease. Copyright © 2017 American Academy of Neurology.

Identification of common variants influencing risk of the tauopathy progressive supranuclear palsy

NARCIS (Netherlands)

G. Hoglinger (Gunter); N.M. Melhem (Nadine); D. Dickson (Dennis); P.M.A. Sleiman (Patrick); L.-S. Wang; L. Klei (Lambertus); R. Rademakers (Rosa); R. de Silva (Rohan); I. Litvan (Irene); D.E. Riley (David); J.C. van Swieten (John); P. Heutink (Peter); Z.K. Wszolek (Zbigniew); R.J. Uitti (Ryan); J. Vandrovcova (Jana); H.I. Hurtig (Howard); R.G. Gross (Rachel); W. Maetzler (Walter); S. Goldwurm (Stefano); E. Tolosa; B. Borroni (Barbara); P. Pastor (Pau); L.B. Cantwell (Laura); M.R. Han; A. Dillman (Allissa); M.P. van der Brug (Marcel); J. Gibbs (Raphael); M.R. Cookson (Mark); D.G. Hernandez (Dena); A. Singleton (Andrew); M.J. Farrer (Matthew); C.-E. Yu (Changen); L.I. Golbe (Lawrence); T. Revesz (Tamas); J. Hardy (John); A.J. Lees (Andrew); B. Devlin (Bernie); H. Hakonarson (Hakon); U. Müller (Ulrich); G.D. Schellenberg (Gerard); R.L. Albin (Roger); E. Alonso (Elena); M. Apfelbacher (Manuela); S.E. Arnold (Steven); J. Avila (Jesús); T.G. Beach (Thomas); S. Beecher (Sherry); D. Berg (Daniela); T.D. Bird (Thomas); N. Bogdanović (Nenad); A.J.W. Boon (Andrea); Y. Bordelon (Yvette); A. Brice (Alexis); H. Budka (Herbert); M. Canesi (Margherita); W.Z. Chiu (Wang Zheng); R. Cilia (Roberto); C. Colosimo (Carlo); P.P. de Deyn (Peter); J.G. de Yebenes; L. Donker Kaat (Laura); R. Duara (Ranjan); A. Durr; S. Engelborghs (Sebastiaan); G. Fabbrini (Giovanni); N.A. Finch (Nicole); R. Flook (Robyn); M.P. Frosch (Matthew); C. Gaig; D. Galasko (Douglas); T. Gasser (Thomas); M. Gearing (Marla); E.T. Geller (Evan); B. Ghetti (Bernardino); N.R. Graff-Radford (Neill); M. Grossman (Murray); D.A. Hall (Deborah); L.-N. Hazrati; M. Höllerhage (Matthias); J. Jankovic (Joseph); J.L. Juncos (Jorge); A. Karydas (Anna); H.A. Kretzschmar (Hans); I. Leber (Isabelle); V.M.Y. Lee (Virginia); A.P. Lieberman (Andrew); K.E. Lyons (Kelly); C. Mariani (Claudio); E. Masliah (Eliezer); L.A. Massey (Luke); C.A. McLean (Catriona); N. Meucci (Nicoletta); B.L. Miller (Bruce); B. Mollenhauer (Brit); J.C. Möller (Jens); H. Morris (Huw); S.S. O'Sullivan (Sean); W. Oertel; D. Ottaviani (Donatella); A. Padovani (Alessandro); R. Pahwa (Rajesh); G. Pezzoli (Gianni); S. Pickering-Brown (Stuart); W. Poewe (Werner); A. Rabano (Alberto); A. Rajput (Alex); S.G. Reich (Stephen); G. Respondek (Gesine); S. Roeber (Sigrun); J.D. Rohrer (Jonathan Daniel); O.A. Ross (Owen); M. Rossor (Martin); G. Sacilotto (Giorgio); W.W. Seeley (William); K. Seppi (Klaus); L. Silveira-Moriyama (Laura); S. Spina (Salvatore); K. Srulijes (Karin); P. St. George-Hyslop (Peter); M. Stamelou (Maria); D.G. Standaert (David); S. Tesei (Silvana); W.W. Tourtellotte (Wallace); C. Trenkwalder (Claudia); C. Troakes (Claire); J.Q. Trojanowski (John); J.C. Troncoso (Juan); V.M. Deerlin (Vivianna); J.P.G. Vonsattel; G.K. Wenning (Gregor); C.L. White III (Charles); P. Winter (Pia); C. Zarow (Chris); A.L. Zecchinelli (Anna); A. Antonini (Angelo)

2011-01-01

textabstractProgressive supranuclear palsy (PSP) is a movement disorder with prominent tau neuropathology. Brain diseases with abnormal tau deposits are called tauopathies, the most common of which is Alzheimer's disease. Environmental causes of tauopathies include repetitive head trauma associated

Identification of common variants influencing risk of the tauopathy progressive supranuclear palsy

NARCIS (Netherlands)

Hoglinger, G.U.; Melhem, N.M.; Dickson, D.W.; Sleiman, P.M.A.; Wang, L.S.; Klei, L.; Rademakers, R.; de Silva, R.; Litvan, I.; Riley, D.E.; van Swieten, J.C.; Heutink, P.; Wszolek, Z.K.; Uitti, R.J.; Vandrovcova, J.; Hurtig, H.I.; Gross, R.G.; Maetzler, W.; Goldwurm, S.; Tolosa, E.; Borroni, B.; Pastor, P.; Cantwell, L.B.; Han, M.R.; Dillman, A.; van der Brug, M.P.; Gibbs, J.R.; Cookson, M.R.; Hernandez, D.G.; Singleton, A.B.; Farrer, M.J.; Yu, C.E.; Golbe, L.I.; Revesz, T.; Hardy, J.; Lees, A.J.; Devlin, B.; Hakonarson, H.; Muller, U.; Schellenberg, G.D.

2011-01-01

Progressive supranuclear palsy (PSP) is a movement disorder with prominent tau neuropathology. Brain diseases with abnormal tau deposits are called tauopathies, the most common of which is Alzheimer's disease. Environmental causes of tauopathies include repetitive head trauma associated with some

Apparent diffusion coefficient measurements in progressive supranuclear palsy

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Ohshita, T.; Oka, M.; Imon, Y.; Yamaguchi, S.; Mimori, Y.; Nakamura, S. [Hiroshima Univ. (Japan). School of Medicine

2000-09-01

We measured the apparent diffusion coefficient (ADC), using diffusion-weighted imaging (DWI) and signal intensity on T2-weighted MRI in the cerebral white matter of patients with progressive supranuclear palsy (PSP) and age-matched normal subjects. In PSP, ADC in the prefrontal and precentral white matter was significantly higher than in controls. There was no significant difference in signal intensity on T2-weighted images. The ADC did correlate with signal intensity. The distribution of the elevation of ADC may be the consequence of underlying pathological changes, such as neurofibrillary tangles or glial fibrillary tangles in the cortex. Our findings suggest that ADC measurement might be useful for demonstrating subtle neuropathological changes. (orig.)

MIDBRAIN CATECHOLAMINERGIC NEURONS CO-EXPRESS α-SYNUCLEIN AND TAU IN PROGRESSIVE SUPRANUCLEAR PALSY

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María Elena eErro Aguirre

2015-03-01

Full Text Available Objective: To analyze the frequency and distribution of α-synuclein deposits in progressive supranuclear palsy (PSP.Methods: The brains of 25 cases of pathologically confirmed PSP were evaluated with immunohistochemistry for α-synuclein and tau. Multiple immunofluorescent stains were applied to analyze the expression of tau and α-synuclein aggregates in catecholaminergic neurons. Patients’ clinical symptoms were retrospectively recorded. Results: Deposits α-synuclein in the form of typical Lewy bodies (LBs were only found in two PSP cases (8% that fulfilled the clinical subtype of PSP known as Richardson’s syndrome (RS. LBs were present in the locus ceruleus, substantia nigra pars compacta, basal forebrain, amygdala and cingulated cortex in a distribution mimicking that of Parkinson’s disease. Triple-immunolabeling revealed co-expression of α-synuclein and tau proteins in some tyrosine hydroxilase-positive neurons of the locus ceruleus and substantia nigra pars compacta.Conclusions: There is no apparent clinical correlation between the presence of LBs in PSP. Tau protein co-aggregate with α-synuclein in catecholaminergic neurons of PSP brains suggesting a synergistic interaction between the two proteins. This is in keeping with the current view of neurodegenerative disorders as ‘misfolded protein diseases’.

Genetic linkage of autosomal dominant progressive supranuclear palsy to 1q31.1.

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Ros, Raquel; Gómez Garre, Pilar; Hirano, Michio; Tai, Yen F; Ampuero, Israel; Vidal, Lídice; Rojo, Ana; Fontan, Aurora; Vazquez, Ana; Fanjul, Samira; Hernandez, Jaime; Cantarero, Susana; Hoenicka, Janet; Jones, Alison; Ahsan, R Laila; Pavese, Nicola; Piccini, Paola; Brooks, David J; Perez-Tur, Jordi; Nyggard, Torbjorn; de Yébenes, Justo G

2005-05-01

Progressive supranuclear palsy (PSP) is a disorder of unknown pathogenesis. Familial clusters of PSP have been reported related to mutations of protein tau. We report the linkage of a large Spanish family with typical autosomal dominant PSP to a new locus in chromosome 1. Four members of this family had typical PSP, confirmed by neuropathology in one case. At least five ancestors had similar disease. Other members of the family have incomplete phenotypes. The power of the linkage analysis was increased by detecting presymptomatic individuals with 18F-fluoro-dopa and 18F-deoxyglucose positron emission tomography. We screened the human genome with 340 polymorphic markers and we enriched the areas of interest with additional markers. The disease status was defined according to the clinical and positron emission tomography data. We excluded linkage to the tau gene in chromosome 17. PSP was linked, in this family, to one area of 3.4 cM in chromosome 1q31.1, with a maximal multipoint < OD score of +3.53. This area contains at least three genes, whose relevance in PSP is unknown. We expect to further define the gene responsible for PSP, which could help to understand the pathogenesis of this disease and to design effective treatment.

Diffusion tensor analysis of corpus callosum in progressive supranuclear palsy

International Nuclear Information System (INIS)

Ito, Shoichi; Makino, Takahiro; Shirai, Wakako; Hattori, Takamichi

2008-01-01

Progressive supranuclear palsy (PSP) is a neurodegenerative disease featuring parkinsonism, supranuclear ophthalmoplegia, dysphagia, and frontal lobe dysfunction. The corpus callosum which consists of many commissure fibers probably reflects cerebral cortical function. Several previous reports showed atrophy or diffusion abnormalities of anterior corpus callosum in PSP patients, but partitioning method used in these studies was based on data obtained in nonhuman primates. In this study, we performed a diffusion tensor analysis using a new partitioning method for the human corpus callosum. Seven consecutive patients with PSP were compared with 29 age-matched patients with Parkinson's Disease (PD) and 19 age-matched healthy control subjects. All subjects underwent diffusion tensor magnetic resonance imaging, and the corpus callosum was partitioned into five areas on the mid-sagittal plane according to a recently established topography of human corpus callosum (CC1-prefrontal area, CC2-premotor and supplementary motor area, CC3-motor area, CC4-sensory area, CC5-parietal, temporal, and occipital area). Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) were measured in each area and differences between groups were analyzed. In the PSP group, FA values were significantly decreased in CC1 and CC2, and ADC values were significantly increased in CC1 and CC2. Receiver operating characteristic analysis showed excellent reliability of FA and ADC analyses of CC1 for differentiating PSP from PD. The anterior corpus callosum corresponding to the prefrontal, premotor, and supplementary motor cortices is affected in PSP patients. This analysis can be an additional test for further confirmation of the diagnosis of PSP

Diffusion tensor analysis of corpus callosum in progressive supranuclear palsy

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Ito, Shoichi; Makino, Takahiro; Shirai, Wakako; Hattori, Takamichi [Department of Neurology, Graduate School of Medicine, Chiba University (Japan)

2008-11-15

Progressive supranuclear palsy (PSP) is a neurodegenerative disease featuring parkinsonism, supranuclear ophthalmoplegia, dysphagia, and frontal lobe dysfunction. The corpus callosum which consists of many commissure fibers probably reflects cerebral cortical function. Several previous reports showed atrophy or diffusion abnormalities of anterior corpus callosum in PSP patients, but partitioning method used in these studies was based on data obtained in nonhuman primates. In this study, we performed a diffusion tensor analysis using a new partitioning method for the human corpus callosum. Seven consecutive patients with PSP were compared with 29 age-matched patients with Parkinson's Disease (PD) and 19 age-matched healthy control subjects. All subjects underwent diffusion tensor magnetic resonance imaging, and the corpus callosum was partitioned into five areas on the mid-sagittal plane according to a recently established topography of human corpus callosum (CC1-prefrontal area, CC2-premotor and supplementary motor area, CC3-motor area, CC4-sensory area, CC5-parietal, temporal, and occipital area). Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) were measured in each area and differences between groups were analyzed. In the PSP group, FA values were significantly decreased in CC1 and CC2, and ADC values were significantly increased in CC1 and CC2. Receiver operating characteristic analysis showed excellent reliability of FA and ADC analyses of CC1 for differentiating PSP from PD. The anterior corpus callosum corresponding to the prefrontal, premotor, and supplementary motor cortices is affected in PSP patients. This analysis can be an additional test for further confirmation of the diagnosis of PSP.

Therapeutic advances in multiple system atrophy and progressive supranuclear palsy.

Science.gov (United States)

Poewe, Werner; Mahlknecht, Philipp; Krismer, Florian

2015-09-15

Multiple system atrophy (MSA) and progressive supranuclear palsy (PSP) are relentlessly progressive neurodegenerative diseases leading to severe disability and ultimately death within less than 10 y. Despite increasing efforts in basic and clinical research, effective therapies for these atypical parkinsonian disorders are lacking. Although earlier small clinical studies in MSA and PSP mainly focused on symptomatic treatment, advances in the understanding of the molecular underpinnings of these diseases and in the search for biomarkers have paved the way for the first large and well-designed clinical trials aiming at disease modification. Targets of intervention in these trials have included α-synuclein inclusion pathology in the case of MSA and tau-related mechanisms in PSP. Since 2013, four large randomized, placebo-controlled, double-blind disease-modification trials have been completed and published, using rasagiline (MSA), rifampicin (MSA), tideglusib (PSP), or davunetide (PSP). All of these failed to demonstrate signal efficacy with regard to the primary outcome measures. In addition, two randomized, placebo-controlled, double-blind trials have studied the efficacy of droxidopa in the symptomatic treatment of neurogenic orthostatic hypotension, including patients with MSA, with positive results in one trial. This review summarizes the design and the outcomes of these and other smaller trials published since 2013 and attempts to highlight priority areas of future therapeutic research in MSA and PSP. © 2015 International Parkinson and Movement Disorder Society. © 2015 International Parkinson and Movement Disorder Society.

Word-Retrieval in Two Cases of Progressive Supranuclear Palsy

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Jennifer M. Gurd

1997-01-01

Full Text Available In this paper, we describe the detailed neuropsychological investigation of two cases of progressive supranuclear palsy (PSP and demonstrate word-finding difficulties associated with pervasive problems in word-retrieval. The pattern of deficits resembles that seen in Parkinson’s Disease (PD but is more severe, even in very mild PSP, and appears less amenable to cue facilitation. Performance on a variety of word-production tasks is compared, and experimental controls for motor effects on performance are included. The role of stimulus cues in speeded word-finding is addressed experimentally, as are central executive influences on task performance. This combines with functional brain-scan data from single photon emission computed tomography (SPECT which shows reduced frontal perfusion in one of the two cases.

Disease-specific structural changes in thalamus and dentatorubrothalamic tract in progressive supranuclear palsy

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Surova, Yulia; Hall, Sara; Widner, Haakan [Lund University, Department of Clinical Sciences, Lund (Sweden); Skaane University Hospital, Department of Neurology, Lund (Sweden); Nilsson, Markus [Lund University, Lund University Bioimaging Center, Lund (Sweden); Laett, Jimmy [Skaane University Hospital, Center for Medical Imaging and Physiology, Lund (Sweden); Lampinen, Bjoern [Lund University, Department of Medical Radiation Physics, Lund (Sweden); Lindberg, Olof [Malmoe, Lund University, Department of Clinical Sciences, Malmoe (Sweden); Nilsson, Christer [Skaane University Hospital, Department of Neurology, Lund (Sweden); Malmoe, Lund University, Department of Clinical Sciences, Malmoe (Sweden); Westen, Danielle van [Lund University, Department of Clinical Sciences, Lund (Sweden); Skaane University Hospital, Center for Medical Imaging and Physiology, Lund (Sweden); Hansson, Oskar [Malmoe, Lund University, Department of Clinical Sciences, Malmoe (Sweden); Skaane University Hospital, Memory Clinic, Lund (Sweden)

2015-11-15

The aim of this study is to identify disease-specific changes of the thalamus, basal ganglia, pons, and midbrain in patients with progressive supranuclear palsy (PSP), Parkinson's disease (PD), and multiple system atrophy with predominant parkinsonism (MSA-P) using diffusion tensor imaging and volumetric analysis. MRI diffusion and volumetric data were acquired in a derivation of 30 controls and 8 patients with PSP and a validation cohort comprised of controls (n = 21) and patients with PSP (n = 27), PD (n = 10), and MSA-P (n = 11). Analysis was performed using regions of interest (ROI), tract-based spatial statistic (TBSS), and tractography and results compared between diagnostic groups. In the derivation cohort, we observed increased mean diffusivity (MD) in the thalamus, superior cerebellar peduncle, and the midbrain in PSP compared to controls. Furthermore, volumetric analysis showed reduced thalamic volumes in PSP. In the validation cohort, the observations of increased MD were replicated by ROI-based analysis and in the thalamus by TBSS-based analysis. Such differences were not found for patients with PD in any of the cohorts. Tractography of the dentatorubrothalamic tract (DRTT) showed increased MD in PSP patients from both cohorts compared to controls and in the validation cohort in PSP compared to PD and MSA patients. Increased MD in the thalamus and along the DRTT correlated with disease stage and motor function in PSP. Patients with PSP, but not PD or MSA-P, exhibit signs of structural abnormalities in the thalamus and in the DRTT. These changes are associated with disease stage and impaired motor function. (orig.)

Disease-specific structural changes in thalamus and dentatorubrothalamic tract in progressive supranuclear palsy

International Nuclear Information System (INIS)

Surova, Yulia; Hall, Sara; Widner, Haakan; Nilsson, Markus; Laett, Jimmy; Lampinen, Bjoern; Lindberg, Olof; Nilsson, Christer; Westen, Danielle van; Hansson, Oskar

2015-01-01

The aim of this study is to identify disease-specific changes of the thalamus, basal ganglia, pons, and midbrain in patients with progressive supranuclear palsy (PSP), Parkinson's disease (PD), and multiple system atrophy with predominant parkinsonism (MSA-P) using diffusion tensor imaging and volumetric analysis. MRI diffusion and volumetric data were acquired in a derivation of 30 controls and 8 patients with PSP and a validation cohort comprised of controls (n = 21) and patients with PSP (n = 27), PD (n = 10), and MSA-P (n = 11). Analysis was performed using regions of interest (ROI), tract-based spatial statistic (TBSS), and tractography and results compared between diagnostic groups. In the derivation cohort, we observed increased mean diffusivity (MD) in the thalamus, superior cerebellar peduncle, and the midbrain in PSP compared to controls. Furthermore, volumetric analysis showed reduced thalamic volumes in PSP. In the validation cohort, the observations of increased MD were replicated by ROI-based analysis and in the thalamus by TBSS-based analysis. Such differences were not found for patients with PD in any of the cohorts. Tractography of the dentatorubrothalamic tract (DRTT) showed increased MD in PSP patients from both cohorts compared to controls and in the validation cohort in PSP compared to PD and MSA patients. Increased MD in the thalamus and along the DRTT correlated with disease stage and motor function in PSP. Patients with PSP, but not PD or MSA-P, exhibit signs of structural abnormalities in the thalamus and in the DRTT. These changes are associated with disease stage and impaired motor function. (orig.)

Retinal degeneration in progressive supranuclear palsy measured by optical coherence tomography and scanning laser polarimetry.

Science.gov (United States)

Stemplewitz, Birthe; Kromer, Robert; Vettorazzi, Eik; Hidding, Ute; Frings, Andreas; Buhmann, Carsten

2017-07-13

This cross-sectional study compared the retinal morphology between patients with progressive supranuclear palsy (PSP) and healthy controls. (The retinal nerve fiber layer (RNFL) around the optic disc and the retina in the macular area of 22 PSP patients and 151 controls were investigated by spectral domain optical coherence tomography (SD-OCT). Additionally, the RNFL and the nerve fiber index (NFI) were measured by scanning laser polarimetry (SLP). Results of RNFL measurements with SD-OCT and SLP were compared to assess diagnostic discriminatory power. Applying OCT, PSP patients showed a smaller RNFL thickness in the inferior nasal and inferior temporal areas. The macular volume and the thickness of the majority of macular sectors were reduced compared to controls. SLP data showed a thinner RNFL thickness and an increase in the NFI in PSP patients. Sensitivity and specificity to discriminate PSP patients from controls were higher applying SLP than SD-OCT. Retinal changes did not correlate with disease duration or severity in any OCT or SLP measurement. PSP seems to be associated with reduced thickness and volume of the macula and reduction of the RNFL, independent of disease duration or severity. Retinal imaging with SD-OCT and SLP might become an additional tool in PSP diagnosis.

Abnormal Resting-State Functional Connectivity in Progressive Supranuclear Palsy and Corticobasal Syndrome

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Komal Bharti

2017-06-01

Full Text Available BackgroundPathological and MRI-based evidence suggests that multiple brain structures are likely to be involved in functional disconnection between brain areas. Few studies have investigated resting-state functional connectivity (rsFC in progressive supranuclear palsy (PSP and corticobasal syndrome (CBS. In this study, we investigated within- and between-network rsFC abnormalities in these two conditions.MethodsTwenty patients with PSP, 11 patients with CBS, and 16 healthy subjects (HS underwent a resting-state fMRI study. Resting-state networks (RSNs were extracted to evaluate within- and between-network rsFC using the Melodic and FSLNets software packages.ResultsIncreased within-network rsFC was observed in both PSP and CBS patients, with a larger number of RSNs being involved in CBS. Within-network cerebellar rsFC positively correlated with mini-mental state examination scores in patients with PSP. Compared to healthy volunteers, PSP and CBS patients exhibit reduced functional connectivity between the lateral visual and auditory RSNs, with PSP patients additionally showing lower functional connectivity between the cerebellar and insular RSNs. Moreover, rsFC between the salience and executive-control RSNs was increased in patients with CBS compared to HS.ConclusionThis study provides evidence of functional brain reorganization in both PSP and CBS. Increased within-network rsFC could represent a higher degree of synchronization in damaged brain areas, while between-network rsFC abnormalities may mainly reflect degeneration of long-range white matter fibers.

Improvement of balance after audio-biofeedback A 6-week intervention study in patients with progressive supranuclear palsy

NARCIS (Netherlands)

Nicolai, S.; Mirelman, A.; Herman, T.; Zijlstra, A.; Mancini, M.; Becker, C.; Lindeman, U.; Berg, D.; Maetzler, W.

Progressive supranuclear palsy (PSP) is a neurodegenerative disease with no sufficient treatment options to date. The most devastating symptom is the loss of balance with consecutive falls Based on the observation that postural control improved in patients with vestibular dysfunction after

Progressive Supranuclear Palsy and Corticobasal Degeneration: Pathophysiology and Treatment Options

OpenAIRE

Lamb, Ruth; Rohrer, Jonathan D.; Lees, Andrew J.; Morris, Huw R.

2016-01-01

Opinion statement There are currently no disease-modifying treatments for progressive supranuclear palsy (PSP) or corticobasal degeneration (CBD), and no approved pharmacological or therapeutic treatments that are effective in controlling their symptoms. The use of most pharmacological treatment options are based on experience in other disorders or from non-randomized historical controls, case series, or expert opinion. Levodopa may provide some improvement in symptoms of Parkinsonism (specif...

Progressive Supranuclear Palsy and Corticobasal Degeneration: Pathophysiology and Treatment Options

OpenAIRE

Lamb, R.; Rohrer, J. D.; Lees, A. J.; Morris, H. R.

2016-01-01

There are currently no disease-modifying treatments for progressive supranuclear palsy (PSP) or corticobasal degeneration (CBD), and no approved pharmacological or therapeutic treatments that are effective in controlling their symptoms. The use of most pharmacological treatment options are based on experience in other disorders or from non-randomized historical controls, case series, or expert opinion. Levodopa may provide some improvement in symptoms of Parkinsonism (specifically bradykinesi...

Postural Stabilization Differences in Idiopathic Parkinson’s Disease and Progressive Supranuclear Palsy during Self-Triggered Fast Forward Weight Lifting

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Stefan Kammermeier

2018-01-01

Full Text Available Progressive supranuclear palsy (PSP and late-stage idiopathic Parkinson’s disease (IPD are neurodegenerative movement disorders resulting in different postural instability and falling symptoms. IPD falls occur usually forward in late stage, whereas PSP falls happen in early stages, mostly backward, unprovoked, and with high morbidity. Self-triggered, weighted movements appear to provoke falls in IPD, but not in PSP. Repeated self-triggered lifting of a 0.5–1-kg weight (<2% of body weight with the dominant hand was performed in 17 PSP, 15 IPD with falling history, and 16 controls on a posturography platform. PSP showed excessive force scaling of weight and body motion with high-frequency multiaxial body sway, whereas IPD presented a delayed-onset forward body displacement. Differences in center of mass displacement apparent at very small weights indicate that both syndromes decompensate postural control already within stability limits. PSP may be subject to specific postural system devolution. IPD are susceptible to delayed forward falling. Differential physiotherapy strategies are suggested.

Environmental and occupational risk factors for progressive supranuclear palsy: Case-control study.

Science.gov (United States)

Litvan, Irene; Lees, Peter S J; Cunningham, Christopher R; Rai, Shesh N; Cambon, Alexander C; Standaert, David G; Marras, Connie; Juncos, Jorge; Riley, David; Reich, Stephen; Hall, Deborah; Kluger, Benzi; Bordelon, Yvette; Shprecher, David R

2016-05-01

The cause of progressive supranuclear palsy (PSP) is largely unknown. Based on evidence for impaired mitochondrial activity in PSP, we hypothesized that the disease may be related to exposure to environmental toxins, some of which are mitochondrial inhibitors. This multicenter case-control study included 284 incident PSP cases of 350 cases and 284 age-, sex-, and race-matched controls primarily from the same geographical areas. All subjects were administered standardized interviews to obtain data on demographics, residential history, and lifetime occupational history. An industrial hygienist and a toxicologist unaware of case status assessed occupational histories to estimate past exposure to metals, pesticides, organic solvents, and other chemicals. Cases and controls were similar on demographic factors. In unadjusted analyses, PSP was associated with lower education, lower income, more smoking pack-years, more years of drinking well water, more years living on a farm, more years living 1 mile from an agricultural region, more transportation jobs, and more jobs with exposure to metals in general. However, in adjusted models, only more years of drinking well water was significantly associated with PSP. There was an inverse association with having a college degree. We did not find evidence for a specific causative chemical exposure; higher number of years of drinking well water is a risk factor for PSP. This result remained significant after adjusting for income, smoking, education and occupational exposures. This is the first case-control study to demonstrate PSP is associated with environmental factors. © 2016 International Parkinson and Movement Disorder Society. © 2016 International Parkinson and Movement Disorder Society.

The pattern of verbal, visuospatial and procedural learning in Richardson variant of progressive supranuclear palsy in comparison to Parkinson's disease.

Science.gov (United States)

Sitek, Emilia J; Wieczorek, Dariusz; Konkel, Agnieszka; Dąbrowska, Magda; Sławek, Jarosław

2017-08-29

Progressive supranuclear palsy (PSP) is regarded either within spectrum of atypical parkinsonian syndromes or frontotemporal lobar degeneration. We compared the verbal, visuospatial and procedural learning profiles in patients with PSP and Parkinson's disease (PD). Furthermore, the relationship between executive factors (initiation and inhibition) and learning outcomes was analyzed. Thirty-three patients with the clinical diagnosis of PSP-Richardson's syndrome (PSP-RS), 39 patients with PD and 29 age -and education -matched controls were administered Mini-Mental State Examination (MMSE), phonemic and semantic fluency tasks, Auditory Verbal Learning Test (AVLT), Visual Learning and Memory Test for Neuropsychological Assessment by Lamberti and Weidlich (Diagnosticum für Cerebralschädigung, DCS), Tower of Toronto (ToT) and two motor sequencing tasks. Patients with PSP-RS and PD were matched in terms of MMSE scores and mood. Performance on DCS was lower in PSP-RS than in PD. AVLT delayed recall was better in PSP-RS than PD. Motor sequencing task did not differentiate between patients. Scores on AVLT correlated positively with phonemic fluency scores in both PSP-RS and PD. ToT rule violation scores were negatively associated with DCS performance in PSP-RS and PD as well as with AVLT performance in PD. Global memory performance is relatively similar in PSP-RS and PD. Executive factors (initiation and inhibition) are closely related to memory performance in PSP-RS and PD. Visuospatial learning impairment in PSP-RS is possibly linked to impulsivity and failure to inhibit automatic responses.

Plasma separation process: Disposal of PSP radioactive wastes

International Nuclear Information System (INIS)

1989-07-01

Radioactive wastes, in the form of natural uranium contaminated scrap hardware and residual materials from decontamination operations, were generated in the PSP facilities in buildings R1 and 106. Based on evaluation of the characteristics of these wastes and the applicable regulations, the various options for the processing and disposal of PSP radioactive wastes were investigated and recommended procedures were developed. The essential features of waste processing included: (1) the solidification of all liquid wastes prior to shipment; (2) cutting of scrap hardware to fit 55-gallon drums and use of inerting agents (diatomaceous earth) to eliminate pyrophoric hazards; and (3) compaction of soft wastes. All PSP radioactive wastes were shipped to the Hanford Site for disposal. As part of the waste disposal process, a detailed plan was formulated for handling and tracking of PSP radioactive wastes, from the point of generation through shipping. In addition, a waste minimization program was implemented to reduce the waste volume or quantity. Included in this document are discussions of the applicable regulations, the types of PSP wastes, the selection of the preferred waste disposal approach and disposal site, the analysis and classification of PSP wastes, the processing and ultimate disposition of PSP wastes, the handling and tracking of PSP wastes, and the implementation of the PSP waste minimization program. 9 refs., 1 fig., 8 tabs

Cerebral blood flow, oxygen and glucose metabolism with PET in progressive supranuclear palsy

International Nuclear Information System (INIS)

Otsuka, Makoto; Ichiya, Yuici; Kuwabara, Yasuo

1989-01-01

Cerebral blood flow, cerebral oxygen metabolic rate and cerebral glucose metabolic rate were measured with positron emission tomography (PET) in four patients with progressive supranuclear palsy (PSP). Decreased blood flow and hypometabolism of oxygen and glucose were found in both subcortical and cortical regions, particularly in the striatum including the head of the caudate nucleus and the frontal cortex. The coupling between blood flow and metabolism was preserved even in the regions which showed decreased blood flow and hypometabolism. These findings indicated the hypofunction, as revealed by decreased blood flow and hypometablolism on PET, both in the striatum and the frontal cortex, and which may underlie the pathophysiological mechanism of motor and mental disturbance in PSP. (author)

Advancing functional dysconnectivity and atrophy in progressive supranuclear palsy

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Jesse A. Brown

2017-01-01

Full Text Available Progressive supranuclear palsy syndrome (PSP-S results from neurodegeneration within a network of brainstem, subcortical, frontal and parietal cortical brain regions. It is unclear how network dysfunction progresses and relates to longitudinal atrophy and clinical decline. In this study, we evaluated patients with PSP-S (n = 12 and healthy control subjects (n = 20 at baseline and 6 months later. Subjects underwent structural MRI and task-free functional MRI (tf-fMRI scans and clinical evaluations at both time points. At baseline, voxel based morphometry (VBM revealed that patients with mild-to-moderate clinical symptoms showed structural atrophy in subcortex and brainstem, prefrontal cortex (PFC; supplementary motor area, paracingulate, dorsal and ventral medial PFC, and parietal cortex (precuneus. Tf-fMRI functional connectivity (FC was examined in a rostral midbrain tegmentum (rMT-anchored intrinsic connectivity network that is compromised in PSP-S. In healthy controls, this network contained a medial parietal module, a prefrontal-paralimbic module, and a subcortical-brainstem module. Baseline FC deficits in PSP-S were most severe in rMT network integrative hubs in the prefrontal-paralimbic and subcortical-brainstem modules. Longitudinally, patients with PSP-S had declining intermodular FC between the subcortical-brainstem and parietal modules, while progressive atrophy was observed in subcortical-brainstem regions (midbrain, pallidum and posterior frontal (perirolandic cortex. This suggested that later-stage subcortical-posterior cortical change may follow an earlier-stage subcortical-anterior cortical disease process. Clinically, patients with more severe baseline impairment showed greater subsequent prefrontal-parietal cortical FC declines and posterior frontal atrophy rates, while patients with more rapid longitudinal clinical decline showed coupled prefrontal-paralimbic FC decline. VBM and FC can augment disease monitoring in PSP

Brain Dopamine Transporter Binding and Glucose Metabolism in Progressive Supranuclear Palsy-Like Creutzfeldt-Jakob Disease

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Eero Rissanen

2014-01-01

Full Text Available Here, we present a patient with Creutzfeldt-Jakob disease (CJD who developed initial symptoms mimicking progressive supranuclear palsy (PSP. Before the development of typical CJD symptoms, functional imaging supported a diagnosis of PSP when [123I]-FP-CIT-SPECT showed a defect in striatal dopamine transporter binding, while [18F]-fluorodeoxyglucose PET showed cortical hypometabolism suggestive of Lewy body dementia. However, the postmortem neuropathological examination was indicative of CJD only, without tau protein or Lewy body findings. This case demonstrates that CJD should be taken into account in rapidly progressing atypical cases of parkinsonism, even when functional imaging supports a diagnosis of a movement disorder.

Cortical thickness, surface area and volume measures in Parkinson's disease, multiple system atrophy and progressive supranuclear palsy.

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Amanda Worker

Full Text Available Parkinson's disease (PD, Multiple System Atrophy (MSA and Progressive Supranuclear Palsy (PSP are neurodegenerative diseases that can be difficult to distinguish clinically. The objective of the current study was to use surface-based analysis techniques to assess cortical thickness, surface area and grey matter volume to identify unique morphological patterns of cortical atrophy in PD, MSA and PSP and to relate these patterns of change to disease duration and clinical features.High resolution 3D T1-weighted MRI volumes were acquired from 14 PD patients, 18 MSA, 14 PSP and 19 healthy control participants. Cortical thickness, surface area and volume analyses were carried out using the automated surface-based analysis package FreeSurfer (version 5.1.0. Measures of disease severity and duration were assessed for correlation with cortical morphometric changes in each clinical group.Results show that in PSP, widespread cortical thinning and volume loss occurs within the frontal lobe, particularly the superior frontal gyrus. In addition, PSP patients also displayed increased surface area in the pericalcarine. In comparison, PD and MSA did not display significant changes in cortical morphology.These results demonstrate that patients with clinically established PSP exhibit distinct patterns of cortical atrophy, particularly affecting the frontal lobe. These results could be used in the future to develop a useful clinical application of MRI to distinguish PSP patients from PD and MSA patients.

H MR spectroscopy in Parkinson's disease and progressive supranuclear palsy : preliminary study

International Nuclear Information System (INIS)

Chang, Kee Hyun; Jeon, Beom Seok; Song, In Chan; Kim, Dong Sung; Min, Kwan Hong; Han, Moon Hee; Kang, Sa Ouk; Min, Byoung Goo; Han, Man Chung

1996-01-01

To determine whether h magnetic resonance spectroscopy (MRS) is useful in differentiating idiopathic Parkinson's disease (IPD) from progressive supranuclear palsy (PSP), based on metabolite ratios. Using a 1.5 T MR Unit, single voxel H MRS using STEAM with a TR of 2000 ms and a TE of 135ms was performed in seven PD and eight PSP patients. Five age-matched volunteers(mean age, 63 years) and another five younger healthy volunteers(mean age, 30 tears) were studied as normal controls. The regions of interest were the putamen and pallidum, with a size of 2X2X2 cm. After measuring the spectral intensities of each metabolite (N-acetylaspartate=NAA, choline=Cho, creatine=Cr and lactate), relative peak height ratios of NAA/Cr, Cho/Cr and NAA/ Cho, and lactate levels among four groups were compared. NAA/ Cho and NAA/ Cr ratios were statistically lower in the PSP group than the IPD group (1.21 ± 0.26 versus 1.45 ± 0.20, and 1.26 ± 0.23 versus 1.38 ± 0.19, respectively : p 0.05). Cho/Cr ratios were not different among four groups. Lactate was not detected in any patients. NAA/Cho and NAA/Cr ratios in the corpus stratum were significantly lower in the PSP group than in the age-matched control and IPD groups. These results suggest that loss of neuron cells in the corpus stratum is more prominent in PSP than in IPD, and that NAA/Cho and NAA/Cr ratios may help in differential diagnosis of IPD and PSP

Voxelwise meta-ananlysis of gray matter anomalies in progressive supranuclear palsy and Parkinson’s disease using anatomic likelihood estimation

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Huifang eShang

2014-02-01

Full Text Available Numerous voxel-based morphometry (VBM studies on gray matter (GM of patients with progressive supranuclear palsy (PSP and Parkinson’s disease (PD have been conducted separately. Identifying the different neuroanatomical changes in GM resulting from PSP and PD through meta-analysis will aid the differential diagnosis of PSP and PD. In this study, a systematic review of VBM studies of patients with PSP and PD relative to healthy controls (HC in the Embase and PubMed databases from January 1995 to April 2013 was conducted. The anatomical distribution of the coordinates of GM differences was meta-analyzed using anatomical likelihood estimation. Separate maps of GM changes were constructed and subtraction meta-analysis was performed to explore the differences in GM abnormalities between PSP and PD. Nine PSP studies and 24 PD studies were included. GM reductions were present in the bilateral thalamus, basal ganglia, midbrain, insular cortex and inferior frontal gyrus, and left precentral gyrus and anterior cingulate gyrus in PSP. Atrophy of GM was concentrated in the bilateral middle and inferior frontal gyrus, precuneus, left precentral gyrus, middle temporal gyrus, right superior parietal lobule, and right cuneus in PD. Subtraction meta-analysis indicated that GM volume was lesser in the bilateral midbrain, thalamus, and insula in PSP compared with that in PD. Our meta-analysis indicated that PSP and PD shared a similar distribution of neuroanatomical changes in the frontal lobe, including inferior frontal gyrus and precentral gyrus, and that atrophy of the midbrain, thalamus, and insula are neuroanatomical markers for differentiating PSP from PD.

Cerebral blood flow SPECT may be helpful in establishing the diagnosis of progressive supranuclear palsy and corticobasal degeneration

International Nuclear Information System (INIS)

Slawek, J.; Lass, P.; Derejko, M.; Dubaniewicz, M.

2001-01-01

We present 4 cases, which illustrate the usefulness of neuroimaging studies in atypical forms of Parkinsonism. Progressive Supranuclear Palsy (PSP) and Corticobasal Degeneration (CBD) are rare neurodegenerative progressive disorders of the central nervous system of unknown cause. The clinical accuracy in this diagnosis is not very high even in centres specialising in movement disorders. Functional imaging can be helpful in diagnosing PSP and CBD. We present the results of cerebral blood flow (CBF) SPECT scanning in 2 patients with PSP and 2 patients with CBD. This was performed using a triple-head gammacamera and 99m Tc-HMPAO. In PSP patients a diffuse frontal perfusion deficit was seen, eventually with striatal and occipital hypoperfusion. CT/MRI was either normal or showed a diffuse cortical-subcortical atrophy. In CBD patients left fronto-parieto-temporal cortex and a striatal hypoperfusion were shown. CT scanning was normal in one case and showed an asymmetrical temporo-parietal atrophy in second one. The pattern of diffuse frontal perfusions deficit in PSP and asymmetrical, contralateral to symptoms of CBD, cortico-subcortical hypoperfusion may be helpful in establishing the correct diagnosis. (author)

Rehabilitation in progressive supranuclear palsy: Effectiveness of two multidisciplinary treatments.

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Ilaria Clerici

Full Text Available to date, there are no medical or surgical treatments for progressive supranuclear palsy (PSP. It is possible to speculate that patients with PSP could benefit from rehabilitative treatments designed for Parkinson's disease, including the use of robot-assisted walking training.to evaluate whether the use of the robotic device Lokomat® is superior in PSP patients to the use of treadmill with visual cues and auditory feedbacks (treadmill-plus in the context of an aerobic, multidisciplinary, intensive, motor-cognitive and goal-based rehabilitation treatment (MIRT conceived for Parkinsonian patients.we enrolled twenty-four PSP patients. Twelve subjects underwent a 4-week MIRT exploiting the use of the treadmill-plus (MIRT group. Twelve subjects underwent the same treatment, but replacing the treadmill-plus with Lokomat® (MIRT-Lokomat group. Subjects were evaluated with clinical and functional scales at admission and discharge. The primary outcomes were the total PSP Rating Scale (PSPRS score and its "limb" and "gait" sub-scores. Secondary outcomes were Berg Balance Scale (BBS, Six Minutes Walking test (6MWT and the number of falls.total PSPRS, PSPRS-gait sub-score, BBS, 6MWT and number of falls improved significantly in both groups (p ≤ 0.003 all, except 6MWT, p = 0.032 and p = 0.018 in MIRT-Lokomat and MIRT group respectively. The PSPRS-limb sub-score improved significantly only in the MIRT group (p = 0.002. A significant difference between groups was observed only for total PSPRS, indicating a slightly better improvement for patients in the MIRT group (p = 0.047. No differences between groups were revealed for the other outcomes, indicating that the effect of rehabilitation was similar in both groups.Lokomat® training, in comparison with treadmill-plus training, does not provide further benefits in PSP patients undergoing MIRT. Our findings suggest the usefulness of an aerobic, multidisciplinary, intensive, motor-cognitive and goal

Combined measurement of plasma cystatin C and low-density lipoprotein cholesterol: A valuable tool for evaluating progressive supranuclear palsy.

Science.gov (United States)

Weng, Ruihui; Wei, Xiaobo; Yu, Bin; Zhu, Shuzhen; Yang, Xiaohua; Xie, Fen; Zhang, Mahui; Jiang, Ying; Feng, Zhong-Ping; Sun, Hong-Shuo; Xia, Ying; Jin, Kunlin; Chan, Piu; Wang, Qing; Gao, Xiaoya

2018-07-01

Progressive supranuclear palsy (PSP) was previously thought as a cause of atypical Parkinsonism. Although Cystatin C (Cys C) and low-density cholesterol lipoprotein-C (LDL-C) are known to play critical roles in Parkinsonism, it is unknown whether they can be used as markers to distinguish PSP patients from healthy subjects and to determine disease severity. We conducted a cross-sectional study to determine plasma Cys C/HDL/LDL-C levels of 40 patients with PSP and 40 healthy age-matched controls. An extended battery of motor and neuropsychological tests, including the PSP-Rating Scale (PSPRS), the Non-Motor Symptoms Scale (NMSS), Geriatric Depression Scale (GDS) and Mini-Mental State Examination (MMSE), was used to evaluate the disease severity. Receiver operating characteristic (ROC) curves were adopted to assess the prognostic accuracy of Cys C/LDL-C levels in distinguishing PSP from healthy subjects. Patients with PSP exhibited significantly higher plasma levels of Cys C and lower LDL-C. The levels of plasma Cys C were positively and inversely correlated with the PSPRS/NMSS and MMSE scores, respectively. The LDL-C/HDL-C ratio was positively associated with PSPRS/NMSS and GDS scores. The ROC curve for the combination of Cys C and LDL-C yielded a better accuracy for distinguishing PSP from healthy subjects than the separate curves for each parameter. Plasma Cys C and LDL-C may be valuable screening tools for differentiating PSP from healthy subjects; while they could be useful for the PSP intensifies and severity evaluation. A better understanding of Cys C and LDL-C may yield insights into the pathogenesis of PSP. Copyright © 2018 Elsevier Ltd. All rights reserved.

PSP-CBS with Dopamine Deficiency in a Female with a FMR1 Premutation.

Science.gov (United States)

Paucar, Martin; Beniaminov, Stanislav; Paslawski, Wojciech; Svenningsson, Per

2016-10-01

Premutations in the fragile X mental retardation 1 (FMR1) gene cause fragile X-associated tremor/ataxia syndrome (FXTAS) and FMR1-related primary ovarian insufficiency (POI). Female FMR1 premutation carriers rarely develop motor features. Dual pathology is an emerging phenomenon among FMR1 premutation carriers. Here, we describe a family affected by FMR1-related disorders in which the female index case has developed a rapidly progressive and disabling syndrome of atypical parkinsonism. This syndrome consists of early onset postural instability, echolalia, dystonia, and varying types of apraxia like early onset orobuccal apraxia and oculomotor apraxia. She has also developed supranuclear gaze palsy, increased latency of saccade initiation, and slow saccades. These features are compatible with progressive supranuclear palsy (PSP) of a corticobasal syndrome (CBS) variant. Imaging displays a marked reduction of presynaptic dopaminergic uptake and cerebrospinal fluid analysis showed reduced dopamine metabolism; however, the patient is unresponsive to levodopa. Midbrain atrophy ("hummingbird sign") and mild cerebellar atrophy were found on brain MRI. Her father was affected by a typical FXTAS presentation but also displayed dopamine deficiency along with the hummingbird sign. The mechanisms by which FMR1 premutations predispose to atypical parkinsonism and dopamine deficiency await further elucidation.

PSP Program close out documentation

Energy Technology Data Exchange (ETDEWEB)

Andringa, K.; Hootman, H.E.; Ferrara, A.S.; Smith, P.K.; Congdon, J.W.; Randolph, H.W.; Young, R.H.; Driggers, F.E.; Topp, S.V.

1985-12-31

In December 1982 DOE-SR directed SRL to study the feasibility and impact of a program to lower the U-236 content of the Highly Enriched Uranium (HEU) stockpile used as fuel for the SRP reactors. In response to this request SRL assessed four technologies, Atomic Vapor Laser Isotope Separation (AVLIS), Molecular Laser Isotope Separation (MLIS), Gas Centrifuge, and the Plasma Separation Process (PSP) for this purpose with the assistance of the Engineering Department. In April 1983 cost/benefit analyses for these processes, high spot cost estimates for production facilities, and process uncertainties were submitted to DOE-SR with a recommendation to proceed with the conceptual design and supporting development programs for a facility based on the use of the PSP process. The current program status for the PSP development program at SRL and the design and documentation of a production facility at SRP, referred to as the Fuel Improvement Demonstration Facility (FIDF), is described in this report.

Pittsburgh Compound B and AV-1451 positron emission tomography assessment of molecular pathologies of Alzheimer's disease in progressive supranuclear palsy.

Science.gov (United States)

Whitwell, Jennifer L; Ahlskog, J Eric; Tosakulwong, Nirubol; Senjem, Matthew L; Spychalla, Anthony J; Petersen, Ronald C; Jack, Clifford R; Lowe, Val J; Josephs, Keith A

2018-03-01

Little is known about Alzheimer's disease molecular proteins, beta-amyloid and paired helical filament (PHF) tau, in progressive supranuclear palsy (PSP). Recent techniques have been developed to allow for investigations of these proteins in PSP. We determined the frequency of beta-amyloid deposition in PSP, and whether beta-amyloid deposition in PSP is associated with PHF-tau deposition pattern, or clinical features. Thirty probable PSP participants underwent MRI, [ 18 F]AV-1451 PET and Pittsburgh compound B (PiB) PET. Apolipoprotein (APOE) genotyping was also performed. A global PiB standard-uptake value ratio (SUVR) was calculated. AV-1451 SUVRs were calculated for a set of Alzheimer's disease (AD)-related regions and a set of PSP-related regions. Voxel-level analyses were conducted to assess for differences in AV-1451 uptake patterns and MRI atrophy between PiB(+) and PiB(-) cases compared to 60 normal PiB(-) controls. Statistical testing for correlations and associations between variables of interest were also performed. Twelve subjects (40%) showed beta-amyloid deposition. Higher PiB SUVR correlated with older age but not with AV-1451 SUVR in the AD- or PSP-related regions. Higher AV-1451 SUVR in AD-related regions was associated with higher AV-1451 SUVR in PSP-related regions. We found little evidence for beta-amyloid related differences in clinical metrics, proportion of APOE e4 carriers, pattern of AV-1451 uptake, or pattern of atrophy. Beta-amyloid deposition occurs in a relatively high proportion of PSP subjects. Unlike in Alzheimer's disease, however, there is little evidence that beta-amyloid, and PHF-tau, play a significant role in neurodegeneration in PSP. Copyright © 2017 Elsevier Ltd. All rights reserved.

Resection methodology for PSP data processing: Recent ...

Indian Academy of Sciences (India)

M. Senthilkumar (Newgen Imaging) 1461 1996 Oct 15 13:05:22

Abstract. PSP data processing, which primarily involves image alignment and image analysis, is a crucial element in obtaining accurate PSP results. There are two broad approaches to image alignment: the algebraic transformation technique, often called image-warping technique, and resection methodology, which uses ...

A follow-up study on brainstem atrophy in progressive supranuclear palsy. When does brain MRI contribute to the differential diagnosis between progressive supranuclear palsy and Parkinson disease?

International Nuclear Information System (INIS)

Yamamoto, Toshiyuki; Oya, Yasushi; Ogawa, Masafumi; Ogata, Katsuhisa; Kawai, Mitsuru

2003-01-01

The objective of this study was to investigate when the MRI can discriminate progressive supranuclear palsy (PSP) from Parkinson disease (PD). We obtained the following parameters using T1-weighted axial images of the midbrain and the middle pons from 40 studies of 17 PSP patients and 26 studies of 26 PD patients; anteroposterior diameter of the pons (Pons AP), anteroposterior length of the pontine tegmentum (Pons T), anteroposterior diameter of the midbrain (Midbrain AP), ratio of anteroposterior diameter of the pontine base to that of the pontine tegmentum (Pons B/T ratio), ratio of the sum of the bilateral crus cerebri widths to the midbrain AP (Midbrain [Cr+Cl]/AP ratio). All the PSP patients were studied more than twice and each study was classified into four groups according to the duration of the illness; less than 24 months (7 studies), from 24 to 47 months (10 studies), from 48 to 71 months (14 studies) and 72 months or longer (9 studies). The first MRI studies (duration of disease 39.9±22.1 months) were compared with the second studies (duration of disease 67.6±31.6 months) in 17 PSP patients. Pons AP, Pons T, and Midbrain AP were significantly smaller in the second studies, indicating progressive pontine and midbrain atrophy. Compared with the PD group, the PSP group showed significant atrophy four years after onset of the disease in Pons AP and two years in Pons T. Pons B/T ratio, and Midbrain [Cr+Cl]/AP ratio were significantly smaller in the PSP group two years after onset, suggesting midbrain and pontine tegmentum atrophy. The diagnostic MRI criteria of Pons B/T ratio more than four and Midbrain [Cr+Cl]/AP ratio more than two each showed accuracy in PSP of more than 70% two years after onset. Discrimination of PSP from PD was difficult during the first two years after onset. The atrophic process in the midbrain and the pontine tegmentum may precede that of the pontine base. Pons B/T ratio and Midbrain [Cr+Cl]/AP ratio presented here are potentially

Conceptual design for PSP mounting bracket

Energy Technology Data Exchange (ETDEWEB)

Ransom, G.; Stein, R. [Martin Marietta Energy Systems, Inc., Piketon, OH (United States)

1991-12-31

Protective structural packages (PSP`s or overpacks) used to ship 2 1/2-ton UF{sub 6} product cylinders are bolted to truck trailers. All bolts penetrate two longitudinal rows of wooden planks. Removal and replacement is required at various intervals for maintenance and routine testing. A conceptual design is presented for mounting brackets which would securely attach PSP`s to trailer frames, reduce removal and replacement time, and minimize risk of personnel injury.

Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE) performance in progressive supranuclear palsy and multiple system atrophy.

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Fiorenzato, Eleonora; Weis, Luca; Falup-Pecurariu, Cristian; Diaconu, Stefania; Siri, Chiara; Reali, Elisa; Pezzoli, Gianni; Bisiacchi, Patrizia; Antonini, Angelo; Biundo, Roberta

2016-12-01

To determine if Montreal Cognitive Assessment (MoCA) is more sensitive than the commonly used Mini-Mental State Examination (MMSE) in detecting cognitive abnormalities in patients with probable progressive supranuclear palsy (PSP) and multiple system atrophy (MSA) compared with Parkinson's disease (PD). In this multicenter observational study, MMSE and MoCA were administered in a random order to 130 patients: 35 MSA, 30 PSP and 65 age, and education and gender matched-PD. We assessed between-group differences for MMSE, MoCA, and their subitems. Receiver-operating characteristic (ROC) curves were calculated. The mean MMSE was higher than the mean MoCA score in each MSA (27.7 ± 2.4 vs. 22.9 ± 3.0, p < 0.0001), PSP (26.0 ± 2.9 vs. 18.2 ± 3.9, p < 0.0001), and PD (27.3 ± 2.0 vs. 22.3 ± 3.5, p < 0.0001). MoCA total score as well as its letter fluency subitem differentiated PSP from MSA and PD with high specificity and moderate sensitivity. More specifically, a cut-off score of 7 F-words or less per minute would support a diagnosis of PSP (PSP vs. PD: 86 % specificity, 70 % sensitivity; PSP vs. MSA: 71 % specificity, 70 % sensitivity). By contrast, MMSE presented an overall ceiling effect for most subitems, except for the pentagon scores, where PSP did less well than MSA or PD patients. These preliminary results suggest that PSP and MSA, similar to PD patients, may present normal MMSE and reduced MoCA performance. Overall, MoCA is more sensitive than MMSE in detecting cognitive impairment in atypical parkinsonism and together with verbal fluency would be a useful test to support PSP diagnosis.

Correlation with neuropsychological assessment and SPM analysis of brain perfusion SPECT in patients with progressive supranuclear palsy

International Nuclear Information System (INIS)

Jeong, Young Jin; Kang, Do Young; Park, Kyung Won; Kim, Jae Woo

2004-01-01

Progressive supranuclear palsy (PSP) is a degenerative condition of unknown aetiology that produces an akinetic-rigid form of parkinsonism characterised by early falls, dementia and abnormalities of extraocular movements. The patterns of decreased regional cerebral blood flow and cognitive impairment in PSP compared with normal control have been insufficiently investigated and a limited number of studies have been performed. We evaluated clinical symptoms, functional neuroimaging study using Tc-99m HMPAO SPECT and neuropsychological profiles in patients with PSP. Eleven patients with PSP diagnosed by the clinical criteria of National Institute of Neurological Disorders and Stroke and the Society for PSP (NINDS-SPSP) (mean age: 70.5±5.6 years, educational period: 4.5±4.7 years) and age-matched 10 healthy control subjects (mean age: 68.1±4.5 years, educational period: 6.5±4.1 years) participated in this study were participated. All patients were given a neurologic examination, brain MRI and cerebral perfusion SPECT using Tc-99m HMPAO. We concomittently evaluated several cognitive profiles using the Seoul Neuropsychological Screening Battery. SPM analysis of the SPECT image showed significant perfusion deficits in the left inferior frontal gyrus, left caudate nucleus, left middle frontal gyrus and cingulate gyrus in the patients with PSP compared with age-matched healthy control (uncorrected p<0.01). On neuropsychological assessment, cognitive deficits on verbal and visual memory, word fluency and frontal executive functions were prominent in most patients with PSP compared with healthy control subjects. Our findings suggest that measurement of regional cerebral blood flow by perfusion SPECT and voxel-based SPM analysis with neuropsychological assessment are useful to understanding the correlation between perfusion deficits and abnormal cognitive profiles in patients with PSP

Correlation with neuropsychological assessment and SPM analysis of brain perfusion SPECT in patients with progressive supranuclear palsy

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Jeong, Young Jin; Kang, Do Young; Park, Kyung Won; Kim, Jae Woo [School of Medicine, Dong-A University, Busan (Korea, Republic of)

2004-07-01

Progressive supranuclear palsy (PSP) is a degenerative condition of unknown aetiology that produces an akinetic-rigid form of parkinsonism characterised by early falls, dementia and abnormalities of extraocular movements. The patterns of decreased regional cerebral blood flow and cognitive impairment in PSP compared with normal control have been insufficiently investigated and a limited number of studies have been performed. We evaluated clinical symptoms, functional neuroimaging study using Tc-99m HMPAO SPECT and neuropsychological profiles in patients with PSP. Eleven patients with PSP diagnosed by the clinical criteria of National Institute of Neurological Disorders and Stroke and the Society for PSP (NINDS-SPSP) (mean age: 70.5{+-}5.6 years, educational period: 4.5{+-}4.7 years) and age-matched 10 healthy control subjects (mean age: 68.1{+-}4.5 years, educational period: 6.5{+-}4.1 years) participated in this study were participated. All patients were given a neurologic examination, brain MRI and cerebral perfusion SPECT using Tc-99m HMPAO. We concomittently evaluated several cognitive profiles using the Seoul Neuropsychological Screening Battery. SPM analysis of the SPECT image showed significant perfusion deficits in the left inferior frontal gyrus, left caudate nucleus, left middle frontal gyrus and cingulate gyrus in the patients with PSP compared with age-matched healthy control (uncorrected p<0.01). On neuropsychological assessment, cognitive deficits on verbal and visual memory, word fluency and frontal executive functions were prominent in most patients with PSP compared with healthy control subjects. Our findings suggest that measurement of regional cerebral blood flow by perfusion SPECT and voxel-based SPM analysis with neuropsychological assessment are useful to understanding the correlation between perfusion deficits and abnormal cognitive profiles in patients with PSP.

Abnormal cortical synaptic plasticity in primary motor area in progressive supranuclear palsy.

Science.gov (United States)

Conte, Antonella; Belvisi, Daniele; Bologna, Matteo; Ottaviani, Donatella; Fabbrini, Giovanni; Colosimo, Carlo; Williams, David R; Berardelli, Alfredo

2012-03-01

No study has yet investigated whether cortical plasticity in primary motor area (M1) is abnormal in patients with progressive supranuclear palsy (PSP). We studied M1 plasticity in 15 PSP patients and 15 age-matched healthy subjects. We used intermittent theta-burst stimulation (iTBS) to investigate long-term potentiation (LTP) and continuous TBS (cTBS) to investigate long-term depression (LTD)-like cortical plasticity in M1. Ten patients underwent iTBS again 1 year later. We also investigated short-interval intracortical inhibition (SICI) and intracortical facilitation (ICF) in M1 with paired-pulse transcranial magnetic stimulation, tested H reflex from upper limb flexor muscles before and after iTBS, and measured motor evoked potential (MEP) input-output (I/O) curves before and after iTBS. iTBS elicited a significantly larger MEP facilitation after iTBS in patients than in healthy subjects. Whereas in healthy subjects, cTBS inhibited MEP, in patients it significantly facilitated MEPs. In patients, SICI was reduced, whereas ICF was normal. H reflex size remained unchanged after iTBS. Patients had steeper MEP I/O slopes than healthy subjects at baseline and became even more steeper after iTBS only in patients. The iTBS-induced abnormal MEP facilitation in PSP persisted at 1-year follow-up. In conclusion, patients with PSP have abnormal M1 LTP/LTD-like plasticity. The enhanced LTP-like cortical synaptic plasticity parallels disease progression.

Role of magnetic resonance planimetry and magnetic resonance parkinsonism index in discriminating Parkinson’s disease and progressive supranuclear palsy: a retrospective study based on 1.5 and 3 T MRI

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Nizamani WM

2017-10-01

Full Text Available Waseem Mehmood Nizamani,1 Fatima Mubarak,1 Muhammad Danish Barakzai,1 Muhammad Saad Ahmed2 1Department of Radiology, Aga Khan University Hospital, Karachi, Pakistan, 2Department of Radiology, Ziauddin University Hospital, Karachi, Pakistan Objective: The objective of the study was to assess magnetic resonance (MR planimetric measurements and MR parkinsonism index (MRPI in differentiating progressive supranuclear palsy (PSP from Parkinson’s disease (PD using 1.5 and 3 T MRI scanner. Subjects and methods: After ethical approval was obtained, analysis of 34 consecutive patients with PSP, 34 patients with PD and 34 healthy controls (HCs was performed. HCs were age-matched adults without any history of neurodegenerative disease or movement disorders. Retrospective data from the past 10 years (from January 2006 to December 2015 were obtained from the Hospital Information Management System, and informed consent was obtained from all participants. The measurements of pons area–midbrain area ratio (P/M and MCP width–superior cerebellar peduncle (SCP width ratio (MCP/SCP were used, and MRPI was calculated by the formula ([P/M]×[MCP/SCP]. Results: Midbrain area and SCP width in patients with PSP (19 males, 15 females; mean age =66.7 years were significantly (P<0.001 smaller than in patients with PD (20 males, 14 females; mean age =66.7 years and control participants (17 males, 17 females; mean age =66.1 years. P/M and MCP/SCP were significantly higher in patients with PSP than in patients with PD and control participants. All measurements showed some overlap of values between patients with PSP and patients from PD group and control participants. MRPI value was significantly higher in patients with PSP (mean 21.00 than in patients with PD (mean 9.50; P<0.001 and control participants (mean 9.6; P<0.001, without any overlap of values among groups. No correlation was found between the duration of disease, PSP rating scale, PSP staging system and MRPI in

4-Repeat Tauopathy Neuroimaging Initiative - Cycle 2

Science.gov (United States)

2018-05-01

Corticobasal Degeneration (CBD); Corticobasal Syndrome (CBS); Cortical-basal Ganglionic Degeneration (CBGD); Progressive Supranuclear Palsy (PSP); Nonfluent Variant Primary Progressive Aphasia (nfvPPA); Oligosymptomatic/Variant Progressive Supranuclear Palsy (o/vPSP)

Identification by [{sup 99m}Tc]ECD SPECT of anterior cingulate hypoperfusion in progressive supranuclear palsy, in comparison with Parkinson's disease

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Varrone, Andrea [University Federico II, Biostructure and Bioimaging Institute, National Research Council/Department of Biomorphological and Functional Sciences, Napoli (Italy); Karolinska Hospital, Department of Clinical Neuroscience, Psychiatry Section, Stockholm (Sweden); Pagani, Marco; Salmaso, Dario [National Research Council, Institute of Cognitive Sciences and Technologies, Rome and Padua (Italy); Salvatore, Elena; Amboni, Marianna; De Michele, Giuseppe; Filla, Alessandro; Barone, Paolo [University Federico II, Department of Neurological Sciences, Napoli (Italy); Sansone, Valeria; Pappata, Sabina; Salvatore, Marco [University Federico II, Biostructure and Bioimaging Institute, National Research Council/Department of Biomorphological and Functional Sciences, Napoli (Italy); Nobili, Flavio [University of Genoa, Clinical Neurophysiology, Department of Endocrinological and Metabolic Sciences, Genoa (Italy)

2007-07-15

Progressive supranuclear palsy (PSP) is an akinetic-rigid syndrome that can be difficult to differentiate from Parkinson's disease (PD), particularly at an early stage. [{sup 99m}Tc]ethyl cysteinate dimer (ECD) SPECT could represent a widely available tool to assist in the differential diagnosis. In this study we used voxel-based analysis and Computerised Brain Atlas (CBA)-based principal component analysis (PCA) of [{sup 99m}Tc]ECD SPECT data to test whether: (1) specific patterns of rCBF abnormalities can differentiate PSP from controls and PD; (2) networks of dysfunctional brain regions can be found in PSP vs controls and PD. Nine PD patients, 16 PSP patients and ten controls were studied with [{sup 99m}Tc]ECD SPECT using a brain-dedicated device (Ceraspect). Voxel-based analysis was performed with statistical parametric mapping. PCA was applied to volume of interest data after spatial normalisation to CBA. The voxel-based analysis showed hypoperfusion of the anterior cingulate and medial frontal cortex in PSP compared with controls and PD. In PSP patients the rCBF impairment extended to the pre-supplementary motor area and prefrontal cortex, areas involved in executive function and motor networks. Compared with PSP patients, PD patients showed a mild rCBF decrease in associative visual areas which could be related to the known impairment of visuospatial function. The PCA identified three principal components differentiating PSP patients from controls and/or PD patients that included groups of cortical and subcortical brain regions with relatively decreased (cingulate cortex, prefrontal cortex and caudate) or increased (parietal cortex) rCBF, representing distinct functional networks in PSP. Anterior cingulate hypoperfusion seems to be an early, distinct brain abnormality in PSP as compared with PD. (orig.)

Anionic lipids and the cytoskeletal proteins MreB and RodZ define the spatio-temporal distribution and function of membrane stress controller PspA in Escherichia coli.

Science.gov (United States)

Jovanovic, Goran; Mehta, Parul; Ying, Liming; Buck, Martin

2014-11-01

All cell types must maintain the integrity of their membranes. The conserved bacterial membrane-associated protein PspA is a major effector acting upon extracytoplasmic stress and is implicated in protection of the inner membrane of pathogens, formation of biofilms and multi-drug-resistant persister cells. PspA and its homologues in Gram-positive bacteria and archaea protect the cell envelope whilst also supporting thylakoid biogenesis in cyanobacteria and higher plants. In enterobacteria, PspA is a dual function protein negatively regulating the Psp system in the absence of stress and acting as an effector of membrane integrity upon stress. We show that in Escherichia coli the low-order oligomeric PspA regulatory complex associates with cardiolipin-rich, curved polar inner membrane regions. There, cardiolipin and the flotillin 1 homologue YqiK support the PspBC sensors in transducing a membrane stress signal to the PspA-PspF inhibitory complex. After stress perception, PspA high-order oligomeric effector complexes initially assemble in polar membrane regions. Subsequently, the discrete spatial distribution and dynamics of PspA effector(s) in lateral membrane regions depend on the actin homologue MreB and the peptidoglycan machinery protein RodZ. The consequences of loss of cytoplasmic membrane anionic lipids, MreB, RodZ and/or YqiK suggest that the mode of action of the PspA effector is closely associated with cell envelope organization. © 2014 The Authors.

[18F]-THK5351 PET Correlates with Topology and Symptom Severity in Progressive Supranuclear Palsy

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Matthias Brendel

2018-01-01

Full Text Available Progressive supranuclear palsy (PSP is a neurodegenerative movement disorder characterized by deposition of fibrillar aggregates of 4R tau-protein in neurons and glial cells of the brain. These deposits are a key neuropathological finding, allowing a diagnosis of “definite PSP,” which is usually established post mortem. To date criteria for clinical diagnosis of PSP in vivo do not include biomarkers of tau pathology. For intervention trials, it is increasingly important to (i establish biomarkers for an early diagnosis and (ii to develop biomarkers that correlate with disease progression of PSP. [18F]-THK5351 is a novel PET-ligand that may afford in vivo visualization and quantification of tau-related alterations. We investigated binding characteristics of [18F]-THK5351 in patients with clinically diagnosed PSP and correlate tracer uptake with clinical findings. Eleven patients (68.4 ± 7.4 year; N = 6 female with probable PSP according to current clinical criteria and nine healthy controls (71.7 ± 7.2 year; N = 4 female underwent [18F]-THK5351 PET scanning. Voxel-wise statistical parametric comparison and volume-of-interest based quantification of standardized-uptake-values (SUV were conducted using the cerebellar cortex as reference region. We correlated disease severity as measured with the help of the PSP Rating Scale (PSPRS as well as several other clinical parameters with the individual PET findings. By voxel-wise mapping of [18F]-THK5351 uptake in the patient group we delineated typical distribution patterns that fit to known tau topology for PSP post mortem. Quantitative analysis indicated the strongest discrimination between PSP patients and healthy controls based on tracer uptake in the midbrain (+35%; p = 3.01E-7; Cohen's d: 4.0, followed by the globus pallidus, frontal cortex, and medulla oblongata. Midbrain [18F]-THK5351 uptake correlated well with clinical severity as measured by PSPRS (R = 0.66; p = 0.026. OCT and MRI

Vocal cord palsy: An uncommon presenting feature of myasthenia gravis

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Sethi Prahlad

2011-01-01

Full Text Available Vocal cord palsy can have myriad causes. Unilateral vocal cord palsy is common and frequently asymptomatic. Trauma, head, neck and mediastinal tumors as well as cerebrovascular accidents have been implicated in causing unilateral vocal cord palsy. Viral neuronitis accounts for most idiopathic cases. Bilateral vocal cord palsy, on the other hand, is much less common and is a potentially life-threatening condition. Myasthenia gravis, an autoimmune disorder caused by antibodies targeting the post-synaptic acetylcholine receptor, has been infrequently implicated in its causation. We report here a case of bilateral vocal cord palsy developing in a 68-year-old man with no prior history of myasthenia gravis 2 months after he was operated on for diverticulitis of the large intestine. Delay in considering the diagnosis led to endotracheal intubation and prolonged mechanical ventilation with attendant complications. Our case adds to the existing literature implicating myasthenia gravis as an infrequent cause of bilateral vocal cord palsy. Our case is unusual as, in our patient, acute-onset respiratory distress and stridor due to bilateral vocal cord palsy was the first manifestation of a myasthenic syndrome.

MRI comparative study of the progressive supranuclear palsy, striatonigral degeneration and Parkinson disease

International Nuclear Information System (INIS)

Wu Wulin; Lou Mingwu; Wang Xiaoyi; Liao Weihua

2009-01-01

Objective: To provide a reliable differential diagnosis among the progressive supranuclear palsy (PSP), striatonigral degeneration (SND) and Parkinson disease (PD). Methods: Conventional MRI data in clinically proved PSP (8 cases), SND (9 cases), PD (12 cases) and 12 normal controls were retrospectively analyzed. Midbrain area, pons area, pons diameter and middle cerebellar peduncles width were measured. The ratio of pons area over midbrain area (pons area / midbrain area) was calculated in all patients and normal controls. Then one way ANOVA and a Kruskal-Wallis H test were used for statistical analysis. Results: Midbrain area of the PSP group [(85.8 ± 12.0 mm 2 ] was the smallest, and there was statistically significant difference (P 2 ], PD group [(133.5 ± 10.8)mm 2 ] and the control group [(135.9 ± 7.5) mm 2 ]. There was no overlapping in the distribution of midbrain area between the PSP group (66.0-98.2 mm 2 ) and SND, PD and normal groups (116.2-142.1, 110.8-146.2 and 121.7-145.8 mm 2 ). The pons area-midbrain area ratio (P/M) of the PSP group (5.9 ± 0.8) was the largest in four groups, and there was statistically significant difference (P 2 , (18.6 ± 2.0) mm and (12.9 ± 2.4) mm] in all groups, and significant difference (P 2 , (22.7 ± 1.7) mm and (16.3 ± 1.1) mm], PD group [3.8 ± 0.3, (500.2 ± 25.8) mm 2 , (23.7 ± 1.0) mm and (16.8 ± 1.1) mm] and the control group [3.8 ± 0.3, (508.8 ± 20.6) mm 2 , (23.2 ± 1.2) mm and (16.4 ± 0.9) mm]. But the PD group and control group had no statistically significant difference in the midbrain area, pons area, pons diameter, P/M and middle cerebellar peduncles width (P > 0.05). Conclusion: MRI measurements helps in the differential diagnosis among PSP, SND and PD. (authors)

Progressive supranuclear palsy dopamine D2 receptor tomoscintigraphy to detect L-dopamine efficiency. Paralysies supra-nucleaires progressives. Quantification des recepteurs dopaminergiques D2 par tomoscintigraphie

Energy Technology Data Exchange (ETDEWEB)

Tranquart, F; Henry Le Bras, F; Toffol, B de; Autret, A; Guilloteau, D; Baulieu, J L [Hopital Bretonneau, 37 - Tours (France)

1994-09-01

Progressive supranuclear palsy (PSP) may sometimes be misdiagnosed as Parkinson's disease in its early stages, hence an early positive diagnosis of PSP based on dopamine D2 receptor density could be extremely valuable. In the present case report, the absence of dopamine D2 receptors was clearly demonstrated in the striatum using [sup 123]I-iodobenzamide (IBZM) tomoscintigraphy. This illustrates the potential use of IBZM tomoscintigraphy to identify Parkinson-like's disease presenting with decreased dopamine D2 receptor density; and hence to predict L-Dopa effectiveness. Further studies are needed to evaluate the value of IBZM tomoscintigraphy in the different Parkinson's like diseases. (authors). 11 refs., 2 figs.

Progressive supranuclear palsy: neuronal and glial cytoskeletal pathology in the higher order processing autonomic nuclei of the lower brainstem.

Science.gov (United States)

Rüb, U; Del Tredici, K; Schultz, C; de Vos, R A I; Jansen Steur, E N H; Arai, K; Braak, H

2002-02-01

The medial and lateral parabrachial nuclei (MPB, LPB), the gigantocellular reticular nucleus (GI), the raphes magnus (RMG) and raphes obscurus nuclei (ROB), as well as the intermediate reticular zone (IRZ) represent pivotal subordinate brainstem centres, all of which control autonomic functions. In this study, we investigated the occurrence and severity of the neuronal and glial cytoskeletal pathology in these six brainstem nuclei from 17 individuals with clinically diagnosed and neuropathologically confirmed progressive supranuclear palsy (PSP). The association between the severity of the pathology and the duration of the disease was investigated by means of correlation analysis. The brainstem nuclei in all of the PSP cases were affected by the neuronal cytoskeletal pathology, with the IRZ and GI regularly showing severe involvement, the MPB, RMG, and ROB marked involvement, and the LPB mild involvement. In the six nuclear greys studied, glial cells undergo alterations of their cytoskeleton on an irregular basis, whereby diseased oligodendrocytes predominantly presented as coiled bodies and affected astrocytes as thorn-shaped astrocytes. In all six nuclei, the severity of the neuronal or glial cytoskeletal pathology showed no correlation with the duration of PSP. In view of their functional role, the neuronal pathology in the nuclei studied offers a possible explanation for the autonomic dysfunctions that eventually develop in the course of PSP.

Radiation resistance of paralytic shellfish poison (PSP) toxins

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San Juan, Edith M

2000-04-01

Radiation resistance of paralytic shellfish poison (PSP) toxins, obtained from Pyrodinium bahamense var. compressum in shellstocks of green mussels, was determined by subjecting the semi-purified toxin extract as well as the shellstocks of green mussels to high doses of ionizing radiation of 5, 10, 15 and 20 kGy. The concentration of the PSP toxins was determined by the Standard Mouse Bioassay (SMB) method. The radiation assistance of the toxins was determined by plotting the PSP toxin concentration versus applied dose in a semilog paper. The D{sub 10} value or decimal reduction dose was obtained from the straight line which is the dose required to reduce the toxicity level by 90%. The effects of irradiation on the quality of green mussels in terms of its physico-chemical, microbiological and sensory attributes were also conducted. The effect of irradiation on the fatty acid components of green mussels was determined by gas chromatography. Radiation resistance of the PSP toxins was determined to be lower in samples with initially high toxicity level as compared with samples with initially low toxicity level. The D{sub 10} values of samples with initially high PSP level were 28.5 kGy in shellstocks of green musssels and 17.5 kGy in the semi-purified toxin extract. When the PSP level was low initially, the D{sub 10} values were as high as 57.5 and 43.5 kGy in shellstocks of green mussels for the two trials, and 43.0 kGy in semi-purified toxin extract. The microbial load of the irradiated mussels was remarkably reduced. No differnce in color and odor characteristics were observed in the mussel samples subjected to varying doses of ionizing radiation. There was darkening in the color of mussel meat and its juice. The concentration of the fatty acid components in the fresh green mussels were considerably higher as compared with those present in the irradiated mussels, though some volatile fatty acids were detected as a result of irradiation. (Author)

Radiation resistance of paralytic shellfish poison (PSP) toxins

International Nuclear Information System (INIS)

San Juan, Edith M.

2000-04-01

Radiation resistance of paralytic shellfish poison (PSP) toxins, obtained from Pyrodinium bahamense var. compressum in shellstocks of green mussels, was determined by subjecting the semi-purified toxin extract as well as the shellstocks of green mussels to high doses of ionizing radiation of 5, 10, 15 and 20 kGy. The concentration of the PSP toxins was determined by the Standard Mouse Bioassay (SMB) method. The radiation assistance of the toxins was determined by plotting the PSP toxin concentration versus applied dose in a semilog paper. The D 10 value or decimal reduction dose was obtained from the straight line which is the dose required to reduce the toxicity level by 90%. The effects of irradiation on the quality of green mussels in terms of its physico-chemical, microbiological and sensory attributes were also conducted. The effect of irradiation on the fatty acid components of green mussels was determined by gas chromatography. Radiation resistance of the PSP toxins was determined to be lower in samples with initially high toxicity level as compared with samples with initially low toxicity level. The D 10 values of samples with initially high PSP level were 28.5 kGy in shellstocks of green musssels and 17.5 kGy in the semi-purified toxin extract. When the PSP level was low initially, the D 10 values were as high as 57.5 and 43.5 kGy in shellstocks of green mussels for the two trials, and 43.0 kGy in semi-purified toxin extract. The microbial load of the irradiated mussels was remarkably reduced. No differnce in color and odor characteristics were observed in the mussel samples subjected to varying doses of ionizing radiation. There was darkening in the color of mussel meat and its juice. The concentration of the fatty acid components in the fresh green mussels were considerably higher as compared with those present in the irradiated mussels, though some volatile fatty acids were detected as a result of irradiation. (Author)

Paralytic Shellfish Poisoning (PSP in Margarita Island, Venezuela

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Amelia La Barbera-Sánchez

2004-09-01

Full Text Available A severe outbreak of Paralytic Shellfish Poisoning (PSP occurred in Manzanillo and Guayacán, northwestern coast of Margarita Island, Venezuela, between August and October 1991. A bloom of dinoflagellates including Prorocentrum gracile, Gymnodinium catenatum and Alexandrium tamarense seemed to be responsible for this outbreak. Levels of PSP toxins in mussels (Perna perna exceeded the international safety limit of saxitoxin, 80 µg STX/100 g meat. PSP toxin values varied between 2 548 and 115 µg STX/100 g meat in Manzanillo, and between 1 422 and 86 µg STX/100 g meat in Guayacán. At both locations, the highest levels were detected in August, when 24 patients exhibited typical symptoms of PSP toxicity after consuming cooked mussels (16 required hospitalization. A high pressure liquid chromatographic (HPLC procedure was recently used on the 1991 samples. The major toxin detected in samples of both locations was decarbamoyl saxitoxin (dcSTX, but low concentrations of saxitoxin were also found in Manzanillo samples. Gonyautoxins GTX1, GTX2 and GTX3 were detected only at Guayacán, while in both locations, decarbamoylgonyatouxin (dcGTX2,3 toxins were detected. These findings represent the first time that causative toxins of PSP in Venezuela have been chemically identified, and confirm the presence of dcSTX and dcGTX in mussels from the Caribbean Sea. The presence of dcSTX and dcGTX in shellfish is indicative that Gymnodinium catenatum was a causative organism for outbreak of PSPUn severo brote de intoxicación paralizante por moluscos (PSP en inglés ocurrió en Manzanillo y Guayacán en la costa noroeste de la Isla de Margarita, Venezuela entre agosto y octubre de 1991. Una proliferación de Prorocentrum gracile, Gymnodinium catenatum y Alexandrium tamarense causó el brote. Los niveles de PSP en mejillón (Perna perna superaron los niveles máximos permisibles de saxitoxina, 80 µg STX/100g carne. Los niveles de toxinas variaron entre 2 548 y 115

Iodine 123-labeled meta-iodobenzylguanidine myocardial scintigraphy in the cases of idiopathic Parkinson`s disease, multiple system atrophy, and progressive supranuclear palsy

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Yoshita, Mitsuhiro; Hayashi, Michiyuki; Hirai, Shunsaku [Tokyo Metropolitan Neurological Hospital (Japan)

1997-06-01

To investigate cardiac sympathetic function in Parkinson`s disease (PD), multiple system atrophy (MSA), and progressive supranuclear palsy (PSP), {sup 123}I-MIBG myocardial scintigraphy was performed in 25 patients with PD, 25 patients with MSA, 14 patients with PSP, and 20 control subjects. In planar imaging studies, the heart-to-mediastinum average count ratio (H/M) was calculated for both early and delayed images. The mean value of H/M in patients with PD was significantly lower than in those with MSA, PSP, or no disease. Regardless of disease severity or intensity of anti-parkinsonian pharmacotherapy, mean values for H/M were always low in patients with PD. The mean values of H/M in patients with MSA and PSP were significantly lower than in controls. There was no significant difference between the mean value of H/M in MSA with orthostatic hypotension (OH) and that in MSA without OH, and also there was no significant difference between the mean value of H/M in MSA with striatonigral degeneration and that in MSA with olivopontocerebellar atrophy. Although the mean value of H/M in PSP with amitriptyline treatment was significantly lower than that in PSP patients without amitriptyline treatment, there was no significant difference between the mean value of H/M in PSP patients without amitriptyline treatment and that in controls. There was no correlation between H/M and disease duration in those three akinetic-rigid disorders that we have studied here. Thus, PD may have an abnormality of cardiac sympathetic function which has not been detected by previous cardiovascular autonomic studies. Particularly in early stages, {sup 123}I-MIBG myocardial scintigraphy may help to differentiate PD from MSA and PSP. (K.H.)

Significance of apparent diffusion coefficient measurement for the differential diagnosis of multiple system atrophy, progressive supranuclear palsy, and Parkinson's disease: evaluation by 3.0-T MR imaging

International Nuclear Information System (INIS)

Tsukamoto, Kazumichi; Kanasaki, Yoshiko; Kakite, Suguru; Fujii, Shinya; Kaminou, Toshio; Ogawa, Toshihide; Matsusue, Eiji

2012-01-01

The clinical differentiation of Parkinson's disease (PD) from multiple system atrophy (MSA) and progressive supranuclear palsy (PSP) may be challenging, especially in their early stages. The aim of this study was to evaluate the utility of apparent diffusion coefficient (ADC) measurement to distinguish among these degenerative disorders. Twenty-five MSA, 20 PSP, and 17 PD patients and 18 healthy controls were retrospectively studied. Axial diffusion-weighted and T2-weighted images were obtained using a 3-T MR system. Regions of interest (ROIs) were precisely placed in the midbrain, pons, putamen, globus pallidus, caudate nucleus, thalamus, superior cerebellar peduncle, middle cerebellar peduncle, cerebellar white matter, and cerebellar dentate nucleus, and the regional ADC (rADC) value was calculated in each ROI. In MSA, rADC values in the pons, middle cerebellar peduncle, cerebellar white matter, and cerebellar dentate nucleus were significantly higher than in PSP, PD, and controls. Furthermore, rADC values in the posterior putamen were significantly higher in MSA than in PSP and controls. In PSP, rADC values were significantly higher in the globus pallidus and midbrain than in MSA, PD, and controls. Furthermore, rADC values in the caudate nucleus and superior cerebellar peduncle were significantly higher in PSP than in MSA and controls. In PD, there were no significant differences in the rADC values compared to in MSA, PSP, and controls in all regions. Evaluation of rADC values in characteristic lesions in MSA, PSP, and PD by placing ROIs using 3-T systems can provide useful additional information for differentiating these disorders. (orig.)

Magnetic Resonance Parkinsonism Index: diagnostic accuracy of a fully automated algorithm in comparison with the manual measurement in a large Italian multicentre study in patients with progressive supranuclear palsy

International Nuclear Information System (INIS)

Nigro, Salvatore; Arabia, Gennarina; Antonini, Angelo; Weis, Luca; Marcante, Andrea; Tessitore, Alessandro; Cirillo, Mario; Tedeschi, Gioacchino; Zanigni, Stefano; Tonon, Caterina; Calandra-Buonaura, Giovanna; Pezzoli, Gianni; Cilia, Roberto; Zappia, Mario; Nicoletti, Alessandra; Cicero, Calogero Edoardo; Tinazzi, Michele; Tocco, Pierluigi; Cardobi, Nicolo; Quattrone, Aldo

2017-01-01

To investigate the reliability of a new in-house automatic algorithm for calculating the Magnetic Resonance Parkinsonism Index (MRPI), in a large multicentre study population of patients affected by progressive supranuclear palsy (PSP) or Parkinson's disease (PD), and healthy controls (HC), and to compare the diagnostic accuracy of the automatic and manual MRPI values. The study included 88 PSP patients, 234 PD patients and 117 controls. MRI was performed using both 3T and 1.5T scanners. Automatic and manual MRPI values were evaluated, and accuracy of both methods in distinguishing PSP from PD and controls was calculated. No statistical differences were found between automated and manual MRPI values in all groups. The automatic MRPI values differentiated PSP from PD with an accuracy of 95 % (manual MRPI accuracy 96 %) and 97 % (manual MRPI accuracy 100 %) for 1.5T and 3T scanners, respectively. Our study showed that the new in-house automated method for MRPI calculation was highly accurate in distinguishing PSP from PD. Our automatic approach allows a widespread use of MRPI in clinical practice and in longitudinal research studies. (orig.)

Magnetic Resonance Parkinsonism Index: diagnostic accuracy of a fully automated algorithm in comparison with the manual measurement in a large Italian multicentre study in patients with progressive supranuclear palsy

Energy Technology Data Exchange (ETDEWEB)

Nigro, Salvatore [National Research Council, Institute of Bioimaging and Molecular Physiology, Catanzaro (Italy); Arabia, Gennarina [University ' ' Magna Graecia' ' , Institute of Neurology, Department of Medical and Surgical Sciences, Catanzaro (Italy); Antonini, Angelo; Weis, Luca; Marcante, Andrea [' ' Fondazione Ospedale San Camillo' ' - I.R.C.C.S, Parkinson' s Disease and Movement Disorders Unit, Venice-Lido (Italy); Tessitore, Alessandro; Cirillo, Mario; Tedeschi, Gioacchino [Second University of Naples, Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, Naples (Italy); Second University of Naples, MRI Research Center SUN-FISM, Naples (Italy); Zanigni, Stefano; Tonon, Caterina [Policlinico S. Orsola - Malpighi, Functional MR Unit, Bologna (Italy); University of Bologna, Department of Biomedical and Neuromotor Sciences, Bologna (Italy); Calandra-Buonaura, Giovanna [University of Bologna, Department of Biomedical and Neuromotor Sciences, Bologna (Italy); IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna (Italy); Pezzoli, Gianni; Cilia, Roberto [ASST G.Pini - CTO, ex ICP, Parkinson Institute, Milano (Italy); Zappia, Mario; Nicoletti, Alessandra; Cicero, Calogero Edoardo [University of Catania, Department ' ' G.F. Ingrassia' ' , Section of Neurosciences, Catania (Italy); Tinazzi, Michele; Tocco, Pierluigi [University Hospital of Verona, Department of Neurological and Movement Sciences, Verona (Italy); Cardobi, Nicolo [University Hospital of Verona, Institute of Radiology, Verona (Italy); Quattrone, Aldo [National Research Council, Institute of Bioimaging and Molecular Physiology, Catanzaro (Italy); University ' ' Magna Graecia' ' , Institute of Neurology, Department of Medical and Surgical Sciences, Catanzaro (Italy)

2017-06-15

To investigate the reliability of a new in-house automatic algorithm for calculating the Magnetic Resonance Parkinsonism Index (MRPI), in a large multicentre study population of patients affected by progressive supranuclear palsy (PSP) or Parkinson's disease (PD), and healthy controls (HC), and to compare the diagnostic accuracy of the automatic and manual MRPI values. The study included 88 PSP patients, 234 PD patients and 117 controls. MRI was performed using both 3T and 1.5T scanners. Automatic and manual MRPI values were evaluated, and accuracy of both methods in distinguishing PSP from PD and controls was calculated. No statistical differences were found between automated and manual MRPI values in all groups. The automatic MRPI values differentiated PSP from PD with an accuracy of 95 % (manual MRPI accuracy 96 %) and 97 % (manual MRPI accuracy 100 %) for 1.5T and 3T scanners, respectively. Our study showed that the new in-house automated method for MRPI calculation was highly accurate in distinguishing PSP from PD. Our automatic approach allows a widespread use of MRPI in clinical practice and in longitudinal research studies. (orig.)

Automatic classification of patients with idiopathic Parkinson's disease and progressive supranuclear palsy using diffusion MRI datasets

Science.gov (United States)

Talai, Sahand; Boelmans, Kai; Sedlacik, Jan; Forkert, Nils D.

2017-03-01

Parkinsonian syndromes encompass a spectrum of neurodegenerative diseases, which can be classified into various subtypes. The differentiation of these subtypes is typically conducted based on clinical criteria. Due to the overlap of intra-syndrome symptoms, the accurate differential diagnosis based on clinical guidelines remains a challenge with failure rates up to 25%. The aim of this study is to present an image-based classification method of patients with Parkinson's disease (PD) and patients with progressive supranuclear palsy (PSP), an atypical variant of PD. Therefore, apparent diffusion coefficient (ADC) parameter maps were calculated based on diffusion-tensor magnetic resonance imaging (MRI) datasets. Mean ADC values were determined in 82 brain regions using an atlas-based approach. The extracted mean ADC values for each patient were then used as features for classification using a linear kernel support vector machine classifier. To increase the classification accuracy, a feature selection was performed, which resulted in the top 17 attributes to be used as the final input features. A leave-one-out cross validation based on 56 PD and 21 PSP subjects revealed that the proposed method is capable of differentiating PD and PSP patients with an accuracy of 94.8%. In conclusion, the classification of PD and PSP patients based on ADC features obtained from diffusion MRI datasets is a promising new approach for the differentiation of Parkinsonian syndromes in the broader context of decision support systems.

Progressive Supranuclear Palsy and Corticobasal Degeneration: Pathophysiology and Treatment Options.

Science.gov (United States)

Lamb, Ruth; Rohrer, Jonathan D; Lees, Andrew J; Morris, Huw R

2016-09-01

There are currently no disease-modifying treatments for progressive supranuclear palsy (PSP) or corticobasal degeneration (CBD), and no approved pharmacological or therapeutic treatments that are effective in controlling their symptoms. The use of most pharmacological treatment options are based on experience in other disorders or from non-randomized historical controls, case series, or expert opinion. Levodopa may provide some improvement in symptoms of Parkinsonism (specifically bradykinesia and rigidity) in PSP and CBD; however, evidence is conflicting and where present, benefits are often negligible and short lived. In fact, "poor" response to levodopa forms part of the NINDS-SPSP criteria for the diagnosis of PSP and consensus criteria for the diagnosis of CBD (Lang Mov Disord. 20 Suppl 1:S83-91, 2005; Litvan et al. Neurology. 48:119-25, 1997; Armstrong et al. Neurology. 80(5):496-503, 2013). There is some evidence that intrasalivery gland botulinum toxin is useful in managing problematic sialorrhea and that intramuscular botulinum toxin and baclofen are helpful in reducing dystonia, including blepharospasm. Benzodiazepines may also be useful in managing dystonia. Myoclonus may be managed using levetiracetam and benzodiazepines. Pharmacological agents licensed for Alzheimer's disease (such as acetylcholinesterase inhibitors and N-Methyl-D-aspartate receptor antagonists) have been used off-label in PSP, CBD, and other tauopathies with the aim of improving cognition; however, there is limited evidence that they are effective and risk of adverse effects may outweigh benefits. The use of atypical antipsychotics for behavioural symptoms is not recommended in the elderly or those with demetia associated conditions and most antipsychotics will worsen Parkinsonism. Antidepressants may be useful for behavioral symptoms and depression but are often poorly tolerated due to adverse effects. In the absence of an effective drug treatment to target the underlying cause of

Shared meanings of success, happiness, and health among adults with cerebral palsy and physiotherapists: implications for practice and research.

Science.gov (United States)

Gannotti, Mary E; Blanchard, Yvette; Blumberg, Lisa; LaRocco, Diana

2018-01-25

To describe shared meanings of success, happiness, and health of adults with cerebral palsy and physiotherapists. Ethnography employed open ended/semi-structured interviews and structured questionnaires (Satisfaction with Life Scale, Beck Depression Inventory-II ® , Oxford Happiness Questionnaire, Life Habits Questionnaire, Medical Outcomes Study-Social Support Survey, and PROMIS ® Pain Interference Scale). Content analysis of qualitative data and principal components analysis of questionnaire responses identified shared meanings. Fourteen adults with cerebral palsy and 15 physiotherapists (median age 46) had similar levels of education. For both groups, social achievements, personal goals, employment, and supporting a family defined success. Adults with cerebral palsy more frequently identified tenacity and persistence as important for success. Both groups described happiness as spending time with loved ones, recreational activities, and having purpose in life. Adults with cerebral palsy identified the importance of self-acceptance for happiness. For both, health included self-care of mind/spirit, cardiovascular and musculoskeletal wellness, and physical fitness (the ability to perform physical tasks). Analysis of questionnaire responses identified shared meanings (eigenvalue 41, 95% explained variance). Adults with cerebral palsy and physiotherapists share similar experiences, behaviors, and feelings about success, happiness, and health. This knowledge may improve communication, enhance evidence-based practice, and foster services to support wellbeing. Implications for rehabilitation Cerebral palsy is a life-long condition, but we know little about social and physical outcomes for adults with cerebral palsy. Lack of understanding about meanings of success, happiness, and health may be a barrier for consumers accessing and for providers delivering evidence-based services. Physiotherapists and adults with cerebral palsy share similar meanings (feelings

Streptococcus pneumoniae PspC Subgroup Prevalence in Invasive Disease and Differences in Contribution to Complement Evasion.

Science.gov (United States)

van der Maten, Erika; van den Broek, Bryan; de Jonge, Marien I; Rensen, Kim J W; Eleveld, Marc J; Zomer, Aldert L; Cremers, Amelieke J H; Ferwerda, Gerben; de Groot, Ronald; Langereis, Jeroen D; van der Flier, Michiel

2018-04-01

The pneumococcal capsular serotype is an important determinant of complement resistance and invasive disease potential, but other virulence factors have also been found to contribute. Pneumococcal surface protein C (PspC), a highly variable virulence protein that binds complement factor H to evade C3 opsonization, is divided into two subgroups: choline-bound subgroup I and LPxTG-anchored subgroup II. The prevalence of different PspC subgroups in invasive pneumococcal disease (IPD) and functional differences in complement evasion are unknown. The prevalence of PspC subgroups in IPD isolates was determined in a collection of 349 sequenced strains of Streptococcus pneumoniae isolated from adult patients. pspC deletion mutants and isogenic pspC switch mutants were constructed to study differences in factor H binding and complement evasion in relation to capsule thickness. Subgroup I pspC was far more prevalent in IPD isolates than subgroup II pspC The presence of capsule was associated with a greater ability of bound factor H to reduce complement opsonization. Pneumococcal subgroup I PspC bound significantly more factor H and showed more effective complement evasion than subgroup II PspC in isogenic encapsulated pneumococci. We conclude that variation in the PspC subgroups, independent of capsule serotypes, affects pneumococcal factor H binding and its ability to evade complement deposition. Copyright © 2018 American Society for Microbiology.

Validation of mobile eye tracking as novel and efficient means for differentiating progressive supranuclear palsy from Parkinson’s disease

Directory of Open Access Journals (Sweden)

Svenja eMarx

2012-12-01

Full Text Available Background: The decreased ability to carry out vertical saccades is a key symptom of Progressive Supranuclear Palsy (PSP. Objective measurement devices can help to reliably detect subtle eye-movement disturbances to improve sensitivity and specificity of the clinical diagnosis. The present study aims at transferring findings from restricted stationary video-oculography to a wearable head-mounted device, which can be readily applied in clinical practice.Methods: We investigated the eye movements in 10 possible or probable PSP patients, 11 Parkinson’s disease (PD patients and 10 age-matched healthy controls (HC using a mobile, gaze-driven video camera setup (EyeSeeCam. Ocular movements were analyzed during a standardized fixation protocol and in an unrestricted real-life scenario while walking along a corridor.Results: The EyeSeeCam detected prominent impairment of both saccade velocity and amplitude in PSP patients, differentiating them from PD and HCs. Differences were particularly evident for saccades in the vertical plane, and stronger for saccades than for other eye movements. Differences were more pronounced during the standardized protocol than in the real-life scenario. Conclusions: Combined analysis of saccade velocity and saccade amplitude during the fixation protocol with the EyeSeeCam provides a simple, rapid (< 20s and reliable tool to differentiate clinically established PSP patients from PD and HCs. As such, our findings prepare the ground for using wearable eye-tracking in patients with uncertain diagnoses.

Role of the tau gene region chromosome inversion in progressive supranuclear palsy, corticobasal degeneration, and related disorders.

Science.gov (United States)

Webb, Amy; Miller, Bruce; Bonasera, Stephen; Boxer, Adam; Karydas, Anna; Wilhelmsen, Kirk C

2008-11-01

An inverted region on chromosome 17 has been previously linked to many Pick complex diseases. Due to the inversion, an exact causal locus has been difficult to identify, but the microtubule-associated protein tau gene is a likely candidate gene for its involvement in these diseases with tau inclusion. To search for variants that confer susceptibility to 4 tauopathies and clinically related disorders. Genomewide association study. University research laboratory. A total of 231 samples were genotyped from an unrelated white population of patients with progressive supranuclear palsy (PSP), corticobasal degeneration (CBD), frontotemporal dementia, and frontotemporal dementia with amyotrophy. Unaffected individuals from the same population were used as controls. The results from an inverted region of chromosome 17 that contains the MAPT gene. Genotypes of cases and controls were compared using a Fisher exact test on a marker-by-marker basis. Haplotypes were determined by visually inspecting genotypes. Comparing any particular disease and controls, the association was constant across the inverted chromosome segment. Significant associations were seen for PSP and PSP combined with CBD. Of the 2 haplotypes seen in the region, H1 was overrepresented in PSP and CBD cases compared with controls. As expected, the markers are highly correlated and the association is seen across the entire region, which makes it difficult to narrow down a disease-causing variant or even a possible candidate gene. However, considering the pathologic abnormalities of these diseases and the involvement of tau mutations seen in familial forms, the MAPT gene represents the most likely cause driving the association.

Familias de la proteína de superficie PspA de Streptococcus pneumoniae: Relación con serotipos y localización Pneumococcal surface protein A (PspA families: Relation with serotypes and clinical site of infection

Directory of Open Access Journals (Sweden)

Clara Mayoral

2010-10-01

Full Text Available PspA, proteína de superficie de Streptococcus pneumoniae es un factor de virulencia, fuertemente inmunogénica y común a todos los serotipos. Aunque el gen que codifica para esta proteína presenta una marcada heterogeneidad en la región correspondiente al N-terminal, la PspA contiene epitopes conservados de manera tal que la inmunización genera protección contra neumococos pertenecientes a diversos tipos capsulares y con distintas PspA. A pesar del marcado polimorfismo del gen pspA es posible agrupar las distintas variantes en 3 familias mayoritarias. Estas propiedades las convierten en candidatas ideales para elaborar vacunas. Debido a que la mayoría de los trabajos sobre identificación de familias fueron realizados sobre serotipos frecuentes en otros países, el objetivo fue identificar las familias de PspA de aislamientos de pacientes de nuestra región y relacionarlas con los serotipos prevalentes y patologías. Se estudiaron 70 aislamientos, provenientes de niños con infecciones invasoras. Se aplicó una PCR utilizando cebadores específicos de cada familia. El 60% fueron familia 1 y 34% familia 2. En un 6% no se identificó ninguna de las familias de PspA. Los serotipos 1 y 5 presentaron familia 1 únicamente; los serotipos 14, 6B, 19F y 18C mostraron genes de ambas familias. La familia 1 se observó en 60% de las neumonías y 50% de las meningitis. La familia 2 en 33% de neumonías y 50% de meningitis. Esta información podría ser un valioso aporte para la formulación de una vacuna regional efectiva utilizando PspA recombinante como inmunógeno.PspA, a pneumococcal surface protein, is highly immunogenic and common to all serotypes. Although pspA gene shows a great heterogeneity at the N-terminal region, PspA protein has conserved epytopes which are able to elicit protective cross-reaction against various serotypes presenting different PspA. In spite of the high polimorfism of the PspA, three majority families can be identified

Upper midbrain profile sign and cingulate sulcus sign. MRI findings on sagittal images in idiopathic normal-pressure hydrocephalus, Alzheimer's disease, and progressive supranuclear palsy

International Nuclear Information System (INIS)

Adachi, Michito; Ohshima, Fumi; Kawanami, Toru; Kato, Takeo

2006-01-01

On magnetic resonance imaging (MRI) sagittal sections, we sometimes encounter abnormal aspects of the superior profile of the midbrain and the cingulate sulcus in patients with dementia. In this preliminary study, we refer to these findings as the ''upper midbrain profile sign'' and the cingulate sulcus sign.'' We prospectively evaluated the usefulness of these signs for the diagnosis of idiopathic normal-pressure hydrocephalus (iNPH), Alzheimer's disease (AD) and progressive supranuclear palsy (PSP). We evaluated the upper midbrain profile sign and the cingulate sulcus sign on MRI sagittal images obtained from 21 people with headaches but no neurological deficit (controls), 10 iNPH patients, 11 AD patients, and 5 PSP patients. The upper midbrain profile sign indicated a concave shape to the superior profile of the midbrain on mid-sagittal images, and the cingulate sulcus sign indicated a narrow, tight aspect of the posterior part of the cingulate sulcus on paramedian-sagittal images. These signs were never seen in any images from the controls. The upper midbrain profile sign was seen in 7 of 10 patients with iNPH, 5 of 11 with AD, and 3 of 5 with PSP. The cingulate sulcus sign was seen in all 10 patients with iNPH but was never seen in any patient with AD or PSP. The upper midbrain profile sign could support a diagnosis of PSP but cannot discriminate among iNPH, AD, and PSP. In contrast, the cingulate sulcus sign has a very high sensitivity for iNPH and should facilitate the distinction of iNPH from other dementias. In the clinical setting, it is momentous to evaluate these signs easily by one simple MRI sequence. (author)

Room Temperature Stable PspA-Based Nanovaccine Induces Protective Immunity

Directory of Open Access Journals (Sweden)

Danielle A. Wagner-Muñiz

2018-03-01

Full Text Available Streptococcus pneumoniae is a major causative agent of pneumonia, a debilitating disease particularly in young and elderly populations, and is the leading worldwide cause of death in children under the age of five. While there are existing vaccines against S. pneumoniae, none are protective across all serotypes. Pneumococcal surface protein A (PspA, a key virulence factor of S. pneumoniae, is an antigen that may be incorporated into future vaccines to address the immunological challenges presented by the diversity of capsular antigens. PspA has been shown to be immunogenic and capable of initiating a humoral immune response that is reactive across approximately 94% of pneumococcal strains. Biodegradable polyanhydrides have been studied as a nanoparticle-based vaccine (i.e., nanovaccine platform to stabilize labile proteins, to provide adjuvanticity, and enhance patient compliance by providing protective immunity in a single dose. In this study, we designed a room temperature stable PspA-based polyanhydride nanovaccine that eliminated the need for a free protein component (i.e., 100% encapsulated within the nanoparticles. Mice were immunized once with the lead nanovaccine and upon challenge, presented significantly higher survival rates than animals immunized with soluble protein alone, even with a 25-fold reduction in protein dose. This lead nanovaccine formulation performed similarly to protein adjuvanted with Alum, however, with much less tissue reactogenicity at the site of immunization. By eliminating the free PspA from the nanovaccine formulation, the lead nanovaccine was efficacious after being stored dry for 60 days at room temperature, breaking the need for maintaining the cold chain. Altogether, this study demonstrated that a single dose PspA-based nanovaccine against S. pneumoniae induced protective immunity and provided thermal stability when stored at room temperature for at least 60 days.

Removal of the phage-shock protein PspB causes reduction of virulence in Salmonella enterica serovar Typhimurium independently of NRAMP1.

Science.gov (United States)

Wallrodt, Inke; Jelsbak, Lotte; Thomsen, Line E; Brix, Lena; Lemire, Sébastien; Gautier, Laurent; Nielsen, Dennis S; Jovanovic, Goran; Buck, Martin; Olsen, John E

2014-06-01

The phage-shock protein (Psp) system is believed to manage membrane stress in all Enterobacteriaceae and has recently emerged as being important for virulence in several pathogenic species of this phylum. The core of the Psp system consists of the pspA-D operon and the distantly located pspG gene. In Salmonella enterica serovar Typhimurium (S. Typhimurium), it has recently been reported that PspA is essential for systemic infection of mice, but only in NRAMP1(+) mice, signifying that attenuation is related to coping with divalent cation starvation in the intracellular environment. In the present study, we investigated the contribution of individual psp genes to virulence of S. Typhimurium. Interestingly, deletion of the whole pspA-D set of genes caused attenuation in both NRAMP1(+) and NRAMP1(-) mice, indicating that one or more of the psp genes contribute to virulence independently of NRAMP1 expression in the host. Investigations of single gene mutants showed that knock out of pspB reduced virulence in both types of mice, while deletion of pspA only caused attenuation in NRAMP1(+) mice, and deletion of pspD had a minor effect in NRAMP1(-) mice, while deletions of either pspC or pspG did not affect virulence. Experiments addressed at elucidating the role of PspB in virulence revealed that PspB is dispensable for uptake to and intracellular replication in cultured macrophages and resistance to complement-induced killing. Furthermore, the Psp system of S. Typhimurium was dispensable during pIV-induced secretin stress. In conclusion, our results demonstrate that removal of PspB reduces virulence in S. Typhimurium independently of host NRAMP1 expression, demonstrating that PspB has roles in intra-host survival distinct from the reported contributions of PspA. © 2014 The Authors.

Magnetisation transfer measurements of the subcortical grey and white matter in Parkinson's disease with and without dementia and in progressive supranuclear palsy

International Nuclear Information System (INIS)

Hanyu, H.; Asano, T.; Sakurai, H.; Takasaki, M.; Shindo, H.; Abe, K.

2001-01-01

We measured the magnetisation transfer ratio (MTR) in the subcortical grey and white matter of 11 patients with idiopathic Parkinson's disease (PD) without dementia, six with PD with dementia (PDD), six with progressive supranuclear palsy (PSP), and 12 elderly control subjects to assess regional differences in structural brain damage. There were no significant differences in MTR in any region between PD and controls. However, patients with PDD had significantly lower MTR in the subcortical white matter, including the frontal white matter and the genu of the corpus callosum than the controls, whereas PSP had significantly lower MTR in the subcortical grey matter, including the putamen, globus pallidus and thalamus, in addition to the subcortical white matter. This suggests that regional patterns of structural brain damage can be detected using the magnetisation transfer technique. Measurement of MTR in the subcortical grey and white matter may be useful in differential diagnosis. (orig.)

Sustaining private sector participation (PSP) in solid waste management in Lagos, Nigeria, a developing country

Energy Technology Data Exchange (ETDEWEB)

Adebola, G. [Richbol Environmental Services Ltd., Lagos (Nigeria)

2000-07-01

Solid waste management in Lagos, Nigeria includes refuse collection and transportation to a landfill site. Disposal of the refuse and maintenance of the landfill site is also included in this task which, in the past was always a responsibility of the Government Agencies at the local level as a social service. This service has recently been privatised in the name of Private Sector Participation (PSP) in domestic refuse collection and disposal. As a new operator in about 23 wards in the ongoing PSP of domestic refuse, Richbol Environmental Ltd., recognized the enormous effort that government will have to make to sustain PSP in solid waste management. Governments can maintain control through re-orientation, legislation, enforcement, strengthening the PSP operators, integrating existing operators, and monitoring the activities of PSP operators. This paper presented a brief overview of the institutional changes that solid waste management has undergone in Lagos since 1977. It was emphasized that integrated waste management is extremely capital intensive. An integrated PSP can be a long term solution to waste management in developing, cash poor countries. The economic importance of PSP lies in the fact that it will reduce government expenditure and will also create a healthier environment and provide employment opportunities for thousands of employees and contribute to the gross domestic product of the country. 5 refs., 3 tabs., 1 fig.

75 FR 29324 - Preferred Supplier Program (PSP)

Science.gov (United States)

2010-05-25

..., DON will use a 5-star system based upon the 5-color ratings used in CPARS, as follows: CPARS PSP Red 0... contractors with the greatest motivation to achieve PSS? 3. Energy Efficiency is a critical DON requirement...

Membrane Stored Curvature Elastic Stress Modulates Recruitment of Maintenance Proteins PspA and Vipp1.

Science.gov (United States)

McDonald, Christopher; Jovanovic, Goran; Ces, Oscar; Buck, Martin

2015-09-01

Phage shock protein A (PspA), which is responsible for maintaining inner membrane integrity under stress in enterobacteria, and vesicle-inducting protein in plastids 1 (Vipp1), which functions for membrane maintenance and thylakoid biogenesis in cyanobacteria and plants, are similar peripheral membrane-binding proteins. Their homologous N-terminal amphipathic helices are required for membrane binding; however, the membrane features recognized and required for expressing their functionalities have remained largely uncharacterized. Rigorously controlled, in vitro methodologies with lipid vesicles and purified proteins were used in this study and provided the first biochemical and biophysical characterizations of membrane binding by PspA and Vipp1. Both proteins are found to sense stored curvature elastic (SCE) stress and anionic lipids within the membrane. PspA has an enhanced sensitivity for SCE stress and a higher affinity for the membrane than Vipp1. These variations in binding may be crucial for some of the proteins' differing roles in vivo. Assays probing the transcriptional regulatory function of PspA in the presence of vesicles showed that a relief of transcription inhibition occurs in an SCE stress-specific manner. This in vitro recapitulation of membrane stress-dependent transcription control suggests that the Psp response may be mounted in vivo when a cell's inner membrane experiences increased SCE stress. All cell types maintain the integrity of their membrane systems. One widely distributed membrane stress response system in bacteria is the phage shock protein (Psp) system. The central component, peripheral membrane protein PspA, which mitigates inner membrane stress in bacteria, has a counterpart, Vipp1, which functions for membrane maintenance and thylakoid biogenesis in plants and photosynthetic bacteria. Membrane association of both these proteins is accepted as playing a pivotal role in their functions. Here we show that direct membrane binding by

Removal of the phage-shock protein PspB causes reduction of virulence in Salmonella enterica serovar Typhimurium independently of NRAMP1

DEFF Research Database (Denmark)

Wallrodt, Inke; Jelsbak, Lotte; Thomsen, Line E.

2014-01-01

The phage-shock protein (Psp) system is believed to manage membrane stress in all Enterobacteriaceae and has recently emerged as being important for virulence in several pathogenic species of this phylum. The core of the Psp system consists of the pspA-D operon and the distantly located pspG gene......IV-induced secretin stress. In conclusion, our results demonstrate that removal of PspB reduces virulence in S. Typhimurium independently of host NRAMP1 expression, demonstrating that PspB has roles in intra-host survival distinct from the reported contributions of PspA....

Detection of pregnancy by radioimmunoassay of a pregnancy serum protein (PSP60) in cattle

International Nuclear Information System (INIS)

Mialon, M.M.; Renand, G.; Camous, S.; Martal, J.; Menissier, F.

1994-01-01

The accuracy and efficiency of pregnancy diagnoses in cattle by pregnancy serum protein (PSP60) radioimmunoassay, a progesterone radioimmunoassay or oestrus detection were compared. Blood samples were taken from 349 suckling heifers and cows ( 1 191 inseminations) at 28, 35, 50 and 90 d post-insemination for PSP60 determination and at 22-23 d for progesterone. Females were declared nonpregnant when plasma PSP60 concentration was lower than 0.2 ng/ml at 28, 35 and 50 d and 0.5 ng/ml at 90 d. When compared with rectal palpation at 90 d, the accuracy of positive (negative) diagnoses by progesterone assay was 80% (100%) in heifers and 75% (99%) in cows. The accuracy of positive diagnoses by PSP60 assay increased with gestation stage from 90% on d 28 in heifers (74% in cows) to 100% (99% in cows) at the time of rectal palpation. This accuracy was 84% on d 28 in cows when the interval from calving to blood sampling was higher than 115 d. Whatever the stage, the accuracy of negative diagnoses was higher than 90%. Efficiency in detecting pregnant or nonpregnant females on d 28 was equivalent to the progesterone assay. The method for detecting oestrus applied in this experiment was as efficient as the PSP60 or progesterone test at any stage of gestation. The PSP60 test is very flexible, which makes its use particularly interesting in naturally mated suckling herds because of the uncertainty regarding the date of fertilization. (authors)

[Facial palsy].

Science.gov (United States)

Cavoy, R

2013-09-01

Facial palsy is a daily challenge for the clinicians. Determining whether facial nerve palsy is peripheral or central is a key step in the diagnosis. Central nervous lesions can give facial palsy which may be easily differentiated from peripheral palsy. The next question is the peripheral facial paralysis idiopathic or symptomatic. A good knowledge of anatomy of facial nerve is helpful. A structure approach is given to identify additional features that distinguish symptomatic facial palsy from idiopathic one. The main cause of peripheral facial palsies is idiopathic one, or Bell's palsy, which remains a diagnosis of exclusion. The most common cause of symptomatic peripheral facial palsy is Ramsay-Hunt syndrome. Early identification of symptomatic facial palsy is important because of often worst outcome and different management. The prognosis of Bell's palsy is on the whole favorable and is improved with a prompt tapering course of prednisone. In Ramsay-Hunt syndrome, an antiviral therapy is added along with prednisone. We also discussed of current treatment recommendations. We will review short and long term complications of peripheral facial palsy.

What makes children with cerebral palsy vulnerable to malnutrition? Findings from the Bangladesh cerebral palsy register (BCPR).

Science.gov (United States)

Jahan, Israt; Muhit, Mohammad; Karim, Tasneem; Smithers-Sheedy, Hayley; Novak, Iona; Jones, Cheryl; Badawi, Nadia; Khandaker, Gulam

2018-04-16

To assess the nutritional status and underlying risk factors for malnutrition among children with cerebral palsy in rural Bangladesh. We used data from the Bangladesh Cerebral Palsy Register; a prospective population based surveillance of children with cerebral palsy aged 0-18 years in a rural subdistrict of Bangladesh (i.e., Shahjadpur). Socio-demographic, clinical and anthropometric measurements were collected using Bangladesh Cerebral Palsy Register record form. Z scores were calculated using World Health Organization Anthro and World Health Organization AnthroPlus software. A total of 726 children with cerebral palsy were registered into the Bangladesh Cerebral Palsy Register (mean age 7.6 years, standard deviation 4.5, 38.1% female) between January 2015 and December 2016. More than two-third of children were underweight (70.0%) and stunted (73.1%). Mean z score for weight for age, height for age and weight for height were -2.8 (standard deviation 1.8), -3.1 (standard deviation 2.2) and -1.2 (standard deviation 2.3) respectively. Moderate to severe undernutrition (i.e., both underweight and stunting) were significantly associated with age, monthly family income, gross motor functional classification system and neurological type of cerebral palsy. The burden of undernutrition is high among children with cerebral palsy in rural Bangladesh which is augmented by both poverty and clinical severity. Enhancing clinical nutritional services for children with cerebral palsy should be a public health priority in Bangladesh. Implications for Rehabilitation Population-based surveillance data on nutritional status of children with cerebral palsy in Bangladesh indicates substantially high burden of malnutrition among children with CP in rural Bangladesh. Children with severe form of cerebral palsy, for example, higher Gross Motor Function Classification System (GMFCS) level, tri/quadriplegic cerebral palsy presents the highest proportion of severe malnutrition; hence, these

Efficacy of Āyurvedic treatment using Pañcakarma combined with balance exercises for disability and balance in progressive supranuclear palsy

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Jindal, Nitin; Shamkuwar, Manoj K.; Kaur, Jaskirat; Berry, Sadhan

2012-01-01

A 55-year-old female presented at Department of Pañcakarma with diagnosis of progressive supranuclear palsy (PSP). For assessing disability, progressive supranuclear palsy rating scale (PSPRS) was used and balance was assessed by using Tetrax Interactive Balance System (IBS) posturography. Āyurvedic treatment was given along with Pañcakarma and balance exercises for 3 months. As part of Āyurvedic treatment, first Virecana karma was done with classical method and then Mātrā basti, Śirobasti, and other palliative treatment was given for 3 months. Amanatidine was not continued during Virecana karma but started thereafter. On comparison with pre-intervention scores, there was a significant improvement in the patient post-treatment. The features which mainly showed improvement were: Eye movements, spontaneous episodes of laughing, dysphagia, dysarthria, double vision, and neck rigidity. Balance showed significant improvement and there was a remarkable decrease in the postural sway. This case study may present new possibilities for treatment of neurodegenerative diseases by Āyurveda. PMID:23929996

Data-Acquisition Software for PSP/TSP Wind-Tunnel Cameras

Science.gov (United States)

Amer, Tahani R.; Goad, William K.

2005-01-01

Wing-Viewer is a computer program for acquisition and reduction of image data acquired by any of five different scientificgrade commercial electronic cameras used at Langley Research center to observe wind-tunnel models coated with pressure or temperature-sensitive paints (PSP/TSP). Wing-Viewer provides full automation of camera operation and acquisition of image data, and has limited data-preprocessing capability for quick viewing of the results of PSP/TSP test images. Wing- Viewer satisfies a requirement for a standard interface between all the cameras and a single personal computer: Written by use of Microsoft Visual C++ and the Microsoft Foundation Class Library as a framework, Wing-Viewer has the ability to communicate with the C/C++ software libraries that run on the controller circuit cards of all five cameras.

Bell's Palsy Treatment

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... Stories Español Eye Health / Eye Health A-Z Bell's Palsy Sections What Is Bell's Palsy? Bell's Palsy Symptoms Bell's Palsy Treatment Bell's Palsy Treatment Leer en Español: Tratamiento de la parálisis ...

Bell's Palsy Symptoms

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... Stories Español Eye Health / Eye Health A-Z Bell's Palsy Sections What Is Bell's Palsy? Bell's Palsy Symptoms Bell's Palsy Treatment Bell's Palsy Symptoms Leer en Español: Síntomas de la parálisis ...

Combination of pneumococcal surface protein A (PspA with whole cell pertussis vaccine increases protection against pneumococcal challenge in mice.

Directory of Open Access Journals (Sweden)

Maria Leonor S Oliveira

Full Text Available Streptococcus pneumoniae is the leading cause of respiratory acute infections around the world. In Latin America, approximately 20,000 children under 5 years of age die of pneumococcal diseases annually. Pneumococcal surface protein A (PspA is among the best-characterized pneumococcal antigens that confer protection in animal models of pneumococcal infections and, as such, is a good alternative for the currently available conjugated vaccines. Efficient immune responses directed to PspA in animal models have already been described. Nevertheless, few low cost adjuvants for a subunit pneumococcal vaccine have been proposed to date. Here, we have tested the adjuvant properties of the whole cell Bordetella pertussis vaccine (wP that is currently part of the DTP (diphtheria-tetanus-pertussis vaccine administrated to children in several countries, as an adjuvant to PspA. Nasal immunization of BALB/c mice with a combination of PspA5 and wP or wP(low--a new generation vaccine that contains low levels of B. pertussis LPS--conferred protection against a respiratory lethal challenge with S. pneumoniae. Both PspA5-wP and PspA5-wP(low vaccines induced high levels of systemic and mucosal antibodies against PspA5, with similar profile, indicating no essential requirement for B. pertussis LPS in the adjuvant properties of wP. Accordingly, nasal immunization of C3H/HeJ mice with PspA5-wP conferred protection against the pneumococcal challenge, thus ruling out a role for TLR4 responses in the adjuvant activity and the protection mechanisms triggered by the vaccines. The high levels of anti-PspA5 antibodies correlated with increased cross-reactivity against PspAs from different clades and also reflected in cross-protection. In addition, passive immunization experiments indicated that antibodies played an important role in protection in this model. Finally, subcutaneous immunization with a combination of PspA5 with DTP(low protected mice against challenge with two

Differential distribution of striatal [123I]β-CIT in Parkinson's disease and progressive supranuclear palsy, evaluated with single-photon emission tomography

International Nuclear Information System (INIS)

Messa, C.; Volonte, M.A.; Fazio, F.; Zito, F.; Carpinelli, A.; D'Amico, A.; Rizzo, G.; Moresco, R.M.; Paulesu, E.; Franceschi, M.; Lucignani, G.

1998-01-01

Functional imaging of the presynaptic dopaminergic activity using single-photon emission tomography (SPET) and iodine-123 labelled 2-β-carboxymethoxy-3-β-(4-iodophenyl)tropane ([ 123 I]β-CIT) is important for the assessment of disease severity and progression in patients with Parkinson's disease (PD). However, its capability to discriminate between different extrapyramidal disorders has not yet been assessed. The aim of this study was to evaluate the possibility of differentiating patients with PD and with progressive supranuclear palsy (PSP) by means of this method. The distribution of [ 123 I]β-CIT in the basal ganglia was assessed in six normal subjects, 13 petients with PD and five patients with PSP in whom the disease was mild. SPET images were obtained 24±2 h after i.v. injection of the tracer using a brain-dedicated system (CERASPECT). MR and SPET images were co-registered in four normal subjects and used to define a standard set of 16 circular regions of interest (ROIs) on the slice showing the highest striatal activity. The basal ganglia ROIs corresponded to (1) the head of caudate, (2) a region of transition between the head of caudate and the anterior putamen, (3) the anterior putamen and (4) the posterior putamen. A ratio of specific to non-displaceable striatal uptake was calculated normalising the activity of the basal ganglia ROIs to that of the occipital cortex (V3''). ANOVA revealed a global reduction of V3'' in all ROIs of PD and PSP patients compared with normal controls (P 123 I]β-CIT distribution in discrete striatal areas provides information on the relative caudate-putamen damage, with different values being obtained in patients clinically diagnosed as having either PD or PSP. (orig.)

Comparative Study of Accuracy in E Speed Intra Oral Films, PSP Intra Oral Digital System and Panoramic Digital Systems (PSP&CCD for Identifying the Extent of Alveolar Bone Loss in Patients with Chronic Periodontitis

Directory of Open Access Journals (Sweden)

J. Moradi Haghgoo

2014-04-01

Full Text Available Introduction & Objective: Diagnosis of periodontal osseous lesions is very important in deter-mining prognosis, treatment plan and maintenance in the long term. This diagnosis can be achieved by using radiography. The aim of this study is to compare accuracy of E speed films, bitewing PSP, panoramic PSP and CCD for identifying the extent of destruction of al-veolar bone in chronic periodontitis. Materials & Methods: In this cross-sectional study, 272 interproximal surfaces were evaluated by 4 radiographic techniques after clinical examination by a periodontist and indication of flap surgery. The distance between CEJ and the alveolar crest was measured by Williams probe during the surgery and before osseous recontouring. These measures were considered as gold standard. This distance was measured using all 4 radiography techniques by 2 radi-ologists at standard conditions after calibration. Results: There was no significant difference between the 4 techniques. The mean distances from CEJ to alveolar crest in all techniques had no significant difference with gold standard, the least difference was in digital BW PSP and the greatest difference was in panoramic PSP. The non-measurable surfaces by E speed BW and panoramic PSP were the fewest and the most, respectively. Conclusion: Better relative accuracy with regard to variation range, mean difference of meas-ures based on gold standard and number of shown surfaces was observed in digital and conventional BW compared to digital panoramic images. (Sci J Hamadan Univ Med Sci 2014; 21 (1:41-48

The pancreas responds to remote damage and systemic stress by secretion of the pancreatic secretory proteins PSP/regI and PAP/regIII.

Science.gov (United States)

Reding, Theresia; Palmiere, Cristian; Pazhepurackel, Clinsyjos; Schiesser, Marc; Bimmler, Daniel; Schlegel, Andrea; Süss, Ursula; Steiner, Sabrina; Mancina, Leandro; Seleznik, Gitta; Graf, Rolf

2017-05-02

In patients with infection and sepsis serum levels of Pancreatic Stone protein/regenerating protein I (PSP) are highly elevated. The origin of PSP during these conditions is presumably the pancreas, however, an intestinal origin cannot be excluded. Similarly, pancreatitis-associated protein (PAP) was identified in the pancreas. These proteins were also localized in intestinal organs. Here we aim to elucidate the bio-distribution of PSP and PAP in animal models of sepsis and in healthy humans. PSP and PAP responded to remote lesions in rats although the pancreatic response was much more pronounced than the intestinal. Tissue distribution of PSP demonstrated a 100-fold higher content in the pancreas compared to any other organ while PAP was most abundant in the small intestine. Both proteins responded to CLP or sham operation in the pancreas. PSP also increased in the intestine during CLP. The distribution of PSP and PAP in human tissue mirrored the distribution in the murine models. Distribution of PSP and PAP was visualized by immunohistochemistry. Rats and mice underwent midline laparotomies followed by mobilization of tissue and incision of the pancreatic duct or duodenum. Standard cecum-ligation-puncture (CLP) procedures or sham laparotomies were performed. Human tissue extracts were analyzed for PSP and PAP. The pancreas reacts to remote lesions and septic insults in mice and rats with increased PSP synthesis, while PAP is selectively responsive to septic events. Furthermore, our results suggest that serum PSP in septic patients is predominantly derived through an acute phase response of the pancreas.

Analysis of Pumped Storage Plants (PSP) viability associated with other types of intermittent renewable energy

International Nuclear Information System (INIS)

Andrade, J G P; Barbosa, P S F; Luvizotto, E Jr; Zuculin, S; Pinto, Marrc; Filho, G L Tiago

2014-01-01

The energy generated by wind or solar photovoltaic (PV system) can be used by PSP to accumulate water in the upper reservoir, in the form of potential energy to be used later, during periods of high energy demand. This procedure offers the advantage of enabling the use of intermittent renewable energy source in times of growing needs of the electric power supply. The location of the PSP, the environmental aspects involved, their possible use for various purposes (stability of the power system at peak times, associate the turbine water for public supply purposes, among others) and the discussion of regulatory issues needs to be debated in the current context, where environmental issues require reliable sources of power generation and demand shows strong growth rates. A dynamic model is used to analyze the behavior of a PSP proposal for a site in Brazil, analyzing a complete cycle of its operation as a pump or turbine. The existing difficulties to use this proposal based on existing regulatory policies are also discussed, and a list of recommended adjustments is provided to allow the penetrations of PSP projects in the Brazilian institutional framework, coupled with other intermittent energy sources

Check-All-That-Apply (CATA), Sorting, and Polarized Sensory Positioning (PSP) with Astringent Stimuli

Science.gov (United States)

Fleming, Erin E.; Ziegler, Gregory R.; Hayes, John E.

2015-01-01

Multiple rapid sensory profiling techniques have been developed as more efficient alternatives to traditional sensory descriptive analysis. Here, we compare the results of three rapid sensory profiling techniques – check-all-that-apply (CATA), sorting, and polarized sensory positioning (PSP) – using a diverse range of astringent stimuli. These rapid methods differ in their theoretical basis, implementation, and data analyses, and the relative advantages and limitations are largely unexplored. Additionally, we were interested in using these methods to compare varied astringent stimuli, as these compounds are difficult to characterize using traditional descriptive analysis due to high fatigue and potential carry-over. In the CATA experiment, subjects (n=41) were asked to rate the overall intensity of each stimulus as well as to endorse any relevant terms (from a list of 13) which characterized the sample. In the sorting experiment, subjects (n=30) assigned intensity-matched stimuli into groups 1-on-1 with the experimenter. In the PSP experiment, (n=41) subjects first sampled and took notes on three blind references (‘poles’) before rating each stimulus for its similarity to each of the 3 poles. Two-dimensional perceptual maps from correspondence analysis (CATA), multidimensional scaling (sorting), and multiple factor analysis (PSP) were remarkably similar, with normalized RV coefficients indicating significantly similar plots, regardless of method. Agglomerative hierarchical clustering of all data sets using Ward’s minimum variance as the linkage criteria showed the clusters of astringent stimuli were approximately based on the respective class of astringent agent. Based on the descriptive CATA data, it appears these differences may be due to the presence of side tastes such as bitterness and sourness, rather than astringent sub-qualities per se. Although all three methods are considered ‘rapid,’ our prior experience with sorting suggests it is best

Facial palsy in Melkersson-Rosenthal syndrome and Bell's palsy: familial history and recurrence tendency.

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Sun, Baochun; Zhou, Chengyong; Han, Zeli

2015-02-01

The aim of this study was to compare genetic predilection and recurrence tendency between facial palsy in Melkersson-Rosenthal syndrome (MRS) and Bell's palsy We carried out an investigation on patients with facial palsy in MRS and those with Bell's palsy who visited the outpatient department in our hospital between February 2009 and February 2013. They were asked about familial history and whether it was the first episode, with the results recorded and compared. There were 16 patients with facial palsy in MRS and 860 patients with Bell's palsy involved in the study. Familial history was positive in 5 of 16 patients (31.3%) with facial palsy in MRS and 56 of 860 patients (6.5%) with Bell's palsy (P palsy in MRS and 88 of 860 cases (10.2%) with Bell's palsy had a history of facial palsy in the past (P Bell's palsy, facial palsy in MRS has an obvious genetic predilection and recurrence tendency. © The Author(s) 2014.

A comparison of film and 3 digital imaging systems for natural dental caries detection: CCD, CMOS, PSP and film

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Han, Won Jeong [Dankook University College of Medicine, Seoul (Korea, Republic of)

2004-03-15

To evaluate the diagnostic accuracy of occlusal and proximal caries detection using CCD, CMOS, PSP and film system. 32 occlusal and 30 proximal tooth surfaces were radiographed under standardized conditions using 3 digital systems; CCD (CDX-2000HQ, Biomedysis Co., Seoul, Korea), CMOS (Schick, Schick Inc., Long Island, USA), PSP (Digora FMX, Orion Co./Soredex, Helsinki, Finland) and 1 film system (Kodak Insight, Eastman Kodak, Rochester, USA). 5 observers examined the radiographs for occlusal and proximal caries using a 5-point confidence scale. The presence of caries was validated histologically and radiographically. Diagnostic accuracy was evaluated using ROC curve areas (AZ). Analysis using ROC curves revealed the area under each curve which indicated a diagnostic accuracy. For occlusal caries, Kodak Insight film had an Az of 0.765, CCD one of 0.730, CMOS one of 0.742 and PSP one of 0.735. For proximal caries, Kodak Insight film had an Az of 0.833, CCD one of 0.832, CMOS one of 0.828 and PSP one of 0.868. No statistically significant difference was noted between any of the imaging modalities. CCD, CMOS, PSP and film performed equally well in the detection of occlusal and proximal dental caries. CCD, CMOS and PSP-based digital images provided a level of diagnostic performance comparable to Kodak Insight film.

A comparison of film and 3 digital imaging systems for natural dental caries detection: CCD, CMOS, PSP and film

International Nuclear Information System (INIS)

Han, Won Jeong

2004-01-01

To evaluate the diagnostic accuracy of occlusal and proximal caries detection using CCD, CMOS, PSP and film system. 32 occlusal and 30 proximal tooth surfaces were radiographed under standardized conditions using 3 digital systems; CCD (CDX-2000HQ, Biomedysis Co., Seoul, Korea), CMOS (Schick, Schick Inc., Long Island, USA), PSP (Digora FMX, Orion Co./Soredex, Helsinki, Finland) and 1 film system (Kodak Insight, Eastman Kodak, Rochester, USA). 5 observers examined the radiographs for occlusal and proximal caries using a 5-point confidence scale. The presence of caries was validated histologically and radiographically. Diagnostic accuracy was evaluated using ROC curve areas (AZ). Analysis using ROC curves revealed the area under each curve which indicated a diagnostic accuracy. For occlusal caries, Kodak Insight film had an Az of 0.765, CCD one of 0.730, CMOS one of 0.742 and PSP one of 0.735. For proximal caries, Kodak Insight film had an Az of 0.833, CCD one of 0.832, CMOS one of 0.828 and PSP one of 0.868. No statistically significant difference was noted between any of the imaging modalities. CCD, CMOS, PSP and film performed equally well in the detection of occlusal and proximal dental caries. CCD, CMOS and PSP-based digital images provided a level of diagnostic performance comparable to Kodak Insight film.

Neuromelanin imaging and midbrain volumetry in progressive supranuclear palsy and Parkinson's disease.

Science.gov (United States)

Taniguchi, Daisuke; Hatano, Taku; Kamagata, Koji; Okuzumi, Ayami; Oji, Yutaka; Mori, Akio; Hori, Masaaki; Aoki, Shigeki; Hattori, Nobutaka

2018-05-14

Background Nigral degeneration patterns differ between PSP and PD. However, the relationship between nigral degeneration and midbrain atrophy in PSP remains unclear. Objective We analyzed differences and relationships between nigral degeneration and midbrain atrophy in PSP and PD. Methods Neuromelanin-sensitive MRI and midbrain volumetry were performed in 11 PSP patients, 24 PD patients, and 10 controls to measure the neuromelanin-sensitive SNpc area and midbrain volume. Results The neuromelanin-sensitive SNpc area and midbrain volume were significantly smaller in PSP patients compared with PD patients and controls. Motor deficits were inversely correlated with neuromelanin-sensitive SNpc area in PD, but not PSP patients. There was no significant correlation between neuromelanin-sensitive SNpc area and midbrain volume in either disease group. Midbrain volumetry discriminated PSP from PD. Diagnostic accuracy was improved when neuromelanin-sensitive MRI analysis was added. Conclusions Neuromelanin-sensitive MRI and midbrain volumetry may reflect the clinical and pathological characteristics of PSP and PD. Combining neuromelanin-sensitive MRI and midbrain volumetry may be useful for differentiating PSP from PD. © 2018 International Parkinson and Movement Disorder Society. © 2018 International Parkinson and Movement Disorder Society.

United Cerebral Palsy

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... your local affiliate Find your local affiliate United Cerebral Palsy United Cerebral Palsy (UCP) is a trusted resource for individuals with Cerebral Palsy and other disabilities and their networks. Individuals with ...

PSP: rapid identification of orthologous coding genes under positive selection across multiple closely related prokaryotic genomes.

Science.gov (United States)

Su, Fei; Ou, Hong-Yu; Tao, Fei; Tang, Hongzhi; Xu, Ping

2013-12-27

With genomic sequences of many closely related bacterial strains made available by deep sequencing, it is now possible to investigate trends in prokaryotic microevolution. Positive selection is a sub-process of microevolution, in which a particular mutation is favored, causing the allele frequency to continuously shift in one direction. Wide scanning of prokaryotic genomes has shown that positive selection at the molecular level is much more frequent than expected. Genes with significant positive selection may play key roles in bacterial adaption to different environmental pressures. However, selection pressure analyses are computationally intensive and awkward to configure. Here we describe an open access web server, which is designated as PSP (Positive Selection analysis for Prokaryotic genomes) for performing evolutionary analysis on orthologous coding genes, specially designed for rapid comparison of dozens of closely related prokaryotic genomes. Remarkably, PSP facilitates functional exploration at the multiple levels by assignments and enrichments of KO, GO or COG terms. To illustrate this user-friendly tool, we analyzed Escherichia coli and Bacillus cereus genomes and found that several genes, which play key roles in human infection and antibiotic resistance, show significant evidence of positive selection. PSP is freely available to all users without any login requirement at: http://db-mml.sjtu.edu.cn/PSP/. PSP ultimately allows researchers to do genome-scale analysis for evolutionary selection across multiple prokaryotic genomes rapidly and easily, and identify the genes undergoing positive selection, which may play key roles in the interactions of host-pathogen and/or environmental adaptation.

Cerebral Palsy (For Teens)

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... Staying Safe Videos for Educators Search English Español Cerebral Palsy KidsHealth / For Teens / Cerebral Palsy What's in this ... do just what everyone else does. What Is Cerebral Palsy? Cerebral palsy (CP) is a disorder of the ...

Bell's Palsy (For Teens)

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... Staying Safe Videos for Educators Search English Español Bell's Palsy KidsHealth / For Teens / Bell's Palsy What's in this ... Print en español Parálisis de Bell What Is Bell's Palsy? Bell's palsy is a temporary weakness or paralysis ...

Microvascular Cranial Nerve Palsy

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... Español Eye Health / Eye Health A-Z Microvascular Cranial Nerve Palsy Sections What Is Microvascular Cranial Nerve Palsy? ... Microvascular Cranial Nerve Palsy Treatment What Is Microvascular Cranial Nerve Palsy? Leer en Español: ¿Qué es una parálisis ...

The prognostic value of concurrent phrenic nerve palsy in newborn babies with neonatal brachial plexus palsy.

Science.gov (United States)

Yoshida, Kiyoshi; Kawabata, Hidehiko

2015-06-01

To investigate the prognostic value of concurrent phrenic nerve palsy for predicting spontaneous motor recovery in neonatal brachial plexus palsy. We reviewed the records of 366 neonates with brachial plexus palsy. The clinical and follow-up data of patients with and without phrenic nerve palsy were compared. Of 366 newborn babies with neonatal brachial plexus palsy, 21 (6%) had concurrent phrenic nerve palsy. Sixteen of these neonates had upper-type palsy and 5 had total-type palsy. Poor spontaneous motor recovery was observed in 13 neonates with concurrent phrenic nerve palsy (62%) and in 129 without concurrent phrenic nerve palsy (39%). Among neonates born via vertex delivery, poor motor recovery was observed in 7 of 9 (78%) neonates with concurrent phrenic nerve palsy and 115 of 296 (39%) without concurrent phrenic nerve palsy. Concurrent phrenic nerve palsy in neonates with brachial plexus palsy has prognostic value in predicting poor spontaneous motor recovery of the brachial plexus, particularly after vertex delivery. Therapeutic IV. Copyright © 2015 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Radiation-induced cranial nerve palsy: hypoglossal nerve and vocal cord palsies

International Nuclear Information System (INIS)

Takimoto, Toru; Saito, Yasuo; Suzuki, Masayuki; Nishimura, Toshirou

1991-01-01

Cranial nerve palsies are an unexpected complication of radiotherapy for head and neck tumours. We present a case of this radiation-induced cranial palsy. An 18-year-old female with nasopharyngeal carcinoma developed a right hypoglossal nerve palsy 42 months after cancericidal doses of radiotherapy. In addition, she developed a bilateral vocal cord palsy 62 months after the therapy. Follow-up over four years has demonstrated no evidence of tumour recurrence and no sign of neurological improvement. (author)

Diffusion tensor imaging of Parkinson's disease, multiple system atrophy and progressive supranuclear palsy: a tract-based spatial statistics study.

Directory of Open Access Journals (Sweden)

Amanda Worker

Full Text Available Although often clinically indistinguishable in the early stages, Parkinson's disease (PD, Multiple System Atrophy (MSA and Progressive Supranuclear Palsy (PSP have distinct neuropathological changes. The aim of the current study was to identify white matter tract neurodegeneration characteristic of each of the three syndromes. Tract-based spatial statistics (TBSS was used to perform a whole-brain automated analysis of diffusion tensor imaging (DTI data to compare differences in fractional anisotropy (FA and mean diffusivity (MD between the three clinical groups and healthy control subjects. Further analyses were conducted to assess the relationship between these putative indices of white matter microstructure and clinical measures of disease severity and symptoms. In PSP, relative to controls, changes in DTI indices consistent with white matter tract degeneration were identified in the corpus callosum, corona radiata, corticospinal tract, superior longitudinal fasciculus, anterior thalamic radiation, superior cerebellar peduncle, medial lemniscus, retrolenticular and anterior limb of the internal capsule, cerebral peduncle and external capsule bilaterally, as well as the left posterior limb of the internal capsule and the right posterior thalamic radiation. MSA patients also displayed differences in the body of the corpus callosum corticospinal tract, cerebellar peduncle, medial lemniscus, anterior and superior corona radiata, posterior limb of the internal capsule external capsule and cerebral peduncle bilaterally, as well as the left anterior limb of the internal capsule and the left anterior thalamic radiation. No significant white matter abnormalities were observed in the PD group. Across groups, MD correlated positively with disease severity in all major white matter tracts. These results show widespread changes in white matter tracts in both PSP and MSA patients, even at a mid-point in the disease process, which are not found in patients

Cerebral Palsy

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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 ...

Bell's Palsy

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Bell's palsy is the most common cause of facial paralysis. It usually affects just one side of the ... become inflamed. You are most likely to get Bell's palsy if you are pregnant, diabetic or sick with ...

Clinical practice guideline: Bell's palsy.

Science.gov (United States)

Baugh, Reginald F; Basura, Gregory J; Ishii, Lisa E; Schwartz, Seth R; Drumheller, Caitlin Murray; Burkholder, Rebecca; Deckard, Nathan A; Dawson, Cindy; Driscoll, Colin; Gillespie, M Boyd; Gurgel, Richard K; Halperin, John; Khalid, Ayesha N; Kumar, Kaparaboyna Ashok; Micco, Alan; Munsell, Debra; Rosenbaum, Steven; Vaughan, William

2013-11-01

Bell's palsy, named after the Scottish anatomist, Sir Charles Bell, is the most common acute mono-neuropathy, or disorder affecting a single nerve, and is the most common diagnosis associated with facial nerve weakness/paralysis. Bell's palsy is a rapid unilateral facial nerve paresis (weakness) or paralysis (complete loss of movement) of unknown cause. The condition leads to the partial or complete inability to voluntarily move facial muscles on the affected side of the face. Although typically self-limited, the facial paresis/paralysis that occurs in Bell's palsy may cause significant temporary oral incompetence and an inability to close the eyelid, leading to potential eye injury. Additional long-term poor outcomes do occur and can be devastating to the patient. Treatments are generally designed to improve facial function and facilitate recovery. There are myriad treatment options for Bell's palsy, and some controversy exists regarding the effectiveness of several of these options, and there are consequent variations in care. In addition, numerous diagnostic tests available are used in the evaluation of patients with Bell's palsy. Many of these tests are of questionable benefit in Bell's palsy. Furthermore, while patients with Bell's palsy enter the health care system with facial paresis/paralysis as a primary complaint, not all patients with facial paresis/paralysis have Bell's palsy. It is a concern that patients with alternative underlying etiologies may be misdiagnosed or have unnecessary delay in diagnosis. All of these quality concerns provide an important opportunity for improvement in the diagnosis and management of patients with Bell's palsy. The primary purpose of this guideline is to improve the accuracy of diagnosis for Bell's palsy, to improve the quality of care and outcomes for patients with Bell's palsy, and to decrease harmful variations in the evaluation and management of Bell's palsy. This guideline addresses these needs by encouraging

Birth Defects: Cerebral Palsy

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... Loss > Birth defects & other health conditions > Cerebral palsy Cerebral palsy E-mail to a friend Please fill in ... this page It's been added to your dashboard . Cerebral palsy (also called CP) is a group of conditions ...

Employees with Cerebral Palsy

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... 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 ...

[Can solar/geomagnetic activity restrict the occurrence of some shellfish poisoning outbreaks? The example of PSP caused by Gymnodinium catenatum at the Atlantic Portuguese coast].

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Vale, P

2013-01-01

Cyclic outbreaks of accumulation of paralytic shellfish poisoning (PSP) toxins in mussels attributed to Gymnodinium catenatum blooms displayed several of the highest inter-annual maxima coincidental with minima of the 11-year solar sunspot number (SSN) cycle. The monthly distribution of PSP was associated with low levels of the solar radio flux, a more quantitative approach than SSN for fluctuations in solar activity. A comparison between monthly distribution of PSP and other common biotoxins (okadaic acid (OA), dinophysistoxin-2 (DTX2) and amnesic shellfish poisoning (ASP) toxins) demonstrated that only PSP was significantly associated with low levels of radio flux (p < 0.01). PSP occurrence suggests a prior decline in solar activity could be required to act as a trigger, in a similar manner to a photoperiodic signal. The seasonal frequency increased towards autumn during the study period, which might be related to the progressive atmospheric cut-off of deleterious radiation associated with the seasonal change in solar declination, and might play an additional role in seasonal signal-triggering. PSP distribution was also associated with low levels of the geomagnetic index Aa. A comparison between monthly distribution of PSP and other common biotoxins, also demonstrated that only PSP was significantly associated with low levels of the Aa index (p < 0.01). In some years of SSN minima no significant PSP-outbreaks in mussels were detected. This was attributed to a steady rise in geomagnetic activity that could disrupt the triggering signal. Global distribution patterns show that hotspots for G. catenatum blooms are regions with deficient crustal magnetic anomalies. In addition to the variable magnetic field mostly of solar origin, static fields related to magnetized rocks in the crust and upper mantle might play a role in restricting worldwide geographic distribution.

Recurrences of Bell's palsy.

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Cirpaciu, D; Goanta, C M; Cirpaciu, M D

2014-01-01

Bell's palsy in known as the most common cause of facial paralysis, determined by the acute onset of lower motor neuron weakness of the facial nerve with no detectable cause. With a lifetime risk of 1 in 60 and an annual incidence of 11-40/100,000 population, the condition resolves completely in around 71% of the untreated cases. Clinical trials performed for Bell's palsy have reported some recurrences, ipsilateral or contralateral to the side affected in the primary episode of facial palsy. Only few data are found in the literature. Melkersson-Rosenthal is a rare neuromucocutaneous syndrome characterized by recurrent facial paralysis, fissured tongue (lingua plicata), orofacial edema. We attempted to analyze some clinical and epidemiologic aspects of recurrent idiopathic palsy, and to develop relevant correlations between the existing data in literature and those obtained in this study. This is a retrospective study carried out on a 10-years period for adults and a five-year period for children. A number of 185 patients aged between 4 and 70 years old were analyzed. 136 of them were adults and 49 were children. 22 of 185 patients with Bell's palsy (12%) had a recurrent partial or complete facial paralysis with one to six episodes of palsy. From this group of 22 cases, 5 patients were diagnosed with Melkersson-Rosenthal syndrome. The patients' age was between 4 and 70 years old, with a medium age of 27,6 years. In the group studied, fifteen patients, meaning 68%, were women and seven were men. The majority of patients in our group with more than two facial palsy episodes had at least one episode on the contralateral side. Our study found a significant incidence of recurrences of idiopathic facial palsy. Recurrent idiopathic facial palsy and Melkersson-Rosenthal syndrome is diagnosed more often in young females. Recurrence is more likely to occur in the first two years from the onset, which leads to the conclusion that we should have a follow up of patients

NEONATAL NERVE PALSIES: A CONTEMPORARY OBSTETRIC PERSPECTIVE

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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.

The inhibitory effects of polysaccharide peptides (PsP of Ganoderma lucidum against atherosclerosis in rats with dyslipidemia

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Titin Andri Wihastuti

2017-04-01

Full Text Available BackgroundAtherosclerosis occurs as a result of low-density lipoprotein (LDL deposits oxidation. Endothelial dysfunction is an early process of atherosclerosis. Restoring endothelial lining back to normal by endothelial progenitor cells (EPCs is critical for slowing or reversing vascular disease progression. Oxidative stress from hydrogen peroxide (H2O2 is increased in dyslipidemia so that antioxidant agent is required to prevent destruction of blood vessels.ObjectivesThis study aims to report Ganoderma lucidum polysaccharide peptide (PsP effects in atherogenic process by measuring H2O2 level, IL-10 level, and EPC number in blood serum, and also intima-media thickness of aorta in dyslipidemia Wistar rat model by giving them a hypercholesterol diet (HCD.Materials and methodsThe study was an experimental in vivo post-test with control group design. Thirty-five Wistar rats (Rattus norwegicus were divided into five groups (normal diet group, HCD group, and hypercholesterol groups that received 50 mg/kg, 150 mg/kg, and 300 mg/kg bodyweight PsP.ResultsEach treatment group showed significant results for the administration of PsP using the one-way analysis of variance test (p<0.050 for the reduction of H2O2 (p = 0.003, levels of IL-10 (p = 0.027, number of EPC in the blood serum (p = 0.011, and the intima-media thickness of the aorta (p = 0.000. PsP from G. lucidum is a potent antioxidant and may prevent atherogenesis process in patients with dyslipidemia.ConclusionsThe optimum doses of PsP in this study is 300 mg/kg bodyweight. Further studies are required to determine the antioxidant effects of PsP G. lucidum and its benefits in the management of dyslipidemia.

Familias de la proteína de superficie PspA de Streptococcus pneumoniae: Relación con serotipos y localización

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Clara Mayoral

2010-10-01

Full Text Available PspA, proteína de superficie de Streptococcus pneumoniae es un factor de virulencia, fuertemente inmunogénica y común a todos los serotipos. Aunque el gen que codifica para esta proteína presenta una marcada heterogeneidad en la región correspondiente al N-terminal, la PspA contiene epitopes conservados de manera tal que la inmunización genera protección contra neumococos pertenecientes a diversos tipos capsulares y con distintas PspA. A pesar del marcado polimorfismo del gen pspA es posible agrupar las distintas variantes en 3 familias mayoritarias. Estas propiedades las convierten en candidatas ideales para elaborar vacunas. Debido a que la mayoría de los trabajos sobre identificación de familias fueron realizados sobre serotipos frecuentes en otros países, el objetivo fue identificar las familias de PspA de aislamientos de pacientes de nuestra región y relacionarlas con los serotipos prevalentes y patologías. Se estudiaron 70 aislamientos, provenientes de niños con infecciones invasoras. Se aplicó una PCR utilizando cebadores específicos de cada familia. El 60% fueron familia 1 y 34% familia 2. En un 6% no se identificó ninguna de las familias de PspA. Los serotipos 1 y 5 presentaron familia 1 únicamente; los serotipos 14, 6B, 19F y 18C mostraron genes de ambas familias. La familia 1 se observó en 60% de las neumonías y 50% de las meningitis. La familia 2 en 33% de neumonías y 50% de meningitis. Esta información podría ser un valioso aporte para la formulación de una vacuna regional efectiva utilizando PspA recombinante como inmunógeno.

Immunomodulatory effect of APS and PSP is mediated by Ca2+-cAMP and TLR4/NF-κB signaling pathway in macrophage.

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Wang, Zhixue; Liu, Zijing; Zhou, Lijng; Long, Tingting; Zhou, Xing; Bao, Yixi

2017-01-01

This study is to investigate the role of second messengers and TLR4/NF-κB signaling pathway in the immunomodulatory activities of Astragalus polysaccharide (APS) and Polysaccharopeptide (PSP) in macrophages. RAW 264.7 macrophage cells were treated with APS, PSP, lipopolysaccharide (LPS), or NiCl 2 . Power-spectral method was used to detect protein kinase C (PKC) and Griess reaction to detect nitric oxide (NO). ELISA was conducted to detect cyclic adenosine monophosphate (cAMP), diglycerides (DAG), inositol 1, 4, 5-triphosphate (IP3), tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6). Confocal laser scanning microscopy was performed to detect calcium level. qRT-PCR and Western blot was used to detect mRNA and protein expression of NF-κB. APS and PSP significantly increased the concentrations of intracellular second messengers (NO, cAMP, DAG, IP3, Ca 2+ ) and the activity of PKC in macrophages (pAPS and PSP (pAPS and PSP mediated immunomodulatory activities in macrophages. Copyright © 2016 Elsevier B.V. All rights reserved.

In vitro comparison between the image obtained using PSP plates and Kodak E-speed films.

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Petel, R; Yaroslavsky, L; Kaffe, I

2014-07-01

The aim of this study was to compare the intra-oral radiographic images obtained by a PSP digital radiography system ("Orex", Israel) with that obtained using Kodak Ultra speed films in terms of image quality, radiation dosage and diagnostic value. The physical measurement of image quality was conducted with an aluminum step-wedge. Radiation dosage was measured with a dosimeter. Fog and base levels were measured by developing unexposed films and scanning unexposed PSP plates. The in vitro model included preparation and radiographic evaluation of approximal artificial lesions in premolars and molars in depths ranging from 0.25 mm to 1.00 mm. Radiographs were evaluated for the existence of a lesion and its size by 8 experienced clinicians. Relative contrast was similar in both methods. The resolving power of the digital system was lower than that of the E-speed film. As for the subjective evaluation of artificial lesions, there was no significant difference between the two methods excluding those tooth images without lesions, where the analog method was found to be more accurate. The PSP system ("Orex") provides good image quality and diagnostic information with reduced exposure when compared with E-speed film.

Peripheral facial palsy in children.

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Yılmaz, Unsal; Cubukçu, Duygu; Yılmaz, Tuba Sevim; Akıncı, Gülçin; Ozcan, Muazzez; Güzel, Orkide

2014-11-01

The aim of this study is to evaluate the types and clinical characteristics of peripheral facial palsy in children. The hospital charts of children diagnosed with peripheral facial palsy were reviewed retrospectively. A total of 81 children (42 female and 39 male) with a mean age of 9.2 ± 4.3 years were included in the study. Causes of facial palsy were 65 (80.2%) idiopathic (Bell palsy) facial palsy, 9 (11.1%) otitis media/mastoiditis, and tumor, trauma, congenital facial palsy, chickenpox, Melkersson-Rosenthal syndrome, enlarged lymph nodes, and familial Mediterranean fever (each 1; 1.2%). Five (6.1%) patients had recurrent attacks. In patients with Bell palsy, female/male and right/left ratios were 36/29 and 35/30, respectively. Of them, 31 (47.7%) had a history of preceding infection. The overall rate of complete recovery was 98.4%. A wide variety of disorders can present with peripheral facial palsy in children. Therefore, careful investigation and differential diagnosis is essential. © The Author(s) 2013.

Prevalence of Cerebral Palsy in Children (Under Five) in and ...

African Journals Online (AJOL)

Cerebral palsy (CP) is a non-progressive disorder of posture and movement due to brain damage/insult/lesion before birth, during delivery or in the perinatal period. It is a neurological disorder of childhood with significant medico-social implications. A retrospective hospital based cross sectional study was conducted to ...

The association of Varicella zoster virus reactivation with Bell's palsy in children.

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Abdel-Aziz, Mosaad; Azab, Noha A; Khalifa, Badwy; Rashed, Mohammed; Naguib, Nader

2015-03-01

Bell's palsy is considered the most common cause of facial nerve paralysis in children. Although different theories have been postulated for its diagnosis, reactivation of the Varicella zoster virus (VZV) has been implicated as one of the causes of Bell's palsy. The aim of the study was to evaluate the association of Varicella-zoster virus infection with Bell's palsy and its outcome in children. A total of 30 children with Bell's palsy were recruited and were assayed for evidence of VZV infection. The severity of facial nerve dysfunction and the recovery rate were evaluated according to House-Brackmann Facial Nerve Grading Scale (HB FGS). Paired whole blood samples from all patients were obtained at their initial visit and 3 weeks later, and serum samples were analyzed for VZV IgG and IgM antibodies using ELISA. A significantly higher percentage of Bell's palsy patients were seropositive for VZV IgM antibodies than controls (36.6% of patients vs 10% of controls) while for VZV IgG antibodies the difference was statistically nonsignificant. HB FGS in Bell's palsy patients with serologic evidence of VZV recent infection or reactivation showed a statistiacally significant less cure rate than other patients. VZV reactivation may be an important cause of acute peripheral facial paralysis in children. The appropriate diagnosis of VZV reactivation should be done to improve the outcome and the cure rate by the early use of antiviral treatment. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Nontypeable pneumococci can be divided into multiple cps types, including one type expressing the novel gene pspK.

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Park, In Ho; Kim, Kyung-Hyo; Andrade, Ana Lucia; Briles, David E; McDaniel, Larry S; Nahm, Moon H

2012-01-01

Although virulence of Streptococcus pneumoniae is associated with its capsule, some pathogenic S. pneumoniae isolates lack capsules and are serologically nontypeable (NT). We obtained 64 isolates that were identified as NT "pneumococci" (i.e., bacteria satisfying the conventional definition but without the multilocus sequence typing [MLST]-based definition of S. pneumoniae) by the traditional criteria. All 64 were optochin sensitive and had lytA, and 63 had ply. Twelve isolates had cpsA, suggesting the presence of a conventional but defective capsular polysaccharide synthesis (cps) locus. The 52 cpsA-negative isolates could be divided into three null capsule clades (NCC) based on aliC (aliB-like ORF1), aliD (aliB-like ORF2), and our newly discovered gene, pspK, in their cps loci. pspK encodes a protein with a long alpha-helical region containing an LPxTG motif and a YPT motif known to bind human pIgR. There were nine isolates in NCC1 (pspK(+) but negative for aliC and aliD), 32 isolates in NCC2 (aliC(+) aliD(+) but negative for pspK), and 11 in NCC3 (aliD(+) but negative for aliC and pspK). Among 52 cpsA-negative isolates, 41 were identified as S. pneumoniae by MLST analysis. All NCC1 and most NCC2 isolates were S. pneumoniae, whereas all nine NCC3 and two NCC2 isolates were not S. pneumoniae. Several NCC1 and NCC2 isolates from multiple individuals had identical MLST and cps regions, showing that unencapsulated S. pneumoniae can be infectious among humans. Furthermore, NCC1 and NCC2 S. pneumoniae isolates could colonize mice as well as encapsulated S. pneumoniae, although S. pneumoniae with an artificially disrupted cps locus did not. Moreover, an NCC1 isolate with pspK deletion did not colonize mice, suggesting that pspK is critical for colonization. Thus, PspK may provide pneumococci a means of surviving in the nasopharynx without capsule. IMPORTANCE The presence of a capsule is critical for many pathogenic bacteria, including pneumococci. Reflecting the

Characterization of TCHQ-induced genotoxicity and mutagenesis using the pSP189 shuttle vector in mammalian cells

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Wang Jing, E-mail: avaecn@gmail.com [State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085 (China); Yu Shouyi [State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085 (China); Jiao Shouhai [State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085 (China); Shandong Institute of Endocrine and Metabolic Diseases, Shandong Academy of Medical Sciences, Jinan 250062 (China); Lv Xiaowen [Feed Safety Reference Laboratory of Ministry of Agriculture, Feed Research Institute, Chinese Academy of Agricultural Sciences, Beijing 100081 (China); Ma Min [Laboratory of Environmental Biotechnology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085 (China); Zhu Benzhan; Du Yuguo [State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085 (China)

2012-01-03

Tetrachlorohydroquinone (TCHQ) is a major toxic metabolite of the widely used wood preservative, pentachlorophenol (PCP), and it has also been implicated in PCP genotoxicity. However, the underlying mechanisms of genotoxicity and mutagenesis induced by TCHQ remain unclear. In this study, we examined the genotoxicity of TCHQ by using comet assays to detect DNA breakage and formation of TCHQ-DNA adducts. Then, we further verified the levels of mutagenesis by using the pSP189 shuttle vector in A549 human lung carcinoma cells. We demonstrated that TCHQ causes significant genotoxicity by inducing DNA breakage and forming DNA adducts. Additionally, DNA sequence analysis of the TCHQ-induced mutations revealed that 85.36% were single base substitutions, 9.76% were single base insertions, and 4.88% were large fragment deletions. More than 80% of the base substitutions occurred at G:C base pairs, and the mutations were G:C to C:G, G:C to T:A or G:C to A:T transversions and transitions. The most common types of mutations in A549 cells were G:C to A:T (37.14%) and A:T to C:G transitions (14.29%) and G:C to C:G (34.29%) and G:C to T:A (11.43%) transversions. We identified hotspots at nucleotides 129, 141, and 155 in the supF gene of plasmid pSP189. These mutation hotspots accounted for 63% of all single base substitutions. We conclude that TCHQ induces sequence-specific DNA mutations at high frequencies. Therefore, the safety of using this product would be carefully examined.

Conjugate Gaze Palsies

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... version Home Brain, Spinal Cord, and Nerve Disorders Cranial Nerve Disorders Conjugate Gaze Palsies Horizontal gaze palsy Vertical ... Version. DOCTORS: Click here for the Professional Version Cranial Nerve Disorders Overview of the Cranial Nerves Internuclear Ophthalmoplegia ...

Defective plastic infection-control barriers and faulty technique may cause PSP plate contamination used in digital intraoral radiography.

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Kuperstein, Arthur S

2012-09-01

Fifty-two disinfected photostimulable phosphor (PSP) plates in plastic barrier envelopes were evaluated for contamination following placement in 30 study participants. Forty-four plates were acceptable for use in the study. The risk factor was the abundant oropharyngeal microbial flora and its ability to breach infection-control barrier sheaths. The presence of bacterial colonies on an agar plate was used to determine bacterial contamination and the presence of any growth indicated failure of the barrier envelope. Before clinical placement of the plates, quality review of the PSP plates revealed defects in the integrity of 4 barrier envelopes most likely caused by forceps-related damage or failure to achieve a uniform seal during manufacturing. These defects allowed substantial contamination. Contamination also occurred as a result of failure to extract the PSP plate from the barrier envelope cleanly. Of the 44 barriers with no obvious signs of a defect, 3 produced bacterial growth following culture. The authors concluded that digital sensor sheathed in barrier envelopes remain a potential source of contamination. PSP plates must be disinfected between removal from a contaminated barrier envelope (used in a patient) and placement in a new barrier envelope. In addition, placement into the barrier envelope should ideally be carried out under aseptic conditions. Finally, the integrity of each sealed barrier envelope must be verified visually. Copyright © 2012. Published by Mosby, Inc. All rights reserved.

Nanomedicine in cerebral palsy

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Balakrishnan, Bindu; Nance, Elizabeth; Johnston, Michael V; Kannan, Rangaramanujam; Kannan, Sujatha

2013-01-01

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. PMID:24204146

[Bell's palsy].

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Prud'hon, S; Kubis, N

2018-03-30

Idiopathic peripheral facial palsy, also named Bell's palsy, is the most common cause of peripheral facial palsy in adults. Although it is considered as a benign condition, its social and psychological impact can be dramatic, especially in the case of incomplete recovery. The main pathophysiological hypothesis is the reactivation of HSV 1 virus in the geniculate ganglia, leading to nerve edema and its compression through the petrosal bone. Patients experience an acute (less than 24 hours) motor deficit involving ipsilateral muscles of the upper and lower face and reaching its peak within the first three days. Frequently, symptoms are preceded or accompanied by retro-auricular pain and/or ipsilateral face numbness. Diagnosis is usually clinical but one should look for negative signs to eliminate central facial palsy or peripheral facial palsy secondary to infectious, neoplastic or autoimmune diseases. About 75% of the patients will experience spontaneous full recovery, this rate can be improved with oral corticotherapy when introduced within the first 72 hours. To date, no benefit has been demonstrated by adding an antiviral treatment. Hemifacial spasms (involuntary muscles contractions of the hemiface) or syncinesia (involuntary muscles contractions elicited by voluntary ones, due to aberrant reinnervation) may complicate the disease's course. Electroneuromyography can be useful at different stages: it can first reveal the early conduction bloc, then estimate the axonal loss, then bring evidence of the reinnervation process and, lastly, help for the diagnosis of complications. Copyright © 2018 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

Parkinson disease and progressive supranuclear palsy: protein expression in skin.

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Rodríguez-Leyva, Ildefonso; Chi-Ahumada, Erika G; Carrizales, Juan; Rodríguez-Violante, Mayela; Velázquez-Osuna, Salvador; Medina-Mier, Verónica; Martel-Gallegos, María G; Zarazúa, Sergio; Enríquez-Macías, Lourdes; Castro, Adriana; Calderón-Garcidueñas, Ana Laura; Jiménez-Capdeville, María E

2016-03-01

This study characterizes the expression of tau (p-tau) and α-synuclein (α-syn) by immunohistochemistry in the skin of three different populations: healthy control (HC), Parkinson disease (PD), and progressive supranuclear paralysis (PSP) subjects, with the purpose of finding a biomarker that could differentiate between subjects with PD and PSP. We evaluated the presence of p-tau and α-syn in a pilot study in the skin of three distinct groups of patients: 17 healthy subjects, 17 patients with PD, and 10 patients with PSP. Four millimeters punch biopsies were obtained from the occipital area and analyzed by immunohistochemistry using antibodies against α-syn and phosphorylated species of tau. PHF (paired helical filaments) antibody identifies p-tau in both normal and pathological conditions and AT8 recognizes p-tau characteristic of pathological conditions. Differences between the three groups were assessed by quantification of immunopositive areas in the epidermis. The immunopositivity pattern of p-tau and α-syn was significantly different among the three groups. Healthy subjects showed minimal staining using AT8 and α-syn. The PD group showed significantly higher α-syn and AT8 immunopositivity, while the PSP group only expressed higher AT8 immunopositivity than HCs. These data suggest that the skin reflects brain pathology. Therefore, immunohistochemical analysis of p-tau and α-syn in the skin can be useful for further characterization of PD and PSP.

Therapeutic interventions in cerebral palsy.

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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.

A longitudinal study of motor, oculomotor and cognitive function in progressive supranuclear palsy.

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Boyd C P Ghosh

Full Text Available We studied the annual change in measures of motor, oculomotor and cognitive function in progressive supranuclear palsy. This had twin objectives, to assess the potential for clinical parameters to monitor disease progression in clinical trials and to illuminate the progression of pathophysiology.Twenty three patients with progressive supranuclear palsy (Richardson's syndrome were compared to 22 matched controls at baseline and 16 of these patients compared at baseline and one year using: the progressive supranuclear palsy rating scale; the unified Parkinson's disease rating scale; the revised Addenbrooke's cognitive examination; the frontal assessment battery; the cubes section of the visual object and space perception battery; the Hayling and Brixton executive tests; and saccadic latencies.Patients were significantly impaired in all domains at baseline. However, cognitive performance was maintained over a year on the majority of tests. The unified Parkinson's disease rating scale, saccadic latency and progressive supranuclear palsy rating scale deteriorated over a year, with the latter showing the largest change. Power estimates indicate that using the progressive supranuclear palsy rating scale as an outcome measure in a clinical trial would require 45 patients per arm, to identify a 50% reduction in rate of decline with 80% power.Motor, oculomotor and cognitive domains deteriorate at different rates in progressive supranuclear palsy. This may be due to differential degeneration of their respective cortical-subcortical circuits, and has major implications for the selection of outcome measures in clinical trials due to wide variation in sensitivity to annual rates of decline.

Facial nerve palsy due to birth trauma

Science.gov (United States)

Seventh cranial nerve palsy due to birth trauma; Facial palsy - birth trauma; Facial palsy - neonate; Facial palsy - infant ... An infant's facial nerve is also called the seventh cranial nerve. It can be damaged just before or at the time of delivery. ...

Nanomedicine in cerebral palsy

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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

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.

[Advances in genetic research of cerebral palsy].

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Wang, Fang-Fang; Luo, Rong; Qu, Yi; Mu, De-Zhi

2017-09-01

Cerebral palsy is a group of syndromes caused by non-progressive brain injury in the fetus or infant and can cause disabilities in childhood. Etiology of cerebral palsy has always been a hot topic for clinical scientists. More and more studies have shown that genetic factors are closely associated with the development of cerebral palsy. With the development and application of various molecular and biological techniques such as chromosome microarray analysis, genome-wide association study, and whole exome sequencing, new achievements have been made in the genetic research of cerebral palsy. Chromosome abnormalities, copy number variations, susceptibility genes, and single gene mutation associated with the development of cerebral palsy have been identified, which provides new opportunities for the research on the pathogenesis of cerebral palsy. This article reviews the advances in the genetic research on cerebral palsy in recent years.

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.

Immunomodulatory effects of herbal formula of astragalus polysaccharide (APS) and polysaccharopeptide (PSP) in mice with lung cancer.

Science.gov (United States)

Zhou, Xing; Liu, Zijing; Long, Tingting; Zhou, Lijng; Bao, Yixi

2018-01-01

This study is to investigate the immunomodulatory effects of the herbal formula of astragalus polysaccharide (APS) and polysaccharopeptide (PSP) in mouse models of immunosuppression and lung cancer. Immune parameters were recorded for these model mice. Peripheral white blood cells (WBC) were detected with the automatic blood cell analyzer. Spleen and thymus indices, and tumor inhibition ratio were obtained. Percentage of peripheral blood CD4 + and CD8 + T lymphocytes were detected by flow cytometry. Serum levels of Th1 (IL-2, TNF, and IFN-γ), Th2 (IL-4, IL-6, and IL-10), and Th17 (IL-17A) were detected with the BD cytometric bead array (CBA) mouseTh1/Th2/Th17 cytokine kit. Compared with the NS group, the PSP and APS herbal formula significantly improved the WBC, thymus index, spleen index, CD4 + /CD8 + ratio, TNF, IFN-γ, IL-2, andIL-17Ainimmunosuppressivemice and lung cancer mice (PAPS herbal formula group (PAPS herbal formula group induced comparable tumor inhibiting effect with the AMD group (23.3% and 24.1%, respectively). The PSP+APS herbal formula have immunomodulatory effects and anti-tumor activity in mice with of lung cancer. Copyright © 2017 Elsevier B.V. All rights reserved.

Brain perfusion SPECT with Brodmann areas analysis in differentiating frontotemporal dementia subtypes.

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Valotassiou, Varvara; Papatriantafyllou, John; Sifakis, Nikolaos; Tzavara, Chara; Tsougos, Ioannis; Psimadas, Dimitrios; Kapsalaki, Eftychia; Fezoulidis, Ioannis; Hadjigeorgiou, George; Georgoulias, Panagiotis

2014-01-01

Despite the known validity of clinical diagnostic criteria, significant overlap of clinical symptoms between Frontotemporal dementia (FTD) subtypes exists in several cases, resulting in great uncertainty of the diagnostic boundaries. We evaluated the perfusion between FTD subtypes using brain perfusion (99m)Tc-HMPAO SPECT with Brodmann areas (BA) mapping. NeuroGam software was applied on single photon emission computed tomographic (SPECT) studies for the semi-quantitative evaluation of perfusion in BA and the comparison with the software's normal database. We studied 91 consecutive FTD patients: 21 with behavioural variants (bvFTD), 39 with language variants (lvFTD) [12 with progressive non-fluent aphasia (PNFA), 27 with semantic dementia (SD)], and 31 patients with progressive supranuclear palsy (PSP)/corticobasal degeneration (CBD). Stepwise logistic regression analyses showed that the BA 28L and 32R could independently differentiate bvFTD from lvFTD, while the BA 8R and 25R could discriminate bvFTD from SD and PNFA, respectively. Additionally, BA 7R and 32R were found to discriminate bvFTD from CBD/PSP. The only BA that could differentiate SD from PNFA was 6L. BA 6R and 20L were found to independently differentiate CBD/PSP from lvFTD. Moreover, BA 20L and 22R could discriminate CBD/PSP from PNFA, while BA 6R, 20L and 45R were found to independently discriminate CBD/PSP from SD. Brain perfusion SPECT with BA mapping can be a useful additional tool in differentiating FTD variants by improving the definition of brain areas that are specifically implicated, resulting in a more accurate differential diagnosis in atypical or uncertain forms of FTD.

Finanční analýza PSP enegineering, a. s.

OpenAIRE

Červinková, Hana

2007-01-01

The purpose of this work is to carry out financial analysis of a manufacturing company which is aimed at discovering of its total financial health, present progress and is also trying to evaluate future perspective. In the methodological part there are selected methods and procedures of financial analysis characterized which are applied also in the practical part. This part is composed of several sections. In the introduction the company PSP engineering a.s. is introduced, also its focus and ...

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.

Neurocysticercosis presenting as pseudobulbar palsy

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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.

NEYROPSYCHOLOGICAL CONSECUENCES OF CEREBRAL PALSY

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ANA MARÍA NAVARRO MELENDRO

2005-01-01

Full Text Available Cerebral Palsy is defined as a movement alteration result of a non progressive damage witch is permanent in anencephalon that has not acquired its final maturation. Patients that suffer cerebral palsy present learning disabilities,that varies between being completely normal to severe as a consequence of memory, gnosis, praxis, perceptive andlanguage impairments. Nevertheless the consequences of this disease are not always predictable. This paper pretendsto make a description of the cognitive and behavioral deficits that overcomes along with the manifestation of thecerebral palsy and its possible treatment. We used a complete neuropsychological battery to evaluate a 7 years oldpatient who was diagnosed of cerebral palsy and spastic diplegia finding some cognitive impairment in fields such asmnesic, gnosic and attention processes.

Eagle's syndrome with facial palsy

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Mohammed Al-Hashim

2017-01-01

Full Text Available Eagle's syndrome (ES is a rare disease in which the styloid process is elongated and compressing adjacent structures. We describe a rare presentation of ES in which the patient presented with facial palsy. Facial palsy as a presentation of ES is very rare. A review of the English literature revealed only one previously reported case. Our case is a 39-year-old male who presented with left facial palsy. He also reported a 9-year history of the classical symptoms of ES. A computed tomography scan with three-dimensional reconstruction confirmed the diagnoses. He was started on conservative management but without significant improvement. Surgical intervention was offered, but the patient refused. It is important for otolaryngologists, dentists, and other specialists who deal with head and neck problems to be able to recognize ES despite its rarity. Although the patient responded to a treatment similar to that of Bell's palsy because of the clinical features and imaging, ES was most likely the cause of his facial palsy.

MR imaging of cerebral palsy

International Nuclear Information System (INIS)

Saginoya, Toshiyuki; Yamaguchi, Keiichiro; Kuniyoshi, Kazuhide

1996-01-01

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)

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)

Frontal dynamic aphasia in progressive supranuclear palsy: Distinguishing between generation and fluent sequencing of novel thoughts.

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Robinson, Gail A; Spooner, Donna; Harrison, William J

2015-10-01

Frontal dynamic aphasia is characterised by a profound reduction in spontaneous speech despite well-preserved naming, repetition and comprehension. Since Luria (1966, 1970) designated this term, two main forms of dynamic aphasia have been identified: one, a language-specific selection deficit at the level of word/sentence generation, associated with left inferior frontal lesions; and two, a domain-general impairment in generating multiple responses or connected speech, associated with more extensive bilateral frontal and/or frontostriatal damage. Both forms of dynamic aphasia have been interpreted as arising due to disturbances in early prelinguistic conceptual preparation mechanisms that are critical for language production. We investigate language-specific and domain-general accounts of dynamic aphasia and address two issues: one, whether deficits in multiple conceptual preparation mechanisms can co-occur; and two, the contribution of broader cognitive processes such as energization, the ability to initiate and sustain response generation over time, to language generation failure. Thus, we report patient WAL who presented with frontal dynamic aphasia in the context of progressive supranuclear palsy (PSP). WAL was given a series of experimental tests that showed that his dynamic aphasia was not underpinned by a language-specific deficit in selection or in microplanning. By contrast, WAL presented with a domain-general deficit in fluent sequencing of novel thoughts. The latter replicated the pattern documented in a previous PSP patient (Robinson, et al., 2006); however, unique to WAL, generating novel thoughts was impaired but there was no evidence of a sequencing deficit because perseveration was absent. Thus, WAL is the first unequivocal case to show a distinction between novel thought generation and subsequent fluent sequencing. Moreover, WAL's generation deficit encompassed verbal and non-verbal responses, showing a similar (but more profoundly reduced) pattern

Unusual cause of brachial palsy with diaphragmatic palsy.

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Gupta, Vishal; Pandita, Aakash; Panghal, Astha; Hassan, Neha

2018-05-12

We report a preterm neonate born with respiratory distress. The neonate was found to have diaphragmatic palsy and brachial palsy. The neonate was born by caesarean section and there was no history of birth trauma. On examination, there was bilateral congenital talipes equinovarus and a scar was present on the forearm. The mother had a history of chickenpox during the 16 weeks of pregnancy for which no treatment was sought. On investigation, PCR for varicella was found to be positive in the neonate. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Clinical practice guideline: Bell's Palsy executive summary.

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Baugh, Reginald F; Basura, Gregory J; Ishii, Lisa E; Schwartz, Seth R; Drumheller, Caitlin Murray; Burkholder, Rebecca; Deckard, Nathan A; Dawson, Cindy; Driscoll, Colin; Gillespie, M Boyd; Gurgel, Richard K; Halperin, John; Khalid, Ayesha N; Kumar, Kaparaboyna Ashok; Micco, Alan; Munsell, Debra; Rosenbaum, Steven; Vaughan, William

2013-11-01

The American Academy of Otolaryngology-Head and Neck Surgery Foundation (AAO-HNSF) has published a supplement to this issue featuring the new Clinical Practice Guideline: Bell's Palsy. To assist in implementing the guideline recommendations, this article summarizes the rationale, purpose, and key action statements. The 11 recommendations developed encourage accurate and efficient diagnosis and treatment and, when applicable, facilitate patient follow-up to address the management of long-term sequelae or evaluation of new or worsening symptoms not indicative of Bell's palsy. There are myriad treatment options for Bell's palsy; some controversy exists regarding the effectiveness of several of these options, and there are consequent variations in care. In addition, there are numerous diagnostic tests available that are used in the evaluation of patients with Bell's palsy. Many of these tests are of questionable benefit in Bell's palsy. Furthermore, while patients with Bell's palsy enter the health care system with facial paresis/paralysis as a primary complaint, not all patients with facial paresis/paralysis have Bell's palsy. It is a concern that patients with alternative underlying etiologies may be misdiagnosed or have an unnecessary delay in diagnosis. All of these quality concerns provide an important opportunity for improvement in the diagnosis and management of patients with Bell's palsy.

Surgical management of third nerve palsy

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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.

Surgical management of third nerve palsy

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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

PSP SAR interferometry monitoring of ground and structure deformations in the archeological site of Pompeii

Science.gov (United States)

Costantini, Mario; Francioni, Elena; Paglia, Luca; Minati, Federico; Margottini, Claudio; Spizzichino, Daniele; Trigila, Alessandro; Iadanza, Carla; De Nigris, Bruno

2016-04-01

The "Major Project Pompeii" (MPP) is a great collective commitment of different institututions and people to set about solving the serious problem of conservation of the largest archeological sites in the world. The ancient city of Pompeii with its 66 hectares, 44 of which are excaveted, is divided into 9 regiones (district), subdivided in 118 insulae (blocks) and almost 1500 domus (houses), and is Unesco site since 1996. The Italian Ministry for Heritage and Cultural Activities and Tourism (MiBACT) and Finmeccanica Group have sealed an agreement whereby the Finmeccanica Group will donate innovative technologies and services for monitoring and protecting the archaeological site of Pompeii. Moreover, the Italian Institute for Environment Protection and Research (ISPRA) - Geological Survey of Italy, was also involved to support the ground based analysis and interpretation of the measurements provided by the industrial team, in order to promote an interdisciplinary approach. In this work, we will focus on ground deformation measurements obtained by satellite SAR interferometry and on their interpretation. The satellite monitoring service is based on the processing of COSMO-SkyMed Himage data by the e-Geos proprietary Persistent Scatterer Pair (PSP) SAR interferometry technology. The PSP technique is a proven SAR interferometry method characterized by the fact of exploiting in the processing only the relative properties between close points (pairs) in order to overcome atmospheric artifacts (which are one of the main problems of SAR interferometry). Validations analyses showed that this technique applied to COSMO-SkyMed Himage data is able to retrieve very dense (except of course on vegetated or cultivated areas) millimetric deformation measurements with sub-metric localization. By means of the COSMO-SkyMed PSP SAR interferometry processing, a historical analysis of the ground and structure deformations occurred over the entire archaeological site of Pompeii in the

Idiopathic Non-traumatic Facial Nerve Palsy (Bell’s Palsy) in Neonates; An Atypical Age and Management Dilemma

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Khair, Abdulhafeez M.; Ibrahim, Khalid

2018-01-01

Idiopathic (Bell’s) palsy is the commonest cause of unilateral facial paralysis in children. Although being idiopathic by definition, possible infectious, inflammatory, and ischemic triggers have been suggested. Bell’s palsy is thought to be responsible for up to three-fourths of cases of acute unilateral facial paralysis worldwide. The diagnosis has to be reached after other causes of acute peripheral palsy have been excluded. However, it is rarely described in neonates and young infants. Steroids may have some role in treatment, but antiviral therapies have doubtful evidence of benefit. Prognosis is good, though residual dysfunction is occasionally encountered. We report the case of a two-week-old neonate with no prior illnesses who presented with acute left facial palsy. Clinical findings and normal brain imaging were consistent with the diagnosis of Bell’s palsy. The patient had a good response to oral steroids. PMID:29468002

Idiopathic Non-traumatic Facial Nerve Palsy (Bell’s Palsy in Neonates; An Atypical Age and Management Dilemma

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Abdulhafeez M. Khair

2018-01-01

Full Text Available Idiopathic (Bell’s palsy is the commonest cause of unilateral facial paralysis in children. Although being idiopathic by definition, possible infectious, inflammatory, and ischemic triggers have been suggested. Bell’s palsy is thought to be responsible for up to three-fourths of cases of acute unilateral facial paralysis worldwide. The diagnosis has to be reached after other causes of acute peripheral palsy have been excluded. However, it is rarely described in neonates and young infants. Steroids may have some role in treatment, but antiviral therapies have doubtful evidence of benefit. Prognosis is good, though residual dysfunction is occasionally encountered. We report the case of a two-week-old neonate with no prior illnesses who presented with acute left facial palsy. Clinical findings and normal brain imaging were consistent with the diagnosis of Bell’s palsy. The patient had a good response to oral steroids.

Resting position of the head and malocclusion in a group of patients with cerebral palsy

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Martinez-Mihi, Victoria; Orellana, Lorena M.; Silvestre-Rangil, Javier

2014-01-01

Cerebral palsy are found as a result of these disorders, along with associated neuromuscular functional alterations that affect the resting position of the head. In this context, the resting position of the head could be responsible for several skeletal and dental occlusal disorders among patients with cerebral palsy. Objective: To assess the presence of malocclusions in patients with cerebral palsy, define the most frequent types of malocclusions, and evaluate how the resting position of the head may be implicated in the development of such malocclusions. Study design: Forty-four patients aged between 12-55 years (18 males and 26 females) were studied. Occlusal conditions, the Dental Aesthetic Index (DAI), changes in the resting position of the head, and breathing and swallowing functions were assessed. Results: Orthodontic treatment was required by 70.8% of the patients, the most frequent malocclusions being molar class II, open bite and high overjet. These individuals showed altered breathing and swallowing functions, as well as habit and postural disorders. The resting position of the head, especially the hyperextended presentation, was significantly correlated to high DAI scores. Conclusions: The results obtained suggest that patients with cerebral palsy are more susceptible to present malocclusions, particularly molar class II malocclusion, increased open bite, and high overjet. Such alterations in turn are more common in patients with a hyperextended position of the head. Key words:Cerebral palsy, malocclusion, head position, disabled patients. PMID:24596627

A PSP-based small-signal MOSFET model for both quasi-static and nonquasi-static operations

NARCIS (Netherlands)

Aarts, A.C.T.; Smit, G.D.J.; Scholten, A.J.; Klaassen, D.B.M.

2008-01-01

In this paper, a small-signal MOSFET model is described, which takes the local effects of both velocity saturation and transverse mobility reduction into account. The model is based on the PSP model and is valid for both quasi-static and nonquasi-static (NQS) operations. Recently, it has been found

Auditory Selective Attention in Cerebral-Palsied Individuals.

Science.gov (United States)

Laraway, Lee Ann

1985-01-01

To examine differences between auditory selective attention abilities of normal and cerebral-palsied individuals, 23 cerebral-palsied and 23 normal subjects (5-21) were asked to repeat a series of 30 items in presence of intermittent white noise. Results indicated that cerebral-palsied individuals perform significantly more poorly when the…

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…

Enhanced MRI in patients with facial palsy

International Nuclear Information System (INIS)

Yanagida, Masahiro; Kato, Tsutomu; Ushiro, Koichi; Kitajiri, Masanori; Yamashita, Toshio; Kumazawa, Tadami; Tanaka, Yoshimasa

1991-01-01

We performed Gd-DTPA-enhanced magnetic resonance imaging (MRI) examinations at several stages in 40 patients with peripheral facial nerve palsy (Bell's palsy and Ramsay-Hunt syndrome). In 38 of the 40 patients, one and more enhanced region could be seen in certain portion of the facial nerve in the temporal bone on the affected side, whereas no enhanced regions were seen on the intact side. Correlations between the timing of the MRI examination and the location of the enhanced regions were analysed. In all 6 patients examined by MRI within 5 days after the onset of facial nerve palsy, enhanced regions were present in the meatal portion. In 3 of the 8 patients (38%) examined by MRI 6 to 10 days after the onset of facial palsy, enhanced areas were seen in both the meatal and labyrinthine portions. In 8 of the 9 patients (89%) tested 11 to 20 days after the onset of palsy, the vertical portion was enhanced. In the 12 patients examined by MRI 21 to 40 days after the onset of facial nerve palsy, the meatal portion was not enhanced while the labyrinthine portion, the horizontal portion and the vertical portion were enhanced in 5 (42%), 8 (67%) and 11 (92%), respectively. Enhancement in the vertical portion was observed in all 5 patients examined more than 41 days after the onset of facial palsy. These results suggest that the central portion of the facial nerve in the temporal bone tends to be enhanced in the early stage of facial nerve palsy, while the peripheral portion is enhanced in the late stage. These changes of Gd-DTPA enhanced regions in the facial nerve may suggest dromic degeneration of the facial nerve in peripheral facial nerve palsy. (author)

DIABETES MELLITUS AND BELL’S PALSY IN IRANIAN POPULATION

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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.

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 ...

A novel form of postcranial skeletal pneumaticity in a sauropod dinosaur: Implications for the paleobiology of Rebbachisauridae

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Lucio M. Ibiricu

2017-06-01

Full Text Available In dinosaurs and other archosaurs, the presence of foramina connected with internal chambers in axial and appendicular bones is regarded as a robust indicator of postcranial skeletal pneumaticity (PSP. Here we analyze PSP and its paleobiological implications in rebbachisaurid diplodocoid sauropod dinosaurs based primarily on the dorsal vertebrae of Katepensaurus goicoecheai, a rebbachisaurid from the Cenomanian–Turonian (Upper Cretaceous Bajo Barreal Formation of Patagonia, Argentina. We document a complex of interconnected pneumatic foramina and internal chambers within the dorsal vertebral transverse processes of Katepensaurus. Collectively, these structures constitute a form of PSP that has not previously been observed in sauropods, though it is closely comparable to morphologies seen in selected birds and non-avian theropods. Parts of the skeletons of Katepensaurus and other rebbachisaurid taxa such as Amazonsaurus maranhensis and Tataouinea hannibalis exhibit an elevated degree of pneumaticity relative to the conditions in many other sauropods. We interpret this extensive PSP as an adaptation for lowering the density of the skeleton, and tentatively propose that this reduced skeletal density may also have decreased the muscle energy required to move the body and the heat generated in so doing. Given that several rebbachisaurids inhabited tropical to subtropical paleolatitudes during the extreme warmth of the mid-Cretaceous, increased PSP may have better enabled these sauropods to cope with extraordinarily high temperatures. Extensive skeletal pneumaticity may have been an important innovation in Rebbachisauridae, and perhaps also in saltasaurine titanosaurs, which evolved an even greater degree of PSP. This may in turn have contributed to the evolutionary success of rebbachisaurids, which were the only diplodocoids to survive into the Late Cretaceous.

Delayed facial nerve decompression for Bell's palsy.

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Kim, Sang Hoon; Jung, Junyang; Lee, Jong Ha; Byun, Jae Yong; Park, Moon Suh; Yeo, Seung Geun

2016-07-01

Incomplete recovery of facial motor function continues to be long-term sequelae in some patients with Bell's palsy. The purpose of this study was to investigate the efficacy of transmastoid facial nerve decompression after steroid and antiviral treatment in patients with late stage Bell's palsy. Twelve patients underwent surgical decompression for Bell's palsy 21-70 days after onset, whereas 22 patients were followed up after steroid and antiviral therapy without decompression. Surgical criteria included greater than 90 % degeneration on electroneuronography and no voluntary electromyography potentials. This study was a retrospective study of electrodiagnostic data and medical chart review between 2006 and 2013. Recovery from facial palsy was assessed using the House-Brackmann grading system. Final recovery rate did not differ significantly in the two groups; however, all patients in the decompression group recovered to at least House-Brackmann grade III at final follow-up. Although postoperative hearing threshold was increased in both groups, there was no significant between group difference in hearing threshold. Transmastoid decompression of the facial nerve in patients with severe late stage Bell's palsy at risk for a poor facial nerve outcome reduced severe complications of facial palsy with minimal morbidity.

Divergence Palsy due to Divalproex and Oxcarbazepine.

Science.gov (United States)

Bouffard, Marc Albert; Caplan, Louis R; Torun, Nurhan

This case series is the first to describe divergence palsy as an adverse effect of antiepileptic drug use. Diplopia is a common adverse effect of antiepileptic drugs, but no explanatory motility deficit has ever been reported. We present 2 patients, 1 on oxcarbazepine and 1 on divalproex, each with a normal examination result between spells and divergency palsy when symptomatic. Discontinuation of the antiepileptic medication led to resolution of the episodes in both cases. Rechallenge with the offending agent after washout in one patient resulted in recurrence of diplopia and divergence palsy, both resolving after subsequent withdrawal of the antiepileptic. Antiepileptic drugs may cause divergence palsy.

KMAH index and separation of PSP-waves from streamer data

Science.gov (United States)

Mitrofanov, Georgy; Priimenko, Viatcheslav

2017-08-01

The presence of triplications (caustics) can be a serious problem in seismic data processing and analysis. The travel-time curve becomes multi-valued and the geometrical spreading correction factor tends to zero due to energy focusing. To select the regions of possible triplications (caustics) of travel-times, which can arise during the propagation of reflected seismic waves, we use the Keller-Maslov-Arnol'd-Hörmander (KMAH) index. The identification of such regions improves the selection of signals associated with target reflecting horizons and their use in solving various inverse dynamic problems, including amplitude-versus-offset (AVO) and full-waveform inversions. The importance of the KMAH index increases in 4D surveys when the structure of the model is already known, and it is necessary to conduct a detailed analysis of the shapes of seismic signals with increasing accuracy when solving inverse seismic problems. In addition, this index can be valuable when solving various marine seismic problems associated with single and converted waves, in particular with PSP-waves. The present work is dedicated to the separation of signals associated with this type of wave using surface marine seismic data. However, the proposed algorithm has a wider application. It is based on: (i) a priori information on the medium under study; (ii) ray tracing method. The ray tracing method enables the identification of the corresponding signals and the determination of the time and space intervals, in which such signals are most accurately traced. These intervals are used in the selection of target signals, particularly signals related to PSP-waves. In order to select optimal areas of observation with higher amplitudes of target signals, we use the τ -p transform. To improve the stability of the signal separation, KMAH index is used. This approach allows the elimination of possible triplications (caustics) in the travel-time curve from the selected intervals.

Clinical studies on Bell's palsy

International Nuclear Information System (INIS)

Yamada, Yoshio

1985-01-01

The purpose of this study was to evaluate the diagnostic value of the salivary gland scintigraphy using sup(99m)Tc-pertechnetate for the prognosis of Bell's palsy. The salivary gland scintigraphy was performed in 40 patients with Bell's palsy and 15 normal subjects. After intravenous injection of 10 mCt of sup(99m)Tc-pertechnetate, sequential scintigrams were taken with a scintillation camera every one minute for 25 minutes. At 15 minutes after injection, both of normal subjects and patients were given ascorbic acid to stimulate the secretion of saliva. By the present method, the time activity curve was examined for the regions of interest over the parotid and submandibular glands and backgrounds. In normal subjects, values of the concentration and excretory ratio between the right and left sides of the parotid and submandibular glands were more than 80%. Some patients with Bell's palsy showed a decreased concentration and/or excretory ratio less than 80% between the normal and affected sides of the parotid glands. This suggests a functional involvement of the facial nerve in the salivary secretion from the parotid glands. On examination within 10 days of the onset of Bell's palsy, 31 cases with complete recovery showed values of the concentration ratio and/or excretory ratio more than 80% between the normal and affected sides of the submandibular glands. In contrast, 9 cases with imcomplete recovery showed low values of the concentration ratio and excretory ratio less than 80%. In the latter, more active treatments such as decompression operation should be considerd in the early stage of the palsy. The salivary scintigraphy using sup(99m)Tc-pertechnetate is more valuable as an early prognostic indicator for Bell's palsy compared with other prognostic tests such as the lid vibration test, the stapedial reflex test, the electrogustometry, the nerve excitability test and the evoked electromyography. (author)

The early markers for later dyskinetic cerebral palsy are different from those for spastic cerebral palsy

NARCIS (Netherlands)

Einspieler, C; Cioni, G; Paolicelli, PB; Bos, AF; Dressler, A; Ferrari, F; Roversi, MF; Prechtl, HFR

Qualitative abnormalities of spontaneous motor activity in new-borns and young infants are early predictive markers for later spastic cerebral palsy. Aim of this research was to identify which motor patterns may be specific for later dyskinetic cerebral palsy. In a large, prospectively performed

Pattern of facial palsy in a typical Nigerian specialist hospital.

Science.gov (United States)

Lamina, S; Hanif, S

2012-12-01

Data on incidence of facial palsy is generally lacking in Nigeria. To assess six years' incidence of facial palsy in Murtala Muhammed Specialist Hospital (MMSH), Kano, Nigeria. The records of patients diagnosed as facial problems between January 2000 and December 2005 were scrutinized. Data on diagnosis, age, sex, side affected, occupation and causes were obtained. A total number of 698 patients with facial problems were recorded. Five hundred and ninety four (85%) were diagnosed as facial palsy. Out of the diagnosed facial palsy, males (56.2%) had a higher incidence than females; 20-34 years age group (40.3%) had a greater prevalence; the commonest cause of facial palsy was found out to be Idiopathic (39.1%) and was most common among business men (31.6%). Right sided facial palsy (52.2%) was predominant. Incidence of facial palsy was highest in 2003 (25.3%) and decreased from 2004. It was concluded that the incidence of facial palsy was high and Bell's palsy remains the most common causes of facial (nerve) paralysis.

Validation of a Cerebral Palsy Register

DEFF Research Database (Denmark)

Topp, Monica; Langhoff-Roos, Jens; 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...

Communication changes experienced by adults with cerebral palsy as they age.

Science.gov (United States)

Dark, Leigha Jane; Clemson, Lindy; Balandin, Susan

2016-12-01

Adults with cerebral palsy (CP) experience multiple, functional changes as they age, including changes to communication modes and methods that enable development and maintenance of relationships, communicative participation and quality-of-life. Little is known about the nature of communication changes experienced by this group. The aim of this study was to better understand how adults with CP experience changes in their communication abilities as they age and the subsequent psychosocial impact. Twenty adults with cerebral palsy aged 40-72 years with complex communication needs (CCN) participated in a series of in-depth interviews, framing their experiences of loss and grief throughout their lives. The impact of changing communication abilities emerged as an important area of focus. Data were analysed using constructivist grounded theory methodology. Themes arising from the participants' perceptions of their communication included experiencing communication change as a loss with subsequent impact on self-concept; and how communication is integral to the process of managing losses associated with older age. Implications for speech-language pathologists working with older people with cerebral palsy and CCN include the need to understand the psychosocial impact of communication changes on social interaction, relationships and communicative participation. It is important to promote positive and meaningful communication options that maintain a coherent sense of self in addition to promoting functional communication skills and communicative participation.

Comprehensive visual impairment evaluation for cerebral palsy children

Directory of Open Access Journals (Sweden)

Ping Wang

2015-01-01

Full Text Available AIM: To evaluate the visual impairment in cerebral palsy children with series objective indicators, and conclude their clinical features of visual function.METHODS: Objective tests including following pursuing test, optokinetic nystagmus(OKNdrum test, refractive error examination, fundus examination, ocular deviation examination, pattern visual evoked potential(P-VEPtests and brain magnetic resonance imaging(MRIwere carried out in 43 cerebral palsy children(86 eyeswith ocular visual dysfunction; The visual impairment data of the cerebral palsy children were collected, and the clinical features and possible mechanism were analyzed.RESULTS: 1. Of the 43 cerebral palsy children(86 eyeswith the visual impairment presented diversified, 25(50 eyes, 58.1%of refractive error, 24(48 eyes, 55.8%of strabismus, 12(24 eyes, 27.9%with nystagmus, 19(38 eyes, 44.2%of optical nerve atrophy or hyperplasia, 35(70 eyes, 81.4%of VEP abnormality. Among children with spastic cerebral palsy, the incidence of visual impairment was statistically significant difference compared with other groups(PP>0.05, no nystagmus in patients with severe occipital cortex damage.CONCLUSION: Cerebral palsy children were usually with visual impairment, and presented with special clinical features; Comprehensive objective visual tests are accurate and reliable for evaluation of the visual function in cerebral palsy children.

Bell's Palsy

Science.gov (United States)

... have been linked to Bell's palsy include the virus that causes: Cold sores and genital herpes (herpes simplex) Chickenpox and shingles (herpes zoster) Infectious mononucleosis (Epstein-Barr) Cytomegalovirus infections Respiratory illnesses (adenovirus) German measles (rubella) ...

Bell's Palsy

Science.gov (United States)

... or paralysis. Bell's palsy is named for Sir Charles Bell, a 19th century Scottish surgeon who described ... confirm diagnosis of the disorder. Generally, a physician will examine the individual for upper and lower facial ...

Case report of a patient with peripheral facial nerve palsy

OpenAIRE

Rysová, Jana

2013-01-01

Title of bachelor's thesis: Case report of a patient with peripheral facial nerve palsy Summary: Teoretical part of bachelor's thesis contains theoretical foundation of peripheral facial nerve palsy. Practical part of bachelor's thesis contains physiotherapeutic case report of patient with peripheral facial nerve palsy. Key words: peripheral facial nerve palsy, casuistry, rehabilitation

Construction, characterization and evaluation of the protective efficacy of the Streptococcus suis double mutant strain ΔSsPep/ΔSsPspC as a live vaccine candidate in mice.

Science.gov (United States)

Hu, Jin; You, Wujin; Wang, Bin; Hu, Xueying; Tan, Chen; Liu, Jinlin; Chen, Huanchun; Bei, Weicheng

2015-01-01

Streptococcus suis serotype 2 (S. suis 2) causes sepsis and meningitis in piglets and humans, and results in one of the most serious bacterial diseases affecting the production of commercial pigs around the world. Due to the failure of the current inactivated vaccine to protect against the disease, development of a new attenuated live vaccine against S. suis 2 by deleting essential virulence factors is urgently needed. We have previously reported the construction and characterization of an SsPep single gene deletion mutant strain ΔSsPep based on S. suis 2. Our previous results have shown that SsPep plays a critical role in the pathogenesis of S. suis 2. In this study, a precisely defined double-deletion mutant ΔSsPep/ΔSsPspC of S. suis 2 without antibiotic-resistance markers was constructed based on ΔSsPep, and the levels of virulence of the wild-type (WT) and ΔSsPep/ΔSsPspC were compared in a mouse experimental infection model. We demonstrated that the double mutant ΔSsPep/ΔSsPspC was less virulent than the WT, and could induce a noticeable antibody response. Analysis of IgG subclasses (IgG1 and IgG2a) indicated that both Th1 and Th2 responses were induced by ΔSsPep/ΔSsPspC, although the IgG2a (Th1) response predominated over the IgG1 (Th2) response. Moreover, ΔSsPep/ΔSsPspC could confer 90% protective efficacy against challenge with a lethal dose of fully virulent S. suis 2. Taken together, these data demonstrate that ΔSsPep/ΔSsPspC can be used as an effective live vaccine and provide a novel strategy against infection of S. suis 2. Copyright © 2014 Elsevier GmbH. All rights reserved.

Plasma Fibrinogen in Patients With Bell Palsy.

Science.gov (United States)

Zhao, Hua; Zhang, Xin; Tang, Yinda; Li, Shiting

2016-10-01

To determine the plasma fibrinogen level in patients with Bell palsy and explore the significances of it in Bell palsy. One hundred five consecutive patients with facial paralysis were divided into 3 groups: group I (Bell palsy), group II (temporal bone fractures), and group III (facial nerve schwannoma). In addition, 22 volunteers were defined as control group. Two milliliters fasting venous blood from elbow was collected, and was evaluated by CA-7000 Full-Automatic Coagulation Analyzer. The plasma fibrinogen concentration was significantly higher in the group of patients with Bell palsy (HB IV-VI) than that in the control group (P 0.05); similarly, there was also no marked difference between group III and control group (P >0.05). In group I, the plasma fibrinogen levels became higher with the HB grading increase. The plasma fibrinogen level of HB-VI was highest. Plasma fibrinogen has an important clinical meaning in Bell palsy, which should be used as routine examination items. Defibrinogen in treatment for patients with high plasma fibrinogen content also should be suggested.

‘Hummingbird’ Sign in a Patient with Guam Parkinsonism-Dementia Complex

Directory of Open Access Journals (Sweden)

Tianrong Yeo

2017-09-01

Full Text Available We present a case of a 71-year-old male Chamorro patient from Guam who presented with progressive supranuclear palsy (PSP-Richardson’s syndrome. Considering his strong family history of parkinsonism and a PSP phenotype, he was clinically diagnosed with Guam parkinsonism-dementia complex (PDC. Magnetic resonance imaging (MRI of the brain revealed prominent midbrain atrophy with preserved pontine volume, forming the ‘hummingbird’ sign, which has not been described before in Guam PDC. Molecular analysis of the chromosome 9 open reading frame 72 gene (C9orf72 showed only 6 GGGGCC repeats. We discuss the clinico-pathological similarities and differences between PSP and Guam PDC, and highlight the topography of neuropathological changes seen in Guam PDC to explain the appearance of the ‘hummingbird’ sign on MRI.

11 Things to Know about Cerebral Palsy

Science.gov (United States)

... Button Past Emails 11 Things to Know about Cerebral Palsy Language: English (US) Español (Spanish) Recommend on Facebook Tweet Share Compartir Cerebral palsy (CP) is the most common motor disability in ...

Simultaneous Bilateral Bell's palsy in a Nigerian man | Owolabi ...

African Journals Online (AJOL)

Bilateral Bellfs palsy occurring simultaneously is exceedingly rare. We report a case of a 27.year.old Nigerian man with bilateral Bellfs palsy, that occurred simultaneously, who had remarkable response to steroid and physiotherapy. We emphasized the importance of considering Bellfs palsy and the various differential ...

Bell palsy in lyme disease-endemic regions of canada: a cautionary case of occult bilateral peripheral facial nerve palsy due to Lyme disease.

Science.gov (United States)

Ho, Karen; Melanson, Michel; Desai, Jamsheed A

2012-09-01

Lyme disease caused by the spirochete Borrelia burgdorferi is a multisystem disorder characterized by three clinical stages: dermatologic, neurologic, and rheumatologic. The number of known Lyme disease-endemic areas in Canada is increasing as the range of the vector Ixodes scapularis expands into the eastern and central provinces. Southern Ontario, Nova Scotia, southern Manitoba, New Brunswick, and southern Quebec are now considered Lyme disease-endemic regions in Canada. The use of field surveillance to map risk and endemic regions suggests that these geographic areas are growing, in part due to the effects of climate warming. Peripheral facial nerve palsy is the most common neurologic abnormality in the second stage of Lyme borreliosis, with up to 25% of Bell palsy (idiopathic peripheral facial nerve palsy) occurring due to Lyme disease. Here we present a case of occult bilateral facial nerve palsy due to Lyme disease initially diagnosed as Bell palsy. In Lyme disease-endemic regions of Canada, patients presenting with unilateral or bilateral peripheral facial nerve palsy should be evaluated for Lyme disease with serologic testing to avoid misdiagnosis. Serologic testing should not delay initiation of appropriate treatment for presumed Bell palsy.

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.

Association of Lead Levels and Cerebral Palsy

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Neha Bansal MD

2017-03-01

Full Text Available Background: Cerebral palsy is a common motor disability in childhood. Raised lead levels affect cognition. Children with cerebral palsy may have raised lead levels, further impairing their residual cognitive motor and behavioral abilities. Environmental exposure and abnormal eating habits may lead to increased lead levels. Aims and Objectives: To measure blood lead levels in children with cerebral palsy and compare them with healthy neurologically normal children. To correlate blood lead levels with environmental factors. Material and Methods: Design: Prospective case-control study. Setting: Tertiary care hospital. Participants: Cases comprised 34 children with cerebral palsy, and controls comprised 34 neurologically normal, age- and sex-matched children. Methods: Clinical and demographic details were recorded as per proforma. Detailed environmental history was recorded to know the source of exposure to lead. These children were investigated and treated as per protocol. Venous blood was collected in ethylenediaminetetraacetic acid vials for analysis of blood lead levels. Lead levels were estimated by Schimadzu Flame AA-6800 (atomic absorption spectrophotometer. Data were analyzed using SPSS version 17. P < .05 was taken as significant. Results: Mean blood lead levels were 9.20 ± 8.31 µg/dL in cerebral palsy cases and 2.89 ± 3.04 µg/dL in their controls (P < .001. Among children with cerebral palsy, 19 (55.88% children had blood lead levels ≥5 µg/dL. Lead levels in children with pica were 12.33 ± 10.02 µg/dL in comparison to children with no history of pica, 6.70 ± 4.60 µg/dL (P = .029. No correlation was found between hemoglobin and blood lead levels in cases and controls. Conclusion: In our study, blood lead levels are raised in children with cerebral palsy. However, further studies are required to show effects of raised levels in these children.

Utility of susceptibility-weighted MRI in differentiating Parkinson's disease and atypical parkinsonism

International Nuclear Information System (INIS)

Gupta, Deepak; Saini, Jitender; Kesavadas, Chandrasekharan; Sarma, P.S.; Kishore, Asha

2010-01-01

Neuropathological studies report varying patterns of brain mineralization in Parkinson's diseases (PD), progressive supranuclear palsy (PSP), and Parkinson variant of multiple system atrophy (MSA-P). Susceptibility-weighted imaging (SWI) is the ideal magnetic resonance imaging (MRI) technique to detect mineralization of the brain. The purpose of this study was to test if SWI can differentiate PD, PSP, and MSA-P. Eleven patients with PD, 12 with PSP, 12 with MSA-P, and 11 healthy controls underwent SWI of the brain. Hypointensity of putamen, red nucleus, substantia nigra, and dentate nucleus in all groups were measured using an objective grading scale and scored from 0 to 3. In PSP, hypointensity score of red nucleus was higher than that in MSA-P (p = 0.001) and PD (p = 0.001), and a score of ≥2 differentiated the PSP group from the PD and MSA-P groups. Putaminal hypointensity score was higher in PSP when compared to that in PD (p = 0.003), and a score of ≥2 differentiated PSP from PD groups. SWI hypointensity scores of red nucleus and putamen had an excellent intrarater and interrater correlation. Substantia nigra hypointensity score of the PSP group was higher than that of the MSA-P (p = 0.004) and PD (p = 0.006) groups, but the scores had only a moderate intrarater and interrater correlation. SWI shows different patterns of brain mineralization in clinically diagnosed groups of PD, PSP, and MSA-P and may be considered as an additional MR protocol to help differentiate these conditions. (orig.)

Efficacy of Mindfulness-Based Cognitive Therapy on Quality of Life of Mothers of Children with Cerebral Palsy

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Zahra Sedaghati-Barog

2015-10-01

Full Text Available Objective: The findings demonstrated that parents of children with cerebral palsy experience elevated levels of distress, depression, anxiety, posttraumatic stress symptom and subjective symptom of stress and low quality of life. Effective interventions targeting relapse have the potential to dramatically reduce the point prevalence of this condition.Many studies have shown that Mindfulness Based Cognitive Therapy (MBCT is an intervention that has shown efficacy in improving quality of life. In this study, the effect of Mindfulness –Based Cognitive Therapy (MBCT on increasing quality of life in mothers of children with cerebral palsy has been examined.Method: Three mothers of CP children with low scores on quality of life in WHOQOL-BREF inventory participated in this single- case study.Results: Findings revealed that the MBCT program elevated quality of life of the participants. The improvement quotient for quality of life of each participant was good.Conclusion: The results have implication for efficacy of mindfulness for improvement of psychosocial life of families of children with cerebral palsy.

The Danish Cerebral Palsy Follow-up Program

DEFF Research Database (Denmark)

Rasmussen, Helle Mätzke; Nordbye-Nielsen, Kirsten; Møller-Madsen, Bjarne

2016-01-01

AIM OF DATABASE: The Danish Cerebral Palsy Follow-up Program is a combined follow-up program and national clinical quality database that aims to monitor and improve the quality of health care for children with cerebral palsy (CP). STUDY POPULATION: The database includes children with CP aged 0...... indicators in three of five regions in Denmark comprising 432 children with CP, corresponding to a coverage of 82% of the expected population. CONCLUSION: The Danish Cerebral Palsy Follow-up Program is currently under development as a national clinical quality database in Denmark. The database holds...

Racial, Ethnic, and Socioeconomic Disparities in the Prevalence of Cerebral Palsy

Science.gov (United States)

Xing, Guibo; Fuentes-Afflick, Elena; Danielson, Beate; Smith, Lloyd H.; Gilbert, William M.

2011-01-01

OBJECTIVE: Racial and ethnic disparities in cerebral palsy have been documented, but the underlying mechanism is poorly understood. We determined whether low birth weight accounts for ethnic disparities in the prevalence of cerebral palsy and whether socioeconomic factors impact cerebral palsy within racial and ethnic groups. METHODS: In a retrospective cohort of 6.2 million births in California between 1991 and 2001, we compared maternal and infant characteristics among 8397 infants with cerebral palsy who qualified for services from the California Department of Health Services and unaffected infants. RESULTS: Overall, black infants were 29% more likely to have cerebral palsy than white infants (relative risk: 1.29 [95% confidence interval: 1.19–1.39]). However, black infants who were very low or moderately low birth weight were 21% to 29% less likely to have cerebral palsy than white infants of comparable birth weight. After we adjusted for birth weight, there was no difference in the risk of cerebral palsy between black and white infants. In multivariate analyses, women of all ethnicities who did not receive any prenatal care were twice as likely to have infants with cerebral palsy relative to women with an early onset of prenatal care. Maternal education was associated with cerebral palsy in a dose-response fashion among white and Hispanic women. Hispanic adolescent mothers (aged cerebral palsy. CONCLUSIONS: The increased risk of cerebral palsy among black infants is primarily related to their higher risk of low birth weight. Understanding how educational attainment and use of prenatal care impact the risk of cerebral palsy may inform new prevention strategies. PMID:21339278

Overexpression of PSP1 enhances growth of transgenic Arabidopsis plants under ambient air conditions.

Science.gov (United States)

Han, Xiaofang; Peng, Keli; Wu, Haixia; Song, Shanshan; Zhu, Yerong; Bai, Yanling; Wang, Yong

2017-07-01

The importance of the phosphorylated pathway (PPSB) of L-serine (Ser) biosynthesis in plant growth and development has been demonstrated, but its specific role in leaves and interaction with photorespiration, the main leaf Ser biosynthetic pathway at daytime, are still unclear. To investigate whether changes in biosynthesis of Ser by the PPSB in leaves could have an impact on photorespiration and plant growth, we overexpressed PSP1, the last enzyme of this pathway, under control of the Cauliflower Mosaic Virus 35S promoter in Arabidopsis thaliana. Overexpressor plants grown in normal air displayed larger rosette diameter and leaf area as well as higher fresh and dry weight than the wild type. By contrast, no statistically significant differences to the wild type were observed when the overexpressor seedlings were transferred to elevated CO 2 , indicating a relationship between PSP1 overexpression and photorespiration. Additionally, the transgenic plants displayed higher photorespiration, an increase in CO 2 net-uptake and stronger expression in the light of genes encoding enzymes involved in photorespiration. We further demonstrated that expression of many genes involved in nitrogen assimilation was also promoted in leaves of transgenic plants and that leaf nitrate reductase activity increased in the light, too, although not in the dark. Our results suggest a close correlation between the function of PPSB and photorespiration, and also nitrogen metabolism in leaves.

The putative thiosulfate sulfurtransferases PspE and GlpE contribute to virulence of Salmonella Typhimurium in the mouse model of systemic disease.

Directory of Open Access Journals (Sweden)

Inke Wallrodt

Full Text Available The phage-shock protein PspE and GlpE of the glycerol 3-phosphate regulon of Salmonella enterica serovar Typhimurium are predicted to belong to the class of thiosulfate sulfurtransferases, enzymes that traffic sulfur between molecules. In the present study we demonstrated that the two genes contribute to S. Typhimurium virulence, as a glpE and pspE double deletion strain showed significantly decreased virulence in a mouse model of systemic infection. However, challenge of cultured epithelial cells and macrophages did not reveal any virulence-associated phenotypes. We hypothesized that their contribution to virulence could be in sulfur metabolism or by contributing to resistance to nitric oxide, oxidative stress, or cyanide detoxification. In vitro studies demonstrated that glpE but not pspE was important for resistance to H2O2. Since the double mutant, which was the one affected in virulence, was not affected in this assay, we concluded that resistance to oxidative stress and the virulence phenotype was most likely not linked. The two genes did not contribute to nitric oxid stress, to synthesis of essential sulfur containing amino acids, nor to detoxification of cyanide. Currently, the precise mechanism by which they contribute to virulence remains elusive.

Prevalence of cerebral palsy in Uganda: a population-based study.

Science.gov (United States)

Kakooza-Mwesige, Angelina; Andrews, Carin; Peterson, Stefan; Wabwire Mangen, Fred; Eliasson, Ann Christin; Forssberg, Hans

2017-12-01

Few population-based studies of cerebral palsy have been done in low-income and middle-income countries. We aimed to examine cerebral palsy prevalence and subtypes, functional impairments, and presumed time of injury in children in Uganda. In this population-based study, we used a nested, three-stage, cross-sectional method (Iganga-Mayuge Health and Demographic Surveillance System [HDSS]) to screen for cerebral palsy in children aged 2-17 years in a rural eastern Uganda district. A specialist team confirmed the diagnosis and determined the subtype, motor function (according to the Gross Motor Function Classification System [GMFCS]), and possible time of brain injury for each child. Triangulation and interviews with key village informants were used to identify additional cases of suspected cerebral palsy. We estimated crude and adjusted cerebral palsy prevalence. We did χ 2 analyses to examine differences between the group screened at stage 1 and the entire population and regression analyses to investigate associations between the number of cases and age, GMFCS level, subtype, and time of injury. We used data from the March 1, 2015, to June 30, 2015, surveillance round of the Iganga-Mayuge HDSS. 31 756 children were screened for cerebral palsy, which was confirmed in 86 (19%) of 442 children who screened positive in the first screening stage. The crude cerebral palsy prevalence was 2·7 (95% CI 2·2-3·3) per 1000 children, and prevalence increased to 2·9 (2·4-3·6) per 1000 children after adjustment for attrition. The prevalence was lower in older (8-17 years) than in younger (cerebral palsy was the most common subtype (45 [46%] of 97 children) followed by bilateral cerebral palsy (39 [40%] of 97 children). 14 (27%) of 51 children aged 2-7 years had severe cerebral palsy (GMFCS levels 4-5) compared with only five (12%) of 42 children aged 8-17 years. Few children (two [2%] of 97) diagnosed with cerebral palsy were born preterm. Post-neonatal events were the

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.

Magnetic resonance imaging in congenital superior oblique palsy

International Nuclear Information System (INIS)

Sato, Miho; Kondo, Nagako; Awaya, Shinobu; Nomura, Hideki; Yagasaki, Teiji.

1996-01-01

MRI examinations were carried out on the defined congenital superior oblique palsy in order to distinguish the congenital and acquired palsies. Subjects were 19 patients diagnosed as congenital and their MRI images of 3 or 5 mm-thick coronary slice were taken. The volume of the oblique muscle was calculated from the images and a comparison was made between the diseased and healthy normal sides. The oblique muscle volume at the diseased side was found reduced in most of congenital superior oblique palsy patients. The reduction was observed even at childhood and was thus considered to be a malformation. Further, it is conceivable that the palsy could be caused by the abnormality in the central nervous system as well as by the present anatomical abnormality. (K.H.)

Pretreatment Hematologic Findings as Novel Predictive Markers for Facial Palsy Prognosis.

Science.gov (United States)

Wasano, Koichiro; Kawasaki, Taiji; Yamamoto, Sayuri; Tomisato, Shuta; Shinden, Seiichi; Ishikawa, Toru; Minami, Shujiro; Wakabayashi, Takeshi; Ogawa, Kaoru

2016-10-01

To examine the relationship between prognosis of 2 different facial palsies and pretreatment hematologic laboratory values. Multicenter case series with chart review. Three tertiary care hospitals. We examined the clinical records of 468 facial palsy patients who were treated with an antiviral drug in combination with either oral or intravenous corticosteroids in participating hospitals between 2010 and 2014. Patients were divided into a Bell's palsy group or a Hunt's palsy group. We used the Yanagihara facial nerve grading system to grade the severity of facial palsy. "Recovery" from facial palsy was defined as achieving a Yanagihara score ≥36 points within 6 months of onset and having no accompanying facial contracture or synkinesis. We collected information about pretreatment hematologic findings, demographic data, and electrophysiologic test results of the Bell and Hunt group patients who recovered and those who did not. We then compared these data across the 2 palsy groups. In the Bell's palsy group, recovered and unrecovered patients differed significantly in age, sex, electroneuronography score, stapedial muscle reflex, neutrophil rate, lymphocyte rate, neutrophil-to-lymphocyte ratio, and initial Yanagihara score. In the Hunt's palsy group, recovered and unrecovered patients differed in age, electroneuronography score, stapedial muscle reflex, monocyte rate, platelet count, mean corpuscular volume, and initial Yanagihara score. Pretreatment hematologic findings, which reflect the severity of inflammation and bone marrow dysfunction caused by a virus infection, are useful for predicting the prognosis of facial palsy. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016.

Reliability of isometric lower-extremity muscle strength measurements in children with cerebral palsy: implications for measurement design

NARCIS (Netherlands)

Willemse, Lydia; Brehm, Merel A.; Scholtes, Vanessa A.; Jansen, Laura; Woudenberg-Vos, Hester; Dallmeijer, Annet J.

2013-01-01

Children with cerebral palsy (CP) typically show muscle weakness of the lower extremities, which can be measured with the use of handheld dynamometry (HHD). The purposes of this study were: (1) to determine test-retest reliability and measurement error of isometric lower-extremity strength

A general practice approach to Bell's palsy.

Science.gov (United States)

Phan, Nga T; Panizza, Benedict; Wallwork, Benjamin

2016-11-01

Bell's palsy is characterised by an acute onset of unilateral, lower motor neuron weakness of the facial nerve in the absence of an identifiable cause. Establishing the correct diagnosis is imperative and choosing the correct treatment options can optimise the likelihood of recovery. This article summarises our understanding of Bell's palsy and the evidence-based management options available for adult patients. The basic assessment should include a thorough history and physical examination as the diagnosis of Bell's palsy is based on exclusion. For confirmed cases of Bell's palsy, corticosteroids are the mainstay of treatment and should be initiated within 72 hours of symptom onset. Antiviral therapy in combination with corticosteroid therapy may confer a small benefit and may be offered on the basis of shared decision making. Currently, no recommendations can be made for acupuncture, physical therapy, electrotherapy or surgical decompression because well-designed studies are lacking and available data are of low quality.

Cerebral Palsy: Still A Social Problem

Directory of Open Access Journals (Sweden)

Angom Bisharda

1997-08-01

Full Text Available Research Problem: What arc the social aspects of cerebral palsy?Objective: To determine the extent and severity of neuromuscular involvement in cases of cerebral palsy and to find out the associated defects among these children.Study Design: Cross sectional study.Setting: Tertiary care hospital, outdoor patients.Participants: Children in the age group of 0 - 12 years.Sample Size: 120 children suffering from cerebral palsy.Study Variables: Social factors, neuromuscular involvement.Statistical Analysis: By proportionsResult: Out of 120 cases, maximum number of cases (66.6% were in the age group of 1- 4 years. 83 cases ( 69.16% were males. Among the various types, spastic type was the commonest (87.5%. Of these spastic cases, 52 (49.52% had quadriplegia. No case of tremor and rigidity was seen. Delayed milestones was the commonest associated disorder, seen in 107 (89.16% cases, followed by speech defect in 58(48.3% cases, visual defect in 34(28.3% cases and convulsions in 24 (20.0% cases. Hearing defect was seen in 5 cases (4.16% only.Conclusion: More concerted efforts arc required to identify children with cerebral palsy and rehabilitate them for the betterment of society.

Cerebral Palsy: Still A Social Problem

Directory of Open Access Journals (Sweden)

Angom Bisharda

1997-08-01

Full Text Available Research Problem: What arc the social aspects of cerebral palsy? Objective: To determine the extent and severity of neuromuscular involvement in cases of cerebral palsy and to find out the associated defects among these children. Study Design: Cross sectional study. Setting: Tertiary care hospital, outdoor patients. Participants: Children in the age group of 0 - 12 years. Sample Size: 120 children suffering from cerebral palsy. Study Variables: Social factors, neuromuscular involvement. Statistical Analysis: By proportions Result: Out of 120 cases, maximum number of cases (66.6% were in the age group of 1- 4 years. 83 cases ( 69.16% were males. Among the various types, spastic type was the commonest (87.5%. Of these spastic cases, 52 (49.52% had quadriplegia. No case of tremor and rigidity was seen. Delayed milestones was the commonest associated disorder, seen in 107 (89.16% cases, followed by speech defect in 58(48.3% cases, visual defect in 34(28.3% cases and convulsions in 24 (20.0% cases. Hearing defect was seen in 5 cases (4.16% only. Conclusion: More concerted efforts arc required to identify children with cerebral palsy and rehabilitate them for the betterment of society.

The MM-CGI Cerebral Palsy: modification and pretesting of an instrument to measure anticipatory grief in parents whose child has cerebral palsy.

Science.gov (United States)

Al-Gamal, Ekhlas; Long, Tony

2014-07-01

To establish the potential of a modified version of the MM-CGI Childhood Cancer to assess anticipatory grief in parents of children with cerebral palsy, to amend the existing scale for use with the specific patient group, to test the psychometric properties of the modified version (MM-CGI Cerebral Palsy) and to review the clinical potential of the new scale. Parents of children with cerebral palsy may experience reactions similar to parents of children with other enduring or life-limiting conditions, and anticipatory grief may be one such psychological reaction. While the burden of caring is sometimes balanced by positive perceptions of the child, which enhance coping ability, for many parents the outcome is damage to their physical and mental health and impaired family functioning. A cross-sectional, descriptive, correlational design. The MM-CGI Cerebral Palsy was administered in structured interviews with 204 parents. Standardised measures of caregivers' depression, stress and perceived social support were also administered. Mothers and fathers were recruited from healthcare centres and schools for special education. Cronbach's alpha was used to assess internal consistency, and Pearson's product-moment correlation was used to assess construct validity. The subscales were each found to measure a single dimension of anticipatory grief, and significant correlations were established with existing instruments. The instrument demonstrated excellent internal consistency reliability and good construct validity. The MM-CGI Cerebral Palsy could be useful for diagnosing anticipatory grief among parents of children with cerebral palsy. This preliminary work moves the programme on to testing in intervention studies. In the absence of an existing measure for the assessment of anticipatory grief, specifically in parents of children with cerebral palsy, the MM-CGI Cerebral Palsy could prove to be an effective assessment tool for clinicians and researchers. © 2013 John Wiley

Reduction of pain sensitivity after somatosensory therapy in adults with cerebral palsy

Directory of Open Access Journals (Sweden)

Inmaculada eRiquelme

2013-06-01

Full Text Available Objective. Pain and deficits in somatosensory processing seem to play a relevant role in cerebral palsy (CP. Rehabilitation techniques based on neuroplasticity mechanisms may induce powerful changes in the organization of the primary somatosensory cortex and have been proved to reduce levels of pain and discomfort in neurological pathologies. However, little is known about the efficacy of such interventions for pain sensitivity in CP individuals. Methods. Adults with cerebral palsy participated in the study and were randomly assigned to the intervention (n=17 or the control group (n=20. The intervention group received a somatosensory therapy including 4 types of exercises (touch, proprioception, vibration, and stereognosis. All participants were asked to continue their standardized motor therapy during the study period. Several somatosensory (pain and touch thresholds, stereognosis, propioception, texture recognition and motor parameters (fine motor skills were assessed before, immediately after and three months after the therapy (follow-up. Results. Participants of the intervention group showed a significant reduction on pain sensitivity after treatment and at follow-up after three months, whereas participants in the control group displayed increasing pain sensitivity over time. No improvements were found on touch sensitivity, proprioception, texture recognition or fine motor skills. Conclusions. Data suggest the possibility that somatosensory therapy was effective in eliciting changes in central somatosensory processing. This hypothesis may have implications for future neuromodulatory treatment of pain complaints in children and adults with cerebral palsy.

[Research on brain white matter network in cerebral palsy infant].

Science.gov (United States)

Li, Jun; Yang, Cheng; Wang, Yuanjun; Nie, Shengdong

2017-10-01

Present study used diffusion tensor image and tractography to construct brain white matter networks of 15 cerebral palsy infants and 30 healthy infants that matched for age and gender. After white matter network analysis, we found that both cerebral palsy and healthy infants had a small-world topology in white matter network, but cerebral palsy infants exhibited abnormal topological organization: increased shortest path length but decreased normalize clustering coefficient, global efficiency and local efficiency. Furthermore, we also found that white matter network hub regions were located in the left cuneus, precuneus, and left posterior cingulate gyrus. However, some abnormal nodes existed in the frontal, temporal, occipital and parietal lobes of cerebral palsy infants. These results indicated that the white matter networks for cerebral palsy infants were disrupted, which was consistent with previous studies about the abnormal brain white matter areas. This work could help us further study the pathogenesis of cerebral palsy infants.

OCULAR FINDINGS IN CHILDREN WITH CEREBRAL PALSY ...

African Journals Online (AJOL)

Cerebral palsy is commonly associated with ocular abnormalities which often impact on their development and education. There is paucity of studies on this in Nigeria. We decided to study/ determine the prevalence of ocular abnormalities among children with cerebral palsy that attended the neurology clinic of University of ...

Radiation-induced cranial nerve palsy

International Nuclear Information System (INIS)

Berger, P.S.; Bataini, J.P.

1977-01-01

Twenty-five patients with 35 cranial nerve palsies were seen at the Fondation Curie during follow-up after radical radiotherapy for head and neck tumors. The twelfth nerve was involved in 19 cases, the tenth in nine, and the eleventh in five; the fifth and second nerves were involved once each and in the same patient. The twelfth nerve was involved alone in 16 patients and the tenth nerve alone in three, with multiple nerves involved in the remaining six patients. The palsy was noted from 12 to 145 months after diagnosis of the tumor. The latency period could be correlated with dose so that the least square fit equation representing NSD vs delay is NSD = 2598--Delay (in months) x 4.6, with a correlation coefficient of -0.58. The distinction between tumor recurrence and radiation-induced nerve palsy is critical. It can often be inferred from the latency period but must be confirmed by observation over a period of time

Cranial nerve palsies

International Nuclear Information System (INIS)

Ruggieri, P.; Adelizzi, J.; Modic, M.T.; Ross, J.S.; Tkach, J.; Masaryk, T.J.

1990-01-01

This paper evaluates the utility of multiplanar reconstructions (MPRs) of three-dimensional (3D) MR angiography data sets in the examination of patients with cranial nerve palsies. The authors hypothesis was that 3D data could be reformatted to highlight the intricate spatial relationships of vessels to adjacent neural tissues by taking advantage of the high vessel-parenchyma contrast in high-resolution 3D time-of-flight sequences. Twenty patients with cranial nerve palsies and 10 asymptomatic patients were examined with coronal T1-weighted and axial T2-weighted imaging plus a gadolinium-enhanced 3D MRA sequence (40/7/15 degrees, axial 60-mm volume, 0.9-mm isotropic resolution). Cranial nerves II-VIII were subsequently evaluated on axial and reformatted coronal and/or sagittal images

Properties of the Circumsolar Dust Distribution Determined from STEREO/SECCHI and Implications for PSP and SolO

Science.gov (United States)

Howard, R.; Stenborg, G.

2017-12-01

We have performed an analysis of the HI-1A instrument in the STEREO/SECCHI suite to determine the inclination and longitude of the ascending node of the plane of symmetry of the F-corona. The F-corona arises from sunlight scattered by the dust in orbit about the Sun. We find that the inclination and ascending node are not constant in the field of view of the HI-1A (4° to 24° elongation), but are functions of the elongation angle i.e. the distance to the Sun and are slightly different from the parameters determined from the Helios mission. These parameters are reflecting the gravitational influences of Jupiter, Venus and the Sun as well as Lorentz and Poynting-Robinson forces on the dust orbits. The center of symmetry is not the center of the Sun, but is offset by 0.5 Rsun from the center in the direction of the average position of Jupiter during the epoch studied: from 2007-2012. We also observe a slight difference in the inclination when it is north or south of the ecliptic. We suggest this may be due to remnant dust in the orbit of the Kreutz sun-grazing comets which occur at an average rate of one every 2-3 days. Finally, as the dust particles evaporate we expect to see the F-coronal brightness correspondingly decrease. The detectability of the decrease will depend on the amount of dust evaporating, but a 10% change in the density is easily detectable. If a dust free zone surrounding the Sun exists, it will affect the F-coronal intensities observed by PSP and SolO by an observable amount.

Probability of walking in children with cerebral palsy in Europe

DEFF Research Database (Denmark)

Beckung, E.; Hagberg, G.; Uldall, P.

2008-01-01

cerebral palsy, as well as to IQ level, active epilepsy, and severe visual and hearing impairment. Severe cerebral palsy, defined as both the inability to walk and an IQ of ...OBJECTIVES: The purpose of this work was to describe walking ability in children with cerebral palsy from the Surveillance of Cerebral Palsy in Europe common database through 21 years and to examine the association between walking ability and predicting factors. PATIENTS AND METHODS: Anonymous data...... on 10042 children with cerebral palsy born between 1976 and 1996 were gathered from 14 European centers; 9012 patients were eligible for the analyses. RESULTS: Unaided walking as the primary way of walking at 5 years of age was reported for 54%, walking with assistive devices was reported for 16...

Facial palsy in children: emergency department management and outcome.

Science.gov (United States)

Wang, Cheng-Hsien; Chang, Yu-Che; Shih, Hong-Mo; Chen, Chun-Yu; Chen, Jih-Chang

2010-02-01

To describe the characteristics of children who present to an emergency department (ED) with facial palsy and determine the association of outcome with etiology, degree of initial paralysis, and ED management. This was a retrospective cohort study of children who presented to an ED with facial nerve paralysis (FNP). There were 85 patients with a mean age of 8.0 (SD, 6.1) years; 60% (n = 51) of the patients were male, and 65.9% (n = 56) were admitted to the hospital. Bell palsy (50.6%) was the most common etiology followed by infectious (22.4%), traumatic (16.5%), congenital (7.1%), and neoplastic etiologies (3.5%). Patients with Bell palsy had shorter recovery times (P = 0.049), and traumatic cases required a longer time for recovery (P = 0.016). Acute otitis media (AOM)-related pediatric FNP had shorter recovery times than non-AOM-related cases (P = 0.005) in infectious group. Patients given steroid therapy did not have a shorter recovery time (P = 0.237) or a better recovery (P = 0.269). There was no difference in recovery rate of pediatric patients with Bell palsy between hospitalization or not (P = 0.952). Bell palsy, infection, and trauma were most common etiologies of pediatric FNP. Recovery times were shorter in pediatric patients with Bell palsy and AOM-related FNP, whereas recovery took longer in traumatic cases. Steroid therapy did not seem beneficial for pediatric FNP. Hospitalization is not indicated for pediatric patients with Bell palsy.

Low bone mineral density in ambulatory persons with cerebral palsy? A systematic review.

Science.gov (United States)

Mus-Peters, Cindy T R; Huisstede, Bionka M A; Noten, Suzie; Hitters, Minou W M G C; van der Slot, Wilma M A; van den Berg-Emons, Rita J G

2018-05-22

Non-ambulatory persons with cerebral palsy are prone to low bone mineral density. In ambulatory persons with cerebral palsy, bone mineral density deficits are expected to be small or absent, but a consensus conclusion is lacking. In this systematic review bone mineral density in ambulatory persons with cerebral palsy (Gross Motor Function Classification Scales I-III) was studied. Medline, Embase, and Web of Science were searched. According to international guidelines, low bone mineral density was defined as Z-score ≤ -2.0. In addition, we focused on Z-score ≤ -1.0 because this may indicate a tendency towards low bone mineral density. We included 16 studies, comprising 465 patients aged 1-65 years. Moderate and conflicting evidence for low bone mineral density (Z-score ≤ -2.0) was found for several body parts (total proximal femur, total body, distal femur, lumbar spine) in children with Gross Motor Function Classification Scales II and III. We found no evidence for low bone mineral density in children with Gross Motor Function Classification Scale I or adults, although there was a tendency towards low bone mineral density (Z-score ≤ -1.0) for several body parts. Although more high-quality research is needed, results indicate that deficits in bone mineral density are not restricted to non-ambulatory people with cerebral palsy. Implications for Rehabilitation Although more high-quality research is needed, including adults and fracture risk assessment, the current study indicates that deficits in bone mineral density are not restricted to non-ambulatory people with CP. Health care professionals should be aware that optimal nutrition, supplements on indication, and an active lifestyle, preferably with weight-bearing activities, are important in ambulatory people with CP, also from a bone quality point-of-view. If indicated, medication and fall prevention training should be prescribed.

The relation of breech presentation at term to cerebral palsy

DEFF Research Database (Denmark)

Krebs, L; Topp, M; Langhoff-Roos, J

1999-01-01

OBJECTIVE: To examine the relation between breech delivery and cerebral palsy, considering the influence of intrauterine growth, low Apgar score at birth, and mode of delivery. DESIGN: Register-based, case-control study. POPULATION: A cohort of infants with cerebral palsy born between 1979 and 1986...... in East Denmark, identified by linkage of the cerebral palsy register with the national birth register. Discharge letters from births of breech infants with cerebral palsy were reviewed. MAIN OUTCOME MEASURES: Presentation, mode of delivery, gestational age, birthweight, Apgar score, type of cerebral...

Clinical significance of the corpus callosum in cerebral palsy

International Nuclear Information System (INIS)

Lee, Eun Ja; Kim, Ji Chang; Kim, Jong Chul; And Others

2000-01-01

To evaluate, using magnetic resonance (MR) imaging, the clinal significance of the corpus callosum by measuring the size of various portions of the corpus callosum in children with cerebral palsy, and in paired controls. Fifty-two children (30 boys and 22 girls aged between six and 96 (median, 19) months) in whom cerebral palsy was clinically diagnosed underwent MR imaging. There were 23 term patients and 29 preterm, and the control group was selected by age and sex matching. Clinal subtypes of cerebral palsy were classified as hemiplegia (n=14), spastic diplegia (n=22), or spastic quadriplegia (n=16), and according to the severity of motor palsy, the condition was also classified as mild (n=26), moderate (n=13), or severe (n=13). In addition to the length and height of the corpus callosum, the thickness of its genu, body, transitional zone and splenium, as seen on midsagittal T1-weighted MR images, were also measured. Differences in the measured values of the two groups were statistically analysed and differences in the size of the corpus callosum according to the clinical severity and subtypes of cerebral palsy, and gestational age, were also assessed. Except for height, the measured values of the corpus callosum in patients with cerebral palsy were significantly less than those of the control group (p less than 0.05). Its size decreased according to the severity of motor palsy. Compared with term patients, the corpus callosum in preterm patients was considerably smaller (p less than 0.05). There was statistically significant correlation between the severity of motor palsy and the size of the corpus callosum. Quantitative evaluation of the corpus callosum might be a good indicator of neurologic prognosis, and a sensitive marker for assessing the extent of brain injury

Clinical significance of the corpus callosum in cerebral palsy

Energy Technology Data Exchange (ETDEWEB)

Lee, Eun Ja; Kim, Ji Chang [The Catholic University of Korea, Seoul (Korea, Republic of); Kim, Jong Chul [School of Medicine, Chungnam National University, Taejon (Korea, Republic of); And Others

2000-10-01

To evaluate, using magnetic resonance (MR) imaging, the clinal significance of the corpus callosum by measuring the size of various portions of the corpus callosum in children with cerebral palsy, and in paired controls. Fifty-two children (30 boys and 22 girls aged between six and 96 (median, 19) months) in whom cerebral palsy was clinically diagnosed underwent MR imaging. There were 23 term patients and 29 preterm, and the control group was selected by age and sex matching. Clinal subtypes of cerebral palsy were classified as hemiplegia (n=14), spastic diplegia (n=22), or spastic quadriplegia (n=16), and according to the severity of motor palsy, the condition was also classified as mild (n=26), moderate (n=13), or severe (n=13). In addition to the length and height of the corpus callosum, the thickness of its genu, body, transitional zone and splenium, as seen on midsagittal T1-weighted MR images, were also measured. Differences in the measured values of the two groups were statistically analysed and differences in the size of the corpus callosum according to the clinical severity and subtypes of cerebral palsy, and gestational age, were also assessed. Except for height, the measured values of the corpus callosum in patients with cerebral palsy were significantly less than those of the control group (p less than 0.05). Its size decreased according to the severity of motor palsy. Compared with term patients, the corpus callosum in preterm patients was considerably smaller (p less than 0.05). There was statistically significant correlation between the severity of motor palsy and the size of the corpus callosum. Quantitative evaluation of the corpus callosum might be a good indicator of neurologic prognosis, and a sensitive marker for assessing the extent of brain injury.

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....

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…

Multiple cranial nerve palsies complicating tympanomastoiditis: case ...

African Journals Online (AJOL)

Otitis media either acute or chronic, is not uncommon in childhood. Multiple cranial nerve palsies occuring as a complication of either form of otitis media is unusual. A case of a nine year old boy with chronic suppurative otitis media with associated mastoiditis complicated with ipsilateral multiple cranial nerve palsies is ...

Risk Factors For Epilepsy In Children With Cerebral Palsy | Lagunju ...

African Journals Online (AJOL)

Epilepsy is said to occur in 15-90% of children with cerebral palsy and this poses additional economic and psychological stress on affected children and their families. Objectives To describe the risk factors for epilepsy in children with cerebral palsy. Methods One hundred and seventy six children with cerebral palsy seen at ...

Facial Palsy Following Embolization of a Juvenile Nasopharyngeal Angiofibroma.

Science.gov (United States)

Tawfik, Kareem O; Harmon, Jeffrey J; Walters, Zoe; Samy, Ravi; de Alarcon, Alessandro; Stevens, Shawn M; Abruzzo, Todd

2018-05-01

To describe a case of the rare complication of facial palsy following preoperative embolization of a juvenile nasopharyngeal angiofibroma (JNA). To illustrate the vascular supply to the facial nerve and as a result, highlight the etiology of the facial nerve palsy. The angiography and magnetic resonance (MR) imaging of a case of facial palsy following preoperative embolization of a JNA is reviewed. A 13-year-old male developed left-sided facial palsy following preoperative embolization of a left-sided JNA. Evaluation of MR imaging studies and retrospective review of the angiographic data suggested errant embolization of particles into the petrosquamosal branch of the middle meningeal artery (MMA), a branch of the internal maxillary artery (IMA), through collateral vasculature. The petrosquamosal branch of the MMA is the predominant blood supply to the facial nerve in the facial canal. The facial palsy resolved since complete infarction of the nerve was likely prevented by collateral blood supply from the stylomastoid artery. Facial palsy is a potential complication of embolization of the IMA, a branch of the external carotid artery (ECA). This is secondary to ischemia of the facial nerve due to embolization of its vascular supply. Clinicians should be aware of this potential complication and counsel patients accordingly prior to embolization for JNA.

[Bell's palsy and facial pain associated with toxocara infection].

Science.gov (United States)

Bachtiar, Arian; Auer, Herbert; Finsterer, Josef

2012-10-01

Toxocarosis involving cranial nerves is extremely rare and almost exclusively concerns the optic nerve. Toxocarosis involving the seventh cranial nerve has not been reported. A 33y male developed left-sided Bell's palsy two days after left-sided otalgia 6y before. Despite extensive diagnostic work-up at that time the cause of Bell's palsy remained unknown. During the following years Bell's palsy slightly improved but retromandibular pain remained almost unchanged and he developed enlarged lymph nodes along the jugular veins, submandibularly, and in the trigonum caroticum. Re-evaluation 6y later revealed an increased titer of serum antibodies against Toxocara canis and a positive Westernblot for Toxocara canis ES-antigen. Despite absent eosinophilia in the serum, toxocarosis was diagnosed and a therapy with albendazole initiated, with benefit for retromandibular pain, but hardly for Bell's palsy or enlarged lymph nodes. CSF investigations after albendazole revealed a positive Westernblot for antibodies against toxocara but absent pleocytosis or eosinophilia, and negative PCR for Toxocara canis. Visceral larva migrans due to Toxocara canis may be associated with Bell's palsy, retromandibular pain, and lymphadenopathy. A causal relation between Bell's palsy and the helminthosis remains speculative. Adequate therapy years after onset of the infestation may be of limited benefit.

Case report of physiotherapy care in patient with facial nervus palsy.

OpenAIRE

Zachová, Lenka

2012-01-01

Title: Case report of physiotherapy care in patient with facial nervus peripheral palsy. Objective: Summary of theoretical knowledge and working out the case report of patient diagnosed with peripheral palsy of right facial nerve. Methode and result: This thesis comprehensively summarizes the findings of peripheral facial nerve palsy and its treatment, especially with physiotherapeutic methods. It gives a wide view at the issue of physiotherapy in facial nerve palsy which is a symptom of many...

Clinical Studies on Herbal Acupuncture Therapy in Peripheral Facial Palsy

Directory of Open Access Journals (Sweden)

Shin, Min-Seop

2001-06-01

Full Text Available Objectives : The treatment of Bell's palsy must be divided into three states(acute, subacute and healing state. 41 cases of the patient suffering from Bell's palsy were treated and observed from january 2000 to July 2001. The usage of herbal acupunctures on that disease have been effective. So I propose a method of herbal acupunctures on Bell's palsy. Methods : By the states(acute, subacute and healing state of Bell's palsy, SY(消炎 herbal acupuncture is used at the acute state, Hominis Placenta(紫河車 at the subacute, JGH(中氣下陷 at the healing state. Results : 1. At the acute state, SY(消炎 herbal acupuncture is effective to postauricular pain. 2. At the subacute state, Hominis Placenta(紫河車 herbal acupuncture is effective to decreasing pain and improving symptoms. 3. By the states(acute, subacute and healing state of Bell's palsy, SY(消炎, Hominis Placenta(紫河車 and JGH(中氣下陷 herbal acupuncture is effective to improving symptoms of Bell's palsy.

Assistive technology for promoting adaptive skills of children with cerebral palsy: ten cases evaluation.

Science.gov (United States)

Stasolla, Fabrizio; Caffò, Alessandro O; Perilli, Viviana; Boccasini, Adele; Damiani, Rita; D'Amico, Fiora

2018-05-06

To extend the use of assistive technology for promoting adaptive skills of children with cerebral palsy. To assess its effects on positive participation of ten participants involved. To carry out a social validation recruiting parents, physiotherapists and support teachers as external raters. A multiple probe design was implemented for Studies I and II. Study I involved five participants exposed to a combined program aimed at enhancing choice process of preferred items and locomotion fluency. Study II involved five further children for a combined intervention finalized at ensuring them with literacy access and ambulation responses. Study III recruited 60 external raters for a social validation assessment. All participants improved their performance, although differences among children occurred. Indices of positive participation increased as well. Social raters favorably scored the use of both technology and programs. Assistive technology-based programs were effective for promoting independence of children with cerebral palsy. Implications for Rehabilitation A basic form of assistive technology such as a microswitch-based program may be useful and helpful for supporting adaptive skills of children with cerebral palsy and different levels of functioning. The same program may improve the participants' indices of positive participation and constructive engagement with beneficial effects on their quality of life. The positive social rating provided by external experts sensitive to the matter may recommend a favorable acceptance and implementation of the program in daily settings.

Peripheral nerve involvement in Bell's palsy

Directory of Open Access Journals (Sweden)

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.

The history of facial palsy and spasm

Science.gov (United States)

Sajadi, Mohamad-Reza M.; Tabatabaie, Seyed Mahmoud

2011-01-01

Although Sir Charles Bell was the first to provide the anatomic basis for the condition that bears his name, in recent years researchers have shown that other European physicians provided earlier clinical descriptions of peripheral cranial nerve 7 palsy. In this article, we describe the history of facial distortion by Greek, Roman, and Persian physicians, culminating in Razi's detailed description in al-Hawi. Razi distinguished facial muscle spasm from paralysis, distinguished central from peripheral lesions, gave the earliest description of loss of forehead wrinkling, and gave the earliest known description of bilateral facial palsy. In doing so, he accurately described the clinical hallmarks of a condition that we recognize as Bell palsy. PMID:21747074

Peripheral facial palsy: Speech, communication and oral motor function.

Science.gov (United States)

Movérare, T; Lohmander, A; Hultcrantz, M; Sjögreen, L

2017-02-01

The aim of the present study was to examine the effect of acquired unilateral peripheral facial palsy on speech, communication and oral functions and to study the relationship between the degree of facial palsy and articulation, saliva control, eating ability and lip force. In this descriptive study, 27 patients (15 men and 12 women, mean age 48years) with unilateral peripheral facial palsy were included if they were graded under 70 on the Sunnybrook Facial Grading System. The assessment was carried out in connection with customary visits to the ENT Clinic and comprised lip force, articulation and intelligibility, together with perceived ability to communicate and ability to eat and control saliva conducted through self-response questionnaires. The patients with unilateral facial palsy had significantly lower lip force, poorer articulation and ability to eat and control saliva compared with reference data in healthy populations. The degree of facial palsy correlated significantly with lip force but not with articulation, intelligibility, perceived communication ability or reported ability to eat and control saliva. Acquired peripheral facial palsy may affect communication and the ability to eat and control saliva. Physicians should be aware that there is no direct correlation between the degree of facial palsy and the possible effect on communication, eating ability and saliva control. Physicians are therefore recommended to ask specific questions relating to problems with these functions during customary medical visits and offer possible intervention by a speech-language pathologist or a physiotherapist. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Prognosis and MRI findings in patients with peripheral facial palsy

International Nuclear Information System (INIS)

Mineta, Masayuki; Saitoh, Yasuhiro; Yoshikawa, Daihei; Yamada, Tomonori; Aburano, Tamio; Matoba, Mitsuaki.

1997-01-01

We examined a series of 21 peripheral facial palsy patients attempted to ( 17 Bell's palsy, 4 Hunt syndrome) with Gd-DTPA-enhanced MRI and attempted to determine the relation between prognosis and MRI findings. We divided patients into two groups based on facial palsy scores of Japanese facial nerve research; a good group (G-Group) and a bad group (B-group). The G-group scored over 20 points on the 20th day after the first visit and the B-group under 20 points. G-group consisted of 9 Bell's palsy and 1 Hunt syndrome patients, and the B-group of 8 Bell's palsy and 3 Hunt syndrome patients. The averaged facial palsy score of both groups was analyzed every week during 4 weeks. Recovery from the palsy was better in the G-group than the B-group (P<0.05); the scores at the 4th week of the G- and B-groups were 32.6±15.2 and 7.8±7.4, respectively. The MRI findings of both groups were examined retrospectively. Nine of 10 G-group and nine of 11 B-group patients had abnormal contrast enhancement. The result of enhanced facial nerve segment was as follows: G-group, auditory canal 1, labyrinthine/geniculate 7, tympanic 7, mastoid 7: B-group, auditory canal 2, labyrinthine/geniculate 8, tympanic 8, mastoid 7. Our results indicate no relation between the prognosis and the MRI findings. Therefore, it is impossible to predict the prognosis of facial palsy from the results of Gd-DTPA-enhanced MRI. (author)

Prognosis and MRI findings in patients with peripheral facial palsy

Energy Technology Data Exchange (ETDEWEB)

Mineta, Masayuki; Saitoh, Yasuhiro; Yoshikawa, Daihei; Yamada, Tomonori; Aburano, Tamio [Asahikawa Medical College, Hokkaido (Japan); Matoba, Mitsuaki

1997-02-01

We examined a series of 21 peripheral facial palsy patients attempted to ( 17 Bell`s palsy, 4 Hunt syndrome) with Gd-DTPA-enhanced MRI and attempted to determine the relation between prognosis and MRI findings. We divided patients into two groups based on facial palsy scores of Japanese facial nerve research; a good group (G-Group) and a bad group (B-group). The G-group scored over 20 points on the 20th day after the first visit and the B-group under 20 points. G-group consisted of 9 Bell`s palsy and 1 Hunt syndrome patients, and the B-group of 8 Bell`s palsy and 3 Hunt syndrome patients. The averaged facial palsy score of both groups was analyzed every week during 4 weeks. Recovery from the palsy was better in the G-group than the B-group (P<0.05); the scores at the 4th week of the G- and B-groups were 32.6{+-}15.2 and 7.8{+-}7.4, respectively. The MRI findings of both groups were examined retrospectively. Nine of 10 G-group and nine of 11 B-group patients had abnormal contrast enhancement. The result of enhanced facial nerve segment was as follows: G-group, auditory canal 1, labyrinthine/geniculate 7, tympanic 7, mastoid 7: B-group, auditory canal 2, labyrinthine/geniculate 8, tympanic 8, mastoid 7. Our results indicate no relation between the prognosis and the MRI findings. Therefore, it is impossible to predict the prognosis of facial palsy from the results of Gd-DTPA-enhanced MRI. (author)

Cerebral Palsy Checklist: Babies & Preschoolers (Birth to age 5)

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... Staying Safe Videos for Educators Search English Español Cerebral Palsy Checklist: Babies & Preschoolers KidsHealth / For Parents / Cerebral Palsy Checklist: Babies & Preschoolers What's in this article? Step ...

Serum levels of pancreatic stone protein (PSP/reg1A as an indicator of beta-cell apoptosis suggest an increased apoptosis rate in hepatocyte nuclear factor 1 alpha (HNF1A-MODY carriers from the third decade of life onward

Directory of Open Access Journals (Sweden)

Bacon Siobhan

2012-07-01

Full Text Available Abstract Background Mutations in the transcription factor hepatocyte nuclear factor-1-alpha (HNF1A result in the commonest type of maturity onset diabetes of the young (MODY. HNF1A-MODY carriers have reduced pancreatic beta cell mass, partially due to an increased rate of apoptosis. To date, it has not been possible to determine when apoptosis is occurring in HNF1A-MODY.We have recently demonstrated that beta cell apoptosis stimulates the expression of the pancreatic stone protein/regenerating (PSP/reg gene in surviving neighbour cells, and that PSP/reg1A protein is subsequently secreted from these cells. The objective of this study was to determine whether serum levels of PSP/reg1A are elevated during disease progression in HNF1A-MODY carriers, and whether it may provide information regarding the onset of beta-cell apoptosis. Methods We analysed serum PSP/reg1A levels and correlated with clinical and biochemical parameters in subjects with HNF1A-MODY, glucokinase (GCK-MODY, and type 1 diabetes mellitus. A control group of normoglycaemic subjects was also analysed. Results PSP/reg1A serum levels were significantly elevated in HNF1A-MODY (n = 37 subjects compared to controls (n = 60 (median = 12.50 ng/ml, IQR = 10.61-17.87 ng/ml versus median = 10.72 ng/ml, IQR = 8.94-12.54 ng/ml, p = 0.0008. PSP/reg1A correlated negatively with insulin levels during OGTT, (rho = −0.40, p = 0.02. Interestingly we noted a significant positive correlation of PSP/reg1A with age of the HNF1A-MODY carriers (rho = 0.40 p = 0.02 with an age of 25 years separating carriers with low and high PSP/reg1A levels. Patients with type 1 diabetes mellitus also had elevated serum levels of PSP/reg1A compared to controls, however this was independent of the duration of diabetes. Conclusion Our data suggest that beta cell apoptosis contributes increasingly to the pathophysiology of HNF1A-MODY in patients 25 years and over

Serum levels of pancreatic stone protein (PSP)/reg1A as an indicator of beta-cell apoptosis suggest an increased apoptosis rate in hepatocyte nuclear factor 1 alpha (HNF1A-MODY) carriers from the third decade of life onward

LENUS (Irish Health Repository)

Bacon, Siobhan

2012-07-18

AbstractBackgroundMutations in the transcription factor hepatocyte nuclear factor-1-alpha (HNF1A) result in the commonest type of maturity onset diabetes of the young (MODY). HNF1A-MODY carriers have reduced pancreatic beta cell mass, partially due to an increased rate of apoptosis. To date, it has not been possible to determine when apoptosis is occurring in HNF1A-MODY.We have recently demonstrated that beta cell apoptosis stimulates the expression of the pancreatic stone protein\\/regenerating (PSP\\/reg) gene in surviving neighbour cells, and that PSP\\/reg1A protein is subsequently secreted from these cells. The objective of this study was to determine whether serum levels of PSP\\/reg1A are elevated during disease progression in HNF1A-MODY carriers, and whether it may provide information regarding the onset of beta-cell apoptosis.MethodsWe analysed serum PSP\\/reg1A levels and correlated with clinical and biochemical parameters in subjects with HNF1A-MODY, glucokinase (GCK-MODY), and type 1 diabetes mellitus. A control group of normoglycaemic subjects was also analysed.ResultsPSP\\/reg1A serum levels were significantly elevated in HNF1A-MODY (n = 37) subjects compared to controls (n = 60) (median = 12.50 ng\\/ml, IQR = 10.61-17.87 ng\\/ml versus median = 10.72 ng\\/ml, IQR = 8.94-12.54 ng\\/ml, p = 0.0008). PSP\\/reg1A correlated negatively with insulin levels during OGTT, (rho = −0.40, p = 0.02). Interestingly we noted a significant positive correlation of PSP\\/reg1A with age of the HNF1A-MODY carriers (rho = 0.40 p = 0.02) with an age of 25 years separating carriers with low and high PSP\\/reg1A levels. Patients with type 1 diabetes mellitus also had elevated serum levels of PSP\\/reg1A compared to controls, however this was independent of the duration of diabetes.ConclusionOur data suggest that beta cell apoptosis contributes increasingly to the pathophysiology of HNF1A-MODY in patients 25 years and

Management of peripheral facial nerve palsy

OpenAIRE

Finsterer, Josef

2008-01-01

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...

[Acute palsy of twelfth cranial nerve].

Science.gov (United States)

Munoz del Castillo, F; Molina Nieto, T; De la Riva Aguilar, A; Triviño Tarradas, F; Bravo-Rodríguez, F; Ramos Jurado, A

2005-01-01

The hypoglossal nerve or Twelfth-nerve palsy is a rare damage with different causes: tumors or metastases in skull base, cervicals tumors, schwannoma, dissection or aneurysm carotid arteries, stroke, trauma, idiopathic cause, radiation, infections (mononucleosis) or multiple cranial neuropathy. Tumors were responsible for nearly half of the cases in different studies. We studied a female with hypoglossal nerve acute palsy. We made a differential diagnostic with others causes and a review of the literature.

Public health issues related to infection in pregnancy and cerebral palsy

DEFF Research Database (Denmark)

Schendel, Diana E.; Schuchat, Anne; Thorsen, Poul

2002-01-01

Cerebral palsy is the most common neuromotor developmental disability of childhood, affecting as many as 8,000 to 12,000 children born in the U.S. each year (corresponding to a prevalence rate of between 2 and 3 per 1000 children). Recent improvements in neonatal care have not resulted in a decline...... in the overall prevalence of cerebral palsy and, in fact, greater numbers of very preterm/very low birth weight infants are surviving with cerebral palsy and other developmental problems. Infection in pregnancy may be an important cause of the disorder. In preterm infants, there appears to be about a 2-fold...... increased risk for cerebral palsy from chorioamnionitis, and in term infants the estimated increased risk is about 4-fold. Provisionally, chorioamnionitis might account for 12% of spastic cerebral palsy in term infants and 28% of cerebral palsy in preterm infants. Studies of biochemical markers of fetal...

Cerebral Palsy Checklist: Teens & Young Adult (13 to 21)

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... Staying Safe Videos for Educators Search English Español Cerebral Palsy Checklist: Teens & Young Adults KidsHealth / For Parents / Cerebral Palsy Checklist: Teens & Young Adults What's in this article? ...

Association of Lead Levels and Cerebral Palsy

Science.gov (United States)

Bansal, Neha; Aggarwal, Anju; Faridi, M. M. A.; Sharma, Tusha; Baneerjee, B. D.

2017-01-01

Background: Cerebral palsy is a common motor disability in childhood. Raised lead levels affect cognition. Children with cerebral palsy may have raised lead levels, further impairing their residual cognitive motor and behavioral abilities. Environmental exposure and abnormal eating habits may lead to increased lead levels. Aims and Objectives: To measure blood lead levels in children with cerebral palsy and compare them with healthy neurologically normal children. To correlate blood lead levels with environmental factors. Material and Methods: Design: Prospective case-control study. Setting: Tertiary care hospital. Participants: Cases comprised 34 children with cerebral palsy, and controls comprised 34 neurologically normal, age- and sex-matched children. Methods: Clinical and demographic details were recorded as per proforma. Detailed environmental history was recorded to know the source of exposure to lead. These children were investigated and treated as per protocol. Venous blood was collected in ethylenediaminetetraacetic acid vials for analysis of blood lead levels. Lead levels were estimated by Schimadzu Flame AA-6800 (atomic absorption spectrophotometer). Data were analyzed using SPSS version 17. P pica were 12.33 ± 10.02 µg/dL in comparison to children with no history of pica, 6.70 ± 4.60 µg/dL (P = .029). No correlation was found between hemoglobin and blood lead levels in cases and controls. Conclusion: In our study, blood lead levels are raised in children with cerebral palsy. However, further studies are required to show effects of raised levels in these children. PMID:28491920

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.

Bell's palsy: aetiology, clinical features and multidisciplinary care.

Science.gov (United States)

Eviston, Timothy J; Croxson, Glen R; Kennedy, Peter G E; Hadlock, Tessa; Krishnan, Arun V

2015-12-01

Bell's palsy is a common cranial neuropathy causing acute unilateral lower motor neuron facial paralysis. Immune, infective and ischaemic mechanisms are all potential contributors to the development of Bell's palsy, but the precise cause remains unclear. Advancements in the understanding of intra-axonal signal molecules and the molecular mechanisms underpinning Wallerian degeneration may further delineate its pathogenesis along with in vitro studies of virus-axon interactions. Recently published guidelines for the acute treatment of Bell's palsy advocate for steroid monotherapy, although controversy exists over whether combined corticosteroids and antivirals may possibly have a beneficial role in select cases of severe Bell's palsy. For those with longstanding sequaelae from incomplete recovery, aesthetic, functional (nasal patency, eye closure, speech and swallowing) and psychological considerations need to be addressed by the treating team. Increasingly, multidisciplinary collaboration between interested clinicians from a wide variety of subspecialties has proven effective. A patient centred approach utilising physiotherapy, targeted botulinum toxin injection and selective surgical intervention has reduced the burden of long-term disability in facial palsy. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

[Cranial nerve palsy caused by tumours of the head and neck

NARCIS (Netherlands)

Delsing, C.P.; Verbist, B.M.; Hoogen, F.J.A. van den

2013-01-01

Cranial nerve palsy is a diagnostic guiding symptom, but often goes unrecognized. The differential diagnosis includes a variety of diseases, including malignant tumours of the head and neck. Here we describe three cases of cranial nerve palsy. In two of the cases the palsy was recognized following

Botulinum toxin treatment for facial palsy: A systematic review.

Science.gov (United States)

Cooper, Lilli; Lui, Michael; Nduka, Charles

2017-06-01

Facial palsy may be complicated by ipsilateral synkinesis or contralateral hyperkinesis. Botulinum toxin is increasingly used in the management of facial palsy; however, the optimum dose, treatment interval, adjunct therapy and performance as compared with alternative treatments have not been well established. This study aimed to systematically review the evidence for the use of botulinum toxin in facial palsy. The Cochrane central register of controlled trials (CENTRAL), MEDLINE(R) (1946 to September 2015) and Embase Classic + Embase (1947 to September 2015) were searched for randomised studies using botulinum toxin in facial palsy. Forty-seven studies were identified, and three included. Their physical and patient-reported outcomes are described, and observations and cautions are discussed. Facial asymmetry has a strong correlation to subjective domains such as impairment in social interaction and perception of self-image and appearance. Botulinum toxin injections represent a minimally invasive technique that is helpful in restoring facial symmetry at rest and during movement in chronic, and potentially acute, facial palsy. Botulinum toxin in combination with physical therapy may be particularly helpful. Currently, there is a paucity of data; areas for further research are suggested. A strong body of evidence may allow botulinum toxin treatment to be nationally standardised and recommended in the management of facial palsy. Copyright © 2017 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Genomic analysis identifies masqueraders of full-term cerebral palsy.

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Takezawa, Yusuke; Kikuchi, Atsuo; Haginoya, Kazuhiro; Niihori, Tetsuya; Numata-Uematsu, Yurika; Inui, Takehiko; Yamamura-Suzuki, Saeko; Miyabayashi, Takuya; Anzai, Mai; Suzuki-Muromoto, Sato; Okubo, Yukimune; Endo, Wakaba; Togashi, Noriko; Kobayashi, Yasuko; Onuma, Akira; Funayama, Ryo; Shirota, Matsuyuki; Nakayama, Keiko; Aoki, Yoko; Kure, Shigeo

2018-05-01

Cerebral palsy is a common, heterogeneous neurodevelopmental disorder that causes movement and postural disabilities. Recent studies have suggested genetic diseases can be misdiagnosed as cerebral palsy. We hypothesized that two simple criteria, that is, full-term births and nonspecific brain MRI findings, are keys to extracting masqueraders among cerebral palsy cases due to the following: (1) preterm infants are susceptible to multiple environmental factors and therefore demonstrate an increased risk of cerebral palsy and (2) brain MRI assessment is essential for excluding environmental causes and other particular disorders. A total of 107 patients-all full-term births-without specific findings on brain MRI were identified among 897 patients diagnosed with cerebral palsy who were followed at our center. DNA samples were available for 17 of the 107 cases for trio whole-exome sequencing and array comparative genomic hybridization. We prioritized variants in genes known to be relevant in neurodevelopmental diseases and evaluated their pathogenicity according to the American College of Medical Genetics guidelines. Pathogenic/likely pathogenic candidate variants were identified in 9 of 17 cases (52.9%) within eight genes: CTNNB1 , CYP2U1 , SPAST , GNAO1 , CACNA1A , AMPD2 , STXBP1 , and SCN2A . Five identified variants had previously been reported. No pathogenic copy number variations were identified. The AMPD2 missense variant and the splice-site variants in CTNNB1 and AMPD2 were validated by in vitro functional experiments. The high rate of detecting causative genetic variants (52.9%) suggests that patients diagnosed with cerebral palsy in full-term births without specific MRI findings may include genetic diseases masquerading as cerebral palsy.

Are we there yet? Evaluating commercial grade brain-computer interface for control of computer applications by individuals with cerebral palsy.

Science.gov (United States)

Taherian, Sarvnaz; Selitskiy, Dmitry; Pau, James; Claire Davies, T

2017-02-01

Using a commercial electroencephalography (EEG)-based brain-computer interface (BCI), the training and testing protocol for six individuals with spastic quadriplegic cerebral palsy (GMFCS and MACS IV and V) was evaluated. A customised, gamified training paradigm was employed. Over three weeks, the participants spent two sessions exploring the system, and up to six sessions playing the game which focussed on EEG feedback of left and right arm motor imagery. The participants showed variable inconclusive results in the ability to produce two distinct EEG patterns. Participant performance was influenced by physical illness, motivation, fatigue and concentration. The results from this case study highlight the infancy of BCIs as a form of assistive technology for people with cerebral palsy. Existing commercial BCIs are not designed according to the needs of end-users. Implications for Rehabilitation Mood, fatigue, physical illness and motivation influence the usability of a brain-computer interface. Commercial brain-computer interfaces are not designed for practical assistive technology use for people with cerebral palsy. Practical brain-computer interface assistive technologies may need to be flexible to suit individual needs.

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. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Pediatric Cerebral Palsy in Africa: Where Are We?

Science.gov (United States)

Donald, Kirsten A; Kakooza, Angelina M; Wammanda, Robinson D; Mallewa, Macpherson; Samia, Pauline; Babakir, Haydar; Bearden, David; Majnemer, Annette; Fehlings, Darcy; Shevell, Michael; Chugani, Harry; Wilmshurst, Jo M

2015-07-01

Cerebral palsy is the most common cause of physical disability in children worldwide. However, little is reported on this condition in the African context. Doctors from 22 countries in Africa, and representatives from a further 5 countries outside Africa, met to discuss the challenges in the evaluation and management of children with cerebral palsy in Africa and to propose service needs and further research. Basic care is limited by the poor availability of diagnostic facilities or medical personnel with experience and expertise in managing cerebral palsy, exacerbated by lack of available interventions such as medications, surgical procedures, or even regular therapy input. Relevant guidelines are lacking. In order to guide services for children with existing disabilities, to effectively target the main etiologies and to develop preventive strategies for the continent, research priorities must include multicenter collaborative studies looking at the prevalence, risk factors, and treatment of cerebral palsy. © The Author(s) 2014.

Sharing Experience dan Resiliensi: Studi atas Facebook Group Orang Tua Anak Cerebral Palsy

Directory of Open Access Journals (Sweden)

Safrina Rofasita

2017-06-01

[Orang tua yang mendapati anaknya terfonis sebagai anak Cerebral Palsy mengalami kedukaan mendalam yang mengakibatkan ketidakpercayaan diri, dan putus asa. Hal itu diakibatkan ketahanan terhadap stres (resiliensi rendah, oleh karena itu orang tua mengikuti sharing experiences penyandang Cerebral Palsy melalui Facebook Group orang tua anak Cerebral Palsy. Penelitian ini bertujuan menjawab pertanyaan adakah pengaruh sharing experiences penyandang Cerebral Palsy terhadap resiliensi orang tua anak Cerebral Palsy yang terhimpun dalam Facebook Group Orang Tua Anak Cerebral Palsy. Penelitian menggunakan methode kombinasi antara kuantitatif dan kualitatif. Penelitian menemukan bahwa Facebook Group berpengaruh pada peningkatan resiliensi orang tua anak cerebal palcy karena mereka mendapatkan pengetahuan dan informasi tambahan dari forum itu.

Bilateral Bell palsy as a presenting sign of preeclampsia.

Science.gov (United States)

Vogell, Alison; Boelig, Rupsa C; Skora, Joanna; Baxter, Jason K

2014-08-01

Bell palsy is a facial nerve neuropathy that is a rare disorder but occurs at higher frequency in pregnancy. Almost 30% of cases are associated with preeclampsia or gestational hypertension. Bilateral Bell palsy occurs in only 0.3%-2.0% of cases of facial paralysis, has a poorer prognosis for recovery, and may be associated with a systemic disorder. We describe a case of a 24-year-old primigravid woman with a twin gestation at 35 weeks diagnosed initially with bilateral facial palsy and subsequently with preeclampsia. She then developed partial hemolysis, elevated liver enzymes, and low platelet count syndrome, prompting the diagnosis of severe preeclampsia, and was delivered. Bilateral facial palsy is a rare entity in pregnancy that may be the first sign of preeclampsia and suggests increased severity of disease, warranting close monitoring.

Cranial ultrasound findings in preterm infants predict the development of cerebral palsy

DEFF Research Database (Denmark)

Skovgaard, Ann Lawaetz; Zachariassen, Gitte

2017-01-01

record review. The cohort consisted of very preterm born children (gestational age ≤ 32 + 0) born from 2004 to 2008. For each infant, we obtained results from all cranial ultrasounds performed during hospitalisation. In 2014, patient records were evaluated for cerebral palsy, Gross Motor Function...... haemorrhagic infarction (PVHI), of whom two developed cerebral palsy. Nine children were diagnosed with periventricular leukomalacia (PVL), of whom six developed cerebral palsy. Cerebral palsy was detected in 14 children (6.4%), and one (0.5%) child was in need of a hearing assistive device. Severe brain...... injury (GMH-IVH3, PVHI or PVL) (p = 0.000) and being of male gender (p = 0.03) were associated with cerebral palsy in childhood. Conclusion: Severe brain injuries detected by neonatal cranial ultrasound in very preterm infants is associated with development of cerebral palsy in childhood....

Finger tapping analysis in patients with Parkinson's disease and atypical parkinsonism.

Science.gov (United States)

Djurić-Jovičić, Milica; Petrović, Igor; Ječmenica-Lukić, Milica; Radovanović, Saša; Dragašević-Mišković, Nataša; Belić, Minja; Miler-Jerković, Vera; Popović, Mirjana B; Kostić, Vladimir S

2016-08-01

The goal of this study was to investigate repetitive finger tapping patterns in patients with Parkinson's disease (PD), progressive supranuclear palsy-Richardson syndrome (PSP-R), or multiple system atrophy of parkinsonian type (MSA-P). The finger tapping performance was objectively assessed in PD (n=13), PSP-R (n=15), and MSA-P (n=14) patients and matched healthy controls (HC; n=14), using miniature inertial sensors positioned on the thumb and index finger, providing spatio-temporal kinematic parameters. The main finding was the lack or only minimal progressive reduction in amplitude during the finger tapping in PSP-R patients, similar to HC, but significantly different from the sequence effect (progressive decrement) in both PD and MSA-P patients. The mean negative amplitude slope of -0.12°/cycle revealed less progression of amplitude decrement even in comparison to HC (-0.21°/cycle, p=0.032), and particularly from PD (-0.56°/cycle, p=0.001), and MSA-P patients (-1.48°/cycle, p=0.003). No significant differences were found in the average finger separation amplitudes between PD, PSP-R and MSA-P patients (pmsa-pd=0.726, pmsa-psp=0.363, ppsp-pd=0.726). The lack of clinically significant sequence effect during finger tapping differentiated PSP-R from both PD and MSA-P patients, and might be specific for PSP-R. The finger tapping kinematic parameter of amplitude slope may be a neurophysiological marker able to differentiate particular forms of parkinsonism. Copyright © 2016 Elsevier Ltd. All rights reserved.

PSP toxin levels and plankton community composition and abundance in size-fractionated vertical profiles during spring/summer blooms of the toxic dinoflagellate Alexandrium fundyense in the Gulf of Maine and on Georges Bank, 2007, 2008, and 2010: 2. Plankton community composition and abundance.

Science.gov (United States)

Petitpas, Christian M; Turner, Jefferson T; Deeds, Jonathan R; Keafer, Bruce A; McGillicuddy, Dennis J; Milligan, Peter J; Shue, Vangie; White, Kevin D; Anderson, Donald M

2014-05-01

As part of the Gulf of Maine Toxicity (GOMTOX) project, we determined Alexandrium fundyense abundance, paralytic shellfish poisoning (PSP) toxin levels in various plankton size fractions, and the community composition of potential grazers of A. fundyense in plankton size fractions during blooms of this toxic dinoflagellate in the coastal Gulf of Maine and on Georges Bank in spring and summer of 2007, 2008, and 2010. PSP toxins and A. fundyense cells were found throughout the sampled water column (down to 50 m) in the 20-64 μm size fractions. While PSP toxins were widespread throughout all size classes of the zooplankton grazing community, the majority of the toxin was measured in the 20-64 μm size fraction. A. fundyense cellular toxin content estimated from field samples was significantly higher in the coastal Gulf of Maine than on Georges Bank. Most samples containing PSP toxins in the present study had diverse assemblages of grazers. However, some samples clearly suggested PSP toxin accumulation in several different grazer taxa including tintinnids, heterotrophic dinoflagellates of the genus Protoperidinium , barnacle nauplii, the harpacticoid copepod Microsetella norvegica , the calanoid copepods Calanus finmarchicus and Pseudocalanus spp., the marine cladoceran Evadne nordmanni , and hydroids of the genus Clytia . Thus, a diverse assemblage of zooplankton grazers accumulated PSP toxins through food-web interactions. This raises the question of whether PSP toxins pose a potential human health risk not only from nearshore bivalve shellfish, but also potentially from fish and other upper-level consumers in zooplankton-based pelagic food webs.

Localization of Basal Ganglia and Thalamic Damage in Dyskinetic Cerebral Palsy.

Science.gov (United States)

Aravamuthan, Bhooma R; Waugh, Jeff L

2016-01-01

Dyskinetic cerebral palsy affects 15%-20% of patients with cerebral palsy. Basal ganglia injury is associated with dyskinetic cerebral palsy, but the patterns of injury within the basal ganglia predisposing to dyskinetic cerebral palsy are unknown, making treatment difficult. For example, deep brain stimulation of the globus pallidus interna improves dystonia in only 40% of patients with dyskinetic cerebral palsy. Basal ganglia injury heterogeneity may explain this variability. To investigate this, we conducted a qualitative systematic review of basal ganglia and thalamic damage in dyskinetic cerebral palsy. Reviews and articles primarily addressing genetic or toxic causes of cerebral palsy were excluded yielding 22 studies (304 subjects). Thirteen studies specified the involved basal ganglia nuclei (subthalamic nucleus, caudate, putamen, globus pallidus, or lentiform nuclei, comprised by the putamen and globus pallidus). Studies investigating the lentiform nuclei (without distinguishing between the putamen and globus pallidus) showed that all subjects (19 of 19) had lentiform nuclei damage. Studies simultaneously but independently investigating the putamen and globus pallidus also showed that all subjects (35 of 35) had lentiform nuclei damage (i.e., putamen or globus pallidus damage); this was followed in frequency by damage to the putamen alone (70 of 101, 69%), the subthalamic nucleus (17 of 25, 68%), the thalamus (88 of 142, 62%), the globus pallidus (7/35, 20%), and the caudate (6 of 47, 13%). Globus pallidus damage was almost always coincident with putaminal damage. Noting consistent involvement of the lentiform nuclei in dyskinetic cerebral palsy, these results could suggest two groups of patients with dyskinetic cerebral palsy: those with putamen-predominant damage and those with panlenticular damage involving both the putamen and the globus pallidus. Differentiating between these groups could help predict response to therapies such as deep brain

Facial nerve palsy: Evaluation by contrast-enhanced MR imaging

International Nuclear Information System (INIS)

Kinoshita, T.; Ishii, K.; Okitsu, T.; Okudera, T.; Ogawa, T.

2001-01-01

AIM: The purpose of this study was to investigate the value of contrast-enhanced magnetic resonance (MR) imaging in patients with peripheral facial nerve palsy. MATERIALS AND METHODS: MR imaging was performed in 147 patients with facial nerve palsy, using a 1.0 T unit. All of 147 patients were evaluated by contrast-enhanced MR imaging and the pattern of enhancement was compared with that in 300 control subjects evaluated for suspected acoustic neurinoma. RESULTS: The intrameatal and labyrinthine segments of the normal facial nerve did not show enhancement, whereas enhancement of the distal intrameatal segment and the labyrinthine segment was respectively found in 67% and 43% of patients with Bell's palsy. The geniculate ganglion or the tympanic-mastoid segment was enhanced in 21% of normal controls versus 91% of patients with Bell's palsy. Abnormal enhancement of the non-paralyzed facial nerve was found in a patient with bilateral temporal bone fracture. CONCLUSION: Enhancement of the distal intrameatal and labyrinthine segments is specific for facial nerve palsy. Contrast-enhanced MR imaging can reveal inflammatory facial nerve lesions and traumatic nerve injury, including clinically silent damage in trauma. Kinoshita T. et al. (2001)

Facial nerve palsy: Evaluation by contrast-enhanced MR imaging

Energy Technology Data Exchange (ETDEWEB)

Kinoshita, T.; Ishii, K.; Okitsu, T.; Okudera, T.; Ogawa, T

2001-11-01

AIM: The purpose of this study was to investigate the value of contrast-enhanced magnetic resonance (MR) imaging in patients with peripheral facial nerve palsy. MATERIALS AND METHODS: MR imaging was performed in 147 patients with facial nerve palsy, using a 1.0 T unit. All of 147 patients were evaluated by contrast-enhanced MR imaging and the pattern of enhancement was compared with that in 300 control subjects evaluated for suspected acoustic neurinoma. RESULTS: The intrameatal and labyrinthine segments of the normal facial nerve did not show enhancement, whereas enhancement of the distal intrameatal segment and the labyrinthine segment was respectively found in 67% and 43% of patients with Bell's palsy. The geniculate ganglion or the tympanic-mastoid segment was enhanced in 21% of normal controls versus 91% of patients with Bell's palsy. Abnormal enhancement of the non-paralyzed facial nerve was found in a patient with bilateral temporal bone fracture. CONCLUSION: Enhancement of the distal intrameatal and labyrinthine segments is specific for facial nerve palsy. Contrast-enhanced MR imaging can reveal inflammatory facial nerve lesions and traumatic nerve injury, including clinically silent damage in trauma. Kinoshita T. et al. (2001)

Cerebral Palsy. Fact Sheet = La Paralisis Cerebral. Hojas Informativas Sobre Discapacidades.

Science.gov (United States)

National Information Center for Children and Youth with Disabilities, Washington, DC.

This fact sheet on cerebral palsy is written in both English and Spanish. First, it provides a definition of cerebral palsy and considers various causes (e.g., an insufficient amount of oxygen reaching the fetal or newborn brain). The fact sheet then offers incidence figures and explains characteristics of the three main types of cerebral palsy:…

Bell's palsy: excluding serious illness in urgent and emergency care settings.

Science.gov (United States)

Mower, Sean

2017-04-13

Bell's palsy is a relatively benign condition that affects about 20 in every 100,000 patients a year, and in most cases the signs and symptoms resolve fully within around six months. The defining characteristic of the condition is a unilateral facial palsy, but this is also apparent in other conditions with a more serious prognosis, including strokes, some viral infections and tumours. This article reviews the literature on recognition of Bell's palsy, examines the underlying pathology, and compares it with other conditions associated with facial palsy. The article critically analyses the evidence and guidelines to identify best practice, and considers areas for improvement. Finally, it discusses how this information can be incorporated into practice, and provides guidance for clinicians on differentiating between conditions in which patients present with facial palsy to ensure they are managed appropriately.

Cerebral palsy litigation: change course or abandon ship.

Science.gov (United States)

Sartwelle, Thomas P; Johnston, James C

2015-06-01

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 mothers and babies alike. This article explains why electronic fetal monitoring remains endorsed as efficacious in the worlds' labor rooms and courtrooms despite being such a feeble medical modality. It also reviews the reasons professional organizations have failed to condemn the use of electronic fetal monitoring in courtrooms. The failures of tort reform, special cerebral palsy courts, and damage limits to stem the escalating litigation are discussed. Finally, the authors propose using a currently available evidence rule-the Daubert doctrine that excludes "junk science" from the courtroom-as the beginning of the end to cerebral palsy litigation and electronic fetal monitoring's 40-year masquerade as science. © The Author(s) 2014.

Bell's Palsy (For Kids)

Science.gov (United States)

... palsy was named after a Scottish doctor, Sir Charles Bell, who studied the two facial nerves that ... who focuses on how the nervous system works — will do a test called electromyography (say: eh-lek- ...

Tinjauan Anatomi Klinik dan Manajemen Bell's Palsy

Directory of Open Access Journals (Sweden)

Nur Mujaddidah

2017-07-01

Full Text Available Bell's Palsy is a peripheral facial nerve weakness (facial nerve with acute onset on one side of the face. This condition causes the inability of the patient to move half of his face consciously (volunter on the affected side. The Bell's Palsy incidence is 20-30 cases out of 100.000 people and accounts for 60-70% of all cases of unilateral facial paralysis. The disease is self-limited, but causes great suffering for patients who are not treated properly. Controversy in the management is still debated, and the cause is still unknown. The underlying hypothesis is ischemic, vascular, viral, bacterial, hereditary, and immunologic. Therapy done so far is to improve facial nerve function and healing process. The management of the therapy used will be closely related to the structure of the anatomy and its functions and associated abnormalities. The modalities of Bell's Palsy therapy are with corticosteroids and antivirals, facial exercises, electrostimulation, physiotherapy and decompression operations. Approximately 80-90% of patients with Bell's palsy recover completely within 6 months, even in 50-60% of cases improved within 3 weeks. Approximately 10% experienced persistent facial muscle asymmetry, and 5% experienced severe sequelae, and 8% of cases were recurrent.

The putative thiosulfate sulfurtransferases PspE and GlpE contribute to virulence of Salmonella Typhimurium in the mouse model of systemic disease

DEFF Research Database (Denmark)

Wallrodt, Inke; Jelsbak, Lotte; Thorndahl, Lotte

2013-01-01

contribute to S. Typhimurium virulence, as a glpE and pspE double deletion strain showed significantly decreased virulence in a mouse model of systemic infection. However, challenge of cultured epithelial cells and macrophages did not reveal any virulence-associated phenotypes. We hypothesized...

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.

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

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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.

Intraneural metastasis of gastric carcinoma leads to sciatic nerve palsy

International Nuclear Information System (INIS)

Ichikawa, Jiro; Matsumoto, Seiichi; Shimoji, Takashi; Tanizawa, Taisuke; Gokita, Tabu; Hayakawa, Keiko; Aoki, Kaoru; Ina, Saori; Kanda, Hiroaki

2012-01-01

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. 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. 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

Association between type of cerebral palsy and the cognitive levels

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Ratna Dewi Kusumaningrum

2009-07-01

Conclusion Our data showed that most patients with cerebral palsy had mental retardation of several cognitive level but there was no significant association between each type of cerebral palsy with cognitive levels.

CT findings of cerebral palsy and behaviour development

International Nuclear Information System (INIS)

Sakamoto, Zenji

1987-01-01

It is well recognized that CT scan is very useful in the early diagnosis of cerebral palsy. The author has studied this time the CT scan findings of cerebral palsy children in their relations to the type of palsy, cause of palsy, complications in the central nervous system, and prognosis of behaviour development, in order to predict the prognosis of behaviour development. Dilatation of the contralateral cerebral ventricle was found in 82 % of hemiplegic type. Abnormal EEG was found in 73 %, but their behaviour development was satisfactory, with good development of speech regardless to the side of palsy. This might be helped by compensational function of the brain due to plasticity. Diplegia presented bilateral moderate dilatation of ventricles with favorable prognosis. Tetraplegia was caused mostly by asphyxia or congenital anomaly and revealed marked dilatation of ventricles or severe cortical atrophy. Some cases presented diffuse cortical low-density, often associated with abnormal EEG, and their prognosis was worst. Athetosis had normal CT finding or mild ventricular dilatation, but all cases of ataxia presented normal CT findings. Hypotonia had mild ventricular dilatation. Two of three mixed type cases had normal CT findings and another had mild ventricular dilatation. No correlation was found between ventricular dilatation and behaviour development, but statistically significant difference was found in the cases with 30 % or more Evans' ratio (P < 0.05). Prognosis of severe ventricular dilatation cases was poor. (author)

[Isolated palsy of the hypoglossal nerve complicating infectious mononucleosis].

Science.gov (United States)

Carra-Dallière, C; Mernes, R; Juntas-Morales, R

2011-01-01

Neurological complications of infectious mononucleosis are rare. Various disorders have been described: meningitis, encephalitis, peripheral neuropathy. Isolated cranial nerve palsy has rarely been reported. A 16-year-old man was admitted for isolated and unilateral hypoglossal nerve palsy, four weeks after infectious mononucleosis. Cerebral MRI, cerebrospinal fluid study and electromyography were normal. IgM anti-VCA were positive. Two months later, without treatment, the tongue had almost fully recovered. To the best of our knowledge, only seven cases of isolated palsy of the hypoglossal nerve complicating infectious mononucleosis have been previously reported. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

Effect of a new physiotherapy concept on bone mineral density, muscle force and gross motor function in children with bilateral cerebral palsy.

Science.gov (United States)

Stark, C; Nikopoulou-Smyrni, P; Stabrey, A; Semler, O; Schoenau, E

2010-06-01

The purpose of this study was to determine the effect of a new physiotherapy concept on bone density, muscle force and motor function in bilateral spastic cerebral palsy children. In a retrospective data analysis 78 children were analysed. The concept included whole body vibration, physiotherapy, resistance training and treadmill training. The concept is structured in two in-patient stays and two periods of three months home-based vibration training. Outcome measures were dual-energy x-ray absorption (DXA), Leonardo Tilt Table and a modified Gross Motor Function Measure before and after six months of training. Percent changes were highly significant for bone mineral density, -content, muscle mass and significant for angle of verticalisation, muscle force and modified Gross Motor Function Measure after six months training. The new physiotherapy concept had a significant effect on bone mineral density, muscle force and gross motor function in bilateral spastic cerebral palsy children. This implicates an amelioration in all International Classification of Functioning, Disability and Health levels. The study serves as a basis for future research on evidence based paediatric physiotherapy taking into account developmental implications.

Increasing rates of cerebral palsy across the severity spectrum in north-east England 1964-1993. The North of England Collaborative Cerebral Palsy Survey.

Science.gov (United States)

Colver, A F; Gibson, M; Hey, E N; Jarvis, S N; Mackie, P C; Richmond, S

2000-07-01

To report epidemiological trends in cerebral palsy including analyses by severity. Descriptive longitudinal study in north-east England. Every child with suspected cerebral palsy was examined by a developmental paediatrician to confirm the diagnosis. Severity of impact of disability was derived from a parent completed questionnaire already developed and validated for this purpose. All children with cerebral palsy, not associated with any known postneonatal insult, born 1964-1993 to mothers resident at the time of birth in the study area. Cerebral palsy rates by year, birth weight, and severity. Severity of 30% and above defines the more reliably ascertained cases; children who died before assessment at around 6 years of age are included in the most severe group (70% and above). 584 cases of cerebral palsy were ascertained, yielding a rate that rose from 1.68 per 1000 neonatal survivors during 1964-1968 to 2.45 during 1989-1993 (rise = 0.77; 95% confidence interval 0.2-1.3). For the more reliably ascertained cases there was a twofold increase in rate from 0.98 to 1.96 (rise = 0.98; 95% confidence interval 0.5-1.4). By birth weight, increases in rates were from 29.8 to 74.2 per 1000 neonatal survivors rate of cerebral palsy has risen in spite of falling perinatal and neonatal mortality rates, a rise that is even more pronounced when the mildest and least reliably ascertained are excluded. The effect of modern care seems to be that many babies rates, and to monitor changes in the distribution of severity.

Nongoitrous autoimmune thyroiditis with facial palsy

Directory of Open Access Journals (Sweden)

Hyung Jik Lee

2013-12-01

Full Text Available We report a case of severe hypothyroidism with nongoitrous, autoimmune thyroiditis and pituitary hyperplasia in a 13-year-old boy, who presented with sudden palsy on the left side of his face. Prednisolone and antiviral medication was administered. However, the facial palsy did not improve completely. The medications were replaced with thyroxine, and the facial palsy recovered. Endocrinological testing showed severe hypothyroidism as follows: thyroid stimulating hormone (TSH level >100 µIU/mL, T4 of 1.04 µg/dL, T3 of 0.31 ng/mL, and free T4 of 0.07 ng/dL. Level of serum antithyroid peroxidase antibodies was 1,933.39 IU/mL, and that of antithyroglobulin antibodies was 848.16 IU/mL. Level of TSH receptor antibodies was >40 IU/L. Bioassay result for TSH receptor stimulating antibodies was negative. Thyroid sonography revealed no increase in the size or vascularity of the bilateral gland. Thyroid scintigraphy with 99mTc showed decreased uptake, and magnetic resonance imaging demonstrated an enlarged pituitary gland.

Hypopituitarism in children with cerebral palsy.

Science.gov (United States)

Uday, Suma; Shaw, Nick; Krone, Ruth; Kirk, Jeremy

2017-06-01

Poor growth and delayed puberty in children with cerebral palsy is frequently felt to be related to malnutrition. Although growth hormone deficiency is commonly described in these children, multiple pituitary hormone deficiency (MPHD) has not been previously reported. We present a series of four children with cerebral palsy who were born before 29 weeks gestation who were referred to the regional endocrinology service, three for delayed puberty and one for short stature, in whom investigations identified MPHD. All patients had a height well below -2 standard deviation score (2nd centile) at presentation and three who had MRI scans had an ectopic posterior pituitary gland. We therefore recommend that the possibility of MPHD should be considered in all children with cerebral palsy and poor growth or delayed puberty. Early diagnosis and treatment is essential to maximise growth and prevent associated morbidity and mortality. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Health-related physical fitness for children with cerebral palsy

Science.gov (United States)

Maltais, Désirée B.; Wiart, Lesley; Fowler, Eileen; Verschuren, Olaf; Damiano, Diane L.

2014-01-01

Low levels of physical activity are a global health concern for all children. Children with cerebral palsy have even lower physical activity levels than their typically developing peers. Low levels of physical activity, and thus an increased risk for related chronic diseases, are associated with deficits in health-related physical fitness. Recent research has provided therapists with the resources to effectively perform physical fitness testing and physical activity training in clinical settings with children who have cerebral palsy, although most testing and training data to date pertains to those who walk. Nevertheless, based on the present evidence, all children with cerebral palsy should engage, to the extent they are able, in aerobic, anaerobic and muscle strengthening activities. Future research is required to determine the best ways to evaluate health-related physical fitness in non-ambulatory children with cerebral palsy and foster long-term changes in physical activity behavior in all children with this condition. PMID:24820339

Bladder and Bowel Control in Children with Cerebral Palsy: Case-Control Study

Science.gov (United States)

Ozturk, Mustafa; Oktem, Faruk; Kisioglu, Nesimi; Demirci, Mustafa; Altuntas, Irfan; Kutluhan, Suleyman; Dogan, Malik

2006-01-01

Aim To determine the age of development of bladder and bowel control and the frequency of enuresis, encopresis, and urinary infections in children with cerebral palsy. Methods The study included 45 children with cerebral palsy who regularly attended a rehabilitation center in Isparta, Turkey, and two groups of age- and sex-matched children, 37 siblings of the children with cerebral palsy and 37 healthy children. Demographic data and information on the age of development of total bladder and bowel control and presence of possible urinary symptoms in children were collected from their caregivers by use of a questionnaire. Frequency of enuresis and encopresis was estimated among the children aged ≥5 years. A mid-way urinary sample was obtained from 40, 22, and 21 children in the cerebral palsy, siblings, and healthy children, respectively. Results The mean age of nighttime bladder and bowel control development was 47 months (95% confidence interval [CI], 35-58) and 45 (36-55) months, respectively, for the children with cerebral palsy, 35 months (95% CI, 24-46) and 26 months (95% CI, 24-28), respectively, for their siblings, and 27 months (95% CI, 22-33) and 25 months (95% CI, 23-27) months, respectively, for the healthy children. Among the children aged ≥5 years, enuresis was present in 11 of 34 children with cerebral palsy, 7 of 30 siblings, and 4 of 30 healthy children (P = 0.200), whereas encopresis was present in 5 children with cerebral palsy, one sibling, and one healthy child. Constipation was significantly more present in chidlren with cerebral palsy than in other two groups (P<0.001). Urine culture was positive in 13 children with cerebral palsy, 1 sibling, and 2 healthy chidlren (P = 0.024). There were no significant differences in other urinary symptoms and laboratory findings among the three groups. Conclusion The children with cerebral palsy gained bladder and bowel control at older age in comparison with their siblings and healthy children

Storytelling: Enhancing Vocabularies For Cerebral Palsy Students

OpenAIRE

Aprilina, Raita Gina

2015-01-01

This paper reported on a study concerned with teaching vocabulary using storytelling technique in one of SLBs in Bandung. This study aimed to find out the cerebral palsy students' ability in English vocabulary before and after the treatment, and to find out whether storytelling significantly improved English vocabulary of students with cerebral palsy. This study used an experimental method with single subject research with A-B-A design which involved two participants. This study revealed that...

Peripheral facial weakness (Bell's palsy).

Science.gov (United States)

Basić-Kes, Vanja; Dobrota, Vesna Dermanović; Cesarik, Marijan; Matovina, Lucija Zadro; Madzar, Zrinko; Zavoreo, Iris; Demarin, Vida

2013-06-01

Peripheral facial weakness is a facial nerve damage that results in muscle weakness on one side of the face. It may be idiopathic (Bell's palsy) or may have a detectable cause. Almost 80% of peripheral facial weakness cases are primary and the rest of them are secondary. The most frequent causes of secondary peripheral facial weakness are systemic viral infections, trauma, surgery, diabetes, local infections, tumor, immune disorders, drugs, degenerative diseases of the central nervous system, etc. The diagnosis relies upon the presence of typical signs and symptoms, blood chemistry tests, cerebrospinal fluid investigations, nerve conduction studies and neuroimaging methods (cerebral MRI, x-ray of the skull and mastoid). Treatment of secondary peripheral facial weakness is based on therapy for the underlying disorder, unlike the treatment of Bell's palsy that is controversial due to the lack of large, randomized, controlled, prospective studies. There are some indications that steroids or antiviral agents are beneficial but there are also studies that show no beneficial effect. Additional treatments include eye protection, physiotherapy, acupuncture, botulinum toxin, or surgery. Bell's palsy has a benign prognosis with complete recovery in about 80% of patients, 15% experience some mode of permanent nerve damage and severe consequences remain in 5% of patients.

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

The Clinical Study about Honilirls Placenta Herbal Acupuncture on Bell's Palsy

Directory of Open Access Journals (Sweden)

Lee Chae-Woo

2005-12-01

Full Text Available Objectives : This study has been designed and performed to identify the effect on Bell's palsy according to the injection of herbal medicine induced from the Hominis Placenta. Methods : We measured the facial palsy changes of the patients who were admitted for Bell's palsy in the Oriental Medical hospital of Dongeui medical center from 03-01-2004 to 07-31-2004. Bell's palsy patients were divided into two groups. One group(A group was injected with Hominis Placenta herbal acupuncture. The other group(B group was injected with normal saline. Then effects of these treatment was evaluated by Yanagihara's unweighted grading system. Results : A group was marked more higher than B group in treatment outcome. we discovered that it is significant differences between two groups after 4 week. Conclusions : These results provided that A group is more effective than B group. For clearly proving the effect of Hominis Placenta herbal acupuncture on Bell's palsy, it is need more sample's number and more treatment's duration.

ocular findings in children with cerebral palsy attending a tertiary

African Journals Online (AJOL)

ocular abnormalities among children with cerebral palsy that attended the neurology clinic of University of. Ilorin Teaching ... recognize faces or hand-held toys (Chen, Weinberg and Catalano ... palsy that is also blind/visually impaired pose a.

Pain symptoms in patients with severe cerebral palsy: Prevalence ...

African Journals Online (AJOL)

Purpose: To evaluate the presence of pain in patients diagnosed with severe cerebral palsy (CP) according to the degree of motor function impairment. Methods: A cross-sectional study was conducted on students of the Association of Parents and Friends of Exceptional Children (APAE) diagnosed with cerebral palsy and ...

Enhanced MRI in patients with facial palsy; Study of time-related enhancement

Energy Technology Data Exchange (ETDEWEB)

Yanagida, Masahiro; Kato, Tsutomu; Ushiro, Koichi; Kitajiri, Masanori; Yamashita, Toshio; Kumazawa, Tadami; Tanaka, Yoshimasa (Kansai Medical School, Moriguchi, Osaka (Japan))

1991-03-01

We performed Gd-DTPA-enhanced magnetic resonance imaging (MRI) examinations at several stages in 40 patients with peripheral facial nerve palsy (Bell's palsy and Ramsay-Hunt syndrome). In 38 of the 40 patients, one and more enhanced region could be seen in certain portion of the facial nerve in the temporal bone on the affected side, whereas no enhanced regions were seen on the intact side. Correlations between the timing of the MRI examination and the location of the enhanced regions were analysed. In all 6 patients examined by MRI within 5 days after the onset of facial nerve palsy, enhanced regions were present in the meatal portion. In 3 of the 8 patients (38%) examined by MRI 6 to 10 days after the onset of facial palsy, enhanced areas were seen in both the meatal and labyrinthine portions. In 8 of the 9 patients (89%) tested 11 to 20 days after the onset of palsy, the vertical portion was enhanced. In the 12 patients examined by MRI 21 to 40 days after the onset of facial nerve palsy, the meatal portion was not enhanced while the labyrinthine portion, the horizontal portion and the vertical portion were enhanced in 5 (42%), 8 (67%) and 11 (92%), respectively. Enhancement in the vertical portion was observed in all 5 patients examined more than 41 days after the onset of facial palsy. These results suggest that the central portion of the facial nerve in the temporal bone tends to be enhanced in the early stage of facial nerve palsy, while the peripheral portion is enhanced in the late stage. These changes of Gd-DTPA enhanced regions in the facial nerve may suggest dromic degeneration of the facial nerve in peripheral facial nerve palsy. (author).

The Association Between Maternal Age and Cerebral Palsy Risk Factors.

Science.gov (United States)

Schneider, Rilla E; Ng, Pamela; Zhang, Xun; Andersen, John; Buckley, David; Fehlings, Darcy; Kirton, Adam; Wood, Ellen; van Rensburg, Esias; Shevell, Michael I; Oskoui, Maryam

2018-05-01

Advanced maternal age is associated with higher frequencies of antenatal and perinatal conditions, as well as a higher risk of cerebral palsy in offspring. We explore the association between maternal age and specific cerebral palsy risk factors. Data were extracted from the Canadian Cerebral Palsy Registry. Maternal age was categorized as ≥35 years of age and less than 20 years of age at the time of birth. Chi-square and multivariate logistic regressions were performed to calculate odds ratios and their 95% confidence intervals. The final sample consisted of 1391 children with cerebral palsy, with 19% of children having mothers aged 35 or older and 4% of children having mothers below the age of 20. Univariate analyses showed that mothers aged 35 or older were more likely to have gestational diabetes (odds ratio 1.9, 95% confidence interval 1.3 to 2.8), to have a history of miscarriage (odds ratio 1.8, 95% confidence interval 1.3 to 2.4), to have undergone fertility treatments (odds ratio 2.4, 95% confidence interval 1.5 to 3.9), and to have delivered by Caesarean section (odds ratio 1.6, 95% confidence interval 1.2 to 2.2). These findings were supported by multivariate analyses. Children with mothers below the age of 20 were more likely to have a congenital malformation (odds ratio 2.4, 95% confidence interval 1.4 to 4.2), which is also supported by multivariate analysis. The risk factor profiles of children with cerebral palsy vary by maternal age. Future studies are warranted to further our understanding of the compound causal pathways leading to cerebral palsy and the observed greater prevalence of cerebral palsy with increasing maternal age. Copyright © 2018 Elsevier Inc. All rights reserved.

Quality of Arithmetic Education for Children with Cerebral Palsy

Science.gov (United States)

Jenks, Kathleen M.; de Moor, Jan; van Lieshout, Ernest C. D. M.; Withagen, Floortje

2010-01-01

The aim of this exploratory study was to investigate the quality of arithmetic education for children with cerebral palsy. The use of individual educational plans, amount of arithmetic instruction time, arithmetic instructional grouping, and type of arithmetic teaching method were explored in three groups: children with cerebral palsy (CP) in…

De novo point mutations in patients diagnosed with ataxic cerebral palsy.

Science.gov (United States)

Parolin Schnekenberg, Ricardo; Perkins, Emma M; Miller, Jack W; Davies, Wayne I L; D'Adamo, Maria Cristina; Pessia, Mauro; Fawcett, Katherine A; Sims, David; Gillard, Elodie; Hudspith, Karl; Skehel, Paul; Williams, Jonathan; O'Regan, Mary; Jayawant, Sandeep; Jefferson, Rosalind; Hughes, Sarah; Lustenberger, Andrea; Ragoussis, Jiannis; Jackson, Mandy; Tucker, Stephen J; Németh, Andrea H

2015-07-01

Cerebral palsy is a sporadic disorder with multiple likely aetiologies, but frequently considered to be caused by birth asphyxia. Genetic investigations are rarely performed in patients with cerebral palsy and there is little proven evidence of genetic causes. As part of a large project investigating children with ataxia, we identified four patients in our cohort with a diagnosis of ataxic cerebral palsy. They were investigated using either targeted next generation sequencing or trio-based exome sequencing and were found to have mutations in three different genes, KCNC3, ITPR1 and SPTBN2. All the mutations were de novo and associated with increased paternal age. The mutations were shown to be pathogenic using a combination of bioinformatics analysis and in vitro model systems. This work is the first to report that the ataxic subtype of cerebral palsy can be caused by de novo dominant point mutations, which explains the sporadic nature of these cases. We conclude that at least some subtypes of cerebral palsy may be caused by de novo genetic mutations and patients with a clinical diagnosis of cerebral palsy should be genetically investigated before causation is ascribed to perinatal asphyxia or other aetiologies. © The Author (2015). Published by Oxford University Press on behalf of the Guarantors of Brain.

Perfusion SPECT studies with mapping of Brodmann areas in differentiating Alzheimer's disease from frontotemporal degeneration syndromes.

Science.gov (United States)

Valotassiou, Varvara; Papatriantafyllou, John; Sifakis, Nikolaos; Tzavara, Chara; Tsougos, Ioannis; Kapsalaki, Eftychia; Hadjigeorgiou, George; Georgoulias, Panagiotis

2012-12-01

The aim of this study was to evaluate the contribution of brain perfusion single-photon emission computed tomography (SPECT) studies with mapping of Brodmann areas (BAs) in the differential diagnosis between Alzheimer's disease (AD) and frontotemporal degeneration (FTLD) syndromes. Thirty-nine patients with AD and 73 patients with FTLD syndromes [behavioural variant FTLD (bvFTLD); language variant FTLD (lvFTLD), including semantic dementia (SD) and progressive nonfluent aphasia (PNFA); and corticobasal degeneration (CBD)/progressive supranuclear palsy (PSP) syndromes] underwent brain perfusion SPECT. The NeuroGam software was used for the semiquantitative evaluation of perfusion in BAs of the left (L) and right (R) hemispheres. Compared with those in AD patients, BAs with statistically significant hypoperfusion were found in the prefrontal, orbitofrontal and cingulated cortices and Broca's areas of FTLD and bvFTLD patients; in the temporal and prefrontal cortices and Broca's areas of lvFTLD patients; in the left temporal gyrus of SD patients; in premotor and supplementary motor, prefrontal, orbitofrontal, temporal and anterior cingulated cortices and Broca's areas of PNFA patients; and in the prefrontal, temporal, posterior cingulated and primary and secondary visual cortices of CBD/PSP patients. BA 46R could differentiate AD patients from FTLD and bvFTLD patients; 21L and 25L were found to be independent predictors for lvFTLD in comparison with AD, and 25R, 21L and 23R could differentiate AD patients from PNFA, SD and CBD/PSP patients, respectively. Brain perfusion SPECT with BA mapping in AD and FTLD patients could improve the definition of brain areas that are specifically implicated in these disorders, resulting in a more accurate differential diagnosis.

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.

Increased risk of peripheral arterial occlusive disease in patients with Bell's palsy using population data.

Directory of Open Access Journals (Sweden)

Li-Syue Liou

Full Text Available This population-based cohort study investigated the risk of developing peripheral arterial occlusive disease (PAOD in patients with Bell's palsy.We used longitudinal claims data of health insurance of Taiwan to identify 5,152 patients with Bell's palsy newly diagnosed in 2000-2010 and a control cohort of 20,608 patients without Bell's palsy matched by propensity score. Incidence and hazard ratio (HR of PAOD were assessed by the end of 2013.The incidence of PAOD was approximately 1.5 times greater in the Bell's palsy group than in the non-Bell's palsy controls (7.75 vs. 4.99 per 1000 person-years. The Cox proportional hazards regression analysis measured adjusted HR was 1.54 (95% confidence interval (CI = 1.35-1.76 for the Bell's palsy group compared to the non-Bell's palsy group, after adjusting for sex, age, occupation, income and comorbidities. Men were at higher risk of PAOD than women in the Bell's palsy group, but not in the controls. The incidence of PAOD increased with age in both groups, but the Bell's palsy group to control group HR of PAOD decreased as age increased. The systemic steroid treatment reduced 13% of PAOD hazard for Bell's palsy patients, compared to those without the treatment, but not significant.Bell's palsy appears to be associated with an increased risk of developing PAOD. Further pathophysiologic, histopathology and immunologic research is required to explore the underlying biologic mechanism.

Risk Factors for Malnutrition Among Children With Cerebral Palsy in Botswana.

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Johnson, Allison; Gambrah-Sampaney, Claudia; Khurana, Esha; Baier, James; Baranov, Esther; Monokwane, Baphaleng; Bearden, David R

2017-05-01

Children with cerebral palsy in low-resource settings are at high risk of malnutrition, which further increases their risk of poor health outcomes. However, there are few available data on specific risk factors for malnutrition among children with cerebral palsy in the developing world. We performed a case-control study among children with cerebral palsy receiving care at a tertiary care hospital in Gaborone, Botswana. Children with cerebral palsy and malnutrition were identified according to World Health Organization growth curves and compared with subjects with cerebral palsy without malnutrition. Risk factors for malnutrition were identified using multivariable logistic regression models. These risk factors were then used to generate a Malnutrition Risk Score, and Receiver Operating Characteristic curves were used to identify optimal cutoffs to identify subjects at high risk of malnutrition. We identified 61 children with cerebral palsy, 26 of whom (43%) met criteria for malnutrition. Nonambulatory status (odds ratio 13.8, 95% confidence interval [CI] 3.8-50.1, P malnutrition. A Malnutrition Risk Score was constructed based on these risk factors, and receiver operating characteristic curve analysis demonstrated excellent performance characteristics of this score (area under the curve 0.92, 95% CI 0.89-0.94). Malnutrition is common among children with cerebral palsy in Botswana, and a simple risk score may help identify children with the highest risk. Further studies are needed to validate this screening tool and to determine optimal nutritional interventions in this population. Copyright © 2017 Elsevier Inc. All rights reserved.

The applause sign and neuropsychological profile in progressive supranuclear palsy and Parkinson's disease.

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Somme, Johanne; Gómez-Esteban, Juan Carlos; Tijero, Beatriz; Berganzo, Koldo; Lezcano, Elena; Zarranz, Juan Jose

2013-08-01

The applause sign has been associated with various neurodegenerative diseases. We investigate its validity in the differential diagnosis of progressive supranuclear palsy and Parkinson's disease, and its relationship with neuropsychological tests. 23 patients with progressive supranuclear palsy and 106 patients with Parkinson's disease were included and administered the following scales: progressive supranuclear palsy rating scale, unified Parkinson's disease rating scale (UPDRS), mini-mental state examination (MMSE), frontal assessment battery (FAB), neuropsychiatric inventory and three-clap test. 73.9% with progressive supranuclear palsy and 21.7% with Parkinson's disease showed a positive applause sign. Only a positive applause sign, UPDRS II score and disease duration were found to be predictors of progressive supranuclear palsy. Both patient-groups showed statistically significant correlations between the applause sign and neuropsychological tests: in progressive supranuclear palsy patients MMSE correlation coefficient: 0.62 (p: 0.002) and FAB correlation coefficient: 0.48 (p: 0.02), and in Parkinson's disease patients MMSE correlation coefficient: 0.47 (pspecific to progressive supranuclear palsy and may also be observed in Parkinson's disease patients with altered cognition, and it's related to cortical frontal abnormalities such as language disorders and inhibitory control. Copyright © 2012 Elsevier B.V. All rights reserved.

Diagnosis and management of patients with Bell's palsy.

Science.gov (United States)

Mooney, Tracy

Bell's palsy (idiopathic facial paralysis) is the most common cause of acute unilateral facial nerve paralysis. Although it is usually a self-limiting condition, it can be distressing for the patient. Many people who experience one-sided facial paralysis fear that it is a symptom of stroke. However, there are subtle differences between Bell's palsy and stroke. This article discusses potential causes of the condition and identifies the differences between Bell's palsy and stroke. In addition, appropriate strategies for the care of patients with the condition are suggested. Management includes antiviral medication, corticosteroid therapy, eye care, botulinum toxin type A injection, physiotherapy, surgery and acupuncture. Psychological and emotional care of these patients is also important because any facial disability caused by facial nerve paralysis can result in anxiety and stress.

The neuropathology of hereditary congenital facial palsy vs Mobius syndrome.

NARCIS (Netherlands)

Verzijl, H.T.F.M.; Zwaag, B. van der; Lammens, M.M.Y.; Donkelaar, H.J. ten; Padberg, G.W.A.M.

2005-01-01

OBJECTIVE: To characterize the neuropathology of hereditary congenital facial palsy. METHODS: The authors compared brainstem pathology of three members of one family with autosomal dominant congenital facial palsy to that in three age-matched controls. The neuropathologic findings of the familial

The First Experience of Triple Nerve Transfer in Proximal Radial Nerve Palsy.

Science.gov (United States)

Emamhadi, Mohammadreza; Andalib, Sasan

2018-01-01

Injury to distal portion of posterior cord of brachial plexus leads to palsy of radial and axillary nerves. Symptoms are usually motor deficits of the deltoid muscle; triceps brachii muscle; and extensor muscles of the wrist, thumb, and fingers. Tendon transfers, nerve grafts, and nerve transfers are options for surgical treatment of proximal radial nerve palsy to restore some motor functions. Tendon transfer is painful, requires a long immobilization, and decreases donor muscle strength; nevertheless, nerve transfer produces promising outcomes. We present a patient with proximal radial nerve palsy following a blunt injury undergoing triple nerve transfer. The patient was involved in a motorcycle accident with complete palsy of the radial and axillary nerves. After 6 months, on admission, he showed spontaneous recovery of axillary nerve palsy, but radial nerve palsy remained. We performed triple nerve transfer, fascicle of ulnar nerve to long head of the triceps branch of radial nerve, flexor digitorum superficialis branch of median nerve to extensor carpi radialis brevis branch of radial nerve, and flexor carpi radialis branch of median nerve to posterior interosseous nerve, for restoration of elbow, wrist, and finger extensions, respectively. Our experience confirmed functional elbow, wrist, and finger extensions in the patient. Triple nerve transfer restores functions of the upper limb in patients with debilitating radial nerve palsy after blunt injuries. Copyright © 2017 Elsevier Inc. All rights reserved.

The asymmetric facial skin perfusion distribution of Bell's palsy discovered by laser speckle imaging technology.

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Cui, Han; Chen, Yi; Zhong, Weizheng; Yu, Haibo; Li, Zhifeng; He, Yuhai; Yu, Wenlong; Jin, Lei

2016-01-01

Bell's palsy is a kind of peripheral neural disease that cause abrupt onset of unilateral facial weakness. In the pathologic study, it was evidenced that ischemia of facial nerve at the affected side of face existed in Bell's palsy patients. Since the direction of facial nerve blood flow is primarily proximal to distal, facial skin microcirculation would also be affected after the onset of Bell's palsy. Therefore, monitoring the full area of facial skin microcirculation would help to identify the condition of Bell's palsy patients. In this study, a non-invasive, real time and full field imaging technology - laser speckle imaging (LSI) technology was applied for measuring facial skin blood perfusion distribution of Bell's palsy patients. 85 participants with different stage of Bell's palsy were included. Results showed that Bell's palsy patients' facial skin perfusion of affected side was lower than that of the normal side at the region of eyelid, and that the asymmetric distribution of the facial skin perfusion between two sides of eyelid is positively related to the stage of the disease (P Bell's palsy patients, and we discovered that the facial skin blood perfusion could reflect the stage of Bell's palsy, which suggested that microcirculation should be investigated in patients with this neurological deficit. It was also suggested LSI as potential diagnostic tool for Bell's palsy.

Increased risk of peripheral arterial occlusive disease in patients with Bell's palsy using population data

Science.gov (United States)

Liou, Li-Syue; Chang, Chih-Ya; Chen, Hsuan-Ju; Tseng, Chun-Hung; Chen, Cheng-Yu

2017-01-01

Objective This population-based cohort study investigated the risk of developing peripheral arterial occlusive disease (PAOD) in patients with Bell’s palsy. Methods We used longitudinal claims data of health insurance of Taiwan to identify 5,152 patients with Bell’s palsy newly diagnosed in 2000–2010 and a control cohort of 20,608 patients without Bell’s palsy matched by propensity score. Incidence and hazard ratio (HR) of PAOD were assessed by the end of 2013. Results The incidence of PAOD was approximately 1.5 times greater in the Bell’s palsy group than in the non-Bell’s palsy controls (7.75 vs. 4.99 per 1000 person-years). The Cox proportional hazards regression analysis measured adjusted HR was 1.54 (95% confidence interval (CI) = 1.35–1.76) for the Bell’s palsy group compared to the non-Bell’s palsy group, after adjusting for sex, age, occupation, income and comorbidities. Men were at higher risk of PAOD than women in the Bell’s palsy group, but not in the controls. The incidence of PAOD increased with age in both groups, but the Bell’s palsy group to control group HR of PAOD decreased as age increased. The systemic steroid treatment reduced 13% of PAOD hazard for Bell’s palsy patients, compared to those without the treatment, but not significant. Conclusions Bell’s palsy appears to be associated with an increased risk of developing PAOD. Further pathophysiologic, histopathology and immunologic research is required to explore the underlying biologic mechanism. PMID:29216223

European study of frequency of participation of adolescents with and without cerebral palsy

DEFF Research Database (Denmark)

Michelsen, Susan I; Flachs, Esben M; Damsgaard, Mogens T

2014-01-01

Children with cerebral palsy participate less in everyday activities than children in the general populations. During adolescence, rapid physical and psychological changes occur which may be more difficult for adolescents with impairments. Within the European SPARCLE project we measured frequency...... respectively linear and logistic regression. Adolescents with cerebral palsy spent less time with friends and had less autonomy in their daily life than adolescents in the general populations. Adolescents with cerebral palsy participated much less in sport but played electronic games at least as often...... populations. Regional variation existed. For example adolescents with cerebral palsy in central Italy were most disadvantaged according to decisional autonomy, while adolescents with cerebral palsy in east Denmark and northern England played sports as often as their general populations. Participation...

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....

Tinjauan Anatomi Klinik dan Manajemen Bell's Palsy

OpenAIRE

Nur Mujaddidah

2017-01-01

Bell's Palsy is a peripheral facial nerve weakness (facial nerve) with acute onset on one side of the face. This condition causes the inability of the patient to move half of his face consciously (volunter) on the affected side. The Bell's Palsy incidence is 20-30 cases out of 100.000 people and accounts for 60-70% of all cases of unilateral facial paralysis. The disease is self-limited, but causes great suffering for patients who are not treated properly. Controversy in the management is sti...

Role of nitric oxide in the onset of facial nerve palsy by HSV-1 infection.

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Hato, Naohito; Kohno, Hisashi; Yamada, Hiroyuki; Takahashi, Hirotaka; Gyo, Kiyofumi

2013-12-01

Although herpes simplex virus type 1 (HSV-1) is a causative agent of Bell palsy, the precise mechanism of the paralysis remains unknown. It is necessary to investigate the pathogenesis and treatment of Bell palsy due to HSV-1 infection. This study elucidated the role of nitric oxide (NO) in the incidence of facial nerve paralysis caused by HSV-1 in mice and to evaluate the possible role of edaravone, a free radical scavenger, in preventing the paralysis. Sixty-two mice served as animal models of Bell palsy in this laboratory study conducted at an academic institution. Levels of NO in the facial nerve were measured using high-performance liquid chromatography and absorption photometry. The incidence of facial palsy was assessed following administration of edaravone immediately after HSV-1 inoculation and daily for 11 days thereafter. The ratio of NO (inoculated side to control side) and incidence of facial palsy. RESULTS Before the onset of facial palsy, no substantial difference in the NO level was noted between the HSV-1-inoculated side and the control side. When facial palsy occurred, usually at 7 days after inoculation, the NO level was significantly higher on the inoculated side than on the control side. Following recovery from the palsy, the high NO level of the inoculated side decreased. No increase in the NO level was observed in animals without transient facial palsy. When edaravone was administered, the incidence of facial palsy decreased significantly. These findings suggest that NO produced by inducible NO synthase in the facial nerve plays an important role in the onset of facial palsy caused by HSV-1 infection, which is considered a causative virus of Bell palsy. Hato and colleagues elucidate the role of nitric oxide in HSV-1–related facial nerve paralysis in mice and evaluate the role of edaravone, a free radical scavenger, in preventing the paralysis.

Increased risk of Bell palsy in patients with migraine: a nationwide cohort study.

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Peng, Kuan-Po; Chen, Yung-Tai; Fuh, Jong-Ling; Tang, Chao-Hsiun; Wang, Shuu-Jiun

2015-01-13

To evaluate the association between migraine and Bell palsy and to examine the effects of age, sex, migraine subtype, and comorbid risk factors for Bell palsy. This nationwide cohort study was conducted using data from the Taiwan National Health Insurance Research Database. Subjects aged 18 years or older with neurologist-diagnosed migraine from 2005 to 2009 were included. A nonheadache age- and propensity score-matched control cohort was selected for comparison. All subjects were followed until the end of 2010, death, or the occurrence of a Bell palsy event. Cox proportional hazards regression was used to calculate the adjusted hazard ratios and 95% confidence intervals to compare the risk of Bell palsy between groups. Both cohorts (n = 136,704 each) were followed for a mean of 3.2 years. During the follow-up period, 671 patients (424,372 person-years) in the migraine cohort and 365 matched control subjects (438,677 person-years) were newly diagnosed with Bell palsy (incidence rates, 158.1 and 83.2/100,000 person-years, respectively). The adjusted hazard ratio for Bell palsy was 1.91 (95% confidence interval, 1.68-2.17; p Bell palsy remained significant in sensitivity analyses, and tests of interaction failed to reach significance in all subgroup analyses. Migraine is a previously unidentified risk factor for Bell palsy. The association between these 2 conditions suggests a linked disease mechanism, which is worthy of further exploration. © 2014 American Academy of Neurology.

Volumetric Magnetic Resonance Imaging Study of Brain and Cerebellum in Children with Cerebral Palsy.

Science.gov (United States)

Kułak, Piotr; Maciorkowska, Elżbieta; Gościk, Elżbieta

2016-01-01

Introduction. Quantitative magnetic resonance imaging (MRI) studies are rarely used in the diagnosis of patients with cerebral palsy. The aim of present study was to assess the relationships between the volumetric MRI and clinical findings in children with cerebral palsy compared to control subjects. Materials and Methods. Eighty-two children with cerebral palsy and 90 age- and sex-matched healthy controls were collected. Results. The dominant changes identified on MRI scans in children with cerebral palsy were periventricular leukomalacia (42%) and posthemorrhagic hydrocephalus (21%). The total brain and cerebellum volumes in children with cerebral palsy were significantly reduced in comparison to controls. Significant grey matter volume reduction was found in the total brain in children with cerebral palsy compared with the control subjects. Positive correlations between the age of the children of both groups and the grey matter volumes in the total brain were found. Negative relationship between width of third ventricle and speech development was found in the patients. Positive correlations were noted between the ventricles enlargement and motor dysfunction and mental retardation in children with cerebral palsy. Conclusions. By using the voxel-based morphometry, the total brain, cerebellum, and grey matter volumes were significantly reduced in children with cerebral palsy.

[Surgical treatment in otogenic facial nerve palsy].

Science.gov (United States)

Feng, Guo-Dong; Gao, Zhi-Qiang; Zhai, Meng-Yao; Lü, Wei; Qi, Fang; Jiang, Hong; Zha, Yang; Shen, Peng

2008-06-01

To study the character of facial nerve palsy due to four different 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. The clinical characters 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. The 24 patients including 10 males and 14 females were analysis, 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 physical 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, 1 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. Removing the lesions completely was the basic factor to the surgery of otogenic facial palsy, moreover, it was important to have facial nerve decompression soon after lesion removal.

Sleep disorders in children with cerebral palsy: An integrative review.

Science.gov (United States)

Lélis, Ana Luíza P A; Cardoso, Maria Vera L M; Hall, Wendy A

2016-12-01

Sleep disorders are more prevalent in children with cerebral palsy. The review aimed to identify and synthesize information about the nature of sleep disorders and their related factors in children with cerebral palsy. We performed an electronic search by using the search terms sleep/child*, and sleep/cerebral palsy in the following databases: Latin American literature on health sciences, SCOPUS, medical publications, cumulative index to nursing and allied health literature, psycinfo, worldcat, web of science, and the Cochrane library. The selection criteria were studies: available in Portuguese, English or Spanish and published between 2004 and 2014, with results addressing sleep disorders in children (ages 0-18 y) with a diagnosis of cerebral palsy. 36,361 abstracts were identified. Of those, 37 papers were selected, and 25 excluded. Twelve papers were incorporated in the study sample: eight quantitative studies, three reviews, and one case study. Eleven types of sleep disorders were identified, such as difficult morning awakening, insomnia, nightmares, difficulties in initiating and maintaining nighttime sleep (night waking), and sleep anxiety. Twenty-one factors were linked to sleep disorders, which we classified as intrinsic factors associated with common comorbidities accompanying cerebral palsy, and extrinsic aspects, specifically environmental and socio-familial variables, and clinical-surgical and pharmacological interventions. Copyright © 2015 Elsevier Ltd. All rights reserved.

Bell palsy in a neonate with rapid response to oral corticosteroids: a case report.

Science.gov (United States)

Saini, Arushi; Singhi, Pratibha; Sodhi, K S; Gupta, Ajit

2013-04-01

Idiopathic facial nerve palsy, also known as Bell palsy is rare in the neonatal age group. Other more common causes such as birth trauma; infections, especially otitis media; and congenital malformations need to be excluded. We present here a 4-week-old neonate with Bell palsy who responded rapidly to oral corticosteroids. Such an early presentation of idiopathic facial nerve palsy and use of corticosteroids in neonates is scarcely reported in the literature.

Computed tomographic (CT) scans in cerebral palsy (CP)

International Nuclear Information System (INIS)

Kolawole, T.M.; Patel, P.J.; Mahdi, A.H.

1989-01-01

The CT findings in 120 cerebral palsied children are analysed. The 72.5% positive findings are correlated with the clinical types, as well as the aetiological basis for the cerebral palsy. The spastic type, 83.3% of the total number of children, had the highest positive findings. The yield was increased in children with seizures (91.3%) and those in the postnatal group (90%), as well as those with birth trauma and neonatal asphyxia (94%). The findings were those of atrophy in 30.8%, hydrocephalus, in 10%, infarct in 11.6%, porencephaly in 8.3% and others. The atropic changes and their patterns are explained. Treatable lesions, such as tumour, hydrocephalus, subdural haematoma, porencephaly and hygroma were identified in 22.5% of cases. It is concluded that CT scan is definitely efficacious in the management of cerebral palsied children. (orig.)

Catheter versus non-catheter angiography in isolated third nerve palsy

International Nuclear Information System (INIS)

Lee, A.G.

2007-01-01

To discuss the controversies surrounding the indications for catheter angiography versus non-catheter and less invasive angiography techniques (e.g. magnetic resonance angiography (MRA) and computerized tomography angiography (CTA)) in the evaluation of patients with a third nerve palsy. Clinical opinion-perspective and literature review. The patient with an isolated third nerve palsy might have a vasculopathic (and typically benign, self limited course) etiology or a life threatening intracranial posterior communicating artery aneurysm. Although it is clear that non-isolated third nerve palsies require imaging directed at the topographical localization of the clinical findings, the evaluation of the neurologically isolated third nerve palsy remains controversial. The completeness of the external (i.e. somatic) motor dysfunction and the presence or absence of internal (i.e. pupillary) dysfunction are generally used to guide the choice of initial neuroimaging. Advances in MRA and CTA technology have reduced but not eliminated our dependence upon catheter angiography in this setting. A properly performed and interpreted MRA or CTA probably will be able to detect greater than 95 % of aneurysms producing a third nerve palsy. The issues surrounding the use of catheter angiography in third nerve palsy are reviewed. If the clinician is highly confident in the capability, availability, and reliability of the neuroradiologist and of their institutional experience and quality of less invasive non-catheter MRA and CTA and if the risk of aneurysm is low or if the risk of angiography is high (e.g. elderly, renal failure, iodinated contrast allergy, risk of stroke) then MRI and MRA (or CTA) may be a reasonable alternative to catheter angiography. Patients with a moderate or uncertain risk of aneurysm and a lower risk for catheter angiography or if there is a low confidence in the quality or the interpretation of the institutional MRA (or CTA) may still require catheter

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.

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...

Pathophysiology of muscle contractures in cerebral palsy.

Science.gov (United States)

Mathewson, Margie A; Lieber, Richard L

2015-02-01

Patients with cerebral palsy present with a variety of adaptations to muscle structure and function. These pathophysiologic symptoms include functional deficits such as decreased force production and range of motion, in addition to changes in muscle structure such as decreased muscle belly size, increased sarcomere length, and altered extracellular matrix structure and composition. On a cellular level, patients with cerebral palsy have fewer muscle stem cells, termed satellite cells, and altered gene expression. Understanding the nature of these changes may present opportunities for the development of new muscle treatment therapies. Published by Elsevier Inc.

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...

PSP SAR interferometry monitoring of ground and structure deformations applied to archaeological sites

Science.gov (United States)

Costantini, Mario; Francioni, Elena; Trillo, Francesco; Minati, Federico; Margottini, Claudio; Spizzichino, Daniele; Trigila, Alessandro; Iadanza, Carla

2017-04-01

Archaeological sites and cultural heritage are considered as critical assets for the society, representing not only the history of region or a culture, but also contributing to create a common identity of people living in a certain region. In this view, it is becoming more and more urgent to preserve them from climate changes effect and in general from their degradation. These structures are usually just as precious as fragile: remote sensing technology can be useful to monitor these treasures. In this work, we will focus on ground deformation measurements obtained by satellite SAR interferometry and on the methodology adopted and implemented in order to use the results operatively for conservation policies in a Italian archaeological site. The analysis is based on the processing of COSMO-SkyMed Himage data by the e-GEOS proprietary Persistent Scatterer Pair (PSP) SAR interferometry technology. The PSP technique is a proven SAR interferometry technology characterized by the fact of exploiting in the processing only the relative properties between close points (pairs) in order to overcome atmospheric artefacts (which are one of the main problems of SAR interferometry). Validations analyses [Costantini et al. 2015] settled that this technique applied to COSMO-SkyMed Himage data is able to retrieve very dense (except of course on vegetated or cultivated areas) millimetric deformation measurements with sub-metric localization. Considering the limitations of all the interferometric techniques, in particular the fact that the measurement are along the line of sight (LOS) and the geometric distortions, in order to obtain the maximum information from interferometric analysis, both ascending and descending geometry have been used. The ascending analysis allows selecting measurements points over the top and, approximately, South-West part of the structures, while the descending one over the top and the South-East part of the structures. The interferometric techniques needs

Biomechanical bases of rehabilitation of children with cerebral palsy

Science.gov (United States)

Davlet'yarova, K. V.; Korshunov, S. D.; Kapilevich, L. V.

2015-11-01

Biomechanical analysis and the study results of children's with cerebral palsy (CP) muscles bioelectrical activity while walking on a flat surface are represented. Increased flexion in the hip and shoulder joints and extension in the elbow joint in children with cerebral palsy were observed, with the movement of the lower limbs had less smooth character in comparison with the control group. Herewith, the oscillation amplitude was significantly increased, and the frequency in the m. gastrocnemius and m. lateralis was decreased. It was shown, that the dynamic stereotype of walking in children with cerebral palsy was characterized by excessive involvement of m. gastrocnemius and m.latissimus dorsi in locomotion. Thus, resulting biomechanical and bioelectrical parameters of walking should be considered in the rehabilitation programs development.

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.

Correlation between physical examination and three-dimensional gait analysis in the assessment of rotational abnormalities in children with cerebral palsy.

Science.gov (United States)

Teixeira, Fernando Borge; Ramalho Júnior, Amancio; Morais Filho, Mauro César de; Speciali, Danielli Souza; Kawamura, Catia Miyuki; Lopes, José Augusto Fernandes; Blumetti, Francesco Camara

2018-01-01

Objective To evaluate the correlation between physical examination data concerning hip rotation and tibial torsion with transverse plane kinematics in children with cerebral palsy; and to determine which time points and events of the gait cycle present higher correlation with physical examination findings. Methods A total of 195 children with cerebral palsy seen at two gait laboratories from 2008 and 2016 were included in this study. Physical examination measurements included internal hip rotation, external hip rotation, mid-point hip rotation and the transmalleolar axis angle. Six kinematic parameters were selected for each segment to assess hip rotation and shank-based foot rotation. Correlations between physical examination and kinematic measures were analyzed by Spearman correlation coefficients, and a significance level of 5% was considered. Results Comparing physical examination measurements of hip rotation and hip kinematics, we found moderate to strong correlations for all variables (pphysical examination and hip rotation kinematics (rho range: 0.48-0.61). Moderate correlations were also found between the transmalleolar axis angle measurement on physical examination and foot rotation kinematics (rho range 0.44-0.56; p<0.001). Conclusion These findings may have clinical implications in the assessment and management of transverse plane gait deviations in children with cerebral palsy.

Surgical and Clinical Decision Making in Isolated Long Thoracic Nerve Palsy.

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Noland, Shelley S; Krauss, Emily M; Felder, John M; Mackinnon, Susan E

2017-10-01

Isolated long thoracic nerve palsy results in scapular winging and destabilization. In this study, we review the surgical management of isolated long thoracic nerve palsy and suggest a surgical technique and treatment algorithm to simplify management. In total, 19 patients who required surgery for an isolated long thoracic nerve palsy were reviewed retrospectively. Preoperative demographics, electromyography (EMG), and physical examinations were reviewed. Intraoperative nerve stimulation, surgical decision making, and postoperative outcomes were reviewed. In total, 19 patients with an average age of 32 were included in the study. All patients had an isolated long thoracic nerve palsy caused by either an injury (58%), Parsonage-Turner syndrome (32%), or shoulder surgery (10%); 18 patients (95%) underwent preoperative EMG; 10 with evidence of denervation (56%); and 13 patients had motor unit potentials in the serratus anterior (72%). The preoperative EMG did not correlate with intraoperative nerve stimulation in 13 patients (72%) and did correlate in 5 patients (28%); 3 patients had a nerve transfer (3 thoracodorsal to long thoracic at lateral chest, 1 pec to long thoracic at supraclavicular incision). In the 3 patients who had a nerve transfer, there was return of full forward flexion of the shoulder at an average of 2.5 months. A treatment algorithm based on intraoperative nerve stimulation will help guide surgeons in their clinical decision making in patients with isolated long thoracic nerve palsy. Intraoperative nerve stimulation is the gold standard in the management of isolated long thoracic nerve palsy.

[New developments in spastic unilateral cerebral palsy].

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Chabrier, S; Roubertie, A; Allard, D; Bonhomme, C; Gautheron, V

2010-01-01

Hemiplegic (or spastic unilateral) cerebral palsy accounts for about 30% of all cases of cerebral palsy. With a population prevalence of 0.6 per 1000 live births, it is the most common type of cerebral palsy among term-born children and the second most common type after diplegia among preterm infants. Many types of prenatal and perinatal brain injury can lead to congenital hemiplegia and brain MRI is the most useful tool to classify them with accuracy and to provide early prognostic information. Perinatal arterial ischemic stroke thus appears as the leading cause in term infants, whereas encephalopathy of prematurity is the most common cause in premature babies. Other causes include brain malformations, neonatal sinovenous thrombosis, parenchymal hemorrhage (for example due to coagulopathy or alloimmune thrombocytopenia) and the more recently described familial forms of porencephaly associated with mutations in the COL4A1 gene. In adjunction with pharmacologic treatment (botulinium neurotoxin injection), new evidence-based rehabilitational interventions, such as constraint-induced movement therapy and mirror therapy, are increasingly being used.

Eina! Ouch! Eish! Professionals’ Perceptions of How Children with Cerebral Palsy Communicate About Pain in South African School Settings: Implications for the use of AAC

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Johnson, Ensa; Nilsson, Stefan; Adolfsson, Margareta

2015-01-01

Abstract Most children with severe cerebral palsy experience daily pain that affects their school performance. School professionals need to assess pain in these children, who may also have communication difficulties, in order to pay attention to the pain and support the children’s continued participation in school. In this study, South African school professionals’ perceptions of how they observed pain in children with cerebral palsy, how they questioned them about it and how the children communicated their pain back to them were investigated. Thirty-eight school professionals participated in five focus groups. Their statements were categorized using qualitative content analysis. From the results it became clear that professionals observed children’s pain communication through their bodily expressions, behavioral changes, and verbal and non-verbal messages. Augmentative and alternative communication (AAC) methods were rarely used. The necessity of considering pain-related vocabulary in a multilingual South African context, and of advocating for the use of AAC strategies to enable children with cerebral palsy to communicate their pain was highlighted in this study. PMID:26372118

New Predictive Parameters of Bell"s Palsy: Neutrophil to Lymphocyte Ratio and Platelet to Lymphocyte Ratio

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Doğan Atan

2015-06-01

Full Text Available Background: Bell’s palsy is the most frequent cause of unilateral facial paralysis. Inflammation is thought to play an important role in the pathogenesis of Bell’s palsy. Aims: Neutrophil to lymphocyte ratio (NLR and platelet to lymphocyte ratio (PLR are simple and inexpensive tests which are indicative of inflammation and can be calculated by all physicians. The aim of this study was to reveal correlations of Bell’s palsy and degree of paralysis with NLR and PLR. Study Design: Case-control study. Methods: The retrospective study was performed January 2010 and December 2013. Ninety-nine patients diagnosed as Bell’s palsy were included in the Bell’s palsy group and ninety-nine healthy individuals with the same demographic characteristics as the Bell’s palsy group were included in the control group. As a result of analyses, NLR and PLR were calculated. Results: The mean NLR was 4.37 in the Bell’s palsy group and 1.89 in the control group with a statistically significant difference (p<0.001. The mean PLR was 137.5 in the Bell’s palsy group and 113.75 in the control group with a statistically significant difference (p=0.008. No statistically significant relation was detected between the degree of facial paralysis and NLR and PLR. Conclusion: The NLR and the PLR were significantly higher in patients with Bell’s palsy. This is the first study to reveal a relation between Bell’s palsy and PLR. NLR and PLR can be used as auxiliary parameters in the diagnosis of Bell’s palsy.

Vírus varicela zoster em paralisia de Bell: estudo prospectivo Varicella zoster virus in Bell's palsy: a prospective study

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Mônica Alcantara de Oliveira Santos

2010-06-01

Full Text Available Embora a paralisia de Bell seja o tipo mais frequente de paralisia facial periférica,sua causa ainda é objeto de inúmeros questionamentos. A reativação do vírus varicela zoster tem sido considerada uma das principais causas da paralisia de Bell, porém, os poucos trabalhos que estudam a prevalência do VVZ como agente etiológico da PB são japoneses, o que determina características geográficas e populacionais bastante díspares de nossa população. OBJETIVOS: Verificar a frequência do vírus varicela zoster em saliva de indivíduos com PB, pela técnica de PCR. MATERIAL E MÉTODO: Estudo prospectivo com 171 pacientes com PFP, sendo 120 pacientes portadores de paralisia de Bell, com até uma semana de evolução, sem uso prévio de drogas antivirais. O grupo controle foi composto de 20 adultos sadios. Nestes indivíduos foram coletadas três amostras de saliva em semanas consecutivas, para pesquisa de DNA viral pela técnica de PCR. RESULTADOS: O vírus varicela zoster foi encontrado em amostras de saliva de dois pacientes com paralisia de Bell (1,7%. Nenhum vírus foi identificado no grupo controle. CONCLUSÃO: Foi verificada frequência de 1,7% para vírus varicela zoster em amostras de saliva de pacientes com paralisia de Bell, pela técnica de PCR.Although Bell's palsy is the major cause of acute peripheral facial palsy, its pathogenesis remains unknown. Reactivation of the varicella zoster virus has been implicated as one of the main causes of Bell's palsy, however, studies which investigate the varicella zoster virus reactivation in Bell's palsy patients are mostly Japanese and, therefore, personal and geographic characteristics are quite different from our population. AIMS: To determine varicella zoster virus frequency in saliva samples from patients with Bell's palsy, using PCR. MATERIAL AND METHOD: One hundred seventy one patients with acute peripheral facial palsy were prospectively enrolled in this study. One hundred twenty

Different metabolic patterns analysis of Parkinsonism on the 18F-FDG PET

International Nuclear Information System (INIS)

Juh, Rahyeong; Kim, Jaesung; Moon, Daehyuk; Choe, Boyoung; Suh, Tasuk

2004-01-01

Idiopathic Parkinson's disease (IPD), progressive supranuclear palsy (PSP) and multiple system atrophy (MSA) are the most common movement disorders associated with neurodegenerative disease. A clinical differential diagnosis of IPD and atypical Parkinsonian disorders, such as MSA and PSP, is often complicated by the presence of symptoms common to both groups. Since Parkinsonism has a different pathophysiology in the cortical and subcortical brain structures, assessing the regional cerebral glucose metabolism may assist in making a differential diagnosis of Parkinsonism. The 18 F-FDG PET images of IPD, MSA and PSP were assessed using statistical parametric mapping (SPM) in order to determine the useful metabolic patterns. Twenty-four patients with Parkinsonism: eight patients (mean age 67.9±10.7 years; M/F: 3/5) with IPD, nine patients (57.9±9.2 years; M/F: 4/5) with MSA and seven patients (67.6±4.8 years; M/F: 3/4) with PSP were enrolled in this study. All patients with Parkinsonism and 22 age-matched normal controls underwent 18 F-FDG PET, (after 370 MBq 18 F-FDG). The three groups and the individual IPD, MSA and PSP patients were compared with a normal control group using a two-sided t-test of SPM (uncorrected P 100 voxel). The IPD, MSA and PSP groups showed significant hypometabolism in the cerebral neocortex compared to the normal control group. The MSA group showed significant hypometabolism in the putamen, pons and cerebellum compared to the normal controls and IPD groups. In addition, PSP showed significant hypometabolism in the caudate nucleus, the thalamus, midbrain and the cingulate gyrus compared to the normal controls, the IPD and the MSA groups. In conclusion, an assessment of the 18 F-FDG PET images using SPM may be a useful adjunct to a clinical examination when making a differential diagnosis of Parkinsonism

Therapeutic outcome of nasopharyngeal carcinoma with cranial nerve palsy: a single institution experience of 104 patients

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Huang CC

2017-04-01

Full Text Available Chun-Chieh Huang,1,2 Fu-Min Fang,1 Hui-Chun Chen,1 Hsuan-Chih Hsu,1 Tai-Lin Huang,3 Yu-Li Su,3 Ya-Chun Chang4 1Department of Radiation Oncology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, 2Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, 3Department of Hematology and Oncology, 4Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan, Republic of China Purpose: Cranial nerve (CN palsy is the main symptom in patients with locally advanced nasopharyngeal carcinoma (NPC. This study aimed to evaluate the therapeutic outcome of NPC with CN palsy and to analyze the prognostic factors.Patients and methods: A total of 104 NPC patients with CN palsy curatively treated by conventional (n=44 or conformal (n=60 radiotherapy (RT were enrolled. Upper CN palsy was present in 81 patients, lower CN palsy in four patients, and both upper and lower CN palsy in 19 patients. Forty-one patients had CN palsy for >2 months before diagnosis.Results: Complete recovery of CN palsy was observed in 74 patients. The actuarial 5-year locoregional control (LRC, distant metastasis-free survival (DMFS, and overall survival (OS rates were 58.2%, 62.2%, and 38.4%, respectively. No significant difference was observed in CN recovery, LRC, DMFS, or OS for patients treated by conventional versus conformal technique. However, significant reduction of grade 3 or greater toxicities was found in those treated by the conformal technique (odds ratio =0.28.Conclusion: Patients with CN palsy presenting >2 months before diagnosis were hard to recover from palsy. The LRC, OS, and recovery from CN palsy did not significantly change with the treatment evolution. Patients with complete recovery from CN palsy had longer OS. Keywords: nasopharyngeal carcinoma, cranial nerve palsy, radiotherapy

Update on managing Bell's palsy.

Science.gov (United States)

2008-07-01

Each year in the UK, around 1 in 5,000 people develops Bell's palsy--idiopathic unilateral lower motor neurone facial weakness of rapid onset. Of those who are not treated, about 16% end up with permanent moderate to severe weakness, which can result in facial dysfunction and disfigurement, and psychological difficulties. There has been longstanding controversy about what, if any, treatment should be given, with potential alternatives including corticosteroids, antiviral drugs, acupuncture and physiotherapy. We last reviewed this condition in 2006, indicating that "published trials on the efficacy of drug treatments have been poor and no firm conclusions can be drawn about the benefit of any single drug", and "it is unclear what place, if any, acupuncture and physiotherapy have in the management of patients with Bell's palsy". Here we update our conclusions in the light of recently published evidence.

Low cost assistive technology to support educational activities for adolescents with cerebral palsy.

Science.gov (United States)

da Silva, Alan Patricio; Bulle Oliveira, Acary Souza; Pinheiro Bezerra, Italla Maria; Pedrozo Campos Antunes, Thaiany; Guerrero Daboin, Blanca Elena; Raimundo, Rodrigo Daminello; Dos Santos, Vagner Rogério; de Abreu, Luiz Carlos

2017-08-30

The concept of assistive technology covers several areas of action; one of them is communication with the elaboration of accessible solutions to overcome daily difficulties. It contributes to the resumption of functional abilities, expanding and facilitating inclusion and independent living. To analyze the usability of a low cost prototype device to support educational activities of adolescents with cerebral palsy. A descriptive observational study. The evaluation of a prototype device was made through a validated questionnaire, Quest Version 2.0, on the level of the user's satisfaction with an assistive technology, composed of 12 evaluation items. The questionnaire was filled out by the educator based on the observation of four wheelchair-bound participants diagnosed with cerebral palsy according to the international classification of diseases and health-related problems, ICD-10, who attend a coexistence and teaching institution in the state of São Paulo, Brazil. The device developed was considered an assistive technology, which provided an experience with a positive level of satisfaction for the participants. The tested prototype contributes to communication and interaction allowing adolescents with cerebral palsy to participate in educational activities. Implications for Rehabilitation The device assists the individual in the educational activities and can positively influence their development, observe the individual number 5, who has an important limitation in coordination and fine movements, placing the role of the task in the vertical position offers a new perspective to perform the task, this stimulates him to try to perform the work, so the challenge was adjusted to the demands of each individual which can contribute to its neuromotor development, the amplitude of the distal movements and the manual ability, since it must look for alternatives to complete the task requested.

Positron emission tomography in degenerative disorders of the dopaminergic system

Energy Technology Data Exchange (ETDEWEB)

Karbe, H; Holthoff, V; Huber, M; Herholz, K; Wienhard, K; Wagner, R; Heiss, W D [Universitaetsklinik fuer Neurologie und Max-Planck-Institut fuer neurologische Forschung, Koeln (Germany)

1992-01-01

21 patients who had Parkinson's disease (PD), PD plus dementia of Alzheimer type (PDAT) or progressive supranuclear palsy (PSP), were studied with positron emission tomography (PET) using ({sup 18}F)-2-fluoro-2-deoxy-D-glucose (FDG). In one patient with strictly unilateral PD side differences in striatal dopa uptake were studied with 6-({sup 18}F)fluoro-L-dopa (F-dopa). In patients with PD PET with FDG did not show any significant change in regional cerebral metabolic rates for glucose (rCMR(Glu)). In PDAT glucose metabolism was generally reduced, the most severe decrease was found in parietal cortex. The metabolic pattern was similar to that typically found in patients with Alzheimer's disease (AD). In the patient with strictly unilateral PD rCMR(Glu) was normal, F-dopa PET, however, revealed a distinct reduction of dopa uptake in the contralateral putamen. In PSP glucose metabolism was significantly decreased in subcortical regions (caudatum, putamen and brainstem) and in frontal cortex. Thus PET demonstrated a clear difference of metabolic pattern between PDAT and PSP. (authors).

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

Microcystic adnexal carcinoma (MAC)-like squamous cell carcinoma as a differential diagnosis to Bell´s palsy: review of guidelines for refractory facial nerve palsy.

Science.gov (United States)

Mueller, S K; Iro, H; Lell, M; Seifert, F; Bohr, C; Scherl, C; Agaimy, A; Traxdorf, M

2017-01-05

Bell´s palsy is the most common cause of facial paralysis worldwide and the most common disorder of the cranial nerves. It is a diagnosis of exclusion, accounting for 60-75% of all acquired peripheral facial nerve palsies. Our case shows the first case of a microcystic adnexal carcinoma-like squamous cell carcinoma as a cause of facial nerve palsy. The patient, a 70-year-old Caucasian male, experienced subsequent functional impairment of the trigeminal and the glossopharyngeal nerve about 1½ years after refractory facial nerve palsy. An extensive clinical work-up and tissue biopsy of the surrounding parotid gland tissue was not able to determine the cause of the paralysis. Primary infiltration of the facial nerve with subsequent spreading to the trigeminal and glossopharyngeal nerve via neuroanastomoses was suspected. After discussing options with the patient, the main stem of the facial nerve was resected to ascertain the diagnosis of MAC-like squamous cell carcinoma, and radiochemotherapy was subsequently started. This case report shows that even rare neoplastic etiologies should be considered as a cause of refractory facial nerve palsy and that it is necessary to perform an extended diagnostic work-up to ascertain the diagnosis. This includes high-resolution MRI imaging and, as perilesional parotid biopsies might be inadequate for rare cases like ours, consideration of a direct nerve biopsy to establish the right diagnosis.

T2 Relaxometry MRI Predicts Cerebral Palsy in Preterm Infants.

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Chen, L-W; Wang, S-T; Huang, C-C; Tu, Y-F; Tsai, Y-S

2018-01-18

T2-relaxometry brain MR imaging enables objective measurement of brain maturation based on the water-macromolecule ratio in white matter, but the outcome correlation is not established in preterm infants. Our study aimed to predict neurodevelopment with T2-relaxation values of brain MR imaging among preterm infants. From January 1, 2012, to May 31, 2015, preterm infants who underwent both T2-relaxometry brain MR imaging and neurodevelopmental follow-up were retrospectively reviewed. T2-relaxation values were measured over the periventricular white matter, including sections through the frontal horns, midbody of the lateral ventricles, and centrum semiovale. Periventricular T2 relaxometry in relation to corrected age was analyzed with restricted cubic spline regression. Prediction of cerebral palsy was examined with the receiver operating characteristic curve. Thirty-eight preterm infants were enrolled for analysis. Twenty patients (52.6%) had neurodevelopmental abnormalities, including 8 (21%) with developmental delay without cerebral palsy and 12 (31.6%) with cerebral palsy. The periventricular T2-relaxation values in relation to age were curvilinear in preterm infants with normal development, linear in those with developmental delay without cerebral palsy, and flat in those with cerebral palsy. When MR imaging was performed at >1 month corrected age, cerebral palsy could be predicted with T2 relaxometry of the periventricular white matter on sections through the midbody of the lateral ventricles (area under the receiver operating characteristic curve = 0.738; cutoff value of >217.4 with 63.6% sensitivity and 100.0% specificity). T2-relaxometry brain MR imaging could provide prognostic prediction of neurodevelopmental outcomes in premature infants. Age-dependent and area-selective interpretation in preterm brains should be emphasized. © 2018 by American Journal of Neuroradiology.

Quality of life as assessed by adults with cerebral palsy.

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Maestro-Gonzalez, Alba; Bilbao-Leon, M Cruz; Zuazua-Rico, David; Fernandez-Carreira, Jose M; Baldonedo-Cernuda, Ricardo F; Mosteiro-Diaz, M Pilar

2018-01-01

We explored the quality of life of adults with cerebral palsy without an intellectual disability and the predictors of quality of life. Because cerebral palsy is a disease that manifests in childhood, much of the research into quality of life for those dealing with it focuses on children; there are few studies that evaluate the quality of life of adults with cerebral palsy. Therefore, it is important to consider their perceptions in order to improve their general wellbeing and self-determination. This was a descriptive, cross-sectional study. Quality of life was measured using the GENCAT Quality of Life Scale. Demographic and personal variables were also collected and examined. Participants comprised 75 adults (58.7 percent men, mean age = 40.84 years) with cerebral palsy who were members of the National Cerebral Palsy Association of Spain between 2014 and 2015. A linear multivariate model was examined as well. The overall mean score indicator of participants' quality of life was 103.29, which corresponds to the 56.6th percentile on the GENCAT scale. Examining the level of qualification, we found significant differences in the factors "personal development" and "self-determination," and those with a university education obtained higher scores than their less-educated counterparts. Having a partner was related to higher quality of life standard scores. After constructing a linear model, it was observed that maintaining sexual relationships was another factor that increased participants' quality of life. This study highlights the importance of social and romantic relationships to achieve a better quality of life in adults with cerebral palsy who do not have an intellectual disability. Social integration and sexuality education programs should be developed to improve their quality of life.

Investigation of Unsteady Pressure-Sensitive Paint (uPSP) and a Dynamic Loads Balance to Predict Launch Vehicle Buffet Environments

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Schuster, David M.; Panda, Jayanta; Ross, James C.; Roozeboom, Nettie H.; Burnside, Nathan J.; Ngo, Christina L.; Kumagai, Hiro; Sellers, Marvin; Powell, Jessica M.; Sekula, Martin K.;

Gd-DTPA enhanced MR imaging in Bell's palsy

International Nuclear Information System (INIS)

Matsumoto, Yasushi; Kawamura, Yuji; Yanagihara, Naoaki; Sadamoto, Masanori; Sadamoto, Kazuhiko.

1991-01-01

Magnetic resonance imaging (MRI) was carried out in 27 patients with Bell's palsy. T1-weighted spin-echo images (TR500/TE25-34) were taken before and after the intravenous administration of Gd-DTPA (0.1 mmol/kg) with 0.5T superconductive MRI. There was significant enhancement at the geniculate ganglion and the horizontal segment of the involved facial nerve in 22 patients (81.5%) and at the vertical segment in 20 (74.1%). Enhancement at the meatal fundus was seen in only 4 patients (14.9%) and at the labyrinthine segment in 8 (29.6%). These results corroborate other evidence that the geniculate ganglion is involved most frequently in Bell's palsy. In addition, the enhancement of the proximal portion, i.e. the meatal fundus and the labyrinthine segment of the nerve, although not common, noted in this study may be important in the diagnosis and treatment of Bell's palsy. (author)

Sudden onset odontoid fracture caused by cervical instability in hypotonic cerebral palsy.

Science.gov (United States)

Shiohama, Tadashi; Fujii, Katsunori; Kitazawa, Katsuhiko; Takahashi, Akiko; Maemoto, Tatsuo; Honda, Akihito

2013-11-01

Fractures of the upper cervical spine rarely occur but carry a high rate of mortality and neurological disabilities in children. Although odontoid fractures are commonly caused by high-impact injuries, cerebral palsy children with cervical instability have a risk of developing spinal fractures even from mild trauma. We herein present the first case of an odontoid fracture in a 4-year-old boy with cerebral palsy. He exhibited prominent cervical instability due to hypotonic cerebral palsy from infancy. He suddenly developed acute respiratory failure, which subsequently required mechanical ventilation. Neuroimaging clearly revealed a type-III odontoid fracture accompanied by anterior displacement with compression of the cervical spinal cord. Bone mineral density was prominently decreased probably due to his long-term bedridden status and poor nutritional condition. We subsequently performed posterior internal fixation surgically using an onlay bone graft, resulting in a dramatic improvement in his respiratory failure. To our knowledge, this is the first report of an odontoid fracture caused by cervical instability in hypotonic cerebral palsy. Since cervical instability and decreased bone mineral density are frequently associated with cerebral palsy, odontoid fractures should be cautiously examined in cases of sudden onset respiratory failure and aggravated weakness, especially in hypotonic cerebral palsy patients. Copyright © 2012 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

Histological chorioamnionitis is associated with cerebral palsy in preterm neonates.

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Horvath, Boldizsár; Grasselly, Magda; Bodecs, Tamas; Boncz, Imre; Bodis, József

2012-08-01

To determine the interaction between histological chorioamnionitis and unexplained neonatal cerebral palsy among low birth weight infants. We studied 141 preterm infants below 1500 g delivered between 2000 and 2010. Clinical data, neonatal neuroimaging, laboratory results, the histopathological features of the placenta and gastric smear within the first hour of delivery, were evaluated. Cerebral palsy was detected in 11 out of 141 preterm newborns (7.8%). The incidence of silent histological chorioamnionitis was 33.6% (43 of 128 cases). Chorioamniontis was significantly associated with the risk of unexplained cerebral palsy (p=0.024). There were also significant correlations between maternal genital infections and chorioamnionitis (p=0.005), and between maternal infections and a positive smear of neonatal gastric aspirates (p=0.000). The rate of cesarean section was 67.4% (95 out of 141 deliveries), and elective cesarean section was performed in 68 cases. Intrauterine exposure to maternal infection was associated with a marked increase in the risk of cerebral palsy in preterm infants. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

High-intensity facial nerve lesions on T2-weighted images in chronic persistent facial nerve palsy

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Kinoshita, T. [Dept. of Radiology, Sendai City Hospital, Sendai (Japan); Dept. of Radiology, Tottori Univ. (Japan); Ishii, K. [Dept. of Radiology, Sendai City Hospital, Sendai (Japan); Okitsu, T. [Dept. of Otolaryngology, Sendai City Hospital (Japan); Ogawa, T. [Dept. of Radiology, Tottori Univ. (Japan); Okudera, T. [Dept. of Radiology, Research Inst. of Brain and Blood Vessels-Akita, Akita (Japan)

2001-05-01

Our aim was to estimate the value of MRI in detecting irreversibly paralysed facial nerves. We examined 95 consecutive patients with a facial nerve palsy (14 with a persistent palsy, and 81 with good recovery), using a 1.0 T unit, with T2-weighted and contrast-enhanced T1-weighted images. The geniculate ganglion and tympanic segment had gave high signal on T2-weighted images in the chronic stage of persistent palsy, but not in acute palsy. The enhancement pattern of the facial nerve in the chronic persistent facial nerve palsy is similar to that in the acute palsy with good recovery. These findings suggest that T2-weighted MRI can be used to show severely damaged facial nerves. (orig.)

Cerebral palsy

International Nuclear Information System (INIS)

Truwit, C.L.; Barkovich, A.J.; Koch, T.; Ferreiro, D.

1990-01-01

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)

Statistic rCBF study of extrapyramidal disorders

Energy Technology Data Exchange (ETDEWEB)

Kamei, Hiroshi; Nakajima, Takashi; Fukuhara, Nobuyoshi [National Saigata Hospital, Ogata, Niigata (Japan)

2002-08-01

We studied regional cerebral blood flow (rCBF) in 16 patients with Parkinson's disease (PD), 2 patients with dementia with Lewy bodies (DLB), 2 patients with progressive supranuclear palsy (PSP), 2 patients with striatonigral degeneration, and 16 normal volunteers, using Three-dimensional stereotactic surface projections (3D-SSP). Decreased rCBF in PD patients was shown in the posterior parietal and occipital cortex. Decreased rCBF in DLB was shown in the frontal, parietal and occipital cortex with relative sparing of the sensorimotor cortex.. Decreased rCBF in PSP was shown in the frontal cortex. Decreased rCBF in SND was shown in the frontal cortex and cerebellum. Statistic rCBF analysis using 3D-SSP was a useful measure for the early differential diagnosis of extrapyramidal disorders. (author)

Case study of physiotherapeutic treatment of patient with diagnosis facial nerve peripheral palsy

OpenAIRE

Zahrádková, Tereza

2015-01-01

Title of Bachelorʼs thesis: Case study of physiotherapeutic treatment of patient with diagnosis facial nerve peripheral palsy. Aim of thesis: Summary of theoretical findings of patientʼs diagnosis, study metodology of physiotherapeutic care, treatment design, monitoring of treatment, and evaluate the effect of patient with diagnosis facial nerve peripheral palsy. Summary: This thesis comprehensively summarizes the findings of of peripheral facial nerve palsy and it's treatment with physiotera...

Multi cranial nerve palsies as the presenting features of prostate carcinoma

International Nuclear Information System (INIS)

Mitchell, D.M.; Wynne, C.J.; Cowan, I.

2008-01-01

Full text: Cranial nerve palsies have previously been reported in metastatic prostate carcinoma, usually occurring late in the course of the disease. We describe the case of a 55-year-old man whose diagnosis of prostate cancer was made following investigation of multiple cranial nerve palsies.

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.

Recurrent Isolated Oculomotor Nerve Palsy after Radiation of a Mesencephalic Metastasis. Case Report and Mini Review

Science.gov (United States)

Grabau, Olga; Leonhardi, Jochen; Reimers, Carl D.

2014-01-01

Introduction: Recurrent oculomotor nerve palsies are extremely rare clinical conditions. Case report: Here, we report on a unique case of a short-lasting recurrent unilateral incomplete external and complete internal oculomotor nerve palsy. The episodic palsies were probably caused by an ipsilateral mesencephalic metastasis of a breast carcinoma and occurred after successful brain radiation therapy. Discussion: While the pathogenic mechanism remains unclear, the recurrent sudden onset and disappearance of the palsies and their decreasing frequency after antiepileptic treatment suggest the occurrence of epilepsy-like brainstem seizures. A review of case reports of spontaneous reversible oculomotor nerve palsies is presented. PMID:25104947

Recurrent isolated oculomotor nerve palsy after radiation of a mesencephalic metastasis. Case report and mini-review.

Directory of Open Access Journals (Sweden)

Olga eGrabau

2014-07-01

Full Text Available Introduction: Recurrent oculomotor nerve palsies are extremely rare clinical conditions. Case report: Here, we report on a unique case of a short-lasting recurrent unilateral incomplete external and complete internal oculomotor nerve palsy. The episodic palsies were probably caused by an ipsilateral mesencephalic metastasis of a breast carcinoma and occurred after successful brain radiation therapy. Discussion: While the pathogenic mechanism remains unclear, the recurrent sudden onset and disappearance of the palsies and their decreasing frequency after antiepileptic treatment suggest the occurrence of epilepsy-like brainstem seizures. A review of case reports of spontaneous reversible oculomotor nerve palsies is presented.

Cerebral palsy in eastern Denmark: declining birth prevalence but increasing numbers of unilateral cerebral palsy in birth year period 1986-1998

DEFF Research Database (Denmark)

Ravn, Susanne Holst; Flachs, Esben Meulengracht; Uldall, Peter

2010-01-01

The Cerebral Palsy Registry in eastern Denmark has been collecting cases using a uniform data sampling procedure since birth year 1979. Children are included by two child neurologists and an obstetrician. Information on pregnancy, birth, neonatal period, impairments and demographic data...... are registered. The total cerebral palsy birth prevalence has been significantly decreasing since the birth period 1983-1986 with 3.0 per 1000 live births until the period 1995-1998 with 2.1 per 1000 live births. The overall decrease was seen in preterm infants (...

Cerebral palsy in eastern Denmark: declining birth prevalence but increasing numbers of unilateral cerebral palsy in birth year period 1986-1998

DEFF Research Database (Denmark)

Ravn, Susanne Holst; Flachs, Esben Meulengracht; Uldall, Peter

2010-01-01

The Cerebral Palsy Registry in eastern Denmark has been collecting cases using a uniform data sampling procedure since birth year 1979. Children are included by two child neurologists and an obstetrician. Information on pregnancy, birth, neonatal period, impairments and demographic data are regis......The Cerebral Palsy Registry in eastern Denmark has been collecting cases using a uniform data sampling procedure since birth year 1979. Children are included by two child neurologists and an obstetrician. Information on pregnancy, birth, neonatal period, impairments and demographic data...

A systematic review of lessons learned from PET molecular imaging research in atypical parkinsonism

International Nuclear Information System (INIS)

Niccolini, Flavia; Politis, Marios

2016-01-01

To systematically review the previous studies and current status of positron emission tomography (PET) molecular imaging research in atypical parkinsonism. MEDLINE, ISI Web of Science, Cochrane Library, and Scopus electronic databases were searched for articles published until 29th March 2016 and included brain PET studies in progressive supranuclear palsy (PSP), multiple system atrophy (MSA), and corticobasal syndrome (CBS). Only articles published in English and in peer-reviewed journals were included in this review. Case-reports, reviews, and non-human studies were excluded. Seventy-seven PET studies investigating the dopaminergic system, glucose metabolism, microglial activation, hyperphosphorilated tau, opioid receptors, the cholinergic system, and GABA A receptors in PSP, MSA, and CBS patients were included in this review. Disease-specific patterns of reduced glucose metabolism have shown higher accuracy than dopaminergic imaging techniques to distinguish between parkinsonian syndromes. Microglial activation has been found in all forms of atypical parkinsonism and reflects the known distribution of neuropathologic changes in these disorders. Opioid receptors are decreased in the striatum of PSP and MSA patients. Subcortical cholinergic dysfunction was more severe in MSA and PSP than Parkinson's disease patients although no significant changes in cortical cholinergic receptors were seen in PSP with cognitive impairment. GABA A receptors were decreased in metabolically affected cortical and subcortical regions in PSP patients. PET molecular imaging has provided valuable insight for understanding the mechanisms underlying atypical parkinsonism. Changes at a molecular level occur early in the course of these neurodegenerative diseases and PET imaging provides the means to aid differential diagnosis, monitor disease progression, identify of novel targets for pharmacotherapy, and monitor response to new treatments. (orig.)

A systematic review of lessons learned from PET molecular imaging research in atypical parkinsonism

Energy Technology Data Exchange (ETDEWEB)

Niccolini, Flavia; Politis, Marios [Neurodegeneration Imaging Group, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King' s College London, London (United Kingdom)

2016-11-15

To systematically review the previous studies and current status of positron emission tomography (PET) molecular imaging research in atypical parkinsonism. MEDLINE, ISI Web of Science, Cochrane Library, and Scopus electronic databases were searched for articles published until 29th March 2016 and included brain PET studies in progressive supranuclear palsy (PSP), multiple system atrophy (MSA), and corticobasal syndrome (CBS). Only articles published in English and in peer-reviewed journals were included in this review. Case-reports, reviews, and non-human studies were excluded. Seventy-seven PET studies investigating the dopaminergic system, glucose metabolism, microglial activation, hyperphosphorilated tau, opioid receptors, the cholinergic system, and GABA{sub A} receptors in PSP, MSA, and CBS patients were included in this review. Disease-specific patterns of reduced glucose metabolism have shown higher accuracy than dopaminergic imaging techniques to distinguish between parkinsonian syndromes. Microglial activation has been found in all forms of atypical parkinsonism and reflects the known distribution of neuropathologic changes in these disorders. Opioid receptors are decreased in the striatum of PSP and MSA patients. Subcortical cholinergic dysfunction was more severe in MSA and PSP than Parkinson's disease patients although no significant changes in cortical cholinergic receptors were seen in PSP with cognitive impairment. GABA{sub A} receptors were decreased in metabolically affected cortical and subcortical regions in PSP patients. PET molecular imaging has provided valuable insight for understanding the mechanisms underlying atypical parkinsonism. Changes at a molecular level occur early in the course of these neurodegenerative diseases and PET imaging provides the means to aid differential diagnosis, monitor disease progression, identify of novel targets for pharmacotherapy, and monitor response to new treatments. (orig.)

Cerebral palsy characterization by estimating ocular motion

Science.gov (United States)

González, Jully; Atehortúa, Angélica; Moncayo, Ricardo; Romero, Eduardo

2017-11-01

Cerebral palsy (CP) is a large group of motion and posture disorders caused during the fetal or infant brain development. Sensorial impairment is commonly found in children with CP, i.e., between 40-75 percent presents some form of vision problems or disabilities. An automatic characterization of the cerebral palsy is herein presented by estimating the ocular motion during a gaze pursuing task. Specifically, After automatically detecting the eye location, an optical flow algorithm tracks the eye motion following a pre-established visual assignment. Subsequently, the optical flow trajectories are characterized in the velocity-acceleration phase plane. Differences are quantified in a small set of patients between four to ten years.

The Cerebral Palsy Research Registry: Development and Progress Toward National Collaboration in the United States

Science.gov (United States)

Hurley, Donna S.; Sukal-Moulton, Theresa; Msall, Michael E.; Gaebler-Spira, Deborah; Krosschell, Kristin J.; Dewald, Julius P.

2011-01-01

Cerebral palsy is the most common neurodevelopmental motor disability in children. The condition requires medical, educational, social, and rehabilitative resources throughout the life span. Several countries have developed population-based registries that serve the purpose of prospective longitudinal collection of etiologic, demographic, and functional severity. The United States has not created a comprehensive program to develop such a registry. Barriers have been large population size, poor interinstitution collaboration, and decentralized medical and social systems. The Cerebral Palsy Research Registry was created to fill the gap between population and clinical-based cerebral palsy registries and promote research in the field. This is accomplished by connecting persons with cerebral palsy, as well as their families, to a network of regional researchers. This article describes the development of an expandable cerebral palsy research registry, its current status, and the potential it has to affect families and persons with cerebral palsy in the United States and abroad. PMID:21677201

Radiation-induced cranial nerve palsy and its causative factors in nasopharyngeal carcinoma

International Nuclear Information System (INIS)

Kong Lin; Zhang Youwang; Wu Yongru; Guo Xiaomao; Li Longgen

2005-01-01

Objective: To analyze the incidence and causative factors of radiation-induced cranial nerve palsy in patients with nasopharyngeal carcinoma (NPC). Methods: 512 NPC patients who underwent radiotherapy from January 1, 1989 to December 31, 1990 and from January 1, 1994 to December 31, 1995 were retrospectively analyzed. According to Fuzhou' 92 NPC Staging Classification, there are 31 patients in stage I, 212 in stage II, 198 in stage III and 71 in stage IV. All patients were treated by 60 Co or 6 MV X-ray with faciocervical fields or pre-auricular fields to primary area. Some patients were boosted by post-auricular fields or cranial fields. The median dose to the nasopharyngeal region was 7130 cGy by external beam radiotherapy. Thirty-four patients were boosted by brachytherapy. The medial dose to cervical lymph nodes was 6410 cGy as definitive treatment and 5480 cGy as prophylactic treatment. 101 patients were treated with combined chemotherapy. Results: The median follow-up was 6.7 years . Radiation-induced cranial nerve palsies occurred in 81 among the 512 patients. The 5- and 10-year cumulative incidences were 10.3%, 25.4%, respectively. The most common affected nerve was XII. On multivariates analysis, cranial nerve invasion before radiation, chemotherapy, dose to the nasopharyngeal region and age were the independent factors of radiation-induced cranial nerve palsy on nerve I-VII, while the N stage and the radiation fields were independent factors on nerve IX-XII. The cumulative incidence of cranial nerve I-VII palsies increased in patients with cranial nerve invasion, chemotherapy and the dose to the nasopharyngeal region (>7000 cGy). The cumulative incidence of cranial nerve IX- XII palsies increased in patients with advanced N stage. Patients in the first group of treatment field had the highest risk to progress cranial nerve IX-XII palsies, followed by the second group, and the third group had the lowest risk. Only 1 in 34 patients with brachytherapy

Stability and Harmony of Gait in Children with Cerebral Palsy

Science.gov (United States)

Iosa, Marco; Marro, Tiziana; Paolucci, Stefano; Morelli, Daniela

2012-01-01

The aim of this study was to quantitatively assess the stability and harmony of gait in children with cerebral palsy. Seventeen children with spastic hemiplegia due to cerebral palsy (5.0 [plus or minus] 2.3 years old) who were able to walk autonomously and seventeen age-matched children with typical development (5.7 [plus or minus] 2.5 years old,…

A case report of physiotherapy treatment of a patient with peripheral facial palsy

OpenAIRE

Příhonská, Jana

2016-01-01

Thesis title: A case report of physiotherapy treatment of a patient with peripheral facial palsy Thesis summary: The thesis focuses on physiotherapy treatment techniques for peripheral facial palsy. It consists of a theoretical part and a practical part. The theoretical part covers basic anatomy and neurology, the characteristics, clinical picture, diagnosis, and treatment. The practical part is a case report of a patient with peripheral facial palsy. The case report includes the clinical exa...

Pain in young people aged 13 to 17 years with cerebral palsy

DEFF Research Database (Denmark)

Parkinson, Kathryn N; Dickinson, Heather O; Arnaud, Catherine

2013-01-01

To determine the prevalence and associations of self- and parent-reported pain in young people with cerebral palsy (CP).......To determine the prevalence and associations of self- and parent-reported pain in young people with cerebral palsy (CP)....

THE EFFECTIVENESS OF CONDUCTIVE EDUCATION ON MOTOR SKILLS IN CHILDREN WITH CEREBRAL PALSY

Directory of Open Access Journals (Sweden)

Negin Khoshvaght

2017-12-01

Full Text Available Background: Cerebral palsy is a nonprogressive neuro-developmental disorders that are caused by damage to the developing brain and affect movement and posture. Children with cerebral palsy suffer difficulty in motor function (coordination and control.The present inquiry investigated the impact of conductive education on motor skills in children having cerebral palsy. Methods: A quasi-experimental research was done using pretest-posttest and control group design. The study subjects consisted of all children with cerebral palsy in Shiraz. A sample of 30 subjects was randomly chosen to employ convenience sampling procedure and classified to two groups of treatment (15 subjects and control (15 subjects. The pretest was performed for both groups, and the experimental group received conductive education in 20 sessions. While the control subjects did not have this education, finally, the post-test was performed for both groups. The Lincoln-Oseretsky test was used to measure motor skills. The data were analyzed using ANCOVA and MANCOVA. Results: The results showed that conductive education had a significant effect on motor skills (P<0.001 and its subscales such as speed of movement (P<0.001, general static coordination (P<0.001, general dynamic coordination (P<0.001, dynamic manual coordination (P<0.001, synchronous-asymmetrical voluntary movements (P<0.001, and asynchronous-asymmetrical voluntary movements (P<0.001 in children with cerebral palsy. Conclusion: The findings indicated the effectiveness of conductive education on cerebral palsy children’s motor skills. Therefore, it is recommended to design and implement a conductive education program to improve motor skills of cerebral palsy children.

Facial nerve palsy associated with a cystic lesion of the temporal bone.

Science.gov (United States)

Kim, Na Hyun; Shin, Seung-Ho

2014-03-01

Facial nerve palsy results in the loss of facial expression and is most commonly caused by a benign, self-limiting inflammatory condition known as Bell palsy. However, there are other conditions that may cause facial paralysis, such as neoplastic conditions of the facial nerve, traumatic nerve injury, and temporal bone lesions. We present a case of facial nerve palsy concurrent with a benign cystic lesion of the temporal bone, adjacent to the tympanic segment of the facial nerve. The patient's symptoms subsided after facial nerve decompression via a transmastoid approach.

Theory of Mind and Irony Comprehension in Children with Cerebral Palsy

Science.gov (United States)

Caillies, Stephanie; Hody, Anais; Calmus, Arnaud

2012-01-01

The main goal of the present study was to characterise the pragmatic abilities of French children with cerebral palsy through their understanding of irony and other people's mental states. We predicted that children with cerebral palsy would have difficulty understanding false-belief and ironic remarks, due to the executive dysfunction that…

Cranial nerve palsies in Nigerian children

African Journals Online (AJOL)

PROF. EZECHUKWU

2014-01-08

Jan 8, 2014 ... Introduction. Cranial nerve palsy is a common clinical problem ... Methodology ... The two cases with three-nerve involvement were re- lated to viral encephalitis and cerebral contusion from ... RTA = road traffic accident.

Genetics Home Reference: progressive supranuclear palsy

Science.gov (United States)

... slow and slurred speech (dysarthria) and trouble swallowing (dysphagia). Most affected individuals also experience changes in personality ... UK): Treatment of Progressive Supranuclear Palsy Partners in Parkinson's: Movement Disorder Specialist Finder University of California, San ...

A Clinical Study on 1 Case of Patient with Bilateral Simultaneous Bell's Palsy Treated by Hominis Placenta Herbal-Acupuncture

Directory of Open Access Journals (Sweden)

Kwon, Kang

2003-06-01

Full Text Available Objective : This study was carried out to investigate the progress of bilateral simultaneous facial palsy and the effect of Hominis Placenta herbal-acupunture and the other oriental medical therapies. Methods : We used two methods to research the progress of disease. 1. Diagnosis - Facial muscle test, Taste test, Hearing test, Photographies, Lab-finding 2. Treatment - Acupuncture, Herbal-acupuncture, Electroacupuncture, Herb-med Results : The onset of Rt. facial palsy was earlier than Lt. facial palsy 3days. The reaction on the treatment of Rt. facial palsy was more dull than Lt. facial palsy. In terms of treatment period, Rt. facial palsy was very longer than Lt. facial palsy. Conclusion : According to the above results, we discoveried that Hominis Placenta herbal-acupunture and the other oriental medical therapies had good influence on the bilateral simultaneous facial palsy. In the future, we should endeavor to know influence between Rt. and Lt. face in case of bilateral simultaneous Bell's palsy.

Neutrophil-to-lymphocyte ratio as a novel-potential marker for predicting prognosis of Bell palsy.

Science.gov (United States)

Bucak, Abdulkadir; Ulu, Sahin; Oruc, Serdar; Yucedag, Fatih; Tekin, Mustafa Said; Karakaya, Fatıma; Aycicek, Abdullah

2014-07-01

Bell palsy can be defined as an idiopathic, acute, facial nerve palsy. Although the pathogenesis of Bell palsy is not fully understood, inflammation seems to play important role. Neutrophil-to-lymphocyte (NLR) ratio was defined as a novel potential marker to determine inflammation and it is routinely measured in peripheral blood. Our goal was to investigate the relationship between Bell palsy and inflammation by using NLR. Retrospective study. The 54 patients who were followed up for Bell palsy for a period of 1 to 3 years, along with 45 age- and sex-matched controls, were included in the study. An automated blood cell counter was used for NLR measurements. All patients were treated with prednisone, 1 mg/kg per day with a progressive dose reduction. Patients were classified according to the House-Brackmann grading system at posttreatment period. Those with House-Brackmann grade I and grade II were regarded as satisfactory recovery; and those with House-Brackmann grade III to grade VI were regarded as nonsatisfactory recovery. The mean NLR and neutrophil values in patients with Bell palsy were significantly higher than in the control group (P=0.001 and PBell palsy and its prognosis. Our result suggest that while evaluating Bell palsy patients, NLR might be taken into account as a novel potential marker to predict the patients' prognosis. 3b. © 2013 The American Laryngological, Rhinological and Otological Society, Inc.

Facial nerve palsy: analysis of cases reported in children in a suburban hospital in Nigeria.

Science.gov (United States)

Folayan, M O; Arobieke, R I; Eziyi, E; Oyetola, E O; Elusiyan, J

2014-01-01

The study describes the epidemiology, treatment, and treatment outcomes of the 10 cases of facial nerve palsy seen in children managed at the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife over a 10 year period. It also compares findings with report from developed countries. This was a retrospective cohort review of pediatric cases of facial nerve palsy encountered in all the clinics run by specialists in the above named hospital. A diagnosis of facial palsy was based on International Classification of Diseases, Ninth Revision, Clinical Modification codes. Information retrieved from the case note included sex, age, number of days with lesion prior to presentation in the clinic, diagnosis, treatment, treatment outcome, and referral clinic. Only 10 cases of facial nerve palsy were diagnosed in the institution during the study period. Prevalence of facial nerve palsy in this hospital was 0.01%. The lesion more commonly affected males and the right side of the face. All cases were associated with infections: Mainly mumps (70% of cases). Case management include the use of steroids and eye pads for cases that presented within 7 days; and steroids, eye pad, and physical therapy for cases that presented later. All cases of facial nerve palsy associated with mumps and malaria infection fully recovered. The two cases of facial nerve palsy associated with otitis media only partially recovered. Facial nerve palsy in pediatric patients is more commonly associated with mumps in the study environment. Successes are recorded with steroid therapy.

X-Ray Hip Examination in Patients with Cerebral Palsy

OpenAIRE

Holiuk, Ye.L.

2017-01-01

Background. X-ray indicators of the hip are important diagnostic factors of spastic hip dislocation in cerebral palsy. Correct X-ray examination has a decisive influence on the treatment strategy. Correct positioning parameters are well known, but their importance is often underestimated. This could be a trigger factor for further diagnostic and treatment errors. Materials and me-thods. The material was radiographs of the hip joints of 126 patients with cerebral palsy aged 2 to 18 years. Retr...

Clinical significance of quantitative analysis of facial nerve enhancement on MRI in Bell's palsy.

Science.gov (United States)

Song, Mee Hyun; Kim, Jinna; Jeon, Ju Hyun; Cho, Chang Il; Yoo, Eun Hye; Lee, Won-Sang; Lee, Ho-Ki

2008-11-01

Quantitative analysis of the facial nerve on the lesion side as well as the normal side, which allowed for more accurate measurement of facial nerve enhancement in patients with facial palsy, showed statistically significant correlation with the initial severity of facial nerve inflammation, although little prognostic significance was shown. This study investigated the clinical significance of quantitative measurement of facial nerve enhancement in patients with Bell's palsy by analyzing the enhancement pattern and correlating MRI findings with initial severity of facial palsy and clinical outcome. Facial nerve enhancement was measured quantitatively by using the region of interest on pre- and postcontrast T1-weighted images in 44 patients diagnosed with Bell's palsy. The signal intensity increase on the lesion side was first compared with that of the contralateral side and then correlated with the initial degree of facial palsy and prognosis. The lesion side showed significantly higher signal intensity increase compared with the normal side in all of the segments except for the mastoid segment. Signal intensity increase at the internal auditory canal and labyrinthine segments showed correlation with the initial degree of facial palsy but no significant difference was found between different prognostic groups.

Acupuncture for sequelae of Bell's palsy: a randomized controlled trial protocol.

Science.gov (United States)

Kwon, Hyo-Jung; Kim, Jong-In; Lee, Myeong Soo; Choi, Jun-Yong; Kang, Sungkeel; Chung, Jie-Yoon; Kim, Young-Jin; Lee, Seung-Hoon; Lee, Sanghoon; Nam, Dongwoo; Kim, Yong-Suk; Lee, Jae-Dong; Choi, Do-Young

2011-03-09

Incomplete recovery from facial palsy has a long-term impact on the quality of life, and medical options for the sequelae of Bell's palsy are limited. Invasive treatments and physiotherapy have been employed to relieve symptoms, but there is limited clinical evidence for their effectiveness. Acupuncture is widely used on Bell's palsy patients in East Asia, but there is insufficient evidence for its effectiveness on Bell's palsy sequelae. The objective is to evaluate the efficacy and safety of acupuncture in patients with sequelae of Bell's palsy. This study consists of a randomized controlled trial with two parallel arms: an acupuncture group and a waitlist group. The acupuncture group will receive acupuncture treatment three times per week for a total of 24 sessions over 8 weeks. Participants in the waitlist group will not receive any acupuncture treatments during this 8 week period, but they will participate in the evaluations of symptoms at the start of the study, at 5 weeks and at 8 weeks after randomization, at which point the same treatment as the acupuncture group will be provided. The primary outcome will be analyzed by the change in the Facial Disability Index (FDI) from baseline to week eight. The secondary outcome measures will include FDI from baseline to week five, House-Brackmann Grade, lip mobility, and stiffness scales.

Motion Tracking of Infants in Risk of Cerebral Palsy

DEFF Research Database (Denmark)

Olsen, Mikkel Damgaard

Every year 2-3 out of 1000 infants are born with cerebral cerebral palsy. Among others, the disorder often affects motor, cognitive and perceptual skills. The disorder is usually detected when the infants are old enough the crawl and walk, i.e. when the infant is 1-2 years old. However, studies...... show that the infant’s movements are affected already in the first year of life and methods exist for assessing the movements. The methods often require observation of the movements and qualitative evaluation of these. A more objective measure is desired in order to be able to diagnose cerebral palsy...... for automatic assessment of infant movement. This includes a preliminary study on automatic classification of movements related to cerebral palsy. The contributions included in this thesis can be divided into two groups. The first two contributions consider the analysis in order to estimate and track the body...

A Stepwise Approach: Decreasing Infection in Deep Brain Stimulation for Childhood Dystonic Cerebral Palsy.

Science.gov (United States)

Johans, Stephen J; Swong, Kevin N; Hofler, Ryan C; Anderson, Douglas E

2017-09-01

Dystonia is a movement disorder characterized by involuntary muscle contractions, which cause twisting movements or abnormal postures. Deep brain stimulation has been used to improve the quality of life for secondary dystonia caused by cerebral palsy. Despite being a viable treatment option for childhood dystonic cerebral palsy, deep brain stimulation is associated with a high rate of infection in children. The authors present a small series of patients with dystonic cerebral palsy who underwent a stepwise approach for bilateral globus pallidus interna deep brain stimulation placement in order to decrease the rate of infection. Four children with dystonic cerebral palsy who underwent a total of 13 surgical procedures (electrode and battery placement) were identified via a retrospective review. There were zero postoperative infections. Using a multistaged surgical plan for pediatric patients with dystonic cerebral palsy undergoing deep brain stimulation may help to reduce the risk of infection.

Speech therapy in peripheral facial palsy: an orofacial myofunctional approach

Directory of Open Access Journals (Sweden)

Hipólito Virgílio Magalhães Júnior

2009-12-01

Full Text Available Objective: To delineate the contributions of speech therapy in the rehabilitation of peripheral facial palsy, describing the role of orofacial myofunctional approach in this process. Methods: A literature review of published articles since 1995, held from March to December 2008, based on the characterization of peripheral facial palsy and its relation with speechlanguage disorders related to orofacial disorders in mobility, speech and chewing, among others. The review prioritized scientific journal articles and specific chapters from the studied period. As inclusion criteria, the literature should contain data on peripheral facial palsy, quotes on the changes in the stomatognathic system and on orofacial miofunctional approach. We excluded studies that addressed central paralysis, congenital palsy and those of non idiopathic causes. Results: The literature has addressed the contribution of speech therapy in the rehabilitation of facial symmetry, with improvement in the retention of liquids and soft foods during chewing and swallowing. The orofacial myofunctional approach contextualized the role of speech therapy in the improvement of the coordination of speech articulation and in the gain of oral control during chewing and swallowing Conclusion: Speech therapy in peripheral facial palsy contributed and was outlined by applying the orofacial myofunctional approach in the reestablishment of facial symmetry, from the work directed to the functions of the stomatognathic system, including oralfacial exercises and training of chewing in association with the training of the joint. There is a need for a greater number of publications in this specific area for speech therapy professional.

[A young woman with central facial nerve palsy].

Science.gov (United States)

Broere, Christiaan M; de Witte, B R René; Claes, J F H M Franka

2014-01-01

The distinction between central and peripheral facial nerve palsy can be difficult but is very important for the workup and treatment. A tumefactive demyelinating lesion (TDL) is a rare condition that can sometimes cause diagnostic difficulties due to its similarity to a brain tumour. We present a 20-year-old female patient who visited her GP with a discrete right-sided drooping corner of her mouth. The GP started treatment with oral glucorticoids because of presumed Bell's palsy and referred her to the neurology outpatient clinic. Repeated neurological examination showed central facial palsy on the right side of the face. An MRI study of the brain revealed a single large contrast-enhanced abnormality in the left hemisphere that was diagnosed as TDL after exclusion of other causes. In view of the limited number of clinical symptoms, an expectative policy was conducted. The patient recovered spontaneously and repeated MRI studies showed partial regression of TDL. TDL is often considered to be a first presentation of multiple sclerosis. Accurate analysis with MRI can help in making a diagnosis without the need for a biopsy.

Handling the Cerebral Palsied Child: Multi-Level Skills Transfer in Pakistan.

Science.gov (United States)

Miles, M.; Frizzell, Yvonne

1990-01-01

The majority of children with cerebral palsy in developing countries have no access to trained therapists; for example, in Pakistan, there is less than one trained general physiotherapist per million population. In Pakistan, cerebral palsy handling skills were taught to a group of parents, teachers, and paraprofessionals in a series of practical…

Attentional and executive impairments in children with spastic cerebral palsy

DEFF Research Database (Denmark)

Bottcher, Louise; Flachs, Esben Meulengracht; Uldall, Peter

2010-01-01

Children with cerebral palsy (CP) are reported to have learning and social problems. The aim of the present study was to examine whether children with CP have impairments in attention or executive function.......Children with cerebral palsy (CP) are reported to have learning and social problems. The aim of the present study was to examine whether children with CP have impairments in attention or executive function....

Executive function in relation to arithmetic development in children with cerebral palsy

NARCIS (Netherlands)

Jenks, K.M.; de Moor, J.; van Lieshout, E.C.D.M.

2009-01-01

Background: Although it is believed that children with cerebral palsy are at high risk for learning difficulties and arithmetic difficulties in particular, few studies have investigated this issue. Methods: Arithmetic ability was longitudinally assessed in children with cerebral palsy in special (n

Rehabilitation of Bells' palsy from a multi-team perspective.

Science.gov (United States)

Hultcrantz, Malou

2016-01-01

Conclusions Defectively healed facial paralysis causes difficulties to talk and eat, involuntary spasms (synkinesis), and cosmetic deformities which can give rise both to severe psychological and physical trauma. A team consisting of Ear-Nose-Throat specialists, Plastic surgeons and Physiotherapists can offer better care, treatment and outcome for patients suffering from Bells' palsy. Objectives Patients suffering from Bells' palsy from all ENT hospitals in Sweden and the University Hospital in Helsinki has been included. Methods Results have been drawn and statistically processed for different outcomes from a prospective, double blind cross over study. Results from a pilot surgical study and therapeutic results from physiotherapy studies have been included. Ideas concerning different kinds of surgery will be reviewed and the role of physiotherapy discussed. Results According to common results, treatment with Prednisolone enhances the recovery rate and should, if possible, be used early in the course. Sunnybrook grading at 1 month after onset most accurately predicts non-recovery at 12 months in Bells' palsy and a risk factor curve will be presented in order to predict outcome and selection of patients for undergoing facial surgery. This report is focusing on how to handle patients with Bells' palsy from a multi-rehabilitation team point of view, and what will be recommended to provide these patients with the best clinical and surgical help.

Self-reported quality of life of adolescents with cerebral palsy

DEFF Research Database (Denmark)

Colver, Allan; Rapp, Marion; Eisemann, Nora

2015-01-01

compared QoL against matched controls in the general population. We used multivariable regression to relate QoL of adolescents with cerebral palsy to impairments (cross-sectional analysis) and to childhood QoL, pain, psychological problems, and parenting stress (longitudinal analysis). FINDINGS: Severity...... QoL. Child psychological problems and parenting stress in childhood or their worsening between childhood and adolescence predicted only small reductions in adolescent QoL. INTERPRETATION: Individual and societal attitudes should be affected by the similarity of the QoL of adolescents with and without...... cerebral palsy. Adolescents with cerebral palsy need particular help to maintain and develop peer relationships. Interventions in childhood to alleviate psychological difficulties, parenting stress, and especially pain, are justified for their intrinsic value and for their longer term effect on adolescent...

Traumatic facial nerve neuroma with facial palsy presenting in infancy.

Science.gov (United States)

Clark, James H; Burger, Peter C; Boahene, Derek Kofi; Niparko, John K

2010-07-01

To describe the management of traumatic neuroma of the facial nerve in a child and literature review. Sixteen-month-old male subject. Radiological imaging and surgery. Facial nerve function. The patient presented at 16 months with a right facial palsy and was found to have a right facial nerve traumatic neuroma. A transmastoid, middle fossa resection of the right facial nerve lesion was undertaken with a successful facial nerve-to-hypoglossal nerve anastomosis. The facial palsy improved postoperatively. A traumatic neuroma should be considered in an infant who presents with facial palsy, even in the absence of an obvious history of trauma. The treatment of such lesion is complex in any age group but especially in young children. Symptoms, age, lesion size, growth rate, and facial nerve function determine the appropriate management.

Acoustic Reflex and House-Brackmann Rating Scale as Prognostic Indicators of Peripheral Facial Palsy in Neuroborreliosis.

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Sekelj, Alen; Đanić, Davorin

2017-09-01

Lyme borreliosis is a vector-borne infectious disease characterized by three disease stages. In the areas endemic for borreliosis, every acute facial palsy indicates serologic testing and implies specific approach to the disease. Th e aim of the study was to identify and confirm the value of acoustic refl ex and House-Brackman (HB) grading scale as prognostic indicators of facial palsy in neuroborreliosis. Th e study included 176 patients with acute facial palsy divided into three groups based on serologic testing: borreliosis, Bell's palsy, and facial palsy caused by herpes simplex virus type 1 (HSV-1). Study patients underwent baseline audiometry with tympanometry and acoustic reflex, whereas current state of facial palsy was assessed by the HB scale. Subsequently, the same tests were obtained on three occasions, i.e. in week 3, 6 and 12 of presentation. Th e patients diagnosed with borreliosis, Bell's palsy and HSV-1 differed according to the time to acoustic refl ex recovery, which took longest time in patients with borreliosis. Th ese patients had the highest percentage of suprastapedial lesions at all time points and recovery was achieved later as compared with the other two diagnoses. Th e mean score on the HB scale declined with time, also at a slower rate in borreliosis patients. Th e prognosis of acoustic refl ex and facial palsy recovery according to HB scale was not associated with the length of elapsed time. The results obtained in the present study strongly confirmed the role of acoustic reflex and HB grading scale as prognostic indicators of facial palsy in neuroborreliosis.

Case report of physiotherapy care for a patient with facial nervus peripheral palsy

OpenAIRE

Kubartová, Veronika

2016-01-01

The title of the thesis: Case report of physiotherapy care for a patient with facial nervus peripheral palsy The aim of the thesis: The aim is to get acquainted with theoretical knowledge on the issues and the development of case studies, including design and the course of therapy for a patient with a diagnosis of facial nervus peripheral palsy. Methodology and evaluation: The content of this thesis is to introduce theoretical knowledge of facial nervus peripheral palsy, its treatment and reh...

A prospective study of 228 cases of Bell's palsy

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Soltanzadeh A

1993-05-01

Full Text Available Two hundred and twenty-eight patients who had developed Bell's palsy were investigated in a prospective study. Among them, 55% were male and 45% were female. The most common age of the disease onset was the third and beginning of the fourth decade of life. We found definite correlation between Bell's palsy, hypertension, and diabetes; its recurrence rate was 9%. The most important complication was facial asymmetry that remained in 15% of the patients. The most common symptom prior to the development of facial palsy was the existence of pain in the back of ears and neck. Our patients responded well to 8 mg dexamethasone administered for a period of one week

Changes in Cardiorespiratory Responses and Kinematics with Hippotherapy in Youth with and without Cerebral Palsy

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Rigby, Brandon Rhett; Gloeckner, Adam Robert; Sessums, Suzanne; Lanning, Beth Anne; Grandjean, Peter Walter

2017-01-01

Purpose: The purpose of this study was to characterize pelvic displacement and cardiorespiratory responses to simulated horseback riding and walking in youth with cerebral palsy and to compare responses to youth without cerebral palsy before and after 8 weeks of hippotherapy. Method: Eight youth with cerebral palsy (M[subscript age] = 10 ± 4…

A three-generation family with idiopathic facial palsy suggesting an autosomal dominant inheritance with high penetrance

DEFF Research Database (Denmark)

Larsen, Christian Grønhøj; Gyldenløve, Mette; Jønch, Aia Elise

2015-01-01

Idiopathic facial palsy (IFP), also known as Bell's palsy, is a common neurologic disorder, but recurrent and familial forms are rare. This case series presents a three-generation family with idiopathic facial palsy. The mode of inheritance of IFP has previously been suggested as autosomal dominant...

Stereotypic behaviors in degenerative dementias.

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Prioni, S; Fetoni, V; Barocco, F; Redaelli, V; Falcone, C; Soliveri, P; Tagliavini, F; Scaglioni, A; Caffarra, P; Concari, L; Gardini, S; Girotti, F

2012-11-01

Stereotypies are simple or complex involuntary/unvoluntary behaviors, common in fronto-temporal dementia (FTD), but not studied in other types of degenerative dementias. The aim was to investigate stereotypy frequency and type in patients with FTD, Alzheimer's disease (AD), progressive supranuclear palsy (PSP) and Parkinson's disease with dementia (PDD) in a multicenter observational study; and to investigate the relation of stereotypies to cognitive, behavioral and motor impairment. One hundred fifty-five consecutive outpatients (45 AD, 40 FTD, 35 PSP and 35 PDD) were studied in four hospitals in northern Italy. Stereotypies were examined by the five-domain Stereotypy Rating Inventory. Cognition was examined by the Mini Mental State and Frontal Assessment Battery, neuropsychiatric symptoms by the Neuropsychiatric Inventory, and motor impairment and invalidity by the Unified Parkinson's Disease Rating Scale part III, and activities of daily living. Stereotypies were present in all groups. FTD and PDD had the greatest frequency of one-domain stereotypies; FTD also had the greatest frequency of two-or-more domain stereotypies; movement stereotypies were the most common stereotypies in all groups. AD patients had fewer stereotypies than the other groups. Stereotypies are not exclusive to FTD, but are also fairly common in PSP and PDD, though less so in AD. Stereotypies may be underpinned by dysfunctional striato-frontal circuits, known to be damaged in PSP and PDD, as well as FTD.

Acupuncture for sequelae of Bell's palsy: a randomized controlled trial protocol

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Kim Yong-Suk

2011-03-01

Full Text Available Abstract Objective Incomplete recovery from facial palsy has a long-term impact on the quality of life, and medical options for the sequelae of Bell's palsy are limited. Invasive treatments and physiotherapy have been employed to relieve symptoms, but there is limited clinical evidence for their effectiveness. Acupuncture is widely used on Bell's palsy patients in East Asia, but there is insufficient evidence for its effectiveness on Bell's palsy sequelae. The objective is to evaluate the efficacy and safety of acupuncture in patients with sequelae of Bell's palsy. Method/Design This study consists of a randomized controlled trial with two parallel arms: an acupuncture group and a waitlist group. The acupuncture group will receive acupuncture treatment three times per week for a total of 24 sessions over 8 weeks. Participants in the waitlist group will not receive any acupuncture treatments during this 8 week period, but they will participate in the evaluations of symptoms at the start of the study, at 5 weeks and at 8 weeks after randomization, at which point the same treatment as the acupuncture group will be provided. The primary outcome will be analyzed by the change in the Facial Disability Index (FDI from baseline to week eight. The secondary outcome measures will include FDI from baseline to week five, House-Brackmann Grade, lip mobility, and stiffness scales. Trial registration Current Controlled-Trials ISRCTN43104115; registration date: 06 July 2010; the date of the first patient's randomization: 04 August 2010

Acupuncture for sequelae of Bell's palsy: a randomized controlled trial protocol

Science.gov (United States)

2011-01-01

Objective Incomplete recovery from facial palsy has a long-term impact on the quality of life, and medical options for the sequelae of Bell's palsy are limited. Invasive treatments and physiotherapy have been employed to relieve symptoms, but there is limited clinical evidence for their effectiveness. Acupuncture is widely used on Bell's palsy patients in East Asia, but there is insufficient evidence for its effectiveness on Bell's palsy sequelae. The objective is to evaluate the efficacy and safety of acupuncture in patients with sequelae of Bell's palsy. Method/Design This study consists of a randomized controlled trial with two parallel arms: an acupuncture group and a waitlist group. The acupuncture group will receive acupuncture treatment three times per week for a total of 24 sessions over 8 weeks. Participants in the waitlist group will not receive any acupuncture treatments during this 8 week period, but they will participate in the evaluations of symptoms at the start of the study, at 5 weeks and at 8 weeks after randomization, at which point the same treatment as the acupuncture group will be provided. The primary outcome will be analyzed by the change in the Facial Disability Index (FDI) from baseline to week eight. The secondary outcome measures will include FDI from baseline to week five, House-Brackmann Grade, lip mobility, and stiffness scales. Trial registration Current Controlled-Trials ISRCTN43104115; registration date: 06 July 2010; the date of the first patient's randomization: 04 August 2010 PMID:21388554

Treatment of os odontoideum in a patient with spastic quadriplegic cerebral palsy.

Science.gov (United States)

Akpolat, Yusuf T; Fegale, Ben; Cheng, Wayne K

2015-08-01

Severe atlantoaxial instability due to os odontoideum in a patient with spastic cerebral palsy has not been well described. There is no consensus on treatment, particularly with regard to conservative or surgical options. Our patient was a 9-year-old girl with spastic cerebral palsy and unstable os odontoideum as an incidental finding. During the waiting period for elective surgical treatment, the patient developed respiratory compromise. Surgery was performed to reduce the subluxation and for C1-C2 arthrodesis and the girl regained baseline respiratory function. A CT scan was obtained 1 year after the initial surgery and revealed adequate maintenance of reduction and patency of the spinal canal. This patient highlights the fact that unstable os odontoideum can cause mortality due to respiratory distress in patients with spastic cerebral palsy. This is an important factor in deciding treatment options for cerebral palsy patients with low functional demand. We review the relevant literature. Copyright © 2015 Elsevier Ltd. All rights reserved.

What constitutes cerebral palsy in the twenty-first century?

DEFF Research Database (Denmark)

Smithers-Sheedy, Hayley; Badawi, Nadia; Blair, Eve

2014-01-01

AIM: Determining inclusion/exclusion criteria for cerebral palsy (CP) surveillance is challenging. The aims of this paper were to (1) define inclusion/exclusion criteria that have been adopted uniformly by surveillance programmes and identify where consensus is still elusive, and (2) provide...... (SCPE; 1976-1998). An expert panel used a consensus building technique, which utilized the SCPE 'decision tree' and the original 'What constitutes cerebral palsy?' paper as frameworks. RESULTS: CP surveillance programmes agree on key clinical criteria pertaining to the type, severity, and origin...

[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.

[Functional electric stimulation (FES) in cerebral palsy].

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Miyazaki, M H; Lourenção, M I; Ribeiro Sobrinho, J B; Battistella, L R

1992-01-01

Our study concerns a patient with cerebral palsy, submitted to conventional occupational therapy and functional electrical stimulation. The results as to manual ability, spasticity, sensibility and synkinesis were satisfactory.

Lyme disease and Bell's palsy: an epidemiological study of diagnosis and risk in England.

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Cooper, Lilli; Branagan-Harris, Michael; Tuson, Richard; Nduka, Charles

2017-05-01

Lyme disease is caused by a tick-borne spirochaete of the Borrelia species. It is associated with facial palsy, is increasingly common in England, and may be misdiagnosed as Bell's palsy. To produce an accurate map of Lyme disease diagnosis in England and to identify patients at risk of developing associated facial nerve palsy, to enable prevention, early diagnosis, and effective treatment. Hospital episode statistics (HES) data in England from the Health and Social Care Information Centre were interrogated from April 2011 to March 2015 for International Classification of Diseases 10th revision (ICD-10) codes A69.2 (Lyme disease) and G51.0 (Bell's palsy) in isolation, and as a combination. Patients' age, sex, postcode, month of diagnosis, and socioeconomic groups as defined according to the English Indices of Deprivation (2004) were also collected. Lyme disease hospital diagnosis increased by 42% per year from 2011 to 2015 in England. Higher incidence areas, largely rural, were mapped. A trend towards socioeconomic privilege and the months of July to September was observed. Facial palsy in combination with Lyme disease is also increasing, particularly in younger patients, with a mean age of 41.7 years, compared with 59.6 years for Bell's palsy and 45.9 years for Lyme disease ( P = 0.05, analysis of variance [ANOVA]). Healthcare practitioners should have a high index of suspicion for Lyme disease following travel in the areas shown, particularly in the summer months. The authors suggest that patients presenting with facial palsy should be tested for Lyme disease. © British Journal of General Practice 2017.

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

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P. Alakram

2011-01-01

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.

Isometric muscle strength and mobility capacity in children with cerebral palsy.

Science.gov (United States)

Dallmeijer, Annet J; Rameckers, Eugene A; Houdijk, Han; de Groot, Sonja; Scholtes, Vanessa A; Becher, Jules G

2017-01-01

To determine the relationship between isometric leg muscle strength and mobility capacity in children with cerebral palsy (CP) compared to typically developing (TD) peers. Participants were 62 children with CP (6-13 years), able to walk with (n = 10) or without (n = 52) walking aids, and 47 TD children. Isometric muscle strength of five muscle groups of the leg was measured using hand-held dynamometry. Mobility capacity was assessed with the 1-min walk, the 10-m walk, sit-to-stand, lateral-step-up and timed-stair tests. Isometric strength of children with CP was reduced to 36-82% of TD. When adjusted for age and height, the percentage of variance in mobility capacity that was explained by isometric strength of the leg muscles was 21-24% (walking speed), 25% (sit-to-stand), 28% (lateral-step-up) and 35% (timed-stair) in children with CP. Hip abductors and knee flexors had the largest contribution to the explained variance, while knee extensors showed the weakest correlation. Weak or no associations were found between strength and mobility capacity in TD children. Isometric strength, especially hip abductor and knee flexor strength, is moderately related to mobility capacity in children with CP, but not in TD children. To what extent training of these muscle groups will lead to better mobility capacity needs further study. Implications for Rehabilitation Strength training in children with cerebral palsy (CP) may be targeted more specifically at hip abductors and knee flexors. The moderate associations imply that large improvements in mobility capacity may not be expected when strength increases.

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

NARCIS (Netherlands)

van de Graaf, RC; Nicolai, JPA

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

Parental Stress and Related Factors in Parents of Children with Cerebral Palsy

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Hui-Yi Wang

2004-07-01

Full Text Available Children with cerebral palsy display prominent motor dysfunction associated with other developmental disorders. Parenting a child with cerebral palsy presents a number of challenges and stresses. The first purpose of this study was to compare parental stress in parents of children with cerebral palsy to that in parents of children with typical development. The second purpose was to analyze the correlations between parental stress and parents' characteristics, the child's characteristics, the child's earliest age when rehabilitation was first commenced, and weekly frequency of rehabilitation for the child. A convenience sample of 63 parents of children with cerebral palsy (mean age of children, 4.3 ± 1.8 years was recruited. Forty parents of children with typical development were recruited as a comparison group. All parents filled out the Chinese version of the Parenting Stress Index (PSI, which consists of child domain and parent domain scales. The scores reported by parents of children with cerebral palsy in the child domain, parent domain, and PSI total scale were significantly higher than those for parents in the comparison group. The child domain score was significantly correlated to the child's age and severity of motor disability. A significant correlation was also found between the parent domain score and the child's earliest age of commencing rehabilitation. The PSI total scale score was significantly associated with both the child's severity of motor disability and age of commencing rehabilitation. Clinical professionals should be concerned about parental stress in parents of children with cerebral palsy and provide resources to support such parents. We suggest some strategies to reduce parental stress by strengthening parents' child-care skills.

The natural history and management of brachial plexus birth palsy

OpenAIRE

Buterbaugh, Kristin L.; Shah, Apurva S.

2016-01-01

Brachial plexus birth palsy (BPBP) is an upper extremity paralysis that occurs due to traction injury of the brachial plexus during childbirth. Approximately 20 % of children with brachial plexus birth palsy will have residual neurologic deficits. These permanent and significant impacts on upper limb function continue to spur interest in optimizing the management of a problem with a highly variable natural history. BPBP is generally diagnosed on clinical examination and does not typically req...

Balance improvement after physical therapy training using specially developed serious games for cerebral palsy children: preliminary results.

Science.gov (United States)

Bonnechère, Bruno; Omelina, Lubos; Jansen, Bart; Van Sint Jan, Serge

2017-02-01

Cerebral palsy (CP) leads to various clinical signs mainly induced by muscle spasticity and muscle weakness. Among these ones impaired balance and posture are very common. Traditional physical therapy exercise programs are focusing on this aspect, but it is difficult to motivate patients to regularly perform these exercises, especially at home without therapist supervision. Specially developed serious games (SG) could therefore be an interesting option to motivate children to perform specific exercise for balance improvement. Ten CP children participated in this study. Patients received four sessions of SG included into conventional therapy (1 session of 30 min a week during 4 weeks). Trunk control and balance were assessed using Trunk Control Motor Scale (TCMS) before and after interventions. Children presented a significant improvement in TCMS global score after interventions [37.6 (8.7) and 39.6 (9.5) before and after interventions, respectively, p = 0.04]. SG could therefore be an interesting option to integrate in the conventional treatment of CP children. Implication for Rehabilitation Cerebral palsy (CP) leads to balance issues. Rehabilitation exercises are not performed (enough) at home. Serious games (SG) could increase patients' motivation. SG increase balance control of CP children.

Antiviral treatment for Bell's palsy (idiopathic facial paralysis).

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Gagyor, Ildiko; Madhok, Vishnu B; Daly, Fergus; Somasundara, Dhruvashree; Sullivan, Michael; Gammie, Fiona; Sullivan, Frank

2015-11-09

Corticosteroids are widely used in the treatment of idiopathic facial paralysis (Bell's palsy), but the effectiveness of additional treatment with an antiviral agent is uncertain. Significant morbidity can be associated with severe cases of Bell's palsy. This review was first published in 2001 and revised several times, most recently in 2009. This version replaces an update of the review in Issue 7 of the Cochrane Library subsequently withdrawn because of an ongoing investigation into the reliability of data from an included study. To assess the effects of antiviral treatments alone or in combination with any other therapy for Bell's palsy. On 7 October 2014 we searched the Cochrane Neuromuscular Disease Group Specialized Register, CENTRAL, MEDLINE, EMBASE, LILACS, DARE, NHS EED, and HTA. We also reviewed the bibliographies of the identified trials and contacted trial authors and known experts in the field and relevant drug companies to identify additional published or unpublished data. We searched clinical trials registries for ongoing studies. We considered randomised controlled trials or quasi-randomised controlled trials of antivirals with and without corticosteroids versus control therapies for the treatment of Bell's palsy. We excluded trials that had a high risk of bias in several domains. Pairs of authors independently assessed trials for relevance, eligibility, and risk of bias, using standard Cochrane procedures. Ten trials, including 2280 participants, met the inclusion criteria and are included in the final analysis. Some of the trials were small, and a number were at high or unclear risk of bias. Other trials did not meet current best standards in allocation concealment and blinding. Incomplete recoveryWe found a significant benefit from adding antivirals to corticosteroids in comparison with corticosteroids alone for people with Bell's palsy (risk ratio (RR) 0.61, 95% confidence interval (CI) 0.39 to 0.97, n = 1315). For people with severe Bell

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.

Congenital Double Elevator Palsy with Sensory Exotropia: A Unique Surgical Management.

Science.gov (United States)

Nagpal, R C; Raj, Anuradha; Maitreya, Amit

2017-01-01

To report a unique surgical approach for congenital double elevator palsy with sensory exotropia. A 7-year-old boy with congenital double elevator palsy and sensory exotropia was managed surgically by Callahan's procedure with recession and resection of the horizontal recti for exotropia without inferior rectus recession, followed by frontalis sling surgery for congenital ptosis. Favourable surgical outcome was achieved without any complication.

Ocular cranial nerve palsies secondary to sphenoid sinusitis

Institute of Scientific and Technical Information of China (English)

Aiman El Mograbi; Ethan Soudry

2017-01-01

Objective:The clinical presentation of sphenoid sinusitis can be highly variable.Rarely,sphenoid sinusitis may present with cranial nerve complications due to the proximity of these structures to the sphenoid sinus.Method:A case series from Rabin Medical Center and all cases of cranial nerves palsies secondary to sphenoid sinusitis that have been reported in the literature were reviewed.Results:Seventeen patients were identified.The abducent nerve was the most common cranial nerve affected (76％),followed by the oculomotor nerve (18％).One patient had combined oculomotor,trochlear and abducent palsies.The most common pathology was isolated purulent sphenoid sinusitis in 64％ followed by allergic fungal sinusitis (AFS) in 18％,and fungal infection in 18％.94％ had an acute presentation.The majority (85％) received a combined intravenous antibiotics and surgical treatment.The remainder received conservative treatment alone.Complete recovery of cranial nerve palsy was noted in 82％ during follow up.Conclusion:Sphenoid sinusitis presenting as diplopia and headaches is rare.A neoplastic process must be ruled out and early surgical intervention with intravenous antimicrobial therapy carry an excellent outcome with complete resolution of symptoms.

Epilepsy and cerebral palsy: characteristics and trends in children born in 1976-1998

DEFF Research Database (Denmark)

Sellier, Elodie; Uldall, Peter; Calado, Eulalia

2012-01-01

Although epilepsy is common in children with cerebral palsy (CP), no data exists on prevalence rates of CP and epilepsy.......Although epilepsy is common in children with cerebral palsy (CP), no data exists on prevalence rates of CP and epilepsy....

Multiple Cranial Nerve Palsy Due to Cerebral Venous Thrombosis

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Esra Eruyar

2017-04-01

Full Text Available Cerebral venous thrombosis (CVT is a rare clinical condition between cerebrovasculer diases. The most common findings are headache, seizure and focal neurological deficit. Multiple cranial nerve palsy due to CVT is rarely seen and it is not clear pathology. A pathology that could explain the lack of cranial nerve imaging is carrying suspected diagnosis but the disease is known to provide early diagnosis and treatment. We want to emphasize with this case multipl cranial nerve palsy due to CVT is seen rarely and good response to treatment.

Impact of the surgical strategy on the incidence of C5 nerve root palsy in decompressive cervical surgery.

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Theresa Krätzig

Full Text Available Our aim was to identify the impact of different surgical strategies on the incidence of C5 palsy.Degenerative cervical spinal stenosis is a steadily increasing morbidity in the ageing population. Postoperative C5 nerve root palsy is a common complication with severe impact on the patients´ quality of life.We identified 1708 consecutive patients who underwent cervical decompression surgery due to degenerative changes. The incidence of C5 palsy and surgical parameters including type and level of surgery were recorded to identify predictors for C5 nerve palsy.The overall C5 palsy rate was 4.8%, with 18.3% of cases being bilateral. For ACDF alone the palsy rate was low (1.13%, compared to 14.0% of C5 palsy rate after corpectomy. The risk increased with extension of the procedures. Hybrid constructs with corpectomy plus ACDF at C3-6 showed significantly lower rates of C5 palsy (10.7% than corpectomy of two vertebrae (p = 0.005. Multiple regression analysis identified corpectomy of C4 or C5 as a significant predictor. We observed a lower overall incidence for ventral (4.3% compared to dorsal (10.9% approaches (p<0.001. When imaging detected a postoperative shift of the spinal cord at index segment C4/5, palsy rate increased significantly (33.3% vs. 12.5%, p = 0.034.Extended surgical strategies, such as dorsal laminectomies, multilevel corpectomies and procedures with extensive spinal cord shift were shown to display a high risk of C5 palsy. The use of extended procedures should therefore be employed cautiously. Switching to combined surgical methods like ACDF plus corpectomy can reduce the rate of C5 palsy.

Restricted Arm Swing Affects Gait Stability and Increased Walking Speed Alters Trunk Movements in Children with Cerebral Palsy

Science.gov (United States)

Delabastita, Tijs; Desloovere, Kaat; Meyns, Pieter

2016-01-01

Observational research suggests that in children with cerebral palsy, the altered arm swing is linked to instability during walking. Therefore, the current study investigates whether children with cerebral palsy use their arms more than typically developing children, to enhance gait stability. Evidence also suggests an influence of walking speed on gait stability. Moreover, previous research highlighted a link between walking speed and arm swing. Hence, the experiment aimed to explore differences between typically developing children and children with cerebral palsy taking into account the combined influence of restricting arm swing and increasing walking speed on gait stability. Spatiotemporal gait characteristics, trunk movement parameters and margins of stability were obtained using three dimensional gait analysis to assess gait stability of 26 children with cerebral palsy and 24 typically developing children. Four walking conditions were evaluated: (i) free arm swing and preferred walking speed; (ii) restricted arm swing and preferred walking speed; (iii) free arm swing and high walking speed; and (iv) restricted arm swing and high walking speed. Double support time and trunk acceleration variability increased more when arm swing was restricted in children with bilateral cerebral palsy compared to typically developing children and children with unilateral cerebral palsy. Trunk sway velocity increased more when walking speed was increased in children with unilateral cerebral palsy compared to children with bilateral cerebral palsy and typically developing children and in children with bilateral cerebral palsy compared to typically developing children. Trunk sway velocity increased more when both arm swing was restricted and walking speed was increased in children with bilateral cerebral palsy compared to typically developing children. It is proposed that facilitating arm swing during gait rehabilitation can improve gait stability and decrease trunk movements in

Isolated oculomotor nerve palsy resulting from acute traumatic tentorial subdural hematoma

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Cui V

2016-10-01

Full Text Available Victoria Cui,1 Timur Kouliev2 1Washington University School of Medicine, St Louis, MO, USA; 2Emergency Department, Beijing United Family Hospital, Beijing, China Abstract: Acute subdural hematoma (SDH resulting from head trauma is a potentially life-threatening condition that requires expedient diagnosis and intervention to ensure optimal patient outcomes. Rapidly expanding or large hematomas, elevated intracranial pressure, and associated complications of brain herniation are associated with high mortality rates and poor recovery of neurological function. However, smaller bleeds (clot thickness <10 mm or hematomas occurring in infrequent locations, such as the tentorium cerebelli, may be difficult to recognize and patients may present with unusual or subtle signs and symptoms, including isolated cranial nerve palsies. Knowledge of neuroanatomy supported by modern neuroimaging can greatly aid in recognition and diagnosis of such lesions. In this report, we present a case of isolated oculomotor nerve palsy resulting from compressive tentorial SDH following blunt head trauma, review the literature concerning similar cases, and make recommendations regarding the diagnosis of SDH in patients presenting with isolated cranial nerve palsies. Keywords: head injury, oculomotor, palsy, subdural hematoma, trauma, tentorium, cerebral herniation, intracranial hemorrhage

Bangladesh Cerebral Palsy Register (BCPR): a pilot study to develop a national cerebral palsy (CP) register with surveillance of children for CP.

Science.gov (United States)

Khandaker, Gulam; Smithers-Sheedy, Hayley; Islam, Johurul; Alam, Monzurul; Jung, Jenny; Novak, Iona; Booy, Robert; Jones, Cheryl; Badawi, Nadia; Muhit, Mohammad

2015-09-25

The causes and pathogenesis of cerebral palsy (CP) are all poorly understood, particularly in low- and middle-income countries (LMIC). There are gaps in knowledge about CP in Bangladesh, especially in the spheres of epidemiological research, intervention and service utilization. In high-income countries CP registers have made substantial contributions to our understanding of CP. In this paper, we describe a pilot study protocol to develop, implement, and evaluate a CP population register in Bangladesh (i.e., Bangladesh Cerebral Palsy Register - BCPR) to facilitate studies on prevalence, severity, aetiology, associated impairments and risk factors for CP. The BCPR will utilise a modified version of the Australian Cerebral Palsy Register (ACPR) on a secured web-based platform hosted by the Cerebral Palsy Alliance Research Institute, Australia. A standard BCPR record form (i.e., data collection form) has been developed in consultation with local and international experts. Using this form, the BPCR will capture information about maternal health, birth history and the nature of disability in all children with CP aged CP will be identified by using the community based Key Informants Method (KIM). Data from the completed BPCR record together with details of assessment by a research physician will be entered into an online data repository. Once implemented, BCPR will be, to the best of our knowledge, the first formalised CP register from a LMIC. Establishment of the BCPR will enable estimates of prevalence; facilitate clinical surveillance and promote research to improve the care of individuals with CP in Bangladesh.

Ocular defects in cerebral palsy

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Katoch Sabita

2007-01-01

Full Text Available There is a high prevalence of ocular defects in children with developmental disabilities. This study evaluated visual disability in a group of 200 cerebral palsy (CP patients and found that 68% of the children had significant visual morbidity. These findings emphasize the need for an early ocular examination in patients with CP.

MANAGEMENT OF CHILDREN WITH CEREBRAL PALSY

African Journals Online (AJOL)

Enrique

ing children with cerbral palsy spans more than 4 decades, and has inspired so many of us to work in .... toy. Prone lying over a longitudinal pillow with weight bearing on the forearms should alternate .... ing being blind and deaf. Assessing a.

Screening and assessment of chronic pain among children with cerebral palsy: a process evaluation of a pain toolbox.

Science.gov (United States)

Orava, Taryn; Provvidenza, Christine; Townley, Ashleigh; Kingsnorth, Shauna

2018-06-08

Though high numbers of children with cerebral palsy experience chronic pain, it remains under-recognized. This paper describes an evaluation of implementation supports and adoption of the Chronic Pain Assessment Toolbox for Children with Disabilities (the Toolbox) to enhance pain screening and assessment practices within a pediatric rehabilitation and complex continuing care hospital. A multicomponent knowledge translation strategy facilitated Toolbox adoption, inclusive of a clinical practice guideline, cerebral palsy practice points and assessment tools. Across the hospital, seven ambulatory care clinics with cerebral palsy caseloads participated in a staggered roll-out (Group 1: exclusive CP caseloads, March-December; Group 2: mixed diagnostic caseloads, August-December). Evaluation measures included client electronic medical record audit, document review and healthcare provider survey and interviews. A significant change in documentation of pain screening and assessment practice from pre-Toolbox (<2%) to post-Toolbox adoption (53%) was found. Uptake in Group 2 clinics lagged behind Group 1. Opportunities to use the Toolbox consistently (based on diagnostic caseload) and frequently (based on client appointments) were noted among contextual factors identified. Overall, the Toolbox was positively received and clinically useful. Findings affirm that the Toolbox, in conjunction with the application of integrated knowledge translation principles and an established knowledge translation framework, has potential to be a useful resource to enrich and standardize chronic pain screening and assessment practices among children with cerebral palsy. Implications for Rehabilitation It is important to engage healthcare providers in the conceptualization, development, implementation and evaluation of a knowledge-to-action best practice product. The Chronic Pain Toolbox for Children with Disabilities provides rehabilitation staff with guidance on pain screening and assessment

Arithmetic difficulties in children with cerebral palsy are related to executive function and working memory.

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Jenks, Kathleen M; de Moor, Jan; van Lieshout, Ernest C D M

2009-07-01

Although it is believed that children with cerebral palsy are at high risk for learning difficulties and arithmetic difficulties in particular, few studies have investigated this issue. Arithmetic ability was longitudinally assessed in children with cerebral palsy in special (n = 41) and mainstream education (n = 16) and controls in mainstream education (n = 16). Second grade executive function and working memory scores were used to predict third grade arithmetic accuracy and response time. Children with cerebral palsy in special education were less accurate and slower than their peers on all arithmetic tests, even after controlling for IQ, whereas children with cerebral palsy in mainstream education performed as well as controls. Although the performance gap became smaller over time, it did not disappear. Children with cerebral palsy in special education showed evidence of executive function and working memory deficits in shifting, updating, visuospatial sketchpad and phonological loop (for digits, not words) whereas children with cerebral palsy in mainstream education only had a deficit in visuospatial sketchpad. Hierarchical regression revealed that, after controlling for intelligence, components of executive function and working memory explained large proportions of unique variance in arithmetic accuracy and response time and these variables were sufficient to explain group differences in simple, but not complex, arithmetic. Children with cerebral palsy are at risk for specific executive function and working memory deficits that, when present, increase the risk for arithmetic difficulties in these children.

A comparative technetium 99m hexamethylpropylene amine oxime SPET study in different types of dementia

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Habert, M O; Piketty, M L; Askienazy, S [Centre Hospitalier Sainte-Anne, 75 - Paris (France). Dept. de Medecine Nucleaire; Spampinato, U; Mas, J L; Recondo, J de; Rondot, P [Centre Hospitalier Sainte-Anne, 75 - Paris (France). Dept. de Neurologie; Bourdel, M C [Centre Hospitalier Sainte-Anne, 75 - Paris (France). Dept. de Psychiatrie

1991-01-01

Regional cerebral perfusion was evaluated by single photon emission tomography (SPET) using technetium 99m hexamethylpropylene amine oxime ({sup 99m}Tc-HMPAO) as a tracer, in 13 control subjects and 44 age-matched patients suffering from dementia of the Alzheimer's type (DAT, n=19) presumed Pick's disease (n=5), idiopathic Parkinson's disease with dementia (DPD, n=15) and progressive supranuclear palsy (PSP, n=5), HMPAO uptake was measured in the superior frontal, inferior frontal, parietal, temporal and occipital cortices, and the perfusion values were expressed as cortical/cerebellar activity ratios. As compared with controls, tracer uptake ratios in the DAT group were signficantly reduced over all cortical regions, with the largest defects in the parieto-temporal and superior frontal cortices. A marked hypoperfusion affecting the superior and inferior frontal cortices was found in Pick's diesease, whereas a mild but significant hypoperfusion was observed only in the superior frontal cortex of patients with PSP. In the DPD group, HMPAO uptake was significantly reduced in the parietal, temporal and occipital cortices, but not in the frontal cortex. These results show that DAT and DPD share the opposite anteroposterior HMPAO uptake defect as compared with the Pick's and PSP groups. (orig.).

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....... social care costs and productivity costs associated with CP point to a potential gain from labour market interventions that benefit individuals with CP.......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...... in 2000. The prevalence of CP in eastern Denmark was approximately 1.7 per 1000. Information on productivity and the use of health care was retrieved from registers. The lifetime cost of CP was about euro860 000 for men and about euro800 000 for women. The largest component was social care costs...

Neuroimpairment, activity limitation, and participation restriction among children with cerebral palsy in Hong Kong.

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Chan, H S S; Lau, P H B; Fong, K H; Poon, D; Lam, C C C

2005-10-01

To study children with cerebral palsy in Hong Kong, their neuroimpairment, activity limitation, and participation restriction in society. Parents' opinion on current medical and rehabilitation services was also sought. Systematic survey using questionnaires. Four associations in Hong Kong: Child Assessment Service, Hong Kong Association for Parents of Children with Physical Disabilities, Association of Parents of the Severely Mentally Handicapped, and Hong Kong Physically Handicapped and Able-Bodied Association. Parents of children with cerebral palsy. Neuroimpairment, activity limitation, and participation restriction. Information from 181 children with cerebral palsy was analysed. Among them, 56% were boys. The mean age was 7 years 6 months (standard deviation, 3 years 11 months). The most common diagnostic type was spastic cerebral palsy. Co-morbidities in children with cerebral palsy were common. Limitation in daily activities including mobility and self-care tasks was considerable and this posed great stress to parents when taking care of their children. Children's participation in both social and leisure activities was regarded as a low priority. A high percentage (70%) of parents reported difficulty in travelling. The reasons involved problems in transportation, building access (entry and exit), and attitudes of the general public. These environmental factors restricted the social participation of the children and their families. Over 75% of parents were satisfied with the current medical and rehabilitation services. Children with cerebral palsy have multiple and complex needs. The findings of this study may serve as a reference for parents, service providers, and policy makers to work in partnership to achieve a more comprehensive health-care service for children with cerebral palsy and to facilitate better integration into the community.

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

International Nuclear Information System (INIS)

Katsuno, Makoto; Kobayashi, Shiro; Yokota, Hiroyuki; Teramoto, Akira

2008-01-01

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)

Recurrent unilateral facial nerve palsy in a child with dehiscent facial nerve canal

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Christopher Liu

2016-12-01

Full Text Available Objective: The dehiscent facial nerve canal has been well documented in histopathological studies of temporal bones as well as in clinical setting. We describe clinical and radiologic features of a child with recurrent facial nerve palsy and dehiscent facial nerve canal. Methods: Retrospective chart review. Results: A 5-year-old male was referred to the otolaryngology clinic for evaluation of recurrent acute otitis media and hearing loss. He also developed recurrent left peripheral FN palsy associated with episodes of bilateral acute otitis media. High resolution computed tomography of the temporal bones revealed incomplete bony coverage of the tympanic segment of the left facial nerve. Conclusions: Recurrent peripheral FN palsy may occur in children with recurrent acute otitis media in the presence of a dehiscent facial nerve canal. Facial nerve canal dehiscence should be considered in the differential diagnosis of children with recurrent peripheral FN palsy.

Evaluation of a physiotherapeutic treatment intervention in "Bell's" facial palsy.

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Cederwall, Elisabet; Olsén, Monika Fagevik; Hanner, Per; Fogdestam, Ingemar

2006-01-01

The aim of this study was to evaluate a physiotherapeutic treatment intervention in Bell's palsy. A consecutive series of nine patients with Bell's palsy participated in the study. The subjects were enrolled 4-21 weeks after the onset of facial paralysis. The study had a single subject experimental design with a baseline period of 2-6 weeks and a treatment period of 26-42 weeks. The patients were evaluated using a facial grading score, a paresis index and a written questionnaire created for this study. Every patient was taught to perform an exercise program twice daily, including movements of the muscles surrounding the mouth, nose, eyes and forehead. All the patients improved in terms of symmetry at rest, movement and function. In conclusion, patients with remaining symptoms of Bell's palsy appear to experience positive effects from a specific training program. A larger study, however, is needed to fully evaluate the treatment.

Phrenic Nerve Palsy as Initial Presentation of Large Retrosternal Goitre.

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Hakeem, Arsheed Hussain; Hakeem, Imtiyaz Hussain; Wani, Fozia Jeelani

2016-12-01

Unilateral phrenic nerve palsy as initial presentation of the retrosternal goitre is extremely rare event. This is a case report of a 57-year-old woman with history of cough and breathlessness of 3 months duration, unaware of the thyroid mass. She had large cervico-mediastinal goiter and chest radiograph revealed raised left sided hemidiaphragm. Chest CT scan did not reveal any lung parenchymal or mediastinal pathology. The patient underwent a total thyroidectomy through a cervical approach. The final pathology was in favor of multinodular goitre. Even after 1 year of follow up, phrenic nerve palsy did not improve indicating permanent damage. Phrenic nerve palsy as initial presentation of the retrosternal goitre is unusual event. This case is reported not only because of the rare nature of presentation, but also to make clinicians aware of the entity so that early intervention may prevent attendant morbidity.

Rhinoscintigraphic analysis of nasal mucociliary function in patients with Bell's palsy.

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Boynuegri, S; Ozer, S; Peksoy, I; Acikalin, A; Tuna, E Ü; Dursun, E; Eryilmaz, A

2016-01-01

Mucociliary transport (MCT) is an important defense mechanism of the respiratory tract. One of the major factors determining MCT is the ciliary activity of the respiratory epithelium. Rhinoscintigraphy is the most commonly used method for the analysis of mucociliary activity. The aim of this study was to investigate the effect of facial paralysis on the nasal mucociliary clearance. This study included 38 Bell's palsy patients as the study group and 10 subjects without any history of paranasal sinus disease or facial paralysis as the control group. A drop of technetium 99m-labeled macroaggregated albumin (Tc-99m MAA) was placed posterior to the head of the inferior turbinate and followed with a gamma camera. MCT rate was measured as the velocity of Tc-99m MAA drop. The mean MCT rate was 4.27 ± 0.76 millimeters per minute (mm/min) on 20 sides of 10 healthy controls, 4.11 ± 2.91 mm/min on the affected sides of the patients with Bell's palsy, and 6.03 ± 3.13 mm/min on the nonparalyzed sides of the patients. MCT rate was statistically significantly faster in the nonparalyzed side when compared to the paralyzed side in Bell's palsy patients (P = 0.001). MCT rates were not significantly different in the control group and paralyzed sides of the Bell's palsy patients (P = 0.810). The MCT rate was statistically significantly faster in the nonparalyzed sides of Bell's palsy patients when compared to the controls (P = 0.017). This study showed a faster MCT rate on the nonparalyzed side in Bell's palsy patients when compared to the paralyzed side and the control subjects. A compensatory mechanism could be the underlying reason for faster MCT on the nonparalyzed side. Further studies on larger patient groups are needed to investigate the effect of facial paralysis on the MCT and changes of facial nerve function on the opposite, nonparalyzed side of the face.

Neonatal risk factors for cerebral palsy in very preterm babies: case-control study.

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Murphy, D. J.; Hope, P. L.; Johnson, A.

1997-01-01

OBJECTIVE: To identify neonatal risk factors for cerebral palsy among very preterm babies and in particular the associations independent of the coexistence of antenatal and intrapartum factors. DESIGN: Case-control study. SETTING: Oxford health region. SUBJECTS: Singleton babies born between 1984 and 1990 at less than 32 weeks' gestation who survived to discharge from hospital: 59 with cerebral palsy and 234 randomly selected controls without cerebral palsy. MAIN OUTCOME MEASURES: Adverse neonatal factors expressed as odds ratios and 95% confidence intervals. RESULTS: Factors associated with an increased risk of cerebral palsy after adjustment for gestational age and the presence of previously identified antenatal and intrapartum risk factors were patent ductus arteriosus (odds ratio 2.3; 95% confidence interval 1.2 to 4.5), hypotension (2.3; 1.3 to 4.7), blood transfusion (4.8; 2.5 to 9.3), prolonged ventilation (4.8; 2.5 to 9.0), pneumothorax (3.5; 1.6 to 7.6), sepsis (3.6; 1.8 to 7.4), hyponatraemia (7.9; 2.1 to 29.6) and total parenteral nutrition (5.5; 2.8 to 10.5). Seizures were associated with an increased risk of cerebral palsy (10.0; 4.1 to 24.7), as were parenchymal damage (32; 12.4 to 84.4) and appreciable ventricular dilatation (5.4; 3.0 to 9.8) detected by cerebral ultrasound. CONCLUSION: A reduction in the rate of cerebral palsy in very preterm babies requires an integrated approach to management throughout the antenatal, intrapartum, and neonatal periods. PMID:9040385

Quality of life of mothers of children with cerebral palsy and their ...

African Journals Online (AJOL)

Quality of life of mothers of children with cerebral palsy and their agematched controls. BOA Adegoke, OO Adenuga, OA Olaleye, CO Akosile. Abstract. Background Caring for a child with cerebral palsy (CP) could negatively impact the quality of life (QoL) of the mothers who are usually the primary caregivers. Studies on the ...

Different metabolic patterns analysis of Parkinsonism on the {sup 18}F-FDG PET

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Juh, Rahyeong; Kim, Jaesung; Moon, Daehyuk; Choe, Boyoung; Suh, Tasuk E-mail: suhsanta@catholic.ac.kr

2004-09-01

Idiopathic Parkinson's disease (IPD), progressive supranuclear palsy (PSP) and multiple system atrophy (MSA) are the most common movement disorders associated with neurodegenerative disease. A clinical differential diagnosis of IPD and atypical Parkinsonian disorders, such as MSA and PSP, is often complicated by the presence of symptoms common to both groups. Since Parkinsonism has a different pathophysiology in the cortical and subcortical brain structures, assessing the regional cerebral glucose metabolism may assist in making a differential diagnosis of Parkinsonism. The {sup 18}F-FDG PET images of IPD, MSA and PSP were assessed using statistical parametric mapping (SPM) in order to determine the useful metabolic patterns. Twenty-four patients with Parkinsonism: eight patients (mean age 67.9{+-}10.7 years; M/F: 3/5) with IPD, nine patients (57.9{+-}9.2 years; M/F: 4/5) with MSA and seven patients (67.6{+-}4.8 years; M/F: 3/4) with PSP were enrolled in this study. All patients with Parkinsonism and 22 age-matched normal controls underwent {sup 18}F-FDG PET, (after 370 MBq {sup 18}F-FDG). The three groups and the individual IPD, MSA and PSP patients were compared with a normal control group using a two-sided t-test of SPM (uncorrected P<0.01, extent threshold >100 voxel). The IPD, MSA and PSP groups showed significant hypometabolism in the cerebral neocortex compared to the normal control group. The MSA group showed significant hypometabolism in the putamen, pons and cerebellum compared to the normal controls and IPD groups. In addition, PSP showed significant hypometabolism in the caudate nucleus, the thalamus, midbrain and the cingulate gyrus compared to the normal controls, the IPD and the MSA groups. In conclusion, an assessment of the {sup 18}F-FDG PET images using SPM may be a useful adjunct to a clinical examination when making a differential diagnosis of Parkinsonism.

Physical activity as a prescription for the children with cerebral palsy

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Arghavan Shariat

2014-03-01

Full Text Available After so many years devoted to practicing medicine as children physiotherapists, the therapists finally found the importance of balance training exercises in children who suffer from cerebral palsy. It is only through controlling balance that we can achieve improvement in body movement and position that will culminate into performance independence in a child. Formerly, working over controlling balance in cerebral palsy children has been very difficult, because contracture and spasticity did not let us to have an effective balance training exercise. In this respect, we have summarized the results of previous authors that specify the level of effectiveness of exercise therapy. The results of different studies showed that level of effectiveness of exercise therapy on alleviating the symptoms of spastic cerebral palsy is average in accordance with Cohen's effect size Interpretation table.

Children's perceptions of their cerebral palsy and their impact on life satisfaction.

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Chong, Jimmy; Mackey, Anna H; Broadbent, Elizabeth; Stott, N Susan

2012-01-01

To assess an individual child's cognitive and emotional perceptions of their cerebral palsy (CP) and how these are associated with their reported life satisfaction and their functional walking ability. Convenience sample of 48 children with cerebral palsy, GMFCS (Gross Motor Function Classification System) I-IV, mean age of 12.2 ± 2.5 years was recruited from tertiary level out-patient clinics. All children completed the Brief Illness Perception Questionnaire-Cerebral Palsy version (BIPQ-CP), Students' Life Satisfaction Scale (SLSS) and 1- and 6-min walk tests. Children with CP reported levels of global life satisfaction (mean score 31.4/42) equivalent to previous studies of typically developing children. Higher total SLSS scores were associated with lower concern about CP (rho = -0.61, p life satisfaction. Life satisfaction in this group of children was strongly associated with a child's perceptions of their CP but was not associated with functional walking ability. Although the cross-sectional nature of the study precludes assumptions of causality, understanding children's cognitive and emotional beliefs about their cerebral palsy would seem to be an important adjunct to clinical management.

Unilateral abducens and bilateral facial nerve palsies associated with posterior fossa exploration surgery.

Science.gov (United States)

Khalil, Ayman; Clerkin, James; Mandiwanza, Tafadzwa; Green, Sandra; Javadpour, Mohsen

2016-03-06

Multiple cranial nerves palsies following a posterior fossa exploration confined to an extradural compartment is a rare clinical presentation. This case report describes a young man who developed a unilateral abducens and bilateral facial nerve palsies following a posterior fossa exploration confined to an extradural compartment. There are different theories to explain this presentation, but the exact mechanism remains unclear. We propose that this patient cranial nerve palsies developed following cerebrospinal fluid (CSF) leak, potentially as a consequence of rapid change in CSF dynamics. Published by Oxford University Press and JSCR Publishing Ltd. All rights reserved. © The Author 2016.

The Effect of Hominis Placenta Herbal Acupuncture on Bell's palsy

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Yun Jeong-hun

2000-07-01

Full Text Available This report was done to observe the effect of Hominis placenta herbal acupuncture on Bell's palsy. The study group comprised 16 patients who arrived at Woo-suk university oriental hospital from January, 1999 till January, 2000 for Bell's palsy. All patients were divided into two group. One was herbal acupunture group, and the other was control group. Acupunture group was done herbal acupuncture therapy on the facial acupuncture points. Followings are achievement and a term of each group. In herbal acupuncture group, 100% motor recovery was 7 case, 75% was 1 case, and 25% motor recovery term was 7.38±5.21 days, 50% was 11.00±6.16 days, 75% was 15.13±9.55 days, 100% was 23.14±7.97 days. In control group, 100% motor recovery was 4 case, 75% was 2 case, 25% below was 2 case and 25% motor recovery term was 11.17±4.96days, 50% was 18.17±6.82 days, 75% was 29.50±6.95 days, 100% was 44.00±11.49 days. The above results indicate that Hominis placenta herbal acupuncture is a useful effect on Bell's palsy. thus, continuous herbal acupunture study will be needed for more clinical application on Bell' palsy.

Prognostic factors for recovery in Portuguese patients with Bell's palsy.

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Ferreira, Margarida; Firmino-Machado, João; Marques, Elisa A; Santos, Paula C; Simões, Ana Daniela; Duarte, José A

2016-10-01

The main aim of this study was to identify the prognostic factors that contribute to complete recovery at 6 weeks and 6 months in patients with Bell's palsy. This is a prospective, longitudinal, and descriptive study that included 123 patients diagnosed with facial nerve palsy (FNP) at a hospital in Guimarães, Portugal. However, only 73 patients with Bell's palsy (BP) were included in the assessment of recovery at 6 weeks and 6 months. We analyzed the demographic and clinical characteristics of the patients, including sex, age, paralyzed side, occupation, previous and associated symptoms, seasonal occurrence, familial facial palsy, patient perception, intervention options, and baseline grade according to the House-Brackmann facial grading system (HB-FGS). Of the 123 cases with FNP, 79 (64.2%) patients had BP. Age, sex, and baseline HB-FGS grades were significant predictors of complete recovery at 6 weeks. Patients with HB-FGS grade III or lower (6 weeks baseline) had significant recovery of function at 6 months. Baseline severity of BP, elderly patients, and male sex were early predictors of poor prognosis. Patients with mild and moderate dysfunction according to the HB-FGS achieved significant normal facial function at 6 months. Further prospective studies with longer observation periods and larger samples are needed to verify the results.

Isolated unilateral sixth cranial nerve palsy: A rare presentation of dengue fever

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Yang Liang Boo

2016-11-01

Full Text Available Dengue fever is a common mosquito-borne viral infection endemic in tropical and subtropical countries. Neurological manifestations in dengue infection are relatively uncommon, and include encephalitis, encephalopathy, neuromuscular disorders and neuro-ocular disorders. Cranial mononeuropathy is a rare manifestation of dengue infection. A 40-year-old man was diagnosed with isolated, unilateral sixth cranial nerve palsy complicating dengue infection. The patient was managed accordingly, and full ocular recovery was observed. This was the first reported case of isolated sixth cranial nerve palsy associated with dengue fever in Malaysia. It is important for clinicians to consider dengue as a differential diagnosis in patients presenting with fever and sixth cranial nerve palsy.

CT findings in patients with cerebral palsy

International Nuclear Information System (INIS)

Konno, Kimiichi

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. (Ueda, J.)

Association of cerebral palsy with Apgar score in low and normal birthweight infants: population based cohort study

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Grøholt, Else-Karin; Eskild, Anne

2010-01-01

Objectives To assess the association of Apgar score 5 minutes after birth with cerebral palsy in both normal weight and low birthweight children, and also the association with the cerebral palsy subdiagnoses of quadriplegia, diplegia, and hemiplegia. Design Population based cohort study. Setting The Medical Birth Registry of Norway was used to identify all babies born between 1986 and 1995. These data were linked to the Norwegian Registry of Cerebral Palsy in Children born 1986-95, which was established on the basis of discharge diagnoses at all paediatric departments in Norway. Population All singletons without malformations born in Norway during 1986-95 and who survived the first year of life (n=543 064). Main outcome measure Cerebral palsy diagnosed before the age of 5 years. Results 988 children (1.8 in 1000) were diagnosed with cerebral palsy before the age of 5 years. In total, 11% (39/369) of the children with Apgar score of less than 3 at birth were diagnosed with cerebral palsy, compared with only 0.1% (162/179 515) of the children with Apgar score of 10 (odds ratio (OR) 53, 95% CI 35 to 80 after adjustment for birth weight). In children with a birth weight of 2500 g or more, those with an Apgar score of less than 4 were much more likely to have cerebral palsy than those who had an Apgar score of more than 8 (OR 125, 95% confidence interval 91 to 170). The corresponding OR in children weighing less than 1500 g was 5 (95% CI 2 to 9). Among children with Apgar score of less than 4, 10-17% in all birthweight groups developed cerebral palsy. Low Apgar score was strongly associated with each of the three subgroups of spastic cerebral palsy, although the association was strongest for quadriplegia (adjusted OR 137 for Apgar score 8, 95% CI 77 to 244). Conclusions Low Apgar score was strongly associated with cerebral palsy. This association was high in children with normal birth weight and modest in children with low birth weight. The strength of the

Health issues in young adults with cerebral palsy: towards a life-span perspective.

NARCIS (Netherlands)

Hilberink, S.R.; Roebroeck, M.E.; Nieuwstraten, W.; Jalink, L.; Verheijden, J.M.; Stam, H.J.

2007-01-01

OBJECTIVE: To obtain better insight into the health issues of young adults with cerebral palsy. DESIGN: Cross-sectional. SUBJECTS: Two data sources were used: 54 adults with cerebral palsy (age range 25-36 years) and 48 physicians (members of the Netherlands Society of Physical and Rehabilitation

Teeth grinding, oral motor performance and maximal bite force in cerebral palsy children.

Science.gov (United States)

Botti Rodrigues Santos, Maria Teresa; Duarte Ferreira, Maria Cristina; de Oliveira Guaré, Renata; Guimarães, Antonio Sergio; Lira Ortega, Adriana

2015-01-01

Identify whether the degree of oral motor performance is related to the presence of teeth grinding and maximal bite force values in children with spastic cerebral palsy. Ninety-five spastic cerebral palsy children with and without teeth grinding, according to caregivers' reports, were submitted to a comprehensive oral motor performance evaluation during the feeding process using the Oral Motor Assessment Scale. Maximal bite force was measured using an electronic gnathodynamometer. The teeth grinding group (n = 42) was younger, used anticonvulsant drugs, and was more frequently classified within the subfunctional oral motor performance category. Teeth grinding subfunctional spastic cerebral palsy children presented lower values of maximal bite force. The functional groups showing the presence or absence of teeth grinding presented higher values of maximal bite force compared with the subfunctional groups. In spastic cerebral palsy children, teeth grinding is associated with the worse oral motor performance. © 2015 Special Care Dentistry Association and Wiley Periodicals, Inc.

Cosmetic appreciation of lateralization of peripheral facial palsy: 'preference for left or right, true or mirror image?'.

Science.gov (United States)

Pouwels, Sjaak; Ingels, Koen; van Heerbeek, Niels; Beurskens, Carien

2014-09-01

There have been several studies in the past depicting asymmetry in 'normal' human faces. Evidence supports the fact that the right hemisphere is superior in the recognition of emotions expressed by the human face and indicates a right hemispheric specialization for processing emotional information. The primary aim of this study is to determine whether there is a difference in cosmetic appreciation of a left peripheral facial palsy compared to a right peripheral facial palsy? Pictures of patients with a facial palsy with House-Brackmann II-VI were reversed as a mirror image and offered as a pair of pictures, together with the true image. Forty-two patients and 24 medical professionals familiar with facial palsy were asked to choose the most attractive photograph. The primary 'end' point was the most attractive side in the pictures chosen by medical professionals and patients. The secondary 'end' points consisted of the preferences for the mirror or true image, and influences of the House-Brackmann score and age. Medical professionals preferred the photographs from patients with a right and left peripheral facial palsy (PFP) in, respectively, a mean of 44 % (41-48 %) and 56 % (52-59 %) of the pictures (p = 0.02). When comparing mirror and true image, patients with a left-sided facial palsy chose their mirror and true image as most attractive in 90 and 10 %, respectively (p 0.05). Subanalysis of patients with a PFP House-Brackmann score V and VI showed that medical professionals did not have a significant preference for a left nor right-sided facial palsy. Patients with a left-sided facial palsy chose their mirror image in all cases and patients with a right-sided palsy chose their mirror and true image in resp. 33 and 67 %. The House-Brackmann score (p = 0.52) and age (p = 0.73) of the patients did not influence preferences. This study, demonstrating that medical professionals find a right-sided facial palsy cosmetically less attractive than a left-sided, has

Effects of electrical stimulation on House-Brackmann scores in early Bell's palsy.

Science.gov (United States)

Alakram, Prisha; Puckree, Threethambal

2010-04-22

ABSTRACT Limited evidence may support the application of electrical stimulation in the subacute and chronic stages of facial palsy, yet some physiotherapists in South Africa have been applying this modality in the acute stage in the absence of published evidence of clinical efficacy. This preliminary study's aim was to determine the safety and potential efficacy of applying electrical stimulation to the facial muscles during the early phase of Bells palsy. A pretest posttest control vs. experimental groups design composed of 16 patients with Bell's palsy of less than 30 days' duration. Adult patients with clinical diagnosis of Bell's palsy were systematically (every second patient) allocated to the control and experimental groups. Each group (n = 8) was pretested and posttested using the House-Brackmann index. Both groups were treated with heat, massage, exercises, and a home program. The experimental group also received electrical stimulation. The House-Brackmann Scale of the control group improved between 17% and 50% with a mean of 30%. The scores of the experimental group ranged between 17% and 75% with a mean of 37%. The difference between the groups was not statistically significant (two-tailed p = 0.36). Electrical stimulation as used in this study during the acute phase of Bell's palsy is safe but may not have added value over spontaneous recovery and multimodal physiotherapy. A larger sample size or longer stimulation time or both should be investigated.

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

Gd-DTPA enhanced MR imaging in Bell's palsy

Energy Technology Data Exchange (ETDEWEB)

Matsumoto, Yasushi; Kawamura, Yuji (Takanoko Hospital, Matsuyama, Ehime (Japan)); Yanagihara, Naoaki; Sadamoto, Masanori; Sadamoto, Kazuhiko

1991-09-01

Magnetic resonance imaging (MRI) was carried out in 27 patients with Bell's palsy. T1-weighted spin-echo images (TR500/TE25-34) were taken before and after the intravenous administration of Gd-DTPA (0.1 mmol/kg) with 0.5T superconductive MRI. There was significant enhancement at the geniculate ganglion and the horizontal segment of the involved facial nerve in 22 patients (81.5%) and at the vertical segment in 20 (74.1%). Enhancement at the meatal fundus was seen in only 4 patients (14.9%) and at the labyrinthine segment in 8 (29.6%). These results corroborate other evidence that the geniculate ganglion is involved most frequently in Bell's palsy. In addition, the enhancement of the proximal portion, i.e. the meatal fundus and the labyrinthine segment of the nerve, although not common, noted in this study may be important in the diagnosis and treatment of Bell's palsy. (author).

Gadolinium-enhanced MR imaging in evaluation of Bell palsy

International Nuclear Information System (INIS)

Wang, A.M.; Wesolowski, D.P.; Bojrab, D.I.; Ernstoff, R.M.; Farah, J.

1989-01-01

Eight patients with Bell palsy were evaluated with Gd-DTPA (Magnevist)-enhanced MR imaging in a 1.0-T Siemen's Magnetom unit. Axial pre-and postcontrast and coronal postcontrast T1-weighted MR images of facial nerves were studied. Significant unilateral enhancement of the facial nerve within the internal auditory canal, with or without involvement of the geniculate ganglia, was found in six patients. Three of these patients without satisfactory response to medical treatment underwent surgical decompression, with excellent recovery of facial nerve function. The authors believe that gadolinium-enhanced MR imaging is valuable in the evaluation and management of Bell palsy

Motor palsies of cranial nerves (excluding VII) after vaccination: reports to the US Vaccine Adverse Event Reporting System.

Science.gov (United States)

Woo, Emily Jane; Winiecki, Scott K; Ou, Alan C

2014-01-01

We reviewed cranial nerve palsies, other than VII, that have been reported to the US Vaccine Adverse Event Reporting System (VAERS). We examined patterns for differences in vaccine types, seriousness, age, and clinical characteristics. We identified 68 reports of cranial nerve palsies, most commonly involving the oculomotor (III), trochlear (IV), and abducens (VI) nerves. Isolated cranial nerve palsies, as well as palsies occurring as part of a broader clinical entity, were reported. Forty reports (59%) were classified as serious, suggesting that a cranial nerve palsy may sometimes be the harbinger of a broader and more ominous clinical entity, such as a stroke or encephalomyelitis. There was no conspicuous clustering of live vs. inactivated vaccines. The patient age range spanned the spectrum from infants to the elderly. Independent data may help to clarify whether, when, and to what extent the rates of cranial nerve palsies following particular vaccines may exceed background levels.

PERIPHERAL FACIAL PALSY IN CHILDHOOD - LYME BORRELIOSIS TO BE SUSPECTED UNLESS PROVEN OTHERWISE

NARCIS (Netherlands)

CHRISTEN, HJ; BARTLAU, N; HANEFELD, F; EIFFERT, H; THOMSSEN, R

1990-01-01

27 consecutive cases with acute peripheral facial palsy were studied for Lyme borreliosis. In 16 out of 27 children Lyme borreliosis could be diagnosed by detection of specific IgM antibodies in CSF. CSF findings allow a clear distinction according to etiology. All children with facial palsy due to

Maternal thyroid disorder in pregnancy and risk of cerebral palsy in the child: a population-based cohort study.

Science.gov (United States)

Petersen, Tanja Gram; Andersen, Anne-Marie Nybo; Uldall, Peter; Paneth, Nigel; Feldt-Rasmussen, Ulla; Tollånes, Mette Christophersen; Strandberg-Larsen, Katrine

2018-05-31

Cerebral palsy is the most frequent motor disability in childhood, but little is known about its etiology. It has been suggested that cerebral palsy risk may be increased by prenatal thyroid hormone disturbances. The objective of this study was to investigate whether maternal thyroid disorder is associated with increased risk of cerebral palsy. A population-based cohort study using two study populations. 1) 1,270,079 children born in Denmark 1979-2007 identified in nationwide registers, and 2) 192,918 children born 1996-2009 recruited into the Danish National Birth Cohort and The Norwegian Mother and Child Cohort study, combined in the MOthers and BAbies in Norway and Denmark (MOBAND) collaboration cohort. Register-based and self-reported information on maternal thyroid disorder was studied in relation to risk of cerebral palsy and its unilateral and bilateral spastic subtypes using multiple logistic regression. Children were followed from the age of 1 year to the age of 6 years, and cerebral palsy was identified in nationwide registers with verified diagnoses. In register data, hypothyroidism was recognized in 12,929 (1.0%), hyperthyroidism in 9943 (0.8%), and unclassifiable thyroid disorder in 753 (cerebral palsy was 1.0 (95% CI: 0.7-1.5). Maternal thyroid disorder identified during pregnancy was associated with elevated risk of unilateral spastic cerebral palsy (odds ratio 3.1 (95% CI: 1.2-8.4)). In MOBAND, 3042 (1.6%) of the mothers reported a thyroid disorder in pregnancy, which was not associated with cerebral palsy overall (odds ratio 1.2 (95% CI: 0.6-2.4)). Maternal thyroid disorder overall was not related to bilateral spastic cerebral palsy, but maternal thyroid disorder identified in pregnancy was associated with increased risk of unilateral spastic cerebral palsy. These findings should be replicated in studies making use of maternal blood samples.

Biofeedback interventions for people with cerebral palsy: a systematic review protocol.

Science.gov (United States)

MacIntosh, Alexander; Vignais, Nicolas; Biddiss, Elaine

2017-01-13

Cerebral palsy is a life-long disability that affects motor control and activities of daily living. Depending on the type of cerebral palsy, some individuals may have trouble performing tasks with one or both of their arms and/or legs. Different strategies exist to help develop motor capacity. Biofeedback therapy is a commonly applied rehabilitation strategy. In biofeedback therapy, information about the motor behavior while completing a task is given back to the individual to help improve their performance. This can provide valuable information that would otherwise be unknown to the individual. Biofeedback may also have a unique method of operation in clinical populations, such as people with cerebral palsy. Therefore, it is important to identify the most effective mechanisms for specific populations. This review aims to evaluate the effects of biofeedback interventions that have been used towards improving motor performance and motor learning in people with cerebral palsy. Using a customized strategy, MEDLINE, CINAHL, Embase, PsycINFO, Cochrane Central Register of Controlled Trials, SCOPUS, SPORTDiscus, and PEDro databases will be searched. Two independent reviewers will screen titles and abstracts, review full texts for inclusion criteria, and extract data from relevant articles using a standardized template. Quality of evidence and risk of bias will be assessed through the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. Several studies have investigated biofeedback-based interventions for people with cerebral palsy. However, there is a great variety and limited consensus regarding how to implement biofeedback mechanisms. This systematic review will consolidate the current evidence to direct future study and develop effective biofeedback rehabilitation strategies. PROSPERO ID: CRD42016047612.

Physical therapy with drug treatment in Bell palsy: a focused review.

Science.gov (United States)

Ferreira, Margarida; Marques, Elisa E; Duarte, José A; Santos, Paula C

2015-04-01

The physical therapy (PT) associated with standard drug treatment (SDT) in Bell palsy has never been investigated. Randomized controlled trials or quasirandomized controlled trials have compared facial PT (except treatments such as acupuncture and osteopathic) combined with SDT against a control group with SDT alone. Participants included those older than 15 yrs with a clinical diagnosis of Bell palsy, and the primary outcome measure was motor function recovery by the House-Brackmann scale. The methodologic quality of each study was also independently assessed by two reviewers using the PEDro scale. Four studies met the inclusion criteria. Three trials indicate that PT in association with SDT supports higher motor function recovery than SDT alone between 15 days and 1 yr of follow-up. On the other hand, one trial showed that electrical stimulation added to conventional PT with SDT did not influence treatment outcomes. The present review suggests that the current practice of Bell palsy treatment by PT associated with SDT seems to have a positive effect on grade and time recovery compared with SDT alone. However, there is very little quality evidence from randomized controlled trials, and such evidence is insufficient to decide whether combined treatment is beneficial in the management of Bell palsy.

Sensory Feedback Training for Improvement of Finger Perception in Cerebral Palsy

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Tobias Blumenstein

2015-01-01

Full Text Available Purpose. To develop and to test a feedback training system for improvement of tactile perception and coordination of fingers in children and youth with cerebral palsy. Methods. The fingers of 7 probands with cerebral palsy of different types and severity were stimulated using small vibration motors integrated in the fingers of a hand glove. The vibration motors were connected through a microcontroller to a computer and to a response 5-button keyboard. By pressing an appropriate keyboard button, the proband must indicate in which finger the vibration was felt. The number of incorrect responses and the reaction time were measured for every finger. The perception and coordination of fingers were estimated before and after two-week training using both clinical tests and the measurements. Results. Proper functioning of the developed system in persons with cerebral palsy was confirmed. The tactile sensation of fingers was improved in five of seven subjects after two weeks of training. There was no clear tendency towards improvement of selective use of fingers. Conclusion. The designed feedback system could be used to train tactile perception of fingers in children and youth with cerebral palsy. An extensive study is required to confirm these findings.

Parental stress in mothers of children and adolescents with cerebral palsy

Directory of Open Access Journals (Sweden)

Maysa Ferreira Martins Ribeiro

2014-06-01

Full Text Available OBJECTIVES: to evaluate parental stress of mothers of children and adolescents with cerebral palsy; to verify whether parental stress undergoes variations according to the level of motor compromise, the child's phase of life, and sociodemographic variables.METHOD: a cross-sectional, descriptive study, with 223 mothers of children and adolescents with cerebral palsy.RESULTS: 45.3% of the mothers presented high levels of stress; there were differences in stress between mothers of children with mild and severe motor impairment; mothers of older children were more stressed than mothers of younger children and of adolescents; paid work and leisure activities reduced the stress.CONCLUSION: mothers of children and adolescents with cerebral palsy, whose children present mild to severe motor impairment are vulnerable to parental stress. Paid work and leisure activities were the factors that contributed most to reducing the stress.

When is facial paralysis Bell palsy? Current diagnosis and treatment.

Science.gov (United States)

Ahmed, Anwar

2005-05-01

Bell palsy is largely a diagnosis of exclusion, but certain features in the history and physical examination help distinguish it from facial paralysis due to other conditions: eg, abrupt onset with complete, unilateral facial weakness at 24 to 72 hours, and, on the affected side, numbness or pain around the ear, a reduction in taste, and hypersensitivity to sounds. Corticosteroids and antivirals given within 10 days of onset have been shown to help. But Bell palsy resolves spontaneously without treatment in most patients within 6 months.

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....

Genetic Variation in the Dopamine System Influences Intervention Outcome in Children with Cerebral Palsy

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Rochellys Diaz Heijtz

2018-02-01

Interpretation: Naturally occurring genetic variation in the dopamine system can influence treatment outcomes in children with cerebral palsy. A polygenic dopamine score might be valid for treatment outcome prediction and for designing individually tailored interventions for children with cerebral palsy.

Antenatal and intrapartum interventions for preventing cerebral palsy: an overview of Cochrane systematic reviews.

Science.gov (United States)

Shepherd, Emily; Salam, Rehana A; Middleton, Philippa; Makrides, Maria; McIntyre, Sarah; Badawi, Nadia; Crowther, Caroline A

2017-08-08

Cerebral palsy is an umbrella term encompassing disorders of movement and posture, attributed to non-progressive disturbances occurring in the developing fetal or infant brain. As there are diverse risk factors and causes, no one strategy will prevent all cerebral palsy. Therefore, there is a need to systematically consider all potentially relevant interventions for their contribution to prevention. To summarise the evidence from Cochrane reviews regarding the effects of antenatal and intrapartum interventions for preventing cerebral palsy. We searched the Cochrane Database of Systematic Reviews on 7 August 2016, for reviews of antenatal or intrapartum interventions reporting on cerebral palsy. Two authors assessed reviews for inclusion, extracted data, assessed review quality, using AMSTAR and ROBIS, and quality of the evidence, using the GRADE approach. We organised reviews by topic, and summarised findings in text and tables. We categorised interventions as effective (high-quality evidence of effectiveness); possibly effective (moderate-quality evidence of effectiveness); ineffective (high-quality evidence of harm or of lack of effectiveness); probably ineffective (moderate-quality evidence of harm or of lack of effectiveness); and no conclusions possible (low- to very low-quality evidence). We included 15 Cochrane reviews. A further 62 reviews pre-specified the outcome cerebral palsy in their methods, but none of the included randomised controlled trials (RCTs) reported this outcome. The included reviews were high quality and at low risk of bias. They included 279 RCTs; data for cerebral palsy were available from 27 (10%) RCTs, involving 32,490 children. They considered interventions for: treating mild to moderate hypertension (two) and pre-eclampsia (two); diagnosing and preventing fetal compromise in labour (one); preventing preterm birth (four); preterm fetal maturation or neuroprotection (five); and managing preterm fetal compromise (one). Quality of

Position as a Cause of Deformity in Children with Cerebral Palsy (1976)

Science.gov (United States)

Scrutton, David

2008-01-01

Deformities in the child with cerebral palsy have been ascribed to muscle imbalance (Sharrard 1961) and increased tone (Pollock 1959) or to the type of cerebral palsy (Bobath and Bobath 1975). As far as we know, the position in which the child is nursed, especially during the first year of life, has not been considered as a cause of deformity. It…

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

OpenAIRE

P. Alakram; T. Puckree

2011-01-01

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...

The tau positron-emission tomography tracer AV-1451 binds with similar affinities to tau fibrils and monoamine oxidases.

Science.gov (United States)

Vermeiren, Céline; Motte, Philippe; Viot, Delphine; Mairet-Coello, Georges; Courade, Jean-Philippe; Citron, Martin; Mercier, Joël; Hannestad, Jonas; Gillard, Michel

2018-02-01

Lilly/Avid's AV-1451 is one of the most advanced tau PET tracers in the clinic. Although results obtained in Alzheimer's disease patients are compelling, discrimination of tracer uptake in healthy individuals and patients with supranuclear palsy (PSP) is less clear as there is substantial overlap of signal in multiple brain regions. Moreover, accurate quantification of [ 18 F]AV-1451 uptake in Alzheimer's disease may not be possible. The aim of the present study was to characterize the in vitro binding of AV-1451 to understand and identify potential off-target binding that could explain the poor discrimination observed in PSP patients. [ 3 H]AV-1451 and AV-1451 were characterized in in vitro binding assays using recombinant and native proteins/tissues from postmortem samples of controls and Alzheimer's disease and PSP patients. [ 3 H]AV-1451 binds to multiple sites with nanomolar affinities in brain homogenates and to tau fibrils isolated from Alzheimer's disease or PSP patients. [ 3 H]AV-1451 also binds with similarly high affinities in brain homogenates devoid of tau pathology. This unexpected binding was demonstrated to be because of nanomolar affinities of [ 3 H]AV-1451 for monoamine oxidase A and B enzymes. High affinity of AV-1451 for monoamine oxidase proteins may limit its utility as a tau PET tracer in PSP and Alzheimer's disease because of high levels of monoamine oxidase expression in brain regions also affected by tau deposition, especially if monoamine oxidase levels change over time or with a treatment intervention. © 2017 International Parkinson and Movement Disorder Society. © 2017 International Parkinson and Movement Disorder Society.

Nonmotor Features in Atypical Parkinsonism.

Science.gov (United States)

Bhatia, Kailash P; Stamelou, Maria

2017-01-01

Atypical parkinsonism (AP) comprises mainly multiple system atrophy (MSA), progressive supranuclear palsy (PSP), and corticobasal degeneration (CBD), which are distinct pathological entities, presenting with a wide phenotypic spectrum. The classic syndromes are now called MSA-parkinsonism (MSA-P), MSA-cerebellar type (MSA-C), Richardson's syndrome, and corticobasal syndrome. Nonmotor features in AP have been recognized almost since the initial description of these disorders; however, research has been limited. Autonomic dysfunction is the most prominent nonmotor feature of MSA, but also gastrointestinal symptoms, sleep dysfunction, and pain, can be a feature. In PSP and CBD, the most prominent nonmotor symptoms comprise those deriving from the cognitive/neuropsychiatric domain. Apart from assisting the clinician in the differential diagnosis with Parkinson's disease, nonmotor features in AP have a big impact on quality of life and prognosis of AP and their treatment poses a major challenge for clinicians. © 2017 Elsevier Inc. All rights reserved.

MR tomography in patients suffering from Parkinson's disease and Parkinson plus syndromes

International Nuclear Information System (INIS)

Hierholzer, J.; Schrag, A.; Cordes, M.; Sander, B.; Schelosky, L.; Harisch, C.; Venz, S.; Keske, U.; Maeurer, J.; Poewe, W.; Felix, R.

1996-01-01

To define characteristic MR-findings in patients with clinically typical extrapyramidal movement disorders. 15 patients with Parkinson's disease (PD), 9 with multisystem atrophy (MSA), and 6 with progressive supranuclear palsy (PSP) underwent MRI using a 1.5 T. Magnetom unit. Two investigators analysed the images with special regard to global and/or focal atrophy and to changes in signal intensity of the CNS in the consensus mode. Normal images of 10 subjects served as controls to patient's images. In all patients with PSP and MSA characteristic pathological findings on MRI were observed including regional changes within the extrapyramidal nuclei. In contrast all patients with PD had an unremarkable MRI study of the CNS. MRI enables us to define characteristic morphological changes of the brain in patients with extrapyramidal movement disorders. Early recognition of these findings avoids misdiagnoses in patients who are difficult to diagnose. (orig.) [de

Bilateral sixth cranial nerve palsy in infectious mononucleosis.

Science.gov (United States)

Neuberger, J.; Bone, I.

1979-01-01

A 15-year-old girl who presented with a bilateral sixth nerve palsy caused by infectious mononucleosis is described. The neurological presentation of infectious mononucleosis is discussed. PMID:225738

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.

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.

VII NERVE PALSY — EVALUATION AND MANAGEMENT

African Journals Online (AJOL)

Enrique

stapedial nerve — stapedius muscle in middle ear. As it exits ... facial palsy at birth. ... ticularly in the early stages of HIV and ... associated symptoms (hearing loss, ... neuron (UMN) or lower motor neuron .... gold weight implant or upper eyelid.

Measurement of striatal dopamine metabolism with 6-[18F]-fluoro-L-dopa and PET

International Nuclear Information System (INIS)

Kuwabara, Y.; Otsuka, M.; Ichiya, Y.; Yoshikai, T.; Fukumura, T.; Masuda, K.; Kato, M.; Taniwaki, T.

1992-01-01

Striatal dopamine metabolism was studied with 6-[ 18 F]-fluoro-L-dopa ( 18 F-DOPA) and PET. The subjects were normal controls, and patients with Parkinson's disease (PD), parkinsonism, multiple system atrophy (MSA), progressive supranuclear palsy (PSP), Alzheimer's disease (AD), Huntington's disease (HD) and other cerebral disorders. Cerebral glucose metabolism (CMRGlc) was also measured in these patients. Striatal dopamine metabolism was evaluated by the relative striatal uptake of 18 F-DOPA referring cerebellum (S/C ratio). In normal controls, the S/C ratio was 2.82 ± 0.32 (n = 6, mean ± SD) at 120 min after injection of 18 F-DOPA. The S/C ratio was low in patients with PD, parkinsonism, MSA and PSP compared to the normal controls and thus coincident with the symptoms of parkinsonism due to decrease in striatal dopamine concentration. The decrease in the striatal CMRGlc was also observed in patients with parkinsonism and PSP, and it was preserved in patients with PD, thus representing that more neurons were damaged in patients with parkinsonism and PSP than in patients with PD. A patient with AD having symptoms of parkinsonism also showed a decrease in S/C ratio. In a patient with HD, the striatal CMRGlc sharply decreased, but the S/C ratio was normal. The measurements of striatal dopamine and glucose metabolism with PET may be useful for studying the pathophysiological mechanism in patients with cerebral disorders. (author)

Facial nerve palsy after reactivation of herpes simplex virus type 1 in diabetic mice.

Science.gov (United States)

Esaki, Shinichi; Yamano, Koji; Katsumi, Sachiyo; Minakata, Toshiya; Murakami, Shingo

2015-04-01

Bell's palsy is highly associated with diabetes mellitus (DM). Either the reactivation of herpes simplex virus type 1 (HSV-1) or diabetic mononeuropathy has been proposed to cause the facial paralysis observed in DM patients. However, distinguishing whether the facial palsy is caused by herpetic neuritis or diabetic mononeuropathy is difficult. We previously reported that facial paralysis was aggravated in DM mice after HSV-1 inoculation of the murine auricle. In the current study, we induced HSV-1 reactivation by an auricular scratch following DM induction with streptozotocin (STZ). Controlled animal study. Diabetes mellitus was induced with streptozotocin injection in only mice that developed transient facial nerve paralysis with HSV-1. Recurrent facial palsy was induced after HSV-1 reactivation by auricular scratch. After DM induction, the number of cluster of differentiation 3 (CD3)(+) T cells decreased by 70% in the DM mice, and facial nerve palsy recurred in 13% of the DM mice. Herpes simplex virus type 1 deoxyribonucleic acid (DNA) was detected in the facial nerve of all of the DM mice with palsy, and HSV-1 capsids were found in the geniculate ganglion using electron microscopy. Herpes simplex virus type 1 DNA was also found in some of the DM mice without palsy, which suggested the subclinical reactivation of HSV-1. These results suggested that HSV-1 reactivation in the geniculate ganglion may be the main causative factor of the increased incidence of facial paralysis in DM patients. © 2014 The American Laryngological, Rhinological and Otological Society, Inc.

Effects of Prolonged Standing on Gait in Children with Spastic Cerebral Palsy

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Salem, Yasser; Lovelace-Chandler, Venita; Zabel, Reta J.; McMillan, Amy Gross

2010-01-01

The purpose of this study was to determine the effects of prolonged standing on gait characteristics in children with spastic cerebral palsy. Six children with spastic cerebral palsy participated in this study with an average age of 6.5 years (SD = 2.5, range = 4.0-9.8 years). A reverse baseline design (A-B-A) was used over a 9-week period. During…

[Early diagnosis and prognosis evaluation of Bell palsy with blink reflex ].

Science.gov (United States)

Xie, Dan-dan; Li, Xiao-song; Liu, Yuan-yuan

2014-11-01

To determine the value of blink reflex in early diagnosis and prognosis evaluation of Bell palsy. Blink reflex and facial nerve conduction were examined in 58 patients with Bell palsy within one week after symptom onset. The patients without response of R1 , R2 and R2 ' waves were classified as complete efferent retardarce (Group A, 30 cases), and those with response of R1 , R2 and R2 ' waves were classified as incomplete efferent anomalies (Group B, 28 cases). The clinical outcomes after three months of systemic therapy were evaluated using the House-Blackmann (H-B) scale. Efferent anomalies of blink reflex occurred in ail of the 58 patients. Abnormal results of facial nerve conduction appeared in 23 (39. 7%) patients. The three months therapy was effective in 93% patients in Group B and 70% patients in Group A (PBell palsy.

The role of diabetes mellitus in the clinical presentation and prognosis of Bell palsy.

Science.gov (United States)

Riga, Maria; Kefalidis, George; Danielides, Vasilios

2012-01-01

Bell palsy is considered to be an entrapment neuropathy resulting from inflammation, edema, and strangulation. Diabetes, hypertension, and hypercholesterolemia have all been related to microangiopathies. However, the relationship between the frequency, severity, and recovery course of Bell palsy in patients with these pathologies is a matter of controversy. Fifty-six patients with Bell palsy were evaluated according to the House-Brackmann grading system a few days after the onset of the disease and 6 months later and correlated to their hypertension, hypercholesterolemia, and diabetes records. Diabetes was evaluated by the use of serum glycosylated hemoglobin (HbA1c). The 20 patients with abnormal HbA1c values were more frequently diagnosed with Bell palsy of grade V/VI (P = .008; odds ratio, 4.7; 95% CI, 1.4-15.2). However, their House-Brackmann scores were not found to be worse at the 6-month follow-up visit (P = .9). No correlations were found for hypertension and hypercholesterolemia. A relationship between the severity of Bell palsy and abnormal HbA1c values seems to be demonstrated. However, the prognosis of these patients does not seem to be worse because at the 6-month follow-up visit they present similar scores to nondiabetic patients.

C5 Palsy After Cervical Spine Surgery: A Multicenter Retrospective Review of 59 Cases.

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Thompson, Sara E; Smith, Zachary A; Hsu, Wellington K; Nassr, Ahmad; Mroz, Thomas E; Fish, David E; Wang, Jeffrey C; Fehlings, Michael G; Tannoury, Chadi A; Tannoury, Tony; Tortolani, P Justin; Traynelis, Vincent C; Gokaslan, Ziya; Hilibrand, Alan S; Isaacs, Robert E; Mummaneni, Praveen V; Chou, Dean; Qureshi, Sheeraz A; Cho, Samuel K; Baird, Evan O; Sasso, Rick C; Arnold, Paul M; Buser, Zorica; Bydon, Mohamad; Clarke, Michelle J; De Giacomo, Anthony F; Derakhshan, Adeeb; Jobse, Bruce; Lord, Elizabeth L; Lubelski, Daniel; Massicotte, Eric M; Steinmetz, Michael P; Smith, Gabriel A; Pace, Jonathan; Corriveau, Mark; Lee, Sungho; Cha, Peter I; Chatterjee, Dhananjay; Gee, Erica L; Mayer, Erik N; McBride, Owen J; Roe, Allison K; Yanez, Marisa Y; Stroh, D Alex; Than, Khoi D; Riew, K Daniel

2017-04-01

A multicenter, retrospective review of C5 palsy after cervical spine surgery. Postoperative C5 palsy is a known complication of cervical decompressive spinal surgery. The goal of this study was to review the incidence, patient characteristics, and outcome of C5 palsy in patients undergoing cervical spine surgery. We conducted a multicenter, retrospective review of 13 946 patients across 21 centers who received cervical spine surgery (levels C2 to C7) between January 1, 2005, and December 31, 2011, inclusive. P values were calculated using 2-sample t test for continuous variables and χ 2 tests or Fisher exact tests for categorical variables. Of the 13 946 cases reviewed, 59 patients experienced a postoperative C5 palsy. The incidence rate across the 21 sites ranged from 0% to 2.5%. At most recent follow-up, 32 patients reported complete resolution of symptoms (54.2%), 15 had symptoms resolve with residual effects (25.4%), 10 patients did not recover (17.0%), and 2 were lost to follow-up (3.4%). C5 palsy occurred in all surgical approaches and across a variety of diagnoses. The majority of patients had full recovery or recovery with residual effects. This study represents the largest series of North American patients reviewed to date.

Non-Hodgkin's lymphoma of the sphenoid sinus presenting as isolated oculomotor nerve palsy

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Huh Ji

2007-08-01

Full Text Available Abstract Background Solitary involvement of the sphenoid sinus has rarely been reported in non-Hodgkin's lymphoma. Isolated oculomotor nerve palsy is uncommon as an initial presentation of malignant tumors of the sphenoid sinus. Case presentation A 53-year-old woman presented with a three-month history of headache and diplopia. Neurological examination revealed complete left oculomotor nerve palsy. Magnetic Resonance Imaging (MRI demonstrated a homogenous soft-tissue lesion occupying the left sphenoid sinus and invading the left cavernous sinus. The patient underwent transsphenoidal biopsy and the lesion was histologically diagnosed as non-Hodgkin's lymphoma, diffuse large B-cell type. Tumor cells were positive for CD20 and negative for CD3. Following six cycles of chemotherapy, the left oculomotor nerve palsy that had been previously observed was completely resolved. There was no enhancing lesion noted on follow-up MRI. Conclusion It is important to recognize that non-Hodgkin's lymphoma of the sphenoid sinus can present with isolated oculomotor nerve palsy, although it is extremely rare. The cranial nerve deficits can resolve dramatically after chemotherapy.

WITHDRAWN. Antiviral treatment for Bell's palsy (idiopathic facial paralysis).

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Gagyor, Ildiko; Madhok, Vishnu B; Daly, Fergus; Somasundara, Dhruvashree; Sullivan, Michael; Gammie, Fiona; Sullivan, Frank

2015-05-04

Corticosteroids are widely used in the treatment of idiopathic facial paralysis (Bell's palsy), but the effectiveness of additional treatment with an antiviral agent is uncertain. Significant morbidity can be associated with severe cases of Bell's palsy. To assess the effects of antiviral treatments alone or in combination with any other therapy for Bell's palsy. On 7 October 2014 we searched the Cochrane Neuromuscular Disease Group Specialized Register, CENTRAL, MEDLINE, EMBASE, LILACS, DARE, NHS EED, and HTA. We also reviewed the bibliographies of the identified trials and contacted trial authors and known experts in the field and relevant drug companies to identify additional published or unpublished data. We searched clinical trials registries for ongoing studies. We considered randomised controlled trials or quasi-randomised controlled trials of antivirals with and without corticosteroids versus control therapies for the treatment of Bell's palsy. We excluded trials that had a high risk of bias in several domains. Pairs of authors independently assessed trials for relevance, eligibility, and risk of bias, using standard Cochrane procedures. Eleven trials, including 2883 participants, met the inclusion criteria and are included in the final analysis. We added four studies to the previous review for this update. Some of the trials were small, and a number were at high or unclear risk of bias. Other trials did not meet current best standards in allocation concealment and blinding. Incomplete recoveryWe found no significant benefit from adding antivirals to corticosteroids in comparison with corticosteroids alone for people with Bell's palsy (risk ratio (RR) 0.69, 95% confidence interval (CI) 0.47 to 1.02, n = 1715). For people with severe Bell's palsy (House-Brackmann scores of 5 and 6 or the equivalent in other scales), we found a reduction in the rate of incomplete recovery at month six when antivirals plus corticosteroids were used (RR 0.64, 95% CI 0.41 to 0

Implications of a neural network model of early sensori-motor development for the field of developmental neurology

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van Heijst, JJ; Touwen, BCL; Vos, JE

This paper reports on a neural network model for early sensori-motor development and on the possible implications of this research for our understanding and, eventually, treatment of motor disorders like cerebral palsy. We recapitulate the results we published in detail in a series of papers [1-4].

Nasopharyngeal carcinoma with cranial nerve palsy: The importance of MRI for radiotherapy

International Nuclear Information System (INIS)

Chang, Joseph T.-C.; Lin, C.-Y.; Chen, T.-M.; Kang, C.-J.; Ng, S.-H.; Chen, I.-H.; Wang, H.-M.; Cheng, A.-J.; Liao, C.-T.

2005-01-01

Purpose: To evaluate various prognostic factors and the impact of imaging modalities on tumor control in patients with nasopharyngeal cancer (NPC) with cranial nerve (China) palsy. Material and Methods: Between September 1979 and December 2000, 330 NPC patients with CN palsy received radical radiotherapy (RT) by the conventional opposing technique at Chang Gung Memorial Hospital-Linkou. Imaging methods used varied over that period, and included conventional tomography (Tm) for 47 patients, computerized tomography (CT) for 195 patients, and magnetic resonance image (MRI) for 88 patients. Upper CN (II-VI) palsy was found in 268 patients, lower CN (IX-XII) in 13, and 49 patients had both. The most commonly involved CN were V or VI or both (23%, 12%, and 16%, respectively). All patients had good performance status (World Health Organization <2). The median external RT dose was 70.2 Gy (range, 63-77.5 Gy). Brachytherapy was also given to 156 patients in addition to external RT, delivered by the remote after-loading, high-dose-rate technique. A total of 139 patients received cisplatin-based chemotherapy, in 115 received as neoadjuvant or adjuvant chemotherapy and in 24 concomitant with RT. Recovery from CN palsy occurred in 171 patients during or after radiotherapy. Patients who died without a specific cause identified were regarded as having died with persistent disease. Results: The 3-year, 5-year, and 10-year overall survival was 47.1%, 34.4%, and 22.2%. The 3-year, 5-year, and 10-year disease-specific survival (DSS) rates were 50.4%, 37.8%, and 25.9%. The 5-year DSS for patients staged with MRI, CT, and Tm were 46.9%, 36.7%, and 21.9%, respectively (p = 0.016). The difference between MRI and CT was significant (p = 0.015). The 3-year and 5-year local control rates were 62% and 53%, respectively. The 5-year local control was 68.2% if excluding patients who died without a specific cause. Patients who had an MRI had a significantly better tumor control rate than those

Virtual rehabilitation in a school setting: is it feasible for children with cerebral palsy?

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Rosie, Juliet A; Ruhen, Shelley; Hing, Wayne A; Lewis, Gwyn N

2015-01-01

To determine the feasibility of a school-based virtual rehabilitation intervention for children with cerebral palsy. A feasibility study was conducted using a mixed method approach. Participants were five children with cerebral palsy who were currently attending a rural school. Each child received an 8-week rehabilitation programme involving an Interactive Virtual Reality Exercise (IREX) system. The IREX was placed in the child's school for the duration of the intervention. Each child's programme was designed by a physiotherapist but supervised by a teacher aide at the school. Feasibility of the intervention was assessed through a questionnaire completed by the child and an interview conducted with the teacher supervisor. The children all rated the IREX intervention as fun, easy to use, and beneficial for their arm. Categories from the supervisor interviews centred on resolving technical issues, the enjoyment of taking part due to the child's progress, and the central role of interacting with the child. Input from the research physiotherapist was critical to the success of the intervention. The IREX is feasible to implement in a school-based setting supervised by teachers. This provides an option for delivering physiotherapy to children in isolated areas who do not receive on-going therapy. Implication for Rehabilitation Virtual rehabilitation programmes using the IREX are feasible in a school-based setting. The negative impact of technical difficulties is likely to be overcome by the user's enjoyment and rehabilitation benefits gained. Input from a therapist in designing and monitoring the programme is critical.