MedWorm: Bell's Palsy

Neurologic adverse events following influenza A (H1N1) vaccinations in children

Pediatrics International — Thu, 02 Feb 2012 05:00:00 +0100

Conclusions: Post‐vaccine NAEs were mainly motor weakness due to poly‐neuropathy, which had a good prognosis of complete improvement within a few months without sequelae.© 2012 The Authors. Pediatrics International © 2012 Japan Pediatric Society (Source: Pediatrics International)

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Botulinum toxin in the treatment of facial synkinesis and hyperkinesis

The Laryngoscope — Tue, 17 Jan 2012 05:00:00 +0100

Conclusions:This work stresses the importance of considering synkinesis and hyperkinesis separately because they are different conditions. These two symptoms showed improvement after botulinum toxin treatment, but only hyperkinesis showed a positive correlation when objective and subjective evaluations were performed. This treatment is effective in the management of facial synkinesis and hyperkinesis due to facial palsy, thus improving quality of life. It is a safe, minimally invasive treatment that can be repeated. (Source: The Laryngoscope)

Botulinum toxin in the treatment of facial synkinesis and hyperkinesis.

Herpes — Tue, 17 Jan 2012 05:00:00 +0100

CONCLUSIONS: This work stresses the importance of considering synkinesis and hyperkinesis separately because they are different conditions. These two symptoms showed improvement after botulinum toxin treatment, but only hyperkinesis showed a positive correlation when objective and subjective evaluations were performed. This treatment is effective in the management of facial synkinesis and hyperkinesis due to facial palsy, thus improving quality of life. It is a safe, minimally invasive treatment that can be repeated. PMID: 22252570 [PubMed - as supplied by publisher] (Source: Herpes)

The reporting completeness of a passive safety surveillance system for pandemic (H1N1) 2009 vaccines: A capture-recapture analysis.

Vaccine — Tue, 17 Jan 2012 05:00:00 +0100

Authors: Huang WT, Huang WI, Huang YW, Hsu CW, Chuang JH Abstract Adverse events following pandemic (H1N1) 2009 vaccines ("2009 H1N1 vaccines") in Taiwan were passively reported to the National Adverse Drug Reaction Reporting System. To evaluate the completeness of spontaneous reporting, cases of death, Guillain-Barré syndrome (GBS), convulsion, Bell's palsy, and idiopathic thrombocytopenic purpura (ITP) after 2009 H1N1 vaccination that occurred between November 1, 2009 and August 31, 2010 were selected from the National Adverse Drug Reaction Reporting System (NADRRS) database and an additionally constructed nationwide large-linked database (LLDB), and matched on a unique personal identifier, date of vaccination (within ±7 days), and date of diagnosis (within ±7 days). Overall, ...

How to identify stroke mimics in patients eligible for intravenous thrombolysis?

Journal of Neurology — Tue, 10 Jan 2012 06:48:21 +0100

Abstract Since decision-making for thrombolysis in acute stroke settings is restricted to a limited time window and based on clinical assessment and CT findings only, thrombolysis is sometimes applied to patients with a final diagnosis other than a stroke. From a prospectively collected stroke/MRI data bank (2004–2010) with 648 suspected ischemic stroke patients treated with rtPA, we identified patients without evidence of acute infarction on follow-up MRI and a final diagnosis other than a stroke or acute cerebrovascular event. We compared demographics, symptoms, complications, and outcome of patients with stroke mimics (SM) to those with acute infarction. In 42 patients, an SM was diagnosed: seizures in 20, conversion disorder in seven, dementia in six, migraine in thr...

Physical therapy for Bell's palsy (idiopathic facial paralysis).

Cochrane Database of Systematic Reviews — Tue, 20 Dec 2011 01:00:04 +0100

CONCLUSIONS: There is no high quality evidence to support significant benefit or harm from any physical therapy for idiopathic facial paralysis. There is low quality evidence that tailored facial exercises can help to improve facial function, mainly for people with moderate paralysis and chronic cases. There is low quality evidence that facial exercise reduces sequelae in acute cases. The suggested effects of tailored facial exercises need to be confirmed with good quality randomised controlled trials. PMID: 22161401 [PubMed - in process] (Source: Cochrane Database of Systematic Reviews)

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The presence of facial nerve weakness on diagnosis of a parotid gland malignant process

European Archives of Oto-Rhino-Laryngology — Sat, 17 Dec 2011 16:43:38 +0100

The objectives of this article are to assess the frequency and significance of facial paralysis and undiagnosed nerve infiltration in patients with parotid malignancies. 103 patients with parotid gland malignancies were treated in a single institution, the tertiary center for ENT at the University Department in Poznan between 1996 and 2006. Facial palsy at the initial presentation was found in 32 patients. The stage of the primary tumor in the examined group of 103 patients is as follows: 20—T1, 31—T2, 20—T3, 32—T4. The correlation between facial nerve function before treatment and patients’ characteristics, including the treatment methods, were analyzed. Intact facial nerve function at patient presentation was a very strong prognostic factor determining the treatment and f...

The Use of Onyx in Different Types of Intracranial Dural Arteriovenous Fistula [INTERVENTIONAL]

American Journal of Neuroradiology — Tue, 13 Dec 2011 05:00:00 +0100

CONCLUSIONs: The treatment of DAVFs by intracranial arterial injection of Onyx is safe, and, in most cases, results in the occlusion of the arterial venous shunt. In DAVFs with direct sinus drainage, sinus preservation was only possible in 7 of 20 patients (35%). (Source: American Journal of Neuroradiology)

Giant Cell Tumour of Mandible: Report of a Rare Case

Indian Journal of Otolaryngology and Head and Neck Surgery — Mon, 12 Dec 2011 17:14:19 +0100

Abstract There are various reports of giant cell tumour of long bones but the documented evidence of occurrence of giant cell tumour of mandible is very rare. Because of extreme rarity of occurrence we report one such case. The patient was a 45 year male presented with hard swelling in region of parotid. In CT scan was suggestive of a heterogeneously enhancing lesion lying deep to right parotid gland. It showed central necrosis and erosion of the right coronoid process of mandible. FNAC report was that of giant cell tumour. Tumour was surgically excised preserving the facial nerve and curetting of coronoid process of mandible. He is on follow up till date with no facial palsy and no sign of recurrence. Content Type Journal ArticleCategory Clinical ReportPages 1-4D...

Facial nerve damage following surgery for cerebellopontine angle tumours. Prevention and comprehensive treatment.

Neurologia i Neurochirurgia Polska — Thu, 08 Dec 2011 11:06:04 +0100

Authors: Kunert P, Smolarek B, Marchel A Abstract Facial nerve (CN VII) palsy or even its transient paresis causes physical disability but is also a psychosocial problem. Immediately after vestibular schwannoma removal, different degrees of CN VII paresis occur in 20-70% of patients. Facial nerve paresis is observed in 10-40% after surgery of cerebellopontine angle meningiomas. Postoperative facial nerve weakness significantly reduces or completely withdraws with time in the majority of cases. However, even if prognosis for CN VII regeneration is good, proper management is needed because of the potential for serious ophthalmic complications. In this paper, the authors raise the issue of perioperative prophylaxis and comprehensive treatment of postoperative paresis of CN VII. Prophy...

Hemihypoglossal-facial nerve anastomosis for facial nerve palsy.

Neurologia i Neurochirurgia Polska — Thu, 08 Dec 2011 11:06:04 +0100

Conclusions : In our experience, HHFA is effective treatment of facial palsy and gives a chance to reduce damage of the tongue. PMID: 22127940 [PubMed - as supplied by publisher] (Source: Neurologia i Neurochirurgia Polska)

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Facial Nerve Outcome after Vestibular Schwannoma Surgery: Our Experience

Skull Base — Thu, 01 Dec 2011 05:00:00 +0100

In this study we evaluate the postoperative facial nerve function after vestibular schwannoma (VS) surgery and analyze the factors that cause it. We included 97 consecutive patients undergoing surgical excision of sporadic unilateral VS. Patient and tumor characteristics, surgical approaches, facial nerve function, extent of tumor removal, perioperative complications are all analyzed through standardized systems. Four different surgical approaches are used: translabyrinthine, retrolabyrinthine, retrosigmoid, and middle cranial fossa. Anatomic preservation of the facial nerve is achieved in 97% of patients. The incidence of postoperative facial palsy is found to be statistically correlated to tumor size, but not to the surgical approach used and to extent of tumor penetration in the interna...

Demyelinating Disease in Patients Treated with TNF Antagonists in Rheumatology: Data from BIOBADASER, a Pharmacovigilance Database, and a Systematic Review

Seminars in Arthritis and Rheumatism — Thu, 01 Dec 2011 05:00:00 +0100

Conclusions: It is not clear whether TNF antagonists increase the incidence of demyelinating diseases in patients with rheumatic diseases. Differences between cases depending on the pharmacovigilance source could be explained by selective reporting bias outside registries. (Source: Seminars in Arthritis and Rheumatism)

Otomastoiditis with acute left facial nerve paralysis caused by Mycobacterium chelonae.

Ear, Nose and Throat Journal — Thu, 01 Dec 2011 05:00:00 +0100

We describe a case of left-sided otomastoiditis with acute facial nerve paralysis caused by this organism in a previously well middle-aged woman. Her facial palsy totally resolved after tympanomastoidectomy plus a 7-week regimen of clarithromycin and moxifloxacin. To our knowledge, a case of otomastoiditis with acute facial nerve paralysis caused by M chelonae has not been reported previously. PMID: 22180118 [PubMed - in process] (Source: Ear, Nose and Throat Journal)

Cholesterol granuloma as long‐term complication of total ear canal ablation in a dog

The Journal of Small Animal Practice — Mon, 28 Nov 2011 05:00:00 +0100

A 13‐year‐old cocker spaniel presented with pain on opening the mouth. History of a previous left total ear canal ablation with lateral bulla osteotomy, left intermittent facial palsy and left intermittent head tilt suggested progression of a total ear canal ablation with lateral bulla osteotomy complication. Magnetic resonance imaging revealed a large mass arising from the tympanic bulla. Cytology of aspirates revealed a chronic suppurative inflammatory reaction and numerous cholesterol crystals. The mass was removed by surgical excision and an active drainage system was placed for a few days. The head tilt, facial palsy and apparent pain were resolved by the surgery. Physical examination was unremarkable nine months postoperatively. Bacterial cultures of the collected fluid were nega...

Ganglion cyst of the temporomandibular joint with intracranial extension in a patient presenting with seventh cranial nerve palsy.

Journal of Neurosurgery — Fri, 25 Nov 2011 05:00:00 +0100

Authors: Mumert ML, Altay T, Shelton C, Harnsberger HR, Couldwell WT Abstract Ganglion cysts arising from the temporomandibular joint are rare entities that often present with swelling and minimal to no pain in the preauricular region. To the authors' knowledge, a temporomandibular joint ganglion cyst occurring with acute facial nerve palsy and intracranial extension has never been reported. The patient in the current case initially underwent treatment for Bell palsy and then draining of the cyst at an outside hospital with no relief of symptoms. Repeat MR imaging showed an increase in the size of the cystic, enhancing, middle fossa lesion measuring 4 cm. Resection of the lesion was undertaken using a middle fossa approach. After a satisfactory surgical decompression, the patient d...

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Chiropractic care of a 47-year-old woman with chronic Bell's palsy: a case study

Journal of Chiropractic Medicine — Fri, 25 Nov 2011 03:17:44 +0100

Conclusions: For this patient, chiropractic care reduced Bell's palsy symptoms. (Source: Journal of Chiropractic Medicine)

Neurosarcoidosis Report of 30 cases and a literature survey.

European Journal of Internal Medicine — Wed, 16 Nov 2011 17:58:25 +0100

CONCLUSION: Neurosarcoidosis requires a high degree of suspicion to establish the diagnosis. Central nervous system involvement is associated with a poor prognosis. PMID: 22075297 [PubMed - in process] (Source: European Journal of Internal Medicine)

Peripheral facial palsy in patients with tick‐borne encephalitis

Clinical Microbiology and Infection — Mon, 14 Nov 2011 13:41:57 +0100

AbstractAlthough tick‐borne encephalitis (TBE) has been recognized in Europe for more than 70 years and has been the topic of numerous reports, information on the involvement of facial nerve in the course of the disease is limited. Our study conducted at a single medical centre revealed that facial nerve involvement in the course of TBE in Central Europe is a) infrequent – it was found in only 11 of 1218 (0.9%) consecutive adult patients diagnosed with TBE; b) manifests with unilateral or rarely bilateral peripheral facial palsy (PFP) (9 and 2 patients, respectively); c) appears late in the course of acute illness – in our patients 10–20 days after the onset of the meningoencephalitic phase of TBE, and often after defervescence (in 8/11 patients; 6–13 days after normalisation of ...

Antiglycine-receptor encephalomyelitis with rigidity

Journal of Neurology, Neurosurgery and Psychiatry — Mon, 07 Nov 2011 05:00:00 +0100

Conclusions The clinical picture associated with GlyR-ab is wider than the classical view of PERM. GlyR-ab should be examined in patients with core symptoms of muscle rigidity and spasms atypical for SPS. (Source: Journal of Neurology, Neurosurgery and Psychiatry)

Idiopathic bilateral facial palsy: is a causative role of anti-GM1 ganglioside and herpes simplex type 1 possible?

Neurological Sciences — Tue, 01 Nov 2011 16:52:05 +0100

Content Type Journal ArticleCategory Letter to the EditorPages 1-3DOI 10.1007/s10072-011-0832-9Authors Elena Pretegiani, Department of Neurological, Neurosurgical and Behavioural Sciences, University of Siena, Viale Bracci, 53100 Siena, ItalyFrancesca Rosini, Department of Neurological, Neurosurgical and Behavioural Sciences, University of Siena, Viale Bracci, 53100 Siena, ItalyDonatella Donati, Department of Neurological, Neurosurgical and Behavioural Sciences, University of Siena, Viale Bracci, 53100 Siena, ItalyAlessandra Rufa, Department of Neurological, Neurosurgical and Behavioural Sciences, University of Siena, Viale Bracci, 53100 Siena, ItalyDonatella Moschettini, Department of Molecular Biology, University of Siena, Siena, ItalyAlfonso Cerase, UOC NINT,–Department of Neurosc...

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Postoperative complications in cochlear implants: a retrospective analysis of 438 consecutive cases

European Archives of Oto-Rhino-Laryngology — Mon, 31 Oct 2011 16:58:26 +0100

In conclusion, we find that Cochlear implantation is a safe low-morbility technique with a relatively low complication rate in the presented population. Content Type Journal ArticleCategory OtologyPages 1-5DOI 10.1007/s00405-011-1818-1Authors A. Ciorba, Audiology Department, University Hospital of Ferrara, C.so Giovecca 203, Ferrara, ItalyR. Bovo, Audiology Department, University Hospital of Ferrara, C.so Giovecca 203, Ferrara, ItalyP. Trevisi, Audiology Department, University Hospital of Ferrara, C.so Giovecca 203, Ferrara, ItalyM. Rosignoli, Audiology Department, University Hospital of Ferrara, C.so Giovecca 203, Ferrara, ItalyC. Aimoni, Audiology Department, University Hospital of Ferrara, C.so Giovecca 203, Ferrara, ItalyA. Castiglione, Audiology Department, University Hospital...

Frontal sinus lymphoma presenting as progressive multiple cranial nerve palsy.

Yonsei Medical Journal — Fri, 28 Oct 2011 05:50:15 +0100

We present an unusual case report of an immunocompetent patient who presented with facial palsy, and then progressively developed other cranial nerve palsies over several months. He was later diagnosed with diffuse large B cell lymphoma originating from the frontal sinus. The patient underwent chemotherapy, but eventually had to receive autologous peripheral blood stem cell transplantation. He is currently disease-free. The clinical course, diagnostic workup, and therapeutic outcome are described. PMID: 22028175 [PubMed - in process] (Source: Yonsei Medical Journal)

The Coexistence of an Intrasellar Adenoma, Lymphocytic Hypophysitis, and Primary Pituitary Lymphoma in a Patient with Acromegaly

Experimental Diabetes Research — Wed, 26 Oct 2011 19:24:29 +0100

We present a case of a 71-year-old female referred for evaluation and treatment of acromegaly. Questioning revealed she was experiencing facial palsy, visual disturbances, and syncopal spells for several weeks. When laboratory evaluation showed elevated somatomedin (IGF-I) levels and an oral glucose tolerance test failed to demonstrate any suppression of her growth hormone (GH) values, an MRI of the pituitary revealed a sellar mass. A presumptive diagnosis of pituitary adenoma was established. The patient underwent transsphenoidal resection of the sellar mass, which proved to be a large B-cell lymphoma (Stage I-E) associated with areas of adenoma and lymphocytic hypophysitis. (Source: Experimental Diabetes Research)

Prognosis of patients with Guillain-Barré syndrome requiring mechanical ventilation

Neurology India — Sat, 22 Oct 2011 04:00:00 +0100

Conclusions: Early identification of modifiable risk factors, such as pulmonary involvement, autonomic dysfunction, hypokalemia, sepsis, bleeding, and nutritional complications, may reduce the mortality and morbidity associated with GBS. (Source: Neurology India)

Remote Assessment of Stroke Using the iPhone 4.

Rural Remote Health — Thu, 20 Oct 2011 04:00:00 +0100

This study demonstrates the efficacy of using the relatively inexpensive iPhone 4 in telestroke management. Twenty patients with stroke were assessed at the bedside using an iPhone 4, and each examination was directed remotely on another iPhone 4. Both the physician performing the bedside exam and the remote physician calculated a National Institutes of Health Stroke Scale (NIHSS) score for each patient. Each physician was blinded to the other's NIHSS score. In the 20 patients assessed, NIHSS scores ranged from 0 to 22. Interrater reliability assessed using the κ statistic demonstrated excellent agreement in 10 items (level of consciousness, month and age, visual fields, right motor arm, left motor arm, right motor leg, left motor leg, sensation, language, and neglect), moderate agreement...

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Surgical treatment of dumbbell-shaped hypoglossal schwannoma via a pure endoscopic transoral approach

Acta Neurochirurgica — Wed, 19 Oct 2011 05:50:22 +0100

Conclusions Dumbbell-shaped hypoglossal schwannomas tend to cause lower cranial nerve deficits, facial paralysis and hearing loss. With appropriate preoperative evaluation and careful planning of the perioperative period, complete tumor resection can be achieved via the purely endoscopic transoral approach. The endoscopic transoral approach is an effectice choice for management of dumbbell-shaped hypoglossal schwannomas. Content Type Journal ArticleCategory Clinical ArticlePages 1-9DOI 10.1007/s00701-011-1193-0Authors Qiuhang Zhang, Skull Base Surgery Center, Department of Neurosurgery, Capital Medical University Xuanwu Hospital, No. 45 Changchunjie Street, Xicheng District, Beijing, Peoples’ Republic of China 100053Feng Kong, Skull Base Surgery Center, Departmen...

Neurological and autoimmune disorders after vaccination against pandemic influenza A (H1N1) with a monovalent adjuvanted vaccine: population based cohort study

NeLM - News — Thu, 13 Oct 2011 04:00:00 +0100

Source: BMJ Area: News The risk of neurological and autoimmune disorders of special interest in people vaccinated against pandemic influenza A (H1N1) with Pandemrix were compared with unvaccinated people over 8-10 months in a retrospective cohort study in Sweden. The study involved all people registered in Stockholm county on 1 October 2009, of whom 1,024,019 were vaccinated against H1N1 and 921,005 were unvaccinated. The main outcome measures were neurological and autoimmune diagnoses according to the European Medicines Agency strategy for monitoring of adverse events of special interest defined using ICD-10 codes for: Guillain-Barré syndrome, Bell's palsy, multiple sclerosis, polyneuropathy, anaesthesia or hypoaesthesia, paraesthesia, narcolepsy (added), and autoimmune condi...

Ramsay-Hunt syndrome presenting laryngeal paralysis.

Acta Otorrinolaringologica Espanola — Thu, 13 Oct 2011 04:00:00 +0100

Authors: Gómez-Torres A, Medinilla Vallejo A, Abrante Jiménez A, Esteban Ortega F Abstract The Ramsay-Hunt syndrome is the association of facial palsy and varicella-zoster virus infection with involvement of the ear canal and eardrum. It may be associated with deafness, tinnitus and dizziness. It can sometimes affect the lower cranial nerves. A case of an immunocompetent patient with affectation of the VII, VIII and X cranial nerves is presented. PMID: 22000484 [PubMed - as supplied by publisher] (Source: Acta Otorrinolaringologica Espanola)

Corticosteroids effective in idiopathic facial nerve palsy (Bell's Palsy) but not necessarily in idiopathic acute vestibular dysfunction (Vestibular Neuritis)

The Laryngoscope — Wed, 12 Oct 2011 04:00:00 +0100

(Source: The Laryngoscope)

Pontine Stroke Mimicking Bell's PalsyPontine Stroke Mimicking Bell's Palsy

Medscape Today Headlines — Thu, 29 Sep 2011 12:02:19 +0100

What did MRI reveal about the cause of this patient's facial nerve palsy? Journal of Medical Case Reports (Source: Medscape Today Headlines)

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The Use of Onyx in Different Types of Intracranial Dural Arteriovenous Fistula [INTERVENTIONAL]

American Journal of Neuroradiology — Thu, 29 Sep 2011 04:00:00 +0100

CONCLUSIONS:The treatment of DAVFs by intracranial arterial injection of Onyx is safe, and, in most cases, results in the occlusion of the arterial venous shunt. In DAVFs with direct sinus drainage, sinus preservation was only possible in 7 of 20 patients (35%). (Source: American Journal of Neuroradiology)

[Microneurovascular facial reanimation via the masseteric nerve : Reconstruction alternative for long-standing facial palsy.]

Der Nervenarzt — Wed, 21 Sep 2011 04:00:00 +0100

CONCLUSIONS: Innervation of free muscle flaps with the masseteric nerve for oral commissure reanimation might play an important role in patients with long-standing facial palsy (as in Möbius syndrome). Synkinesis persists for long periods after surgery. However, most of the patients had learned to express their emotions by overcoming this phenomenon. Despite hypercorrection or inadequate correction, patients evaluate themselves favorably. PMID: 21932149 [PubMed - as supplied by publisher] (Source: Der Nervenarzt)

A 17-month-old boy with cerebral infarction following mild respiratory symptoms

Journal of Clinical Virology — Wed, 21 Sep 2011 04:00:00 +0100

A 17-month-old boy, who had no history of immunological or neurological disorder, was admitted to our hospital because of acute right hemiparesis and aphasia. Mild upper respiratory symptoms had been recognized for a week prior to his hospitalization. He had no family history of immunological or hematological disorders. Pharyngitis, skin rash, lymphadenopathy and hepatosplenomegaly were absent on admission. The examination of the respiratory and cardiac systems was unremarkable. He could not speak any meaningful words, and presented hemiparesis and facial palsy in the right side. Grading of muscle strength was 0/5 and 2/5, on the right upper and right lower extremities, respectively. Deep tendon reflex was slightly exaggerated with positive Babinski's sign on the right side. (Source: Journ...

Are Steroids Effective for Treating Bell's Palsy?

Annals of Emergency Medicine — Mon, 19 Sep 2011 04:00:00 +0100

Corticosteroids are safe and effective in treating Bell's palsy patients with incomplete paralysis, especially if started within 48 hours of symptom onset. The authors searched the Cochrane Neuromuscular Disease Group Trials Specialized register, MEDLINE, EMBASE, and LILACS databases. Bibliographies of relevant randomized trials were reviewed, and authors and experts were contacted to obtain additional published or unpublished data. (Source: Annals of Emergency Medicine)

Reactivation of type 1 herpes simplex virus and varicella zoster virus in an immunosuppressed patient with acute peripheral facial weakness

Journal of the Neurological Sciences — Mon, 19 Sep 2011 04:00:00 +0100

We describe a 26-year-old man treated with azathioprine for myasthenia gravis who developed acute left-sided peripheral facial weakness. Brain magnetic resonance imaging (MRI) revealed enhancement in the left geniculate ganglion and in the intracanalicular and tympanic segments of the facial nerve. Analysis of cerebrospinal fluid (CSF) and serum revealed intrathecal synthesis of anti-varicella zoster virus (VZV) IgG antibody. Although previous analyses of saliva, blood mononuclear cells, serum antibodies, middle ear fluid, and auricular and geniculate zone skin scrapings have shown that a small but definite proportion of patients with idiopathic peripheral facial palsy (“Bell's palsy”) have the Ramsay Hunt syndrome zoster sine herpete (RHS ZSH), this is the first confirmation of RHS ZS...

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Bell's Palsy: I feared I'd look like Frankenstein forever

the Mail online | Health — Sun, 18 Sep 2011 11:46:23 +0100

It began with a crackling sensation across my right cheek, as though there were caterpillars crawling across my skin. I then felt a contracture in my lips, says Isabel Wolff. (Source: the Mail online | Health)

Steroid-induced central serous retinopathy

Indian Journal of Pharmacology — Thu, 15 Sep 2011 04:00:00 +0100

Samidh P Shah, Chetna K Desai, Mira K Desai, RK DikshitIndian Journal of Pharmacology 2011 43(5):607-608A-24 year-old male was prescribed prednisolone (60 mg/day) for left sided facial palsy. After three days of therapy, the patient complained of black spots in his vision in right eye. Fluorescein angiography of right eye showed evidence of central serous retinopathy (CSR). Prednisolone dose was withdrawn gradually and the patient improved within a week. There were no other systemic or ophthalmic diseases reported by the patient, which could have caused this condition. An improvement after dechallenge confirmed steroid-induced CSR. Recurrent CSR is known to cause permanent loss of vision. Hence, awareness regarding this adverse drug reaction (ADR) with steroids and its reporting can minimi...

[Cephalic tetanus revealed by peripheral facial palsy.]

Revue de Stomatologie et de Chirurgie Maxillo-Faciale — Wed, 14 Sep 2011 04:00:00 +0100

We report a case of cephalic tetanus revealed by peripheral facial palsy and trismus. DISCUSSION: Facial peripheral palsy often appears after trismus. It is very rarely the first symptom of cephalic tetanus, making the diagnosis difficult. PMID: 21924448 [PubMed - as supplied by publisher] (Source: Revue de Stomatologie et de Chirurgie Maxillo-Faciale)

Cerebrospinal fluid findings in adults with acute Lyme neuroborreliosis

Journal of Neurology — Tue, 06 Sep 2011 15:51:30 +0100

The objective of the study was to investigate the CSF changes during acute LNB. Routine CSF parameters [leukocyte count, protein, lactate and albumin concentrations, CSF/serum quotients of albumin (QAlb), IgG, IgA and IgM, and oligoclonal IgG bands] and the Borrelia burgdorferi (BB)-specific antibody index were retrospectively studied in relation to the clinical presentation in patients diagnosed with acute LNB. A total of 118 patients with LNB were categorized into the following groups according to their symptoms at presentation; group 1: polyradiculoneuritis (Bannwarth’s syndrome), group 2: isolated facial palsy and group 3: predominantly meningitic course of the disease. In addition to the CSF of patients with acute LNB, CSF of 19 patients with viral meningitis (VM) and 3 with n...

Institute of Medicine adverse reactions report admits MMR vaccines cause measles, seizures, anaphylaxis and other health problems

NaturalNews.com — Sun, 28 Aug 2011 07:00:00 +0100

(NaturalNews) The Institute of Medicine, which has long functioned as a front group for the pharmaceutical industry and receives tens of millions of dollars in annual funding from drug companies and global elitists (like Bill Gates, Ted Turner, etc.), has issued a report that declares the MMR vaccine is not linked to autism. This is now being widely reported in the conventional (controlled) media, which isn't telling you the real story behind this report.What's the real story? That this IOM report, even though it goes out of its way to excuse vaccines and dismiss safety concerns, still openly admits that vaccines cause measles, febrile seizures, anaphylactic shock and other potentially fatal side effects. It also admits that other vaccines are linked to a whole host of bizarre side effects...

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[Case Report] Lumbar puncture in paediatric stroke

LANCET — Fri, 26 Aug 2011 23:00:00 +0100

In April, 2010, a 2-year-old, previously healthy boy was referred to our hospital with acute left-sided hemiparesis. His parents reported no preceding illness, except chickenpox 10 months earlier. On neurological examination he had left upper motor neuron facial palsy and left-sided weakness of the arm and leg with hyper-reflexia and a positive Babinski sign. At admission, diffusion-weighted brain MRI images showed signs of recent cerebral ischaemia in the right middle cerebral artery territory (). (Source: LANCET)

Isolated facial palsy and ophthalmoplegia – First symptoms of a cerebral granulomatous vasculitis with giant cells – A diagnostic challenge

Clinical Neurology and Neurosurgery — Thu, 25 Aug 2011 23:00:00 +0100

Primary cerebral vasculitis is a rare disease. There are considerable difficulties in recognition and diagnosis in the absence of systemic involvement. Primary angiitis of the central nervous system causes focal and diffuse neurologic symptoms . (Source: Clinical Neurology and Neurosurgery)

Vaccines And Bell's Palsy Link? Report Says No; Utilize Prevention

Health News from Medical News Today — Thu, 25 Aug 2011 19:00:00 +0100

There has been a long time fear that vaccine can bring the onset of serious mentally and physically debilitating illness such as the scourges of diabetes, asthma, or even Bell's palsy. However, a new study from the nonprofit Institute of Medicine finds that vaccines cause few health problems in fact. Ellen Wright Clayton, MD, JD, director of the Center for Biomedical Ethics and Society at Vanderbilt University explains: "The findings should be reassuring to parents that few health problems are clearly connected to immunizations, and these effects occur relatively rarely... (Source: Health News from Medical News Today)

Surgical treatment of Bell's palsy: Current attitudes

The Laryngoscope — Mon, 15 Aug 2011 23:00:00 +0100

Conclusions:Disagreement persists among practicing otologists about the role of surgical decompression for Bell's palsy. More convincing clinical evidence will be needed before there is widespread consensus regarding the surgical treatment of this condition. (Source: The Laryngoscope)

Superficial parotidectomy: antegrade versus retrograde facial nerve dissection

Surgical Practice — Wed, 10 Aug 2011 23:00:00 +0100

Conclusion: Retrograde parotidectomy can be performed safely without compromising the oncologic outcome. (Source: Surgical Practice)

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Clinical characteristics and cerebrospinal fluid parameters in patients with peripheral facial palsy caused by Lyme neuroborreliosis compared with facial palsy of unknown origin (Bell's palsy)

BMC Infectious Diseases — Tue, 09 Aug 2011 23:00:00 +0100

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Acute inflammatory demyelinating polyradiculoneuropathy (Guillain-Barré syndrome) following dengue fever.

Revista do Instituto de Medicina Tropical de Sao Paulo — Mon, 01 Aug 2011 04:00:00 +0100

Authors: Gonçalves E Abstract This paper reports a case of dengue in a six-year-old female child who suddenly developed excruciating headaches, fever, myalgia and paresis. Laboratory examinations included blood count, platelet count, biochemical tests (BUN, creatinine, aminotransferases, and total bilirubin and bilirubin fractions) and specific IgM titers (enzyme-immunoassay with recombinant tetravalent dengue). After ten days of hospitalization and having already been in a home environment, a new clinical image emerged, characterized by dysphagia, dysphonia, weakness, peripheral facial palsy and paresthesia. The diagnosis of Guillain-Barré Syndrome was based on clinical findings, cerebrospinal fluid examination, electrophysiological findings and the exclusion of other pathologie...

Objective method of assessing and presenting the House‐Brackmann and regional grades of facial palsy by production of a facogram

Clinical Otolaryngology — Sun, 31 Jul 2011 23:00:00 +0100

Conclusion: It is possible to measure consistently and objectively the H‐B and regional grades of facial palsy using trained ANNs to analyse video pixel data, and this can be performed in a routine clinical environment by a technician. The results from each region of the face are presented as a facogram along with the H‐B grade. (Source: Clinical Otolaryngology)

A material advance in evaluating patients with a facial palsy: the Glasgow Facial Palsy System

Clinical Otolaryngology — Sun, 31 Jul 2011 23:00:00 +0100

(Source: Clinical Otolaryngology)

H1N1 and Seasonal Influenza Vaccine Safety in the Vaccine Safety Datalink Project

American Journal of Preventive Medicine — Thu, 21 Jul 2011 20:58:12 +0100

Conclusions: No major safety problems following H1N1 or seasonal influenza vaccines were detected in the 2009–2010 season in weekly sequential analyses. Seasonality likely contributed to the Bell's palsy signal following MIV. Prospective safety monitoring followed by rigorous signal refinement is critical to inform decision-making by regulatory and public health agencies. (Source: American Journal of Preventive Medicine)

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The history of facial palsy and spasm: Hippocrates to Razi

Neurology — Sun, 10 Jul 2011 23:00:00 +0100

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. (Source: Neurology)

Epstein–Barr virus‐related lymphoproliferative disorder, cytomegalovirus reactivation, and varicella zoster virus encephalitis during treatment of medulloblastoma

Journal of Medical Virology — Fri, 08 Jul 2011 14:46:57 +0100

AbstractThe case of a 14‐year‐old girl who developed Epstein–Barr virus‐related lymphoproliferative disorder, cytomegalovirus reactivation, and Varicella zoster virus encephalitis during treatment for medulloblastoma is described. The patient was diagnosed with a cerebral medulloblastoma and treated with systemic chemotherapy, intrathecal chemotherapy, and radiotherapy. Six months later, she developed persistent low‐grade fever, abdominal pain, and vomiting. Several mucosal or ulcerated lesions of the stomach and colon were found on fiberscopy. The infiltrating cells were positive for CD20 and EBER1, and the diagnosis of lymphoproliferative disorder was made. CMV antigen was found in the peripheral lymphocytes at that time. At the same time, it was noted that the patient's langua...

Differential diagnosis and treatments of necrotizing otitis externa: A report of 19 cases

Auris, Nasus, Larynx — Wed, 06 Jul 2011 15:23:45 +0100

Conclusion: The proportion of patients with facial palsy and diabetes in our series was comparable to those reported in the literature. But the incidence of P. aeruginosa was much lower and the rate of resistance to ciprofloxacin was high, which was supposed to result from the popularity and previous use of the quinolone ear drops before referral. And the leading cause of mortality is patient's comorbidities. Treating necrotizing otitis externa remains a great challenge even in nowadays with modern image modalities and advanced antibiotics. Physicians should have a high index of suspicion when facing patients at risk with refractory external ear infection so as to give them timely diagnosis and optimal treatment. (Source: Auris, Nasus, Larynx)

Psychological distress in people with disfigurement from facial palsy

Eye — Fri, 01 Jul 2011 07:00:00 +0100

Authors: L Fu, C Bundy & S A Sadiq (Source: Eye)

Bell's palsy with concomitant idiopathic cranial nerve polyneuropathy in seven dogs

The Journal of Small Animal Practice — Thu, 30 Jun 2011 23:00:00 +0100

(Source: The Journal of Small Animal Practice)

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'Dead' Facial Nerves Brought Back To Life By Physiotherapist

Health News from Medical News Today — Wed, 22 Jun 2011 12:00:00 +0100

A physiotherapist based at Southampton's teaching hospitals has discovered movement in the faces of patients with 'dead' nerves - by stretching the inside of their mouths with her finger. The finding, made by specialist neurological physiotherapist Lorraine Clapham at Southampton General Hospital, gives hope to patients who suffer from facial palsy, where damage to nerves from injury, surgery or unexplained syndromes causes muscles to weaken and droop... (Source: Health News from Medical News Today)

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

Trials — Mon, 20 Jun 2011 23:00:00 +0100

This study is registered with ClinicalTrials.gov (reference no. NCT01201642). (Source: Trials)

Reinnervation by the contralateral facial nerve in patients with peripheral facial palsy

Muscle and Nerve — Tue, 14 Jun 2011 23:00:00 +0100

Conclusion:These findings indicate short distance sprouting of axons that innervate muscle fibers, which originate from the unaffected facial nerve, resulting in propagation of impulses to muscle fibers in the midline. (Source: Muscle and Nerve)

James Le Fanu: Doctor's Diary

The Telegraph : Health Advice — Fri, 20 May 2011 14:03:28 +0100

Why we should all fall for t'ai chi (Source: The Telegraph : Health Advice)

Bell's Palsy Linked to Stroke Risk

Medscape Today Headlines — Thu, 19 May 2011 21:48:33 +0100

Herpes and varicella viruses might play a role in the link, researchers say. Medscape Medical News (Source: Medscape Today Headlines)

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Varicella Zoster Vasculopathy

Journal of the International Association of Physicians in AIDS Care (JIAPAC) — Wed, 18 May 2011 23:00:00 +0100

Varicella-zoster virus can cause neurological disease in primary and reactivated latent forms, with a wide spectrum of disorders throughout a person’s lifetime. 35-year-old male with AIDS; histoplasmosis; mild, intermittent asthma; and hypertension presented to hospital with left-sided weakness and slurred speech. Exam showed left hemiparesis with left upper motor neurons facial palsy and dysarthria. Acute right basal ganglia infarct was detected in head CT without contrast. A subsequent MRI showed acute non-hemorrhagic infarct, right basal ganglia; fusiform dilatation, and proximal right middle cerebral artery. A CT angiogram of the bilateral carotid arteries revealed occlusion of the right anterior cerebral artery with conical dilatation at the origin; significant stenosis, and dil...

Bell's palsy during pregnancy: Is it associated with adverse perinatal outcome?

The Laryngoscope — Sun, 15 May 2011 23:00:00 +0100

Conclusions:Chronic hypertension and obesity are independent risk factors for Bell's palsy. Bell's palsy during pregnancy is significantly associated with severe preeclampsia. Nevertheless, no significant association exists between Bell's palsy and adverse perinatal outcomes. (Source: The Laryngoscope)

Dermoid cyst in the facial nerve—A unique diagnosis

International Journal of Pediatric Otorhinolaryngology — Thu, 12 May 2011 18:18:19 +0100

We present the first reported case of a dermoid tumor in the facial nerve causing facial paralysis in a child. Case report at a tertiary Children's Hospital. A 9-month-old was referred to our institution for evaluation of persistent, complete right sided facial paralysis three months after receiving a diagnosis of Bell's palsy. A workup at our institution including MRI and CT revealed marked widening of the facial canal in the mastoid segment consistent with facial nerve schwannoma or hemangioma. Surgical exploration via mastoidectomy and facial nerve decompression revealed keratinous material containing hair that had fully eroded the facial nerve, disrupting it completely. The entire tumor was removed along with the involved segment of facial nerve, and the missing facial nerve segment wa...

Lid Loading for Treatment of Paralytic Lagophthalmos

Aesthetic Plastic Surgery — Tue, 10 May 2011 06:00:35 +0100

In conclusion, although lid loading cannot solve all the problems associated with the paralyzed eyelid, it is a simple, reversible, and effective way to treat paralytic lagophthalmos. Content Type Journal ArticlePages 1-7DOI 10.1007/s00266-011-9740-xAuthors Yongchun Yu, Department of Oral & Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041 People’s Republic of ChinaJie Sun, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041 People’s Republic of ChinaLin Chen, Department of Oral & Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041 People’s Republic of ChinaLei Liu, Department of Oral & Maxillofacial Surgery, West China Hospital of Stomatolog...

Response

Pediatric Neurology — Mon, 09 May 2011 14:38:34 +0100

We appreciate the comments of Pienczk-Reclawowicz and Pilarska concerning our article on pediatric Tolosa-Hunt syndrome preceded by facial palsy. Few cases of Tolosa-Hunt syndrome have been described in the pediatric population. In an undefined proportion of these clinical cases, features do not correspond with current diagnostic criteria, and we agree that these criteria should be revised. Our patient responded to steroid treatment, but required low doses of steroids to maintain clinical improvement. Nevertheless, we did not state that low doses of steroids were sufficient to overcome the inflammatory process, and we understood that the resolution of magnetic resonance imaging abnormalities was incomplete. Although the normalization of findings on magnetic resonance imaging is usually tho...

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Tolosa-Hunt Syndrome Preceded by Facial Palsy in a Child

Pediatric Neurology — Mon, 09 May 2011 14:38:33 +0100

Pediatric Tolosa-Hunt syndrome is a rare disease, and data regarding its course and treatment responses derive from only a few case reports. Hence we thank Cerisola et al. for their report on pediatric Tolosa-Hunt syndrome preceded by facial nerve palsy . The patient in this report presents one of the most interesting clinical cases in terms of the profound impact on cranial neuropathy in Tolosa-Hunt syndrome. This case supports two previously published contentions : (1) a revision of the diagnostic criteria for Tolosa-Hunt syndrome is necessary (i.e., the resolution of cranial nerve palsies after steroid therapy should not be limited to 72 hours); and (2) the lack of specific management in pediatric patients with Tolosa-Hunt syndrome may result in treatment failure as well as corticoster...

Utilization of the Tympanomastoid Fissure for Intraoperative Identification of the Facial Nerve: A Cadaver Study

Journal of Oral and Maxillofacial Surgery — Sun, 08 May 2011 23:00:00 +0100

Conclusions: The results showed that the tympanomastoid fissure is a close and predictable anatomic landmark that can be used to identify the facial nerve trunk intraoperatively. (Source: Journal of Oral and Maxillofacial Surgery)

Combined protocol for treatment of secondary effects from facial nerve palsy.

Acta Oto-Laryngologica — Sun, 01 May 2011 23:00:00 +0100

Conclusion: Rehabilitation was significantly efficient in both groups of patients with synkinesis, especially in those in whom treatment with botulinum toxin type A (BTX-A) preceded physical rehabilitation. Objective: To determine the influence of preventive treatment with BTX-A on synkinesis when physical rehabilitation is planned. Methods: Twenty patients, who recovered from facial palsy with final House-Brackmann (HB) grade II and III, were randomized to assess the efficacy of preventive BTX-A treatment on final synkinesis score after physical rehabilitation. Synkinesis was graded according to the four-point scale derived from the SunnyBrook Facial Grading System (FGS). Physical rehabilitation was carried out using NeuroMuscular Retraining Therapy (NMRT). In the randomized groups, NMRT ...

[Post-traumatic meningitis in children: eleven years' analysis].

Acta Medica Portuguesa — Sun, 01 May 2011 04:00:00 +0100

Conclusions: Bacterial meningitis is a complication to be considered in head injury with basilar skull fracture, particularly when associated with cerebrospinal fluid leakage, even though the injury occurred several years earlier, and is usually a serious condition. One of our children died. Similar to what is described, S. pneumoniae was the most common bacteria, and this fact supports that children with head trauma and cerebrospinal fluid leakage should receive pneumococcal vaccine. The follow-up of these children requires constant vigilance and should include a multidisciplinary approach. PMID: 22015025 [PubMed - in process] (Source: Acta Medica Portuguesa)

Bell's Palsy Associated with Chronic HCV Infection Before and During Peginterferon Alfa and Ribavirin Therapy.

Archives of Iranian Medicine — Sat, 30 Apr 2011 23:00:00 +0100

Authors: Jabbari H, Fakharzadeh E, Merat S, Zamini H, Sharifi AH Neuropsychiatric side effects of peg interferon-alpha (PEG-IFN-alpha) therapy consist of a large spectrum of symptoms. Organic personality syndrome, organic affective syndrome, psychotic manifestations and seizures are more common side effects of PEG-IFN-alpha whereas cranial neuropathy and movement disorders are less common. Bell's palsy is often idiopathic, but has been linked to some viral infections, particularly with herpes viruses. Other infections, such as human immunodeficiency virus infection and Lyme disease, may also lead to idiopathic facial paralysis. Neither acute nor chronic Hepatitis C infection has been implicated previously in Bell's palsy, but PEG-IFN-alpha may play a role. Two patients with CHC who d...

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Correlation of functional recovery with the course of electrophysiological parameters after free muscle transfer for reconstruction of the smile in irreversible facial palsy

Muscle and Nerve — Thu, 28 Apr 2011 23:00:00 +0100

Discussion:Processes of reinnervation can be detected earlier by electrophysiological analysis than by quantified clinical analysis. Pathological spontaneous activity alone as well as the combined assessment with motor unit action potentials in the early postoperative stage are strong prognostic indicators. (Source: Muscle and Nerve)

Gold weight implantation as a treatment measure for correction of paralytic lagophthalmos

Table of Contents : Indian Journal of Dental Research : 2006 - 17(3) — Sun, 24 Apr 2011 23:00:00 +0100

We report a case of a patient with facial paralysis who underwent gold weight implantation of the upper eyelid for correction of paralytic lagophthalmos. (Source: Table of Contents : Indian Journal of Dental Research : 2006 - 17(3))

The Subtarsal Incision: Where Should It Be Placed?

Journal of Oral and Maxillofacial Surgery — Thu, 21 Apr 2011 23:00:00 +0100

Conclusions: The results of this study indicate that the optimal placement of the subtarsal incision is as close as possible to the inferior border of the tarsal plate. The incision should be placed within an existing skin crease, if possible, and should be made with the knowledge that the more inferior the incision is placed, the greater the visualization of the fracture, but the more visible the scar. (Source: Journal of Oral and Maxillofacial Surgery)

Conservative Management of Acute Mastoiditis in Children [Original Article]

Archives of Otolaryngology — Sun, 17 Apr 2011 23:00:00 +0100

Conclusion Antibiotic drug use combined with retroauricular puncture and grommet insertion is an effective alternative to mastoidectomy in the treatment of acute mastoiditis with SA in children. (Source: Archives of Otolaryngology)

[Disease With Generalized Pain.]

Praxis — Tue, 12 Apr 2011 23:00:00 +0100

Authors: Schleich A, Baumann H A 43-year-old women is suffering from immobilizing generalized muscular pain. Initial diagnostic course doesn't lead to diagnosis. Some days later after appearing of a facial palsy a Guillain-Barré syndrome is diagnosed after lumbar puncture showing a increased protein and normal white-cell count. Because the patient is seriously affected with immobilization a treatment with intravenous immunoglobulin is established, leading to a quick improvement. Pain as a leading symptom of Guillain- Barré syndrome and has a potential for leading to misdiagnosis effecting delay in therapy in possible harmful disease. PMID: 21484714 [PubMed - as supplied by publisher] (Source: Praxis)

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Mepivacaine: Bell's palsy: case report

Reactions — Tue, 12 Apr 2011 16:15:37 +0100

(Source: Reactions)

Facial nerve palsy following bilateral sagittal split ramus osteotomy for setback of the mandible

International Journal of Oral and Maxillofacial Surgery — Thu, 07 Apr 2011 23:00:00 +0100

Abstract: Sagittal split osteotomy of the mandible is frequently used to correct dentofacial deformities. Postoperative facial palsy is one of the most serious complications because it reduces the quality of life and significantly reduces social interaction. The case of a 22-year-old patient who underwent sagittal split setback osteotomy is described. The medical records, perioperative photographs and literature were reviewed in detail to collect data on the clinical course, treatment and outcomes. (Source: International Journal of Oral and Maxillofacial Surgery)

Facial Nerve Schwannoma Involving Middle Cranial Fossa: When the Unilateral Sensorineural Hearing Loss Guide to the Correct Diagnosis

Indian Journal of Otolaryngology and Head and Neck Surgery — Tue, 05 Apr 2011 10:07:35 +0100

We present a case of giant facial nerve schwannoma involved the middle cranial fossa without facial nerve paralysis. In these cases the unilateral hearing loss (if present) guide to a correct diagnosis. Content Type Journal ArticlePages 1-3DOI 10.1007/s12070-011-0190-1Authors Alessandro De Stefano, ENT Institute, “G.d’Annunzio” University of Chieti and Pescara, Chieti, ItalyFrancesco Dispenza, Otolaryngology Department, University of Palermo, Palermo, ItalyGautham Kulamarva, ENT Department, KIMS Hospital, Kasaragod, Kerala, India Journal Indian Journal of Otolaryngology and Head & Neck SurgeryOnline ISSN 0973-7707Print ISSN 0019-5421 (Source: Indian Journal of Otolaryngology and Head and Neck Surgery)

The many faces of hemifacial spasm: Differential diagnosis of unilateral facial spasms

Movement Disorders — Mon, 04 Apr 2011 23:00:00 +0100

AbstractHemifacial spasm is defined as unilateral, involuntary, irregular clonic or tonic movement of muscles innervated by the seventh cranial nerve. Most frequently attributed to vascular loop compression at the root exit zone of the facial nerve, there are many other etiologies of unilateral facial movements that must be considered in the differential diagnosis of hemifacial spasm. The primary purpose of this review is to draw attention to the marked heterogeneity of unilateral facial spasms and to focus on clinical characteristics of mimickers of hemifacial spasm and on atypical presentations of nonvascular cases. In addition to a comprehensive review of the literature on hemifacial spasm, medical records and videos of consecutive patients referred to the Movement Disorders Clinic at B...

Clinical Assessment of a New Computerised Objective Method of Measuring Facial Palsy

Clinical Otolaryngology — Thu, 31 Mar 2011 23:00:00 +0100

Conclusion: This new computerised objective method of assessing the degree of facial palsy shows promise as a standardized objective method of assessing the degree of facial palsy. (Source: Clinical Otolaryngology)

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Morphological abnormalities of embryonic cranial nerves after in utero exposure to valproic acid: implications for the pathogenesis of autism with multiple developmental anomalies.

International Journal of Developmental Neuroscience — Wed, 30 Mar 2011 23:00:00 +0100

Authors: Tashiro Y, Oyabu A, Imura Y, Uchida A, Narita N, Narita M Autism is often associated with multiple developmental anomalies including asymmetric facial palsy. In order to establish the etiology of autism with facial palsy, research into developmental abnormalities of the peripheral facial nerves is necessary. In the present study, to investigate the development of peripheral cranial nerves for use in an animal model of autism, rat embryos were treated with valproic acid (VPA) in utero and their cranial nerves were visualized by immunostaining. Treatment with VPA after embryonic day 9 had a significant effect on the peripheral fibers of several cranial nerves. Following VPA treatment, immunoreactivity within the trigeminal, facial, glossopharyngeal and vagus nerves was significa...

Prognosis of patients with recurrent facial palsy

European Archives of Oto-Rhino-Laryngology — Tue, 29 Mar 2011 17:33:00 +0100

Abstract No studies to date have classified recurrent facial palsy according to the House-Brackmann grade, thus limiting any comparisons between patients with recurrent and primary facial palsy. The aims of the study were to analyze the degree of recovery from recurrent facial palsy and factors affecting the degree of recovery and to compare with patients recovering from primary facial palsy. Seventy-two patients with recurrent facial palsy were treated by the same treatment approach as 1,185 patients with general facial palsy. Underlying disease, palsy side, and extent of recovery were measured. Temporal bone magnetic resonance image (MRI), Electroneurography (ENoG), electromyography (EMG), and initial House-Brackmann grade were assessed and compared by statistical analys...

Facing the Truth About Bell Palsy

Medscape Today Headlines — Mon, 28 Mar 2011 15:30:14 +0100

In this interview, founder of the Facial Paralysis and Bell's Palsy Foundation, Dr. Babak Azizzadeh shares insights into the surgical management of facial paralysis. Medscape Plastic Surgery & Aesthetic Medicine (Source: Medscape Today Headlines)

Adverse events associated with acupuncture: three multicentre randomized controlled trials of 1968 cases in China

Trials — Thu, 24 Mar 2011 00:00:00 +0100

Conclusions: Acupuncture is a safe therapy with low risk of adverse events in clinical practice. The risk factors for adverse events (AEs) were related to the patients' gender and age and the local anatomical structure of the acupoints. AEs could be reduced and mitigated by improving the medical environment, ensuring a high technical level of the acupuncture practitioners and establishing a good relationship of mutual trust between doctor and patient.Trial registrationClinicaltrials.gov identification numbers: NCT00599586, NCT00599677, NCT00608660. (Source: Trials)

Bell's palsy.

Herpes — Sat, 19 Mar 2011 08:00:06 +0100

Authors: Holland J, Bernstein J Bell's palsy is characterised by an acute, unilateral, partial, or complete paralysis of the face (i.e., lower motor neurone pattern). The weakness may be partial (paresis) or complete (paralysis), and may be associated with mild pain, numbness, increased sensitivity to sound, and altered taste. Bell's palsy remains idiopathic, but a proportion of cases may be caused by reactivation of herpes viruses from the geniculate ganglion of the facial nerve. Bell's palsy is most common in people aged 15 to 40 years, with a 1 in 60 lifetime risk. Most make a spontaneous recovery within 1 month, but up to 30% show delayed or incomplete recovery. METHODS AND OUTCOMES: We conducted a systematic review to answer the following clinical question: What are the effects of...

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Osteopetrosis manifesting as recurrent bilateral facial palsy in childhood: A case report

Clinical Neurology and Neurosurgery — Tue, 15 Mar 2011 23:35:14 +0100

Bilateral lower motor neuron (LMN) facial palsy is an uncommon entity in the routine clinical practice and requires investigations to rule out various causes. Osteopetrosis is a rare disease due to a defect in the bone resorption by the osteoclasts, resulting in the generalized sclerosis and increase in the bone density with neurological and hematological complications. In this interesting case report we describe a child with milder form of osteopetrosis presenting with recurrent LMN facial palsy and conductive deafness. (Source: Clinical Neurology and Neurosurgery)

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

Trials — Wed, 09 Mar 2011 00:00:00 +0100

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 as 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 ...

Bell's palsy

Clinical Evidence — Mon, 07 Mar 2011 23:00:00 +0100

New option(s) added for: Hyperbaric oxygen therapy New option added with one RCT comparing hyperbaric oxygen versus corticosteroids. The RCT found that a higher proportion of people completely recovered with hyperbaric oxygen compared with corticosteroids. It also reported that time to complete recovery was faster with hyperbaric oxygen. Categorised as Unknown effectiveness as there remains insufficient high-quality evidence to assess the effects of hyperbaric oxygen for people with Bell's palsy. New evidence; conclusion confirmed for: Corticosteroids Two systematic reviews added. Both reviews and two large RCTs included in the reviews found that corticosteroids improved rates of complete recovery of facial function...

Facial exercise therapy for facial palsy: systematic review and meta-analysis.

Clinical Rehabilitation — Mon, 07 Mar 2011 00:00:00 +0100

Conclusion: Facial exercise therapy is effective for facial palsy for the outcome functionality. PMID: 21382865 [PubMed - as supplied by publisher] (Source: Clinical Rehabilitation)

A case of multiple abnormalities with eustachian tube obstruction by a protruded internal carotid artery

International Journal of Pediatric Otorhinolaryngology — Tue, 01 Mar 2011 00:00:00 +0100

We report a case of multiple abnormalities with eustachian tube obstruction by a protruded internal carotid artery. A 10-year-old male presented with multiple abnormalities including anomalous pinna, poor eyesight, facial palsy, moderate conductive deafness, and otitis media with effusion. Temporal bone computed tomography demonstrated obstruction of the right eustachian tube by a protruded internal carotid artery. Insertion of a tympanostomy tube did not improve his hearing, indicating a possible ossicular chain anomaly. Although tympanoplasty is necessary to improve the patients’ hearing, the poor drainage function makes this difficult. Knowledge of this vascular anomaly is important when performing myringotomy or tympanoplasty. (Source: International Journal of Pediatric Otorhinolaryn...

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Surgical interventions for the early management of Bell's palsy

Neurological Conditions Specialist Library — Mon, 28 Feb 2011 11:16:59 +0100

The objective of this review was to assess the effectiveness of surgery in the management of Bell's palsy and to compare this to outcomes of medical management. (Source: Neurological Conditions Specialist Library)

Our Experience with Split Electrode Array Implant for Obliterated Cochlea

Indian Journal of Otolaryngology and Head and Neck Surgery — Thu, 24 Feb 2011 08:05:46 +0100

Abstract To study the outcomes of split electrode array cochlear implantation in ossified cochlea using the CAP scoring system. Retrospective case study. Tertiary referral center. Six cochleae in three adult and three pediatric patients with ossification. Intervention(s): All Patients underwent cochlear implantation with a split electrode array system. Major outcome parameter(s): Number of electrodes inserted during surgery, number of functioning electrodes on follow-up and auditory performance evaluation using the CAP score—Category of Auditory Perception [TSC Revised Version, based on Nottingham CI Program, 1995]. Six patients (three children and three adults) had insertion of split electrode array system. The mean number of electrodes inserted were 18.3 (range 15–21)...

New Cochrane review on Surgical interventions for the early management of Bell's palsy

NLH Specialist Library for ENT and Audiology Latest News — Wed, 23 Feb 2011 12:09:27 +0100

23/02/11 The Cochrane Library Issue 2, 2011 (Source: NLH Specialist Library for ENT and Audiology Latest News)

Surgical interventions for the early management of Bell's palsy.

Cochrane Database of Systematic Reviews — Sat, 19 Feb 2011 14:00:09 +0100

Authors: McAllister K, Walker D, Donnan PT, Swan I Bell's palsy is an acute paralysis of one side of the face of unknown aetiology. Bell's palsy should only be used as a diagnosis in the absence of all other pathology. As the proposed pathophysiology is swelling and entrapment of the nerve, some surgeons suggest surgical decompression of the nerve as a possible management option. PMID: 21328293 [PubMed - in process] (Source: Cochrane Database of Systematic Reviews)

Cardiopulmonary Arrest Caused by Craniometaphyseal Dysplasia

Indian Journal of Pediatrics — Thu, 17 Feb 2011 08:00:35 +0100

Abstract Craniometaphyseal dysplasia is a rare congenital disorder that can cause craniofacial skeleton and tubular bone anomalies. A 7-month-old girl, with congenital facial palsy, mouth breathing, and nasal obstruction, was brought to the hospital because she suffered sudden cardiopulmonary arrest. Computed tomography showed bony narrowing of the choanae. The diagnosis was cardiopulmonary arrest triggered by asphyxia caused by severe choanal stenosis. She showed hypoxic encephalopathy and underwent a tracheotomy and an operation to enlarge choanae. When a neonate or young infant shows signs of nasal obstruction, physicians should aggressively search for and consider the possibility of choanal atresia or severe stenosis. Content Type Journal ArticlePages 1-3DOI 10.100...

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Bell's palsy

Neurological Conditions Specialist Library — Wed, 16 Feb 2011 12:10:44 +0100

In this video, published by NHS Choices, a speech therapist explains who is most at risk from Bell's Palsy and describes common causes and treatment options available. (Source: Neurological Conditions Specialist Library)

The role of facial palsy in staging squamous cell carcinoma of the temporal bone and external auditory canal

NLH Specialist Library for ENT and Audiology Latest Content — Wed, 16 Feb 2011 10:42:34 +0100

Authors' conclusions: This pooled-data survival analysis for SCC of the EAC demonstrates that facial nerve involvement is associated with a poor outcome and that the survival outcomes for subjects with facial palsy more closely parallel the survival curves of advanced stage T4 disease. Disease with facial palsy should be classified as stage T4, in accordance with the PITT-2000 system. (Source: NLH Specialist Library for ENT and Audiology Latest Content)

The benefits of steroids versus steroids plus antivirals for treatment of Bell's palsy: a meta-analysis

NeLM - Disease Focused Reviews — Wed, 16 Feb 2011 00:00:00 +0100

Source: DARE Area: Evidence > Disease Focused Reviews CRD Summary: This review evaluated whether steroid treatment plus antivirals provided a greater degree of facial muscle recovery than steroids alone in patients with Bell's palsy. The authors concluded that combined treatment provided no additional benefit in achieving at least partial facial muscle recovery. This was a generally well-conducted review, and the authors' conclusion is likely to be reliable. [The included steroid was oral prednisone or prednisolone; the included antivirals were acyclovir, valacyclovir, and famcyclovir.] CRD Commentary: This review addressed a clear question, and this was supported by potentially reproducible inclusion criteria. The search strategy included various relevant sources, and attempts were m...

[Continuous monitoring of a guideline: Bell's palsy.]

Herpes — Thu, 10 Feb 2011 00:00:00 +0100

We present the continuous monitoring of our Bell's palsy guideline. MATERIAL AND METHODS: Emergency and medical reports of the children seen in Child Neurology surgery from July 2006 to August 2009 (group 2) are reviewed for the purpose of finding out the present level of compliance with guideline quality criteria and compare it with the previously reviewed period (group 1, from March 2003 to June 2006). Scientific evidence on this topic is also updated. RESULTS: Comparing the compliance rate in group 1 with group 2 shows a rise in group 2 from 85.1% to 100% in facial expression description, from 11.1% to 31.6% on whether or not there is evidence of Herpes Zoster vesicles, from 77.7% to 84.2% whether or not there is evidence fundoscopic examination, and from 77.7% to 86.8% as regards crani...

Use of the masseter nerve as a “babysitter” procedure in short term facial palsy: “babysitting” or replacement of the facial nerve?

European Journal of Plastic Surgery — Mon, 07 Feb 2011 22:47:00 +0100

Content Type Journal ArticlePages 1-2DOI 10.1007/s00238-011-0545-6Authors Steffen U. Eisenhardt, Department of Plastic and Hand Surgery, University of Freiburg Medical Centre, 79106 Freiburg, GermanyHolger Bannasch, Department of Plastic and Hand Surgery, University of Freiburg Medical Centre, 79106 Freiburg, GermanyG. Björn Stark, Department of Plastic and Hand Surgery, University of Freiburg Medical Centre, 79106 Freiburg, Germany Journal European Journal of Plastic SurgeryOnline ISSN 1435-0130Print ISSN 0930-343X (Source: European Journal of Plastic Surgery)

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[Pre-eclampsia and facial paralysis.]

Gynecologie, Obstetrique et Fertilite — Tue, 01 Feb 2011 00:00:00 +0100

We describe here the case of a patient affected with pre-eclampsia and who had ididiopathic facial palsy and HELLP syndrome during the puerperium. It developed favourably with a treatment associated with an antihypertensive medicine, corticoid therapy and ophtalmological care. There is an association between pre-eclampsia and idiopathic facial palsy during pregnancy. This can be explained by identical physiopathological mechanisms. Facial palsy generally appears in the course of the third trimester of pregnancy or during the early puerperium. The prognosis is usually good and does not seem to be influenced by pregnancy. When idiopathic facial palsy appears during pregnancy, evidence of pre-eclampsia must be looked for. PMID: 21292528 [PubMed - as supplied by publisher] (Source: Gynecol...

The approaches and outcomes of skull base surgery for pediatric sarcoma after initial therapy

Auris, Nasus, Larynx — Fri, 28 Jan 2011 16:03:33 +0100

Conclusion: These tumors were safely removed with minimum morbidity. Skull base surgery is recommended to remove residual pediatric sarcoma after the initial treatment. (Source: Auris, Nasus, Larynx)

Primary glioblastoma of the cerebellopontine angle in adults.

Journal of Neurosurgery — Fri, 21 Jan 2011 00:00:00 +0100

Authors: Wu B, Liu W, Zhu H, Feng H, Liu J Gliomas are rare entities in the cerebellopontine angle (CPA) in adults. The authors present clinical, neuroradiological, serological, and neuropathological findings in a 60-year-old man with an extraaxial CPA glioblastoma arising from the proximal portion of cranial nerve VIII. The patient presented with progressive left-sided deafness and left-sided facial palsy lasting less than 2 months and progressive dysarthria and dysphagia lasting 2 weeks. Preoperative neuroimaging suggested the diagnosis of CPA meningioma with "dural-tail" sign and involvement of the internal auditory canal. Serological examination showed an increase in the malignant markers of ferritin and neuron-specific enolase, which suggested underlying malignancy. The tumor was ...

Facial Palsy and Idiopathic Intracranial Hypertension in Twins With Cystic Fibrosis and Hypovitaminosis A

Pediatric Neurology — Wed, 19 Jan 2011 17:33:40 +0100

We report on 10-week-old monozygotic twins, diagnosed with cystic fibrosis by newborn screening, who developed facial palsy and increased intracranial pressure. Cranial imaging and cerebrospinal fluid analysis produced normal results. Levels of serum vitamin A were below normal range. Low levels of vitamin A are associated with facial nerve paralysis, and are at least partly implicated in the development of increased intracranial pressure in infants with cystic fibrosis. (Source: Pediatric Neurology)

[Efficacy of first-line radiation for non-resectable carotid paraganglioma.]

Journal des Maladies Vasculaires — Fri, 14 Jan 2011 00:00:00 +0100

CONCLUSION: External beam radiation therapy seems to be a good alternative therapy for local control of carotid paragangliomas if surgical resection is impossible. PMID: 21239128 [PubMed - as supplied by publisher] (Source: Journal des Maladies Vasculaires)

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Intrathecal liposomal cytarabine (lipoCIT) administration in patients with leukemic or lymphomatous meningitis

Investigational New Drugs — Wed, 12 Jan 2011 17:06:54 +0100

Conclusion In our experience, intrathecal liposomal cytarabine injections were convenient in the management of leukemic and lymphomatous meningitis, and can lead to long-term survival. Although neurotoxicity was rare, clinicians should exercise caution when retreatment is required in relapsing patients. Content Type Journal ArticlePages 1-6DOI 10.1007/s10637-011-9632-6Authors Annie Brion, Centre hospitalier universitaire, Service d’Hématologie, Besançon, 25030 FranceFaezeh Legrand, Centre hospitalier universitaire, Service d’Hématologie, Besançon, 25030 FranceFabrice Larosa, Centre hospitalier universitaire, Service d’Hématologie, Besançon, 25030 FranceFrançoise Schillinger, Etablissement Français du Sang Bourgogne-Franche Comté, Laboratoire de biologie médicale, B...

Limitations of Modern Imaging Techniques in Detection of Parotid Carcinoma

Journal of Oral and Maxillofacial Surgery — Fri, 07 Jan 2011 00:00:00 +0100

Most peripheral facial paralysis is of unknown cause and labeled as idiopathic or Bell's palsy. Only for about 20% of peripheral facial paralysis cases can a specific cause be identified. The common diagnostic workup of peripheral facial nerve palsies includes routine investigations, such as a neurologic examination and a complete neuro-otologic screening (pure tone audiometry, caloric vestibular and stapedial reflex testing, Schirmer tear test, gustometry, serologic examination to rule out viral or bacterial infections, and brainstem audiometry in cases of equivocal findings), as well as electromyography of the facial muscles. Approximately 5% of facial nerve palsies can be demonstrated to have a neoplastic etiology, mainly parotid carcinoma. Facial nerve involvement is an important diagn...

Corticosteroid and antiviral therapy for Bell palsy: A network meta-analysis

BMC Neurology — Wed, 05 Jan 2011 00:00:00 +0100

Conclusions: Our evidence suggests that the current practice of treating Bell's palsy with AVT plus corticosteroid may lead to slightly higher recovery rates compared to treating with prednisone alone but this does not quite reach statistical significance; prednisone remains the best evidence-based treatment. (Source: BMC Neurology)

Integrating Spatial Epidemiology Into a Decision Model for Evaluation of Facial Palsy in Children [Article]

Archives of Pediatrics — Mon, 03 Jan 2011 00:00:00 +0100

Conclusions Most physicians intuitively integrate geographic information into Lyme disease management, but we demonstrate quantitatively how formal use of geographically based incidence in a clinical algorithm improves diagnostic accuracy. These findings demonstrate potential for improved outcomes from investments in health information technology that foster bidirectional communication between public health and clinical settings. (Source: Archives of Pediatrics)

Razi's Description and Treatment of Facial Paralysis.

Archives of Iranian Medicine — Sat, 01 Jan 2011 00:00:00 +0100

Authors: Tabatabaei SM, Kalantar Hormozi A, Asadi M In the modern medical era, facial paralysis is linked with the name of Charles Bell. This disease, which is usually unilateral and is a peripheral facial palsy, causes facial muscle weakness in the affected side. Bell gave a complete description of the disease; but historically other physicians had described it several hundred years prior although it had been ignored for different reasons, such as the difficulty of the original text language. The first and the most famous of these physicians who described this disease was Mohammad Ibn Zakaryya Razi (Rhazes). In this article, we discuss his opinion. PMID: 21194269 [PubMed - in process] (Source: Archives of Iranian Medicine)

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Bell's palsy related to dental infection

Dental Abstracts — Sat, 01 Jan 2011 00:00:00 +0100

Bell's palsy was first described in 1821 but its pathogenesis remains unclear. About 25% of cases are related to trauma, surgery, local infection, tumor, stroke, and other causes; the other 75% were previously considered idiopathic. These latter cases are now considered viral and associated with ischemia and compression of the facial nerve in the area of the temporal bone. Herpes simplex virus type 1 (HSV-1) has been identified in some Bell's palsy cases. The condition has been described as facial nerve paralysis that originates from an HSV-1 reactivation. What triggers the reactivation is unknown, but many factors appear to contribute. Dental/oral events and seventh cranial nerve paresis have been linked in a cause–effect connection. Peripheral nerve paresis may occur after dental manip...

Tolosa-Hunt Syndrome Preceded by Facial Palsy in a Child

Pediatric Neurology — Tue, 14 Dec 2010 07:21:36 +0100

We report on a previously healthy 11-year-old boy with unilateral periorbital mild headache and facial nerve palsy, followed during the next 5 months by recurrent unilateral headaches and subsequent extrinsic paresis of the third cranial nerve and paresis of the sixth cranial nerve, each of which improved with steroids. Cranial magnetic resonance imaging revealed increased thickening of the left cavernous sinus and adjacent structures, with marked gadolinium enhancement. Eight months after the initial signs, he developed left retro-orbital headache that lasted 16 days and was relieved 24 hours after resuming steroid treatment. Recurrent multiple cranial neuropathies, neuroimaging findings, and long-lasting headache that responded to steroids indicated Tolosa-Hunt syndrome, further confirme...

Facial palsy: Etiology, outcome and management in children.

European Journal of Paediatric Neurology — Mon, 13 Dec 2010 00:00:00 +0100

CONCLUSION: Based on the rate of 97.6% spontaneous complete recovery we believe that the routine use of corticosteroids in children with facial palsy is not justified, unless there is new data from controlled trials in children. PMID: 21159531 [PubMed - as supplied by publisher] (Source: European Journal of Paediatric Neurology)

Facial nerve palsy in childhood

Brain and Development — Thu, 09 Dec 2010 00:00:00 +0100

Abstract: Facial nerve palsy in children is usually idiopathic but can also result from many conditions such as neoplasias, systemic diseases, or congenital anomalies with poor prognosis. Children with idiopathic facial palsy (Bell’s palsy) have a very good prognosis, while treatment with prednisone does not certainly improve the outcome. The causes of facial nerve palsy in childhood differ from those in adults. A detailed investigation and differential diagnosis are recommended for facial palsy in children. (Source: Brain and Development)

A rare case of pontomedullary infarction presenting with peripheral-type facial palsy

Auris, Nasus, Larynx — Wed, 01 Dec 2010 00:00:00 +0100

Abstract: Ipsilateral facial palsy (FP) of the peripheral-type can result from lesions involving the inferomedial tegmentum of the pons. However, cases of a medullary lesion with peripheral-type FP have rarely been reported. The authors experienced an 83-year-old man with a pontomedullary infarction who presented with ipsilateral peripheral-type FP. Brain diffusion MRI revealed a hyper-intense signal on the left dorsolateral portion of the upper medulla and pontomedullary junction. This case suggests that clinicians should take into account the possibility of a central lesion and brainstem infarction, even when patients present with peripheral-type FP. (Source: Auris, Nasus, Larynx)

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C-B5-02: H1N1 Vaccine Safety Monitoring in the Vaccine Safety Datalink Project: New Challenges and Useful Lessons.

Clinical Medicine and Research — Wed, 01 Dec 2010 00:00:00 +0100

Authors: Lieu T, Greene S, Yin R, Li R, Kulldorff M, Weintraub E, Fireman B, Baxter R, Nordin J, Jacobsen S, Lewis E, Baggs J, Rett M, Platt R, Lee G Background and Aims: The worldwide introduction of influenza A (H1N1) vaccines in fall 2009 has raised widespread public questions about the safety of these new vaccines. The Vaccine Safety Datalink Project, a collaboration among CDC and eight health care systems in the HMORN, began accelerated monitoring of this vaccine's safety in early fall 2009. Methods: The VSD Project conducts near real-time monitoring of potential adverse events following vaccination for all new vaccines. Each week, each site updates dynamic data files, and the coordinating center analyzes all data cumulatively. Repeated analysis of the same data requires adjustmen...

Blink Lagophthalmos and Dry Eye Keratopathy in Patients with Non-facial Palsy: Clinical Features and Management with Upper Eyelid Loading

Ophthalmology — Mon, 22 Nov 2010 00:00:00 +0100

Conclusions: We highlight the need to consider incomplete blink and reduced FOB as exacerbating factors for corneal-related disorders, including dry eye. Upper eyelid loading with gold weight implantation is a useful and predictive method of improving exposure-related keratopathy due to LOB in the absence of facial palsy.Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article. (Source: Ophthalmology)

Subacute vocal cord paralysis, facial palsy and paraesthesias of lower limbs following surreptitious administration of disulfiram

Journal of Neurology, Neurosurgery and Psychiatry — Wed, 17 Nov 2010 00:00:00 +0100

(No abstract is available for this citation) (Source: Journal of Neurology, Neurosurgery and Psychiatry)

Differential cellular FGF-2 upregulation in the rat facial nucleus following axotomy, functional electrical stimulation and corticosterone: a possible therapeutic target to Bell's palsy.

Journal of Brachial Plexus and Peripheral Nerve Injury — Tue, 09 Nov 2010 00:00:00 +0100

Conclusion: FGF-2 may exert paracrine/autocrine trophic actions in the facial nucleus and may be relevant as a therapeutic target to Bell's palsy. (Source: Journal of Brachial Plexus and Peripheral Nerve Injury)

Isolated facial palsy as a hallmark of CSF overdrainage in shunted intracranial arachnoid cyst

Acta Neurochirurgica — Sat, 06 Nov 2010 20:19:05 +0100

Content Type Journal ArticleDOI 10.1007/s00701-010-0860-xAuthors Volker Maus, Department of Neurosurgery, University Hospital Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3, 24116 Kiel, GermanyAthanasios K. Petridis, Department of Neurosurgery, University Hospital Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3, 24116 Kiel, GermanyAlexandros Doukas, Department of Neurosurgery, University Hospital Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3, 24116 Kiel, GermanyHubertus Maximilian Mehdorn, Department of Neurosurgery, University Hospital Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3, 24116 Kiel, Germany Journal Acta NeurochirurgicaOnline ISSN 0942-0940Print ISSN 0001-6268 (Source: Acta Neurochirurgica)

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Which electrophysiological measure is appropriate in predicting prognosis of facial paralysis?

Clinical Neurology and Neurosurgery — Tue, 02 Nov 2010 02:18:34 +0100

Conclusion: Prognosis can be determined, and excessive tests can be eliminated with proper timing and electrophysiological testing.Significance: In determining the prognosis of facial paralysis, the nerve excitability test should be used in the acute phase, and NCS and needle EMG should be used in the subacute phase. Blink reflex studies are helpful in both the acute and subacute phases. (Source: Clinical Neurology and Neurosurgery)

Modern concepts in facial nerve reconstruction

Head and Face Medicine — Mon, 01 Nov 2010 00:00:00 +0100

Conclusion: A standardized approach is feasible: Patients with chronic facial palsy first need an exact classification of the palsy's aetiology. A step-by-step clinical examination, if necessary MRI imaging and electromyographic examination allow a classification of the palsy's aetiology as well as the determination of the severity of the palsy and the functional deficits. Considering the patient's desire, age and life expectancy, an individual surgical concept is applicable using three main approaches: a) early extratemporal reconstruction, b) early reconstruction of proximal lesions if extratemporal reconstruction is not possible, c) late reconstruction in cases of congenital palsy. Twelve to 24 months after the last step of surgical reconstruction a standardized evaluation of the therap...

[Unilateral acneiform rash in facial palsy.]

Annales de Dermatologie et de Cenereologie — Mon, 01 Nov 2010 00:00:00 +0100

DISCUSSION: To our knowledge the medical literature contains no other such cases. Our hypothesis is that lymphoedema associated with facial palsy reduces lymphatic drainage, promoting the deposition of cetuximab on EGFR and persistence of local signs. PMID: 21074658 [PubMed - as supplied by publisher] (Source: Annales de Dermatologie et de Cenereologie)

Intrameatal thrombosed anterior inferior cerebellar artery aneurysm mimicking a vestibular schwannoma.

Journal of Neurosurgery — Thu, 21 Oct 2010 23:00:00 +0100

Authors: Päsler D, Baldauf J, Runge U, Schroeder HW Aneurysms of the anterior inferior cerebellar artery (AICA) are a rare entity. Purely intrameatal aneurysms are even rarer. The authors report an intrameatal thrombosed AICA aneurysm mimicking a vestibular schwannoma that was treated by resection and end-to-end anastomosis. This 22-year-old man presented with acute hearing loss, vertigo, and moderate facial palsy. Magnetic resonance imaging showed an atypical intrameatal lesion with dilation of the internal auditory canal. Microsurgical inspection via a retrosigmoid approach and drilling of the posterior wall of the internal auditory canal revealed a thrombosed AICA aneurysm. The aneurysm was excised, and an end-to-end suture was performed to restore AICA continuity. Intraoperative i...

[Ramsay Hunt syndrome: our experience.]

Acta Otorrinolaringologica Espanola — Tue, 28 Sep 2010 23:00:00 +0100

CONCLUSION: In this syndrome, the prognosis of facial palsy depends on the initial symptoms and clinical findings. Otologic symptoms occur more frequently in patients having a greater degree of facial nerve affectation. Vestibular symptoms have a good prognosis. Hypoacusis is much more frequent than reported; as it may go unnoticed in these patients, it should always be confirmed by complementary tests. PMID: 20887959 [PubMed - as supplied by publisher] (Source: Acta Otorrinolaringologica Espanola)

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Demyelinating Disease in Patients Treated with TNF Antagonists in Rheumatology: Data from BIOBADASER, a Pharmacovigilance Database, and a Systematic Review

Seminars in Arthritis and Rheumatism — Thu, 23 Sep 2010 00:00:00 +0100

New Cochrane review on acupuncture for Bell's palsy

NLH Specialist Library for ENT and Audiology Latest News — Tue, 21 Sep 2010 08:23:07 +0100

21/09/10 The Cochrane Library Issue 9, 2010 (Source: NLH Specialist Library for ENT and Audiology Latest News)

Use of the interposed nerve graft to reduce differences in functional muscle transfer outcome arising from variability in motor input

Journal of Plastic, Reconstructive and Aesthetic Surgery — Mon, 20 Sep 2010 00:00:00 +0100

Summary: Regulation of functional muscle transfer outcome by means of an interposed nerve graft:The gold standard treatment of chronic unilateral facial palsy is a functional muscle transfer (FMT) reinnervated by a branch of the contralateral facial nerve via a cross-facial nerve graft, but clinical outcome varies from underactivity to overactivity of the transferred muscle. Work in an animal model has established that the magnitude of donor motor input received by heterotopically transferred muscle correlates with reinnervation and force production, the corollary being that standardising donor motor input could standardise outcome. We hypothesise that a ‘low-capacity’ interposed nerve graft could deliver a fixed motor input to an FMT despite variable motor input, thereby standardising...

Cutaneous γδ T‐cell lymphoma presenting as facial palsy

British Journal of Dermatology — Mon, 06 Sep 2010 00:00:00 +0100

(Source: British Journal of Dermatology)

Central facial palsy revisited: A clinical‐radiological study

Annals of Neurology — Tue, 31 Aug 2010 23:00:00 +0100

Abstract (Source: Annals of Neurology)

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Cutaneous gamma/delta T‐cell lymphoma presenting as facial palsy

British Journal of Dermatology — Tue, 31 Aug 2010 23:00:00 +0100

(Source: British Journal of Dermatology)

Acupuncture Benefits a Pregnant Patient Who Has Bell's Palsy: A Case Study

The Journal of Alternative and Complementary Medicine — Thu, 26 Aug 2010 03:00:27 +0100

The Journal of Alternative and Complementary Medicine , Vol. 0, No. 0. (Source: The Journal of Alternative and Complementary Medicine)

A rare case of pontomedullary infarction presenting with peripheral-type facial palsy

Auris, Nasus, Larynx — Tue, 10 Aug 2010 08:12:56 +0100

Acupuncture for Bell's palsy.

Cochrane Database of Systematic Reviews — Sat, 07 Aug 2010 01:33:04 +0100

CONCLUSIONS: The quality of the included trials was inadequate to allow any conclusion about the efficacy of acupuncture. More research with high quality trials is needed. PMID: 20687071 [PubMed - in process] (Source: Cochrane Database of Systematic Reviews)

Long-term changes in cerebellar activation during functional recovery from transient peripheral motor paralysis.

Experimental Neurology — Tue, 03 Aug 2010 23:00:00 +0100

Authors: Smit A, van der Geest J, Metselaar M, van der Lugt A, Vanderwerf F, De Zeeuw C Localized altered cerebellar cortical activity can be associated with short-term changes in motor learning that take place in the course of hours, but it is unknown whether it can be correlated to long-term recovery from transient peripheral motor diseases, and if so, whether it occurs concomitantly in related brain regions. Here we show in a longitudinal fMRI study of patients with unilateral Bell's palsy that increases in ipsilateral cerebellar activity follow the recovery course of facial motor functions over at least one and a half years. These findings hold true for changes in brain activity related to both oral and peri-orbital activation, even though these processes are differentially mediate...

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The chemokine CXCL13 in acute neuroborreliosis

Journal of Neurology, Neurosurgery and Psychiatry — Tue, 03 Aug 2010 14:31:24 +0100

Conclusions The study confirms the relevance of CXCL13 as a diagnostic biomarker of NB and suggests that CSF CXCL13 in NB is linked to duration of disease and could be a marker of disease activity and response to antibiotic therapy. (Source: Journal of Neurology, Neurosurgery and Psychiatry)

Management of complex cases of petrous bone cholesteatoma.

The Annals of Otology, Rhinology, and Laryngology — Sat, 31 Jul 2010 23:00:00 +0100

CONCLUSIONS: Classification is fundamental to choosing the right surgical approach. Transotic and modified transcochlear approaches hold the key to treating complex cases. Infratemporal fossa approach type B has to be used for extension into the clivus, sphenoid sinus, or rhinopharynx. Internal carotid artery, jugular bulb, and sigmoid sinus involvement should be identified before operation. PMID: 20860276 [PubMed - in process] (Source: The Annals of Otology, Rhinology, and Laryngology)

Greater petrosal nerve schwannomas—analysis of four cases and review of the literature

Urosurgical Review — Wed, 28 Jul 2010 17:40:17 +0100

We report on four cases of GPN schwannomas and discuss the surgical approach for their removal. Four patients with GPN schwannomas underwent surgery at Keio University Hospital. We present the pre- and postoperative clinical findings and describe the structures around the GPN schwannomas as observed during the surgery. Histological sections were performed around the GPN using Masson’s trichrome stain to elucidate the membrane structures. Three patients presented with xerophthalmia, and one with facial palsy, hearing disturbance, and generalized convulsions. Contrast-enhanced magnetic resonance images revealed tumors in the temporal lobe. Bone-window computed tomography showed erosion of the anterior petrous apex. During the operation, the temporal lobe was retracted epidurally. The...

Recurrent Pleomorphic Adenoma: Results of Surgical Treatment

Annals of Surgical Oncology — Tue, 20 Jul 2010 08:01:42 +0100

Conclusion Surgery is recommended in pleomorphic adenoma recurrence because of the high rate of carcinoma ex pleomorphic adenoma (16.1%). Nevertheless, a definitive facial paralysis ≥grade III rate of 11.3% is reported after multiple nerve dissection. New recurrence after surgery is less frequent if the initial treatment for pleomorphic adenoma is total parotidectomy. Content Type Journal ArticleCategory Head and Neck OncologyDOI 10.1245/s10434-010-1173-2Authors Marc Makeieff, CHU Department of Head and Neck Surgery Montpellier FrancePierfrancesco Pelliccia, CHU Department of Head and Neck Surgery Montpellier FranceFlavie Letois, CHU Department of Medical Information Montpellier FranceGrégoire Mercier, CHU Department of Medical Information Montpellier FranceSebas...

Warthin's tumour and facial nerve palsy: an unusual association

The British Journal of Oral and Maxillofacial Surgery — Sun, 04 Jul 2010 23:00:00 +0100

We describe a man with Warthin's tumour diagnosed on core biopsy, who presented with ipsilateral facial palsy. He was managed conservatively with subsequent resolution of the palsy, which suggested many diseases. The association of a benign parotid neoplasm with facial palsy is unusual, and appropriate investigations are essential for accurate diagnosis and surgical planning. (Source: The British Journal of Oral and Maxillofacial Surgery)

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Prophylactic cross-face nerve flap for muscle protection prior to facial palsy

Journal of Plastic, Reconstructive and Aesthetic Surgery — Mon, 28 Jun 2010 00:00:00 +0100

Summary: The facial muscles of a 28-year-old woman with left acoustic neuroma were successfully protected with a vascularised cross-face nerve flap using a vascularised lateral femoral cutaneous nerve along with a perforator of the lateral circumflex femoral system. It was transferred as a vascularised cross-face nerve flap to bridge a 15-cm-long defect between the bilateral buccal branches. Three months after the nerve flap transfer, the total tumour including the facial nerve was resected. Postoperatively, rapid nerve sprouting through the nerve flap and excellent facial reanimation were obtained 3–6 months after resection. This method is a one-stage reconstruction procedure, has minimal donor-site morbidity and results in strong postoperative muscle contraction. To our knowledge, this...

Patient with pontine warning syndrome and bilateral posterior internuclear ophthalmoplegia: case report

BMC Neurology — Sun, 27 Jun 2010 23:00:00 +0100

Conclusions: 1) Pontine warning syndrome may be underestimated and understudied. 2) Posterior internuclear ophthalmoplegia is a rare clinical sign in cerebrovascular diseases, while it can help to locate a brainstem lesion rather than an internal capsular one. 3) Blood pressure lowing administration may be improper for patients with pontine warning syndrome. (Source: BMC Neurology)

Prognostic factors for the incidence and recovery of delayed facial nerve palsy after vestibular schwannoma resection.

Journal of Neurosurgery — Thu, 24 Jun 2010 23:00:00 +0100

Conclusions Although patients with DFP did not exhibit any distinguishable characteristics when compared with patients without postoperative facial palsy, our analysis identified significant differences in patients with palsy presenting immediately postoperatively. Further study of patients with DFP should be undertaken to predict its incidence following VS resection. PMID: 20578799 [PubMed - as supplied by publisher] (Source: Journal of Neurosurgery)

Neuroinflammation in Lyme neuroborreliosis affects amyloid metabolism

BMC Neurology — Mon, 21 Jun 2010 23:00:00 +0100

Conclusions: Amyloid metabolism is altered in LNB. CSF levels of alpha-sAPP, beta-sAPP and P-tau are decreased in acute infection and increase after treatment. In combination with earlier findings in multiple sclerosis, cerebral SLE and HIV with cerebral engagement, this points to an influence of neuroinflammation on amyloid metabolism. (Source: BMC Neurology)

New facial nerve disorders topic

NLH Specialist Library for ENT and Audiology Latest News — Mon, 21 Jun 2010 09:36:54 +0100

A new facial nerve disorders topic is now available, including all high quality evidence on Bell's Palsy. (Source: NLH Specialist Library for ENT and Audiology Latest News)

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Intraoperative Monitoring of Motor Evoked Potential for the Facial Nerve Using a Cranial Peg-Screw Electrode and a “Threshold-level” Stimulation Method

Skull Base — Sat, 12 Jun 2010 13:15:00 +0100

Skull BaseDOI: 10.1055/s-0030-1261270ABSTRACTTranscranial motor evoked potential (MEP) for the facial nerve (facial MEP) has been recognized as a good method for quantitative monitoring of facial nerve function in skull base surgery. To improve the feasibility and safety of facial MEP monitoring, a peg-screw electrode and a “threshold-level” method were investigated. From 2007 to 2009, intraoperative facial MEP monitoring with the peg-screw electrode and threshold-level method was successfully achieved in 26 of 29 patients who underwent surgery for the posterior fossa extra-axial tumor. The relationship between the change in the facial MEP threshold level and the postoperative function of the facial nerve was analyzed in 23 patients who had no facial palsy preoperatively. There...

Bell's palsy: a manifestation of prediabetes?

Acta Neurologica Scandinavica — Tue, 08 Jun 2010 23:00:00 +0100

Conclusions [ndash] In this study we found that prediabetes is frequently associated with facial palsy. We propose to perform a 2h-OGTT in patients with peripheral facial palsy and normal fasting glycaemia. HOMA-index should be evaluated in obese facial palsy patients. (Source: Acta Neurologica Scandinavica)

Facial Nerve Paralysis After Cervical Traction.

Medical Physics — Sun, 06 Jun 2010 23:00:00 +0100

Authors: So EC So EC: Facial nerve paralysis after cervical traction.Cervical traction is a frequently used treatment in rehabilitation clinics for cervical spine problems. This modality works, in principle, by decompressing the spinal cord or its nerve roots by applying traction on the cervical spine through a harness placed over the mandible (Olivero et al., Neurosurg Focus 2002;12:ECP1). Previous reports on treatment complications include lumbar radicular discomfort, muscle injury, neck soreness, and posttraction pain (LaBan et al., Arch Phys Med Rehabil 1992;73:295-6; Lee et al., J Biomech Eng 1996;118:597-600). Here, we report the first case of unilateral facial nerve paralysis developed after 4 wks of intermittent cervical traction therapy. Nerve conduction velocity examination r...