Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0030552 (paresis)
 5,831 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Of 156 consecutive patients with malignant tumor of the testis 99 were alive two years after treatment. Of these, 12 had radiation-induced neurologic complications which, in 5 instances, consisted of persisting, wholly or partially disabling paresis in the lower limbs. Five had mild, transient symptoms and had persisting symptoms which were not incapacitating. In all those with disabling symptoms the irradiation dose had been higher than 1 600 reu, corresponding to 54.5 Gy over 6 weeks with daily fractions 5 days a week.
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PMID:Neurologic complications after irradiation of malignant tumors of the testis. 10 69

A 62-year-old woman developed neurologic deficits 7 months after pulmonary lobectomy for alveolar cell carcinoma of the lung. CT scan of the head demonstrated two metastases with marked peritumoral edema. Administration of Decadron, chemotherapy and 3,000 rad cranial radiation resulted in dramatic improvement of dysphasia and right hand paresis. Almost 2 months later, rhythmic, involuntary movements of the left hand developed. There was progression to multifocal seizures, grand mal seizures, postictal depression, status epilepticus, and coma, with death 9 days after onset of the movement disorder. Bronchoalveolar carcinoma was widely disseminated in lungs and bones, and as three metastases in brain. Bland "ischemic" necrosis in a pseudolaminar pattern was present in the neocortex. Innumerable Cowdry type A intranuclear inclusion bodies were seen in neurons, astrocytes, and oligodenodroglia. Immunofluorescence demonstrated Herpes simplex virus type 2 antigen and electron microscopy revealed virions with the morphology of the Herpes group. The case is significant for (1) the concurrence of intracranial metastases and Herpes simplex encephalitis, and (2) the causal agent, Herpes simplex virus type 2. The implication for the clinical neurocientist is the potential in a patient with systemic cancer, for the causation of neurologic complications by more than one factor or mechanism.
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PMID:Herpes simplex type 2 encephalitis concurrent with known cerebral metastases. 22 22

A 69-year-old man presented with acute stridor and was found to have the superior vena cava syndrome and bilateral laryngeal paresis. A clinical diagnosis of malignancy was made, but before any definite investigations could be made an emergency operation had to be performed to relieve the trachea. On operation the patient was found to have a benign goitre. The literature on the subject is discussed. Since the great majority of cases with the superior vena cava syndrome is caused by malignant diseases, it has been suggested that in acute cases radiation therapy should be started without a microscopic diagnosis if necessary, but such a practice must be warned strongly against.
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PMID:Intrathoracic goitre with the superior vena cava syndrome, hoarseness and acute stridor. 57 39

Report on a newborn with left-sided radial paresis due to a solitary angioleiomyoma in the lateral distal third of the upper arm. The literature does not disclose that this rare benign tumor can produce radial palsy. A palpable soft-part tumor in the new born suggests malignancy. The tumor including the atrophic radial nerve was radically excised. When histology proved it to be benign, a nerve graft with the sural nerve was carried out. After 6 months of electrical and physiotherapeutic treatment partial radial function had returned. In differential diagnosis of radial palsy of the neonate, birthtrauma is a likely cause. Tumors as a cause are rare and are found almost exclusively in adults, due to lipoma, neuroma or ganglia. In the neonate the socalled "idiopathic" radial paresis does not occur and in adults is usually due to the "supinator syndrome".
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PMID:[Neonatal paresis of the radial nerve due to benign angioleiomyoma (author's transl)]. 84 85

Certain head and neck malignancies tend to invade branches of the cranial nerves and progress centripetally. The maxillary and mandibular divisions of the V (trigeminal) nerve are the most commonly invaded, but the VII (facial) nerve may harbor extensions of primary parotid malignancies and/or skin cancers originating in or near the ear. Paresis of the VII nerve signifies a serious but not entirely hopeless situation if countered with an appropriate surgical procedure. The optimal treatment of malignancies invading cranial nerves is surgical excision, which may necessitate removal of substantial portions of the cranium. Surgical pursuit of a malignancy in the facial nerve leads to a direct confrontation with the petrous pyramid of the temporal bone. Resection of the petrous pyramide is surgically feasible, but, if performed en bloc, extracts a high morbidity and mortality. An alternate technique in which the soft tissue and bones are removed disjunct is advocated. In this technique, the soft tissues are excised flush with the surface of the temporal bone. After making perforator and burr openings in the squamous temporal bone, a subtotal temporal craniectomy is completed with rongeurs. A prerequisite for success with this technique is the rotation of a large scalp flap and other local flaps to cover the exposed meninges and carotid arteries. A resume of four cases using this technique is presented. The age of the patients, the type, stage, and duration of the malignancies, and other factors which might influence the end stage results are given.
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PMID:A surgical technique for resecting malignancies invading the facial nerve and petrous pyramid. 89 54

Based on this patient's history and the imaging studies, all the consultants agree that they are dealing with a juvenile nasopharyngeal angiofibroma. They agree that a biopsy is not necessary. However, angiography would be obtained by 2 physicians (Drs. Seid and Weber). When treating an extensive JNA, the consultants differ in their approaches. One favors a lateral infratemporal fossa approach (Dr. Gantz), but the others favor a combined approach (Drs. Seid and Weber). In this particular case, 2 experts favor resection (Drs. Gantz and Weber), but one would irradiate (Dr. Seid). There is also disagreement regarding the severity of morbidity. Minor problems include conductive hearing loss, paresis of the third division of the fifth cranial nerve (Dr. Gantz), and a transient facial nerve paralysis (Dr. Weber). They are more concerned about the long-range problems from skull-base radiotherapy including brain-stem compromise, pituitary dysfunction, and radiation-induced malignancies. No one suggests chemotherapy or multimodal therapy. Regarding the natural history of JNA, the views range from no spontaneous regression (Dr. Gantz), gradual involution over time (Dr. Seid), or an indolent nature that requires tapering the treatment to the benign nature of the process (Dr. Weber).
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PMID:Nasopharyngeal angiofibroma. 132 May 99

A 62-year-old man was admitted because of paresis of the legs and a bleeding tendency. He was diagnosed as metastatic bone cancer with disseminated intravascular coagulation (DIC). In spite of treatment, his general condition progressively deteriorated and he died of respiratory failure 13 days later. Autopsy revealed a carcinoma in adenoma in the rectum. Although the depth of cancer invasion was confined to the submucosal layer, disseminated carcinomatosis of the bone marrow and tumor emboli in blood vessels of the lung were present.
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PMID:Disseminated carcinomatosis of bone marrow from submucosal carcinoma in adenoma of the rectum. 147 66

The records of 90 cases of oculosympathetic paresis (1982-1991), 39 women and 51 men aged between 3 months and 82 years, were evaluated. The mean baseline anisocoria was 0.92 mm but did not exceed 2.4 mm. The mean difference in the position of the upper eyelid was 2.3 mm. Enophthalmus of 1 mm or more was found in only 25% and exophthalmus of 1 mm or more, in 18%. Exophthalmus or enophthalmus of more than 2 mm was not encountered. The cocaine test (5% solution in most cases) was performed in 85 cases and could be quantified in 65 cases. The average dilation of the involved pupil was 0.52 mm, whereas the normal pupil dilated 2.14 mm. The average postcocaine anisocoria was 2.54 mm. Hydroxyamphetamine 1% dilated the involved pupil in cases with presumed preganglionic lesions slightly more than the normal fellow pupil (2.39 mm and 2.09 mm respectively). The difference was significant (P < 0.05). In postganglionic lesions, the hydroxyamphetamine dilation was 0.57 mm. The hydroxyamphetamine test had a specificity of 90% for postganglionic lesions and 88% for preganglionic. An underlying acquired disease could be identified in 53 cases; 6 cases were congenital. In 37 cases (including the congenital ones), no cause was found. Among the 33 preganglionic lesions, only one malignant tumor was found, whereas 6 malignant tumors were encountered among the 20 postganglionic cases. Additional ocular motor palsies or other local signs were present in these 6 cases. Goiter was frequently associated with preganglionic Horner's syndrome.
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PMID:Horner's syndrome: a retrospective analysis of 90 cases and recommendations for clinical handling. 147 33

Involvement of the temporal bone by lymphoreticular neoplasm is rare; all reported cases have been of secondary involvement. This article presents what we believe to be the first two reported cases of primary temporal bone lymphoma. The patients, an elderly man and a boy, both presented with infection of the ear, hearing loss, and facial nerve paresis. In both cases, facial paresis resolved after appropriate chemotherapeutic treatment. Patient presentation and clinical course are discussed in light of published work on temporal bone malignancy. Further investigation, including computed tomography and biopsy, should be considered for patients who present with an apparent middle ear infection unresponsive to medical therapy. The development of facial paralysis in such a patient warrants heightened suspicion of malignancy.
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PMID:Primary lymphoma of the temporal bone. 172 83

Computed tomographic examinations were performed on 24 patients with entirely submucosal laryngeal mass lesions. Presenting complaints were hoarseness (17 patients), dysphagia (1 patient), airway obstruction (5 patients), and a cervical nodal metastasis (1 patient). The masses were visible endoscopically as submucosal bulges in 21 patients. Three other patients presenting with hoarseness and vocal cord paresis or paralysis had otherwise negative endoscopy and a mass demonstrated on CT. Thirteen patients were eventually diagnosed as having squamous cell carcinoma, which was the primary working diagnosis following CT in 12 cases. The group of 13 carcinoma patients had a range of two to five endoscopic procedures with one to four negative biopsies and a 6 week to 9 month delay in histologic confirmation of cancer. Other lesions included five laryngoceles, two chondrosarcomas, and one case each of paraganglioma, fibrosarcoma, lymphoma, and tuberculous laryngitis. Computed tomography is an indispensable tool for evaluating submucosal laryngeal masses or otherwise unexplainable symptoms (usually hoarseness) that might herald such a mass. A definite submucosal mass on CT should prompt a deep or wedge biopsy to reach a pathologic diagnosis. This will avoid the delay in diagnosis that frequently occurs in these patients.
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PMID:CT of submucosal and occult laryngeal masses. 172 14


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