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Query: UMLS:C0030552 (paresis)
 5,831 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Impairment of vocal cord function is a threat to patients with thyroid carcinoma; either due to the tumor having infiltrated the larynx or the recurrent nerve, or to accidental damage to the laryngeal nerves during thyroid surgery. We have reviewed 1,245 patients' records which were filed under the diagnosis of thyroid carcinoma at Det Norske Radiumhospital from 1956 to 1978. Pareses of vocal cords were noted in 465 patients (37.3%) during the course of their illness. In 135 patients (10.8%) the pareses were due to infiltration by the tumor, most commonly seen in anaplastic carcinoma. In 267 patients (21.4%) the pareses followed surgery; planned resections of the recurrent nerves were performed in 48 patients (3.9%). Transient pareses with normal vocal cord movements within months were experienced in 137 cases (11%). Permanent paralysis caused accidentally during surgery was seen in 82 patients, representing 6.6% of all patients and 4.7% of the surgically exposed nerves. We stress the need for pre- and postoperative evaluation of vocal cord movement as an aid to future diagnosis and optimal surgical planning.
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PMID:[Thyroid carcinoma and the recurrent nerve. Recurrence fall-out, incidence and causal circumstances in a large case-load of patients with thyroid carcinoma]. 232 Dec 24

The authors describe the case-history of a 63-years-old patient with primary carcinoma of the sphenoid sinus. The tumour penetrated through the lateral wall of the sinus into the intracranium. It was manifested by pain in the left half of the face, Horner's syndrome and paresis of the abducent nerve. The diagnosis was based on the case-history, clinical picture, computed tomography and biopsy. A non-differentiated carcinoma was involved. The authors discuss the reasons of the retarded diagnosis.
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PMID:[Carcinoma of the sphenoid sinus]. 235 Aug 3

Twelve patients who developed radiation-induced brachial plexopathy (RIBP) after receiving radiation therapy for breast carcinoma (7 patients) or Hodgkin's lymphoma (5 patients) were followed for 12 or more years, with a mean follow-up time of 20 years. Tingling and numbness of the fingers as well as weakness of the hand or arm were the most prominent presenting symptoms of RIBP. Whereas pain in most patients evolved only later in the course, it became a predominant feature in only 2. In 8 of the 12 patients, the plexopathy was surgically treated, either by neurolysis only or by neurolysis plus omental grafting in order to stop progression or paresis and/or pain. In 8 patients, including 6 of the operated group, there was slow and steady progression of RIBP over time, with the final outcome being almost complete paralysis of the arm (2 patients) or severe sensorimotor paresis rendering the hand useless (6 patients). In only 4 patients, including 2 of the non-operated group, was there absence of progression and stabilization of the paresis with only slight functional loss of the affected arm in 3 patients and severe palsy in 1. None of the 12 patients had any clear long-lasting improvement of their sensorimotor impairment. It is concluded from this study that RIBP, irrespective of surgery (neurolysis and/or omentum transplant), left two-thirds of the patients with severe or total paresis of the arm. However, the almost complete relief of severe pain (6 of 8 patients), both immediately and in follow-up patients treated with neurolysis and/or omental transplant, indicates that surgical treatment has a beneficial effect on pain relief.
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PMID:Natural history of radiation-induced brachial plexopathy compared with surgically treated patients. 239 47

Clinical charts and biopsies of 32 children with thyroid nodules were reviewed at the National Children's Hospital from 1970 to 1988. The classification between benign and malignant types was only possible by surgery and biopsy. Twenty three (72%) were found to be benign forms and nine (28%) were carcinomas (8 papillary and one follicular). Two of the carcinomas had been irradiated previously because of neuroblastoma, as well as one of the benign type who received radiation to the neck and mediastinum because of a Hodgkin's disease. No patients showed alteration in thyroid functional test (T4 and TSH). Twenty two per cent of the carcinomas and 16% of the benign forms presented higher retention in the gammagram test. Seventy eight per cent of the carcinomas and 70% of the benign types showed a normal gammagram test. Surgery in the benign cases included 10 hemithyroidectomy, 7 sub-total thyroidectomy, 3 total thyroidectomy and 3 node resection. Carcinoma cases included 6 patients with total thyroidectomy with ganglionar modified dissection in three patients; 2 hemithyroidectomy and one with sub-total thyroidectomy. Complications included 3 hypoparathyroidisms, one of them permanent, 3 transitory recurrent paresis and only one child died because of pulmonary metastasis. All carcinoma patients were treated with levothyroxine and three of them also received 1131 in order to control ganglionar metastasis. Total survival rate for carcinoma patients was 83% at 90 months. It is concluded that only with surgery it is possible to classify correctly the histological type of children with thyroid nodes. Clinical evaluation and laboratory tests are useless. However, it has not been defined how big the surgery must be.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Thyroid nodules in children. Experience at the National Children Hospital of Costa Rica]. 260 73

Neurologic abnormalities were the predominant historic and physical findings in 5 dogs and 2 cats with primary nasal cavity tumors that had invaded the cranial vault. Seizures, behavior changes, and obtundation were the most common signs. Other neurologic signs included paresis, ataxia, circling, visual deficit, and proprioceptive deficit. Although 1 dog and 2 cats had historic findings of mild respiratory disease, no physical abnormalities related to the respiratory tract were found in any of the 7 animals. Nasal cavity neoplasia was suggested by radiographic and computed tomographic studies and was confirmed histopathologically in each case. The nasal tumor types in the 5 dogs were epidermoid carcinoma (n = 1), adenocarcinoma (n = 2), solid carcinoma (n = 1), and anaplastic chondrosarcoma (n = 1). An esthesioneuroblastoma was found in each cat. Radiation therapy was effective for 3 months in palliating the clinical signs in the 2 dogs in which it was used. Neoplasia of the nasal cavity should be considered in the differential diagnosis for animals with neurologic signs suggestive of cerebral disorders.
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PMID:Neurologic abnormalities as the predominant signs of neoplasia of the nasal cavity in dogs and cats: seven cases (1973-1986). 276 45

A now 61-year old man with hypersecretion of vasoactive intestinal polypeptide (VIP) due to carcinoma of the tail of the pancreas was treated and followed for nine years. Combined administration of lomustin (2.5 mg/kg on day 1) and 5-fluorouracil (30 mg/kg on days 2-6) over eight courses at six-week intervals achieved clinical remission for 13 months. No clinical improvement was observed with streptozocin (500 mg/m2 on days 1-5) for two courses four weeks apart. Treatment had to be discontinued after the second course because of the onset of (rarely observed) neurotoxic side-effect of bilateral peroneal paresis. High doses of somatostatin (6.9 micrograms/kg hourly intravenously) immediately and markedly reduced stool quantity. But at a lower dose (3.4 micrograms/kg hourly i.v.) there was no noticeable effect. In the further course of the disease, massive attacks of diarrhoea at varying intervals were best controlled in intensity and duration by prednisolone (50-60 mg daily). Other drugs which have been recommended for such cases (indometacin, lithium, trifluoperazine, nicotinic acid and clonidine) had no worth-while effect. In future long-acting somatostatin analogues may provide better prospects for long-term treatment.
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PMID:[Vipoma. 9-year observations using currently available therapy methods]. 286 74

Iatrogenic vocal cord paralysis is a well-publicized complication of thyroid and parathyroid operations. Less appreciated is the improvement of vocal cord function after resection of a thyroid or parathyroid tumor. Over the last 22 years, 14 patients presented with vocal cord paresis in the presence of thyroid or parathyroid tumors. Of these 14 patients, nine had complete resolution of paresis following resection of the thyroid or parathyroid tumors: three had a thyroid carcinoma impinging upon the nerve, three had large colloid goiters, two had a follicular adenoma and one had a parathyroid adenoma displacing the nerve. In five of the 14 patients the vocal cord paralysis persisted after operation. In three, the pathology accounted for the vocal cord paralysis and was not amenable to operative improvement: one patient had an unresectable anaplastic thyroid carcinoma, one patient had long-standing idiopathic unilateral vocal cord paralysis, and one patient had laryngeal adenoid cystic carcinoma with thyroid invasion. The fourth patient had an extensive thyroid hemangioma. The paralysis persisted after resection. The fifth patient had long-standing idiopathic vocal cord palsy. A preoperative vocal cord paresis in a patient with thyroid or parathyroid disease does not indicate permanent loss of recurrent nerve function, even in the presence of carcinoma. In this series, vocal cord function was restored in 9 of 10 patients with resectable thyroid or parathyroid tumors.
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PMID:Improvement of vocal cord paresis after thyroidectomy. 360 54

During a follow-up of 11 years of thyroid carcinoma 136 patients were repeatedly examined. 43% papillary, 43% follicular, 11% anaplastic and 2% medullary carcinomas was found. The incidence of these types of carcinoma differed considerably; the frequency peak of papillary carcinomas was reached in 45-year-old humans, that of the follicular carcinomas in people aged 60, that of the anaplastic carcinomas in 70-year-old humans. 84% of the patients was female. Classification in pTNM-system: 8% in pT1, 27% in pT2, 12% in pT3 and 49% in pT4. Local and distant metastases were found at a low rate equally in pT1, pT2 and pT3; 26% of patients in pT4 had local metastases and 18% had distant ones in addition. There were 6 patients with metastases of a differentiated adenocarcinoma accumulating no 131-iodine and with no thyroglobulin in serum. 29% of patients had after thyroidectomy an unilateral paresis of the nervus recurrens and 4% a bilateral one. 26% of patients had a permanent hypoparathyroidism after thyroidectomy.
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PMID:Thyroid carcinoma: a follow-up study of 11 years. 368 51

The cases of three patients with spinal cord compression who presented with acute urinary retention are discussed. Two patients had previously diagnosed carcinoma; in one, acute urinary retention was the first sign of metastatic renal cell carcinoma. Two patients had a history compatible with prostatic hypertrophy. All had either paresthesias or sensory or motor deficits on initial presentation. All three patients were left with permanent hypotonic bladders. Two patients had permanent lower extremity paresis as well.
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PMID:Acute urinary retention as a presenting sign of spinal cord compression. 375 60

On the basis of our own patients, the anamnestic data and the neurological constellation in late radiogenic paresis (the most frequent peripheral nervous condition in treatment of mammary carcinoma) are described. A comparison with the situation in metastatic infiltration of the brachial plexus shows the great difficulties in differential diagnosis. Pain can be observed more frequently in metastatic plexus infiltration. The presence of a Horner syndrome can be regarded as decisive evidence for recurrent growth of a carcinoma. If a Horner syndrome is absent, tumor growth can be demonstrated conclusively only by biopsy or surgical exploration. The most frequent condition which is not connected with mammary carcinoma and its followup treatment, but which can stimulate a late radiogenic paresis of the brachial plexus is the carpal tunnel syndrome. Whereas a certain differentiation is not always possible on the basis of the anamnesis and clinical findings, a clear discrimination is possible by means of electrophysiological investigation techniques.
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PMID:[Lesions of the peripheral nervous system in the treatment of breast cancer]. 618 90


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