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

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

Out of 121 patients examined with acute unilateral facial paralysis, 93 were determined to have idiopathic facial palsy (Bell's palsy). The examination included pure-tone and speech audiometry, stapedial reflex recordings, temporal bone radiography and auditory-evoked brain-stem response testing (ABR). If a retrocochlear lesion was suspected, computed tomography or magnetic resonance imaging was performed. Patients with sensorineural hearing loss affecting all frequencies were compared to one group with hearing loss affecting only high frequencies and to another group with ABR findings suggesting a cochlear lesion. No association could be made between the etiology of these pathological results and the concurrent facial paresis. Most of them were probably caused by unrelated disorders of the auditory system. In cases with prolonged inter-peak latencies representing brain-stem responses, abnormal ABRs could be caused by the same pathology as the paralysis. This might well suggest the presence of a neuropathy in both the central auditory system and the facial tracts.
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PMID:Auditory-evoked brain-stem responses and auditory disorders in patients with Bell's palsy. 174 52

We report a case of unilateral transient and reversible facial paresis, which was superimposed on a congenital bifacial palsy in a young adult with Moebius syndrome. Our case illustrates the potential for two conditions, both affecting the facial nerve and both of unknown etiology, to be juxtaposed in a single individual. Worsening of facial palsy in the Moebius syndrome may not signify progressive disease.
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PMID:Bell's palsy in Moebius syndrome. 191 24

A 29-year-old man presented with headache, nuchal rigidity and bilateral facial paralysis. Lumbar puncture revealed eosinophilic CSF pleocytosis. Facial diplegia was improved by supportive treatment. Thus, eosinophilic meningitis is one of the etiologies of bilateral facial nerve paresis.
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PMID:Bilateral facial nerve paresis in eosinophilic meningitis. 194 Jul 9

Eight patients with extensive petrous bone cholesteatomas that invaded the labyrinth and fallopian canal are presented. The eight cases are added to a tabulation of prior literature reports to elucidate concepts of routes of extension of medially invasive temporal bone cholesteatoma. Medially invasive petrous bone cholesteatoma develops insidiously, often without symptoms other than facial palsy and/or unilateral deafness. Typically, a history of chronic ear disease can be obtained. While hearing is unlikely to be preserved in this group of patients, facial nerve function can usually be preserved, and a facial nerve graft was not necessary in our series. Acute facial nerve palsy or facial nerve paresis progressing to palsy in patients with a history of chronic ear disease should be studied radiographically for petrous bone cholesteatoma, even if there is no physical evidence of cholesteatoma.
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PMID:Facial nerve and medially invasive petrous bone cholesteatomas. 174 34

Facial nerve paralysis associated with cerebellopontine angle surgery has been reported to range up to 26% in a recent series. Various methods of intraoperatively monitoring the facial nerve have been developed to reduce the incidence of facial paralysis. We report our experience with an intraoperative monitoring technique using intramuscular EMG electrodes to detect subclinical electrical responses that were amplified and made audible to the operating surgeon after gating stimulus artifacts. A 3.6% incidence of facial paralysis in 111 consecutive cases with this intraoperative monitoring method compared with 14.5% in 207 previously unmonitored cases indicates significant reduction of this complication in cerebellopontine angle surgery (p less than 0.001). Along with this reduction in facial paralysis, an increase in the percentage of partial facial paresis was observed in the monitored group (p less than 0.05). The percentage of those with intact facial function was similar in the monitored (82.0%) and unmonitored groups (78.3%).
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PMID:Intraoperative monitoring of facial nerve function in cerebellopontine angle surgery. 212 86

One hundred patients have been treated over a 13-year period with a transmeatal approach to the internal auditory canal for cochleovestibular neurectomy. Ninety-one of these patients have followup of more than 3 months (average, 4.67 years). The most common indication for the procedure was Meniere's disease (71%). Chronic labyrinthitis, usually following stapes, middle ear, or mastoid surgery, was the next most common indication. Patients with the preoperative diagnosis of Meniere's disease had better results in the curing of vertigo (89%) than those having chronic labyrinthitis (68%). Overall, vertigo was cured in 84% of patients and markedly improved in another 15.1%. Tinnitus was relieved or improved in 65% of all patients and in 67% of patients with Meniere's disease. Mild unsteadiness was commonly noticed postoperatively, but only 11% described this as severe. Eighty percent of these latter patients reported unsteadiness preoperatively. Complications were uncommon and temporary: one case of delayed facial paresis that recovered completely, one CSF leak, and one wound infection. There were no cases of permanent facial paralysis or meningitis. The advantages of the transmeatal approach to the IAC for CVN over labyrinthectomy without CVN are assurance of complete labyrinthine denervation, increased likelihood of improved tinnitus, practice at sectioning the posterior ampullary nerve (PAN), and the ability to inspect the internal auditory canal for a small tumor or other pathology. We recommend this procedure for treatment of unilateral vestibular dysfunction in patients with no serviceable hearing.
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PMID:Long-term results of transmeatal cochleovestibular neurectomy: an analysis of 100 cases. 249 13

A 64-year-old man with right aural discharge presented complaining of progressive deafness. Other otological symptoms were absent and specifically there was no seventh nerve paresis. A right aural polyp was identified and biopsied. Histology showed the polyp to be a schwannoma. Subsequent temporal bone computed tomography showed expansion of the distal facial canal. At operation, the schwannoma filled the middle ear cleft and extended from the genu to the region of the stylomastoid foramen. The floor of the middle ear had been eroded, exposing the jugular bulb. Facial paresis is the usual presenting feature of a facial schwannoma, while deafness, ageusia and reduced lacrimation are variable, dependent upon the site of the lesion. The absence of facial palsy as a presenting feature is very rare and this case illustrates the need for histological examination of all abnormal aural material.
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PMID:Facial schwannoma without facial paralysis. 258 62

Facial paralysis in the presence of a parotid mass has been associated classically with a presumed diagnosis of malignancy. However, isolated case reports have documented the occurrence of paresis or paralysis secondary to pathologically benign, nonneurogenic parotid lesions. These previous cases have been reviewed and three additional cases are described. Comparisons are made on age, sex, symptoms, physical findings, pathologic findings, and prognosis. Involvement of the seventh nerve may be explained on the basis of compression, especially in association with local inflammation. Although facial paralysis still should be considered indicative of a malignancy, it also may be caused by benign masses, particularly those associated with rapid enlargement and/or infection.
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PMID:Facial nerve paralysis with benign parotid masses. 276 49

Locked-in Syndrome (LIS) is a rare clinical entity consisting of quadriplegia, paralysis of lower cranial nerves, mutism, and bilateral paresis of horizontal gaze. The prognosis is usually poor. Most patients who do survive have severe residual impairment or develop chronic LIS. Review of the literature shows that recovery has been reported but not systematically studied, particularly with respect to early prognostic signs. We report a case of LIS with bilateral pontine infarctions shown by MRI. Severe neurological deficits included quadriplegia, paresis of horizontal gaze, facial paralysis, and bulbar palsy. Horizontal eye movements were present and smooth by the second week after onset. The patient had almost full functional motor recovery within four months, after a comprehensive rehabilitation program. Fourteen other reported cases of LIS with full recovery had documented recovery of lateral gaze in the early stage. In addition, smooth horizontal gaze is the most frequent activity in incomplete LIS. Early recovery of horizontal eye movement may indicate that the brain lesion is limited and may be a good prognostic sign in LIS.
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PMID:Early smooth horizontal eye movement: a favorable prognostic sign in patients with locked-in syndrome. 292 43


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