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)

We present a rare case of thalamic germinoma with crossed aphasia in a dextral. A patient, 17-year-old righat-handed male, was admitted to Nippon Medical School Hospital with chief complaints of headache, abnormality of visual field and speech disturbance. There were pigmentations on the back of hand, foot and the perineum. Neurological examination revealed left homonymous hemianopsia, right slight degree of ptosis, left facial palsy, a mild paresis of the left upper extremity and motor aphasia. Right carotid angiography showed marked unrolling and midline shift of right anterior cerebral artery. CT scan revealed ring-like high density area in the right thalamic region, which was enhanced after constant infusion. Brain scintigraphy also showed an abnormal accumulation at the same site. The hen-egg sized tumor of 40 g. weight was almost totally removed by the right fronto-parietal craniotomy. The tumor was characterized histologically by the so-called two cell pattern with teratomatous components. As postoperative treatment local injection of adriamycine, irradiation and immunotherapy with picibanil were performed, and then left hemiparesis was markedly improved without sign of recurrence. Language evaluation was performed after operation. There were dysarthria, remarkable word amnesia, paraphasia and perseveration. Repetition was also impaired. His speech function was concluded to be a mixed type aphasia mainly composed of Broca's aphasia. The speech function of thalamus and crossed aphasia with dextrales were discussed.
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PMID:[A case of thalamic germinoma with crossed aphasia in a dextral (author's transl)]. 743 99

A 53-year-old man developed multifocal radicular pain. The diagnosis of Lyme neuroborreliosis was delayed until bifacial paresis and right lower abdominal wall weakness developed, prompting further evaluation. Cerebrospinal fluid (CSF) examination showed aseptic meningitis. Antibodies directed against Borrelia burgdorferi were present in the serum; higher titers were present in the CSF, indicating local antibody production. Electrophysiologic studies showed both an axonal polyradiculopathy as well as demyelinative facial palsy. Ceftriaxone therapy led to marked improvement in pain and facial palsies.
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PMID:Acute Lyme neuropathy presenting with polyradicular pain, abdominal protrusion, and cranial neuropathy. 841 80

5 patients (3 men, 2 women, aged from 28 to 51 years) with unilateral facial palsy after surgery of a cerebellopontine angle tumour have been investigated by transcranial magnetic stimulation. The purpose was to evaluate the prognostic aspects of this method, which was compared with the electrical stimulation of the facial nerve and the elicitation of an orbicularis-oculi reflex. The components of the blink reflex were absent in all cases. In 3 patients electrical stimulation was possible (compound muscle action potentials were delayed). With transcranial magnetic stimulation ipsilateral short-latency and contralateral long-latency responses (stimulation of the cortex) were elicited and registered from the M. mentalis as well as 3 times from the M. orbicularis oculi. The short-latency response revealed no prognostic aspects. Despite the missing response, a recovery was possible. Long-latency responses could be evoked in all patients. The extent of delay in latency was strongly correlated with clinical improvement of the paresis. Interestingly, this correlation could also be observed in the single rami of the facial nerve when two muscles were investigated in a patient. Transcranial magnetic stimulation is an important improvement in electrophysiological diagnosis of perioperative lesion of facial nerve to prove continuity of the nerve and to evaluate the clinical course.
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PMID:[Transcranial magnetic stimulation in perioperative damage to the facial nerve]. 843 54

In some previously reported cases, facial palsy, even in Bell's palsy, involved vestibular dysfunction. Vestibular dysfunction in facial palsy is considered to be due to a retro-labyrinthine disorder such as vestibular neuronitis or acoustic neuromas. For the past 9 years we have been using the galvanic body sway test (GBST) routinely for differential diagnosis of the vestibular system. This paper reports GBST detected, retro-labyrinthine disorders in facial palsy. From 1981 to 1989, equilibrium examinations were performed in 33 cases with Bell's palsy and in 12 cases with Hunt's syndrome within 2 weeks after the onset. GBST was tested in 10 out of the 17 cases showing canal paresis (CP) in the caloric test. Abnormal GBST responses were detected in 9 cases (90%), 4 (80%) with Bell's palsy and 5 (100%) with Hunt's syndrome. The incidence of abnormal GBST was very high not only in Hunt's syndrome but also in Bell's palsy. The results indicate that vestibular dysfunction combined with facial palsy is mainly due to a retro-labyrinthine disorder and suggest that what is called vestibular neuronitis might be caused by a pathogenesis similar to that of facial palsy.
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PMID:Retro-labyrinthine disorder in cases with peripheral facial palsy. 847 Apr 92

It is generally recognized that surgery for congenital aural atresia is difficult. The success or failure of the operation is often directly related to the degree of development of the middle ear. In poorly developed middle ears, the facial nerve may overhang and conceal the oval window niche, making this area inaccessible to inspection, let alone manipulation. The criteria for transposing the facial nerve are; (1) the atresia must be bilateral, (2) there must be preoperative imaging evidence of a stapes and/or patent oval window, (3) there must be no large blood vessels feeding or draining the facial nerve, and (4) facial nerve monitoring must be available. Over the past 2 years, 6 of 94 patients undergoing surgery for atresia were operated with an intent to transpose the facial nerve in order to access the oval window. In all patients, it was impossible to see the oval window niche due to a displaced nerve. In four of six cases, the facial nerve was transposed. The ossicular chain was reconstructed with a total ossicular replacement prosthesis. In no case was there a postoperative facial paralysis or paresis. Facial nerve transposition allows a final chance of achieving serviceable hearing through surgery. The lack of facial nerve injury and the potential for hearing restoration make this procedure feasible in otherwise marginal or poor surgical candidates.
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PMID:Transposition of the facial nerve in congenital aural atresia. 858 21

Experiences with patients with facial paralysis over the last 25 years and recent efforts to develop objective measures of paresis and synkinesis led us to three hypotheses: (a) dysfunction in certain regions of the face is more disturbing than that in others, (b) there are major psychosocial impacts of facial paralysis, and (c) the impact of facial paralysis is underestimated. An initial questionnaire of 10 open-ended items was submitted to 11 subjects stabilized after acoustic tumor resection. Responses were tabulated qualitatively, and frequency counts were made of responses. These results show that the region of the face that is most disturbing is the mouth; however, early in the time course of paralysis, the eye is most disturbing. Synkinesis above the eye is ultimately more disturbing than paresis in that region, and it may worsen. Major psychosocial impacts of paralysis appear common and underestimated. These pilot data qualitatively support the hypotheses.
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PMID:Defining functional limitation, disability, and societal limitations in patients with facial paresis: initial pilot questionnaire. 872 73

Glial fibrillary acidic protein (GFAp), the main protein constituent of the intermediate filaments of astrocytes, was analysed in the cerebrospinal fluid (CSF) of 20 patients with Lyme neuroborreliosis as a marker of the astroglial reaction. The mean GFAp level before antibiotic treatment in the study group was significantly elevated (592 pg/ml +/- 596 [SD]) compared to that in 24 healthy controls (121 +/- 87 [SD]) (p < 0.01). The highest CSF-GFAp levels were seen in the patients with the most severe disease, but the levels were also increased in patients with peripheral paresis, such as facial palsy with no or only minor encephalitic symptoms. This implies that the infection was not limited to radix dorsalis or the meningeal tissues, but affected the central nervous system as well. Furthermore, the astroglial reaction seemed to occur early in Lyme neuroborreliosis since CSF-GFAp levels were elevated also in patients with recent (< 3 weeks) onset of disease. After antibiotic treatment, the GFAp levels decreased. It is suggested the CSF-GFAp concentrations might be useful for monitoring CNS involvement in Lyme neuroborreliosis.
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PMID:Increased cerebrospinal fluid levels of glial fibrillary acidic protein (GFAp) in Lyme neuroborreliosis. 874 Jan 4

Peripheral facial palsy can occur after aural surgery and neurosurgery. Routine neurophysiological investigation (utilizing electrical stimulation and the blink reflex) does not allow the direct assessment of the site of a lesion. In the present study transcranial magnetic stimulation (TMS) was applied in order to evaluate the usefulness of this method for prognosis. Twenty-three patients with postoperative facial pareses (after removals of an acoustic neuroma in 12 patients and parotid tumors in 11) were investigated. Ipsilateral short-latency and contralateral long-latency responses (after cortex stimulation) were elicited. At the first examination (11.7 +/- 9 days after onset of the palsy) the components of the blink reflex were absent in all cases. Responses to electrical stimulation were abnormal in 80%. Ipsilateral short-latency responses after TMS could be obtained in 7 patients. Pathological long-latency TMS responses were elicited in 17 patients. Follow-up investigations up to 2 years revealed no prognostic aspects from peripheral electrical stimulation, the blink reflex and the short-latency TMS response. The absence or extent of delay in long-latency responses at first examination was strongly correlated with final clinical outcomes. As improvements of the responses preceded clinical regressions of the paresis, TMS proved to be an important neurophysiological method for an early prognosis of recovery after perioperative lesions of the facial nerve.
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PMID:Perioperative lesions of the facial nerve: follow-up investigations using transcranial magnetic stimulation. 911 34

This study demonstrates that the platysma is occasionally palsied in leprosy and that this only occurs when the facial nerve already has some other palsy. That there needs to be a facial palsy before there can be a platysma palsy is strongly suggested, in that there was no case of an isolated platysma palsy. Patients, regardless of age or other factors, could mimic a platysma contraction. This obviates the need for electrical testing to examine for a platysma palsy. It also means that a nonfunctioning platysma on clinical examination is, in fact, a palsied platysma. While lagophthalmos is regularly examined for, and any obvious facial paresis would be noticed, less severe forms of facial muscle paresis will only be found if formally examined for. The mechanism whereby the facial nerve is involved in leprosy is not clarified, but our findings suggest that proximal spread of a lesion that began in the zygomatico-temporal branches and reaches to the facial nerve trunk is more likely than new lesions developing de novo in other peripheral facial nerve branches. That the primary lesion is within the facial nerve trunk in all cases but we only see the frequent zygomatic sequelae due to secondary factors is not excluded.
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PMID:Cervical branch of the facial nerve in leprosy. 925 88

In 35 patients with idiopathic facial palsy (FP) clinical and electrophysiological examinations were performed during the first month. The patients were followed up until the 4th month to establish the prognostic value of different electrophysiological tests. Electrophysiological investigations consisted of the recording of blink reflex (BR) and the recording of the direct response (DR) elicited by the stimulation of the facial nerve. FP recovered satisfactorily in 80% of the patients. In patients in whom marked paresis remained, DR amplitude ratio of the affected side to the healthy side (DRr) was less than 25%. BR indicated a poor outcome, if it was still absent at the first month. In general, BR and DR measurements gave similar information about prognosis. Rare exceptions could be explained by the representation of different mechanisms by these two methods, demyelination and axonal degeneration.
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PMID:Electrophysiological investigations and prognosis in idiopathic facial palsy. 929 44


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