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)

The etiology, frequency and prognosis of recurrent Bell's palsy were studied in patients with peripheral paresis of n.facialis of various etiology. Fourteen (11.9%) of 117 patients with Bell's palsy had a recurrent paresis of n.facialis. Nine of these were of homolateral and five contralateral type. Seven recurrent facial paralyses in idiopathic Bell's palsy (i.e. 10.4% of the patients with idiopathic facial palsy), 3 facial palsies of viral origin (i.e. 8.8% of the patients with viral facial palsy), one in association with diabetes mellitus, one during pregnancy, one combined with positive rheumatic serological tests, and one in a case of Melkersson-Rosenthal syndrome were found. The frequency and heterogenity of etiology of recurrent facial palsies suggest a predisposing factor or immune mechanisms. In eight patients there was within 6 to 8 weeks a good, in two patients a moderate and in four patients a poor recovery of function. The greater reduction of the compound action potential of the m.orbicularis oris in recurrent homolateral facial palsy in relation to patients with single manifestation point out the greater denervation and therefore the poorer prognosis of recurrent palsies. A prophylactic decompression to prevent a third attack of recurrent facial paresis is considered.
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PMID:Recurrent Bell's palsy. Etiology, frequency, prognosis. 7 1

Electrophysiological investigations were carried out on 20 healthy controls and 130 patients with peripheral facial nerve paralysis. The aetiology was as follows: idiopathic (Bell's palsy) in 60 cases, viral in 29, traumatic in 18, postoperative in 4, in connexion with chronic otitis media in 6, diabetes mellitus in 4, positive rheumatological tests in 3, disturbed lipid metabolism in 2, the Melkersson-Rosenthal syndrome in 1, as a complication of pregnancy in 2, and in association with a tumour in 1 case. The compound action potential (CAP) of the orbicularis oris muscle was determinedi n 370 occasions in a right/left comparision, the record of the muscle response was intergrated over the time of action (IAR) on 32 occasions and trison of 255 occasions. The normal values are given in the first place and their dependence of the age of the subject. Then, the prognostic sifnficance of the above-mentioned parameters is investigated in cases of peripheral facial nerve paralysis. It is apparent that the determination of the CAP in a right/left comparison is a valuable prognostic guide as early as the 4th day, insofar as a decrease in this parameter of under 50% can be interpreted as a favourable sign and satisfactory reversal of the paralysis can be expected within 6-8 weeks. By contrast, a decrease of over 70% in the CAP is a bad prognostic sign, indicative of presumably only a poor trend to reversal of the paralysis. An intermediate depression of the CAP in the range of 50-70% signifies an expected moderate recovery within 6-8 weeks ahe case of CAP determination at the time of maximum amplitude depression (as opposed to the 4th day), then a decrease of less than 70% is taken to be indicative of satisfactory functional recovery within 6-8 weeks; a decrease of 95-100% signifies a bad prognosis, whilst a decrease amounting to between 70 and 95% carries an uncertain prognosis. The maximum decrease in amplitude was registered on the 8th day on average; the range lay between the 4th and the 14th day. An exception to these figures was the delayed response of the CAP in the case of 6 patients, 5 of whom showed a maximum decrease during the 3rd week and the last patient as late as the 4th week following the onset of facial nerve paresis. Similar reliance can be placed on the prognostic value of the IAR. however, the decrease in the IAR is smaller than that of the CAP measured on the same potential in a right/left comparison, so that a decrease in the IAR of over 60% can already herald a poor recovery. Repeated determination of the latency in cases of facial nerve paralysis showed that the mean latency value for the entire group of patients was slightly prolonged at the end of the 1st week, but the latency values obtained in any one particular patient are of no prognostic significance. A comparison between CAP and latency values obtained with the opposite (i.e...
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PMID:[Prognostic assessment in peripheral facial nerve paralysis with particular reference to electroneurography (author's transl)]. 18 19

Apart from the apparent trias of oro-facial swellings, facial paresis, and lingua plicata (LP), Melkersson-Rosenthal syndrome (MRS) comprises a variety of complex signs and symptoms. During the last 18 years, 73 patients suffering from MRS were admitted to our hospital. Re-examination of 42 out of these patients and evaluation of all data available proved preceding facial paresis(es) in only 34% of all cases and LP of various degrees in 52%. In more than 80%, however, we found vasomotoric, sialo-secretory, or other neurovegetative "minor signs", locally and/or temporally connected with swellings of either skin or mucosa. Since such minor signs are essential for the diagnosis and the understanding of both "complete" and "incomplete" forms of MRS (either associated with or without typical cheilitis granulomatosa), we worked out a classification of MRS considering the dermal, neurological, and neurovegetative affections observed in our cases and according to the relevant literature. A systematic classification like this, which takes into account the diagnostic signification of the findings, allows exact recognition of "incomplete" forms of MRS and represents a conditio sine qua non with regard to family studies and the follow-up of patients concerned.
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PMID:[Classification and scope of clinical variations of Melkersson-Rosenthal syndrome]. 368 63

Recurrent facial paralysis is an infrequent problem for the otolaryngologist. This paralysis may be associated with the Melkersson-Rosenthal syndrome, a triad of recurrent facial paralysis, relapsing facial edema, and associated fissured tongue. Most patients do not have the accompanying stigmata of this syndrome. This paralysis may occur unilaterally or bilaterally. The usual sequelae of recurrent facial paralysis are progressive synkinesis and increasing residual paresis with each episode, and total facial paralysis may be the final outcome. Two patients, one with unilateral Melkersson-Rosenthal syndrome and the other with a bilateral recurrent idiopathic facial paralysis, were treated with combined transmastoid and middle cranial fossa total facial nerve exposure, decompression, and slitting of the fibrous nerve sheath. Postoperatively they have not suffered from facial paralysis during a follow-up period of three years. It appears that this surgical management safely and effectively prevents recurrent facial paralysis unilaterally or bilaterally, whether or not it is associated with the Melkersson-Rosenthal syndrome. Until further experience with this particular management of recurrent facial paralysis is reported, however, caution should be used in recommending it. Additionally, it should not be assumed from this experience that surgical treatment for idiopathic facial paralysis in Bell's palsy is necessarily implied.
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PMID:Total facial nerve decompression in recurrent facial paralysis and the Melkersson-Rosenthal syndrome: a preliminary report. 394 79

The Melkersson-Rosenthal syndrome consists of the following signs: recurrent oedema of the lips and intermittent facial oedema with recidivant aspect; recidivant peripheral facial paresis; scrotal tongue. The cases of a 14-years-old girl is presented. She has two elements of the above signs (recurrent oedema of the lips with facial oedema and scrotal tongue), and additionally ocular affectation: keratitis and bilateral blepharitis. This associations, which has not been found in the literature, is emphasized.
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PMID:[The ocular manifestations in the Melkersson-Rosenthal syndrome]. 776 74

We report a 31P Magnetic Resonance Spectroscopy (31P-MRS) study on the changes of energy metabolism in human leg anterior and lateral compartment muscles with paresis due to compression from a herniated lumbar disc at the L4-L5 level and recovery to normality. A low phosphocreatine to inorganic phosphate ratio due to both decreased phosphocreatine and increased inorganic phosphate contents and a normal intracellular pH were the features of muscles with paresis. Changes of 31P-MRS parameters were followed during 18 weeks of treatment with physical therapy until complete recovery. Results show that 31P-MRS is a useful clinical tool for detecting even small biochemical changes that may occur in muscles and for checking the effects of therapy.
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PMID:Energy metabolism in muscle paresis and recovery studied by 31P-MR spectroscopy: a case report. 831 81

The details of brain metabolism in chronic cerebral infarcts have not been clarified. Using proton MR spectroscopy (1H-MRS) at 1.5 T, we measured biochemical changes in 16 patients with large infarcts involving the motor cortex in the chronic phase (median 293.9 days) and related the findings to clinical data. Localised spectra were obtained using point-resolved spectroscopy, with an echo time of 270 ms. Regions of interest were placed on the frontal lobe, including the precentral gyrus and central sulcus. Motor function was assessed by the manual muscle power test at the time of the 1H-MRS study. Only three patients with severe paresis had no signal in the lesions and a lactate signal was obtained in 13 cases. N-acetyl aspartate (NAA) was observed in 4 cases with recanalisation of an occluded vessel. Motor function correlated strongly with the NAA/choline-containing compounds (Cho) ratio (P < 0.01) and lactate/Cho ratio (P < 0.01). We found various metabolic patterns, reflecting residual neurological function.
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PMID:Metabolic and neurological patterns in chronic cerebral infarction: a single-voxel 1H-MR spectroscopy study. 927 92

This study was done to determine the independent predictors of long-term survival and long-term functional outcome in geriatric stroke patients with a high level of co-morbidity. We prospectively recruited 302 consecutive patients transferred from local hospitals of acute care to inpatient geriatric rehabilitation with a median of 23 days after stroke. The cohort with a mean age of 75.1 (range 60-90) years was followed up for 2 years after discharge from rehabilitation. The 24 month survival rate was 71.2%. Urinary continence (p = 0.000), younger age (p = 0.000), and absence of coronary artery disease (CAD) (p = 0.039) were predictors of survival. Independence in activities of daily living (Barthel Index (BI) > or = 85) 24 months after discharge was 43.2% and predicted by an admission BI > or = 50 (p = 0.000), urinary continence (p = 0.007), and absence of CAD (p = 0.018). Good functional outcome by the Modified Rankin Scale (MRS < or = 3) 24 months after discharge was 38.4%. It was predicted by absence of CAD (p = 0.001), first-ever stroke (p = 0.014), admission BI > or = 50 (p = 0.024), urinary continence (p = 0.025), mild motor paresis (p = 0.032), and good sitting balance (p = 0.039). Our study of a relatively aged and co-morbid stroke cohort confirmed most of the well-known predictors of outcome. A new result is that CAD also seems to be an important determinant of long-term outcome.
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PMID:Predictors of favorable outcome in elderly stroke patients two years after discharge from geriatric rehabilitation. 1171 2

The article describes Rossolimo-Melkersson-Rosenthal disease (RMRD); historical background and the modern concept of its pathogenesis are presented in brief. The clinical picture of the disease is described in more detail; the variants of the course of the disease and the manifestations of the monosymptomatic, bisymptomatic, and triadic variants are presented. The article contains a clinical observation of a female patient aged 38, whose first symptoms developed at the age of 18 as facial neuritis and left mimic musculature paresis. With time, the patient developed all the three characteristic components of RMRD.
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PMID:[A case of Rossolimo-Melkersson-Rosenthal disease]. 1756 41

Balo's concentric sclerosis (BCS) is a variant of multiple sclerosis (MS). It may present as a lesior clinically and radiologically indistinguishable from brain tumour particularly on computerized tomography (CT) scans. Diagnosis only gets clear when magnetic resonance imaging and spectroscopy (MRI & MRS) and brain biopsy is done. We report a case of 30 year old male with progressive headache and left hemi paresis for 3 weeks. There was upper motor neuron (UMN) facial palsy on the left with bilateral papilledema. CT scan of brain showed large hypo-dense area in right frontoparietal lobe consistent with brain tumour. On MRI the diagnosis of BCS was made on basis of concentric lesions of myelinated and demyelinated rings. Demyelination wa confirmed on brain biopsy.
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PMID:ONION PEEL APPEARANCE IN BALOS CONCENTRIC SCLEROSIS--A VARIANT OF MULTIPLE SCLEROSIS. 2618 86


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