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

An efficacious treatment has not been available to patients with aberrant regeneration of the facial nerve as a result of Bell's palsy or after acoustic neuroma excision. This prospective controlled trial examines the efficacy of electromyographic feedback versus mirror feedback as treatment strategies for patients suffering from long-standing (18 months minimum) facial nerve paresis. Twenty-five patients were randomly assigned to electromyography with mirror feedback or mirror feedback alone. Seven rural patients who did not undergo treatment served as controls. At 0, 6, and 12 months, facial motor function was objectively quantified by linear measurement of facial movement, visual assessment of voluntary movement, and electrical measurement of facial nerve response to maximal stimulation. Statistically significant improvements were noted in both electromyography and mirror-feedback groups with respect to symmetry of voluntary movement (P less than .03) and linear measurement of facial expression (P less than .01). The positive results of this controlled trial demonstrate that feedback training in combination with a structured home rehabilitation program is a clinically efficacious treatment for patients with facial nerve paresis.
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PMID:Efficacy of feedback training in long-standing facial nerve paresis. 206 55

Meningopolyradiculitis (Garin-Bujadoux syndrome, Bannwarth syndrome) is the second stage of Lyme disease, a tick-borne Borrelia infection. Almost 60% of these patients develop an acute peripheral facial paresis. The disease can be differentiated from Bell's palsy only by finding the specific Borrelia antibodies in serum and CSF. Other cranial nerve lesions can be found besides facial paresis. The follow-up of seven Borrelia-infected patients is described: one showed bilateral, the others unilateral, facial paresis. High dosage of penicillin or tetracycline for 10-14 days is the appropriate therapy. The prognosis of facial paresis in tick-borne Borrelia infection is considered to be good. All our patients showed complete recovery of motor nerve function.
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PMID:[Prognosis of peripheral facial paralysis in Lyme borreliosis (Garin-Bujadoux, Bannwarth meningopolyradiculitis)]. 272 77

In an effort to refine and amplify the basis for clinical prognosis in Bell's palsy, 14 factors in a clinical study were analysed. From the results, it is still impossible to make a certain prognosis of recovery in the individual patient. However, it is obvious that, based on degree of paresis on assessment, and to a lesser degree the MAP value, at least a quantitative statement can be made.
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PMID:Bell's palsy: factors affecting the prognosis in 200 patients with reference to hypertension and diabetes mellitus. 282 19

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

To evaluate the hypothesis of CNS involvement in Bell's palsy, the auditory brain stem responses (ABR) of 31 patients were studied. In nine of these patients ABR abnormalities were found. None of these patients showed evidence of dysfunction of the cochlear nerve. Six of the patients who had abnormal ABR were retested after they recovered from the facial paresis. Five of these patients showed persistent ABR abnormality, and one showed a normalization of the ABR. These results may be consistent with an injury at the brain stem level in some patients with Bell's palsy. The possible causative agent of a reactivation of a herpes simplex virus infection is discussed.
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PMID:Auditory brain stem response abnormalities in patients with Bell's palsy. 641 90

The degree of remaining motor unit activity at maximal voluntary contraction of the face was examined in three of the facial muscles in 43 untreated patients with Bell's palsy. All the patients were examined within 10 days of the onset of the paresis. In 40 patients the EMG activity was compared with the clinical evaluation of the paresis and in 33 patients with the results from sialometry. EMG revealed remaining motor activity in several patients who had clinically total paresis. It was concluded that EMG can be used as a prognostic indicator at an early stage in Bell's palsy. Sialometry was found to predict the final outcome of the paresis with a slightly better accuracy than EMG.
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PMID:Electromyography (EMG) and sialometry in the prognosis of Bell's palsy. A methodological study of early investigated, untreated patients. 725 61

Although ocular manifestations of Lyme disease have long been noted, they remain a rare feature of the disease. The spirochete invades the eye early and remains dormant, accounting for both early and late ocular manifestations. A nonspecific follicular conjunctivitis occurs in approximately 10% of patients with early Lyme disease. Keratitis occurs often within a few months of onset of disease and is characterized by nummular nonstaining opacities. Inflammatory syndromes, such as vitritis and uveitis, have been reported; in some cases, a vitreous tap is required for diagnosis. Neuro-ophthalmic manifestations include neuroretinitis, involvement of multiple cranial nerves, optic atrophy, and disc edema. Seventh nerve paresis can lead to neurotrophic keratitis. In endemic areas, Lyme disease may be responsible for approximately 25% of new-onset Bell's palsy. Criteria for establishing that eye findings can be attributed to Lyme disease include the lack of evidence of other disease, other clinical findings consistent with Lyme disease, occurrence in patients living in an endemic area, positive serology, and, in most cases, response to treatment. Management of ocular manifestations often requires intravenous therapy.
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PMID:Ocular manifestations of Lyme disease. 772 93

Facial paresis is the only clinical symptom of two deep-seated, moderately malignant salivary duct carcinomas. The unusual course of the pareses (recurrences, varying degrees of severity) prompts the diagnosis of Bell's palsy. The final, exact diagnosis of a epithelial-myoepithelial intercalated duct carcinoma, respectively of a polymorphic low-grade adenocarcinoma, is made as late as six, respectively three, years after onset of the paresis.
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PMID:[Paralysis of the facial nerve caused by "low-grade" adenocarcinoma of the parotid gland--a contribution to the differential diagnosis of Bell's palsy]. 777 24

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

This paper reports on 379 investigations of patients with the diagnosis of Bell's palsy. The computerized analysis was carried out retrospectively with the programme FANDOS (6). In most electrophysiological measurements five standard muscles (frontalis muscle, orbicularis oculi muscle, levator labii muscle, zygomaticus muscle, orbicularis oris muscle) were investigated with electromyography (EMG); further, neuromyography was performed. In 77.3% of the cases electromyographically incomplete and 22.7% complete palsies were found. The distribution of the reduced innervation patterns and the degeneration of the muscles did not show a preferred lesion of certain muscles. In about sixty per cent of all cases in at least four muscles a homogeneous electromyographic pattern of the lesion in the mimic musculature could be detected. Degeneration potentials, however, were mostly found in one muscle only. In order to provide a differentiated analysis of the electromyographical state of a facial paresis an "EMG-index" was introduced that allows a general judgement of the "degree of palsy" in all five investigated muscles. An analysis of the time dependence of the "EMG-index" over the course of two weeks following onset of the palsy showed no variation during this time period. This proves that the complete status of the palsy is reached early after onset and that a deterioration or improvement is rarely seen within this time interval.
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PMID:[Electrophysiologic studies of the pattern of lesions of mimetic muscles in Bell's palsy]. 849 91


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