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

We have encountered six zoster patients whose pain preceded rash by 7 to more than 100 days. Pain was severe, burning, and radicular, and located both in dermatomes different from, as well as in, the area of eventual rash. Two patients ultimately developed disseminated zoster with neurologic complications, one of zoster paresis, and the other, a fatal zoster encephalitis; both had been taking long-term, low-dose steroids. A third case of preherpetic neuralgia developed in a patient with prior metastatic carcinoma, and another case in a patient with an earlier episode of brachial neuritis. The final two cases of preherpetic neuralgia developed in individuals with no underlying disease. An extended period of pain before the onset of zoster rash has gone largely unrecognized.
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PMID:Preherpetic neuralgia. 186 8

Intractable, unexplained deep-ear pain presents a rare, albeit significant problem in otolaryngological and neurosurgical practice. The authors review their experience with 18 cases of primary otalgia during the past 15 years. A total of 31 surgical procedures were performed. Seventeen patients had sequential rhizotomies and one patient had microvascular decompression alone. Based on the clinical diagnosis, the nerves sectioned were singly or in combination: the nervus intermedius (14 patients), geniculate ganglion (10 patients), ninth nerve (14 patients), 10th nerve (11 patients), tympanic nerve (four patients), and chorda tympani nerve (one patient). Microvascular decompression of the involved nerves was undertaken in nine patients, in whom vascular loops were discovered. Adhesions (six patients), thickened arachnoid (three patients), and benign osteoma (one patient) were other intraoperative abnormalities noted. The overall success of these procedures in providing pain relief was 72.2%, and the mean follow-up period was 3.3 years (range 1 month to 14.5 years). There was no surgical mortality. Expected side effects were: decreased lacrimation, salivation, and taste related to nervus intermedius nerve section, and transient hoarseness and diminished gag related to ninth and 10th nerve section. Four patients developed sequelae consisting of sensorineural hearing loss, vertigo, and transient facial nerve paresis. One patient had a cerebrospinal fluid leak and another developed aseptic meningitis as postoperative complications. Except when primary glossopharyngeal neuralgia is the working diagnosis, a combined posterior cranial fossa-middle cranial fossa approach is recommended for adequate exploration and/or section of the fifth, ninth, and 10th cranial nerves as well as the geniculate ganglion and nervus intermedius.
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PMID:Geniculate neuralgia: the surgical management of primary otalgia. 152 Mar 57

The author describes the examination technique of trigeminal evoked potential (TEP) by electric stimulation with paired skin electrodes separately for each side of the maxillary and mandibular branch of the trigeminal nerve. The obtained evoked response contains two negative and two positive deflections N11, P19, N27, P39, whereby wave P39 could not be evaluated in 47.8%; therefore it was not processed by statistical method. The other latency values are stable against a major variability of amplitudes. Evaluation by linear regression displayed only a minor correlation of latencies of the trigeminal evoked potential with advancing age. The author present normal latency and amplitude values for every side of maxillary and mandibular part of the Vth nerve as well as maximal lateral differences. With regard to the hypothetical possibility to influence results of the trigeminal potential by afferentiations of the VIIth nerve in patients with idiopathic paresis of the fascial nerve, this method in not a suitable model for testing the selectivity of examinations of TEP. The submitted method of trigeminal evoked potential is reliable and simple and can be used as a diagnostic aid in examinations of the functional state of the pathway of the Vth nerve, e.g. in multiple sclerosis, neuralgia of the Vth nerve, tumours of the Vth nerve and in conditions after operation of the Vth nerve.
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PMID:[Trigeminal evoked potentials. Normal values]. 222 78

Direct trauma to the superior-oblique muscle of the eyeball may result in active and passive ocular motility disturbance, e.g. paresis, Brown phenomenon, cyclorotation disorder, head-tilt and faulty head posture. In individual cases combinations of these and rather complex forms may occur. Surgery should aim at sufficient centralization of the binocular field of vision. The author usually recommends indirect procedures, at the ipsilateral inferior oblique muscle, to correct excyclorotation, or at the contralateral inferior rectus muscle to correct paresis. A pronounced Brown phenomenon should be treated by recession of the superior oblique muscle, or rather its transposition to the nasal side of the superior rectus. In addition, recession of the contralateral superior-rectus muscle or resection of the ipsilateral inferior-rectus muscle may be advisable. Out of eight patients, one refused surgery, five were sufficiently cured in one session, and another patient in three surgical sessions. One patient could not be satisfactority treated by surgery; in addition to a Brown phenomenon she had excyclorotation, especially in down-gaze, and paresis of the superior oblique muscle plus severe neuralgic pain in up-gaze. In this patient the trochlea had been accidentally lost during a foreign-body excision in the upper medial orbit. A secondary reconstruction of the trochlea was found not to be advisable in this patient, because the neuralgia was thought to be due to traction within the superior oblique tendon or the periost.
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PMID:[Direct superior oblique muscle trauma and dysfunction--surgical possibilities and results]. 258 46

Ten patients with intractable hemifacial spasm were treated by posterior fossa exploration and microsurgical technique. These patients have been followed 1 to 5 years. The spasmodic motor disorder was related to compression of the 7th nerve or its exit zone at the brain stem by a dolichoectatic anterior inferior cerebellar artery in eight patients and to kinking and ectasia of the basilar or vertebral artery in two patients. In five patients, there were prominent arachnoidal adhesions in the cerebellopontine angle, and an arachnoid cyst was a component of the lesion in another patient. Additional conditions associated with hemifacial spasm included geniculate neuralgia, facial paresis, vertigo, hearing loss, and trigeminal neuralgia. The surgical morbidity and postoperative results are discussed.
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PMID:Microsurgical treatment of intractable hemifacial spasm. 730 Oct 83

Damage to a plexus or peripheral nerve is a rare and avoidable complication of surgical anesthesia. We reviewed 2,750 case histories of patients who underwent surgery between 1985 and 1992, finding 6 cases of nerve lesions presenting postoperatively. Sequelae involved 1 abdomino-genital neuralgia, 1 case of post-epidural radicular pain, 2 cases of peroneal nerve palsies and 2 of cubital paresis. Three of these cases were related to position during surgery, 1 to position during a prolonged period in bed in the intensive care unit, 1 to the anesthetic technique and 1 to surgical manipulation. Our data are important given the difficulty of studying the incidence of such cases due to patient dispersion and the loss of records of possible occurrences. The mechanisms by which lesions are produced are sometimes difficult to pinpoint but all are generally preventable.
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PMID:[Postoperative lesions of the peripheral nerves. 8 years' analysis]. 777 80

Although a recognized migrainous phenomenon in adults, transient oculosympathetic paresis in childhood has been rarely observed. Six pediatric patients are reported with transient oculosympathetic paresis occurring within the context of characteristic vascular headaches. The clinical profiles of the patients suggest transient dysfunction of third-order ocular sympathetic pathways and represent most likely a benign, self-limited variant of pediatric migrainous neuralgia.
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PMID:Transient oculosympathetic paresis (group II Raeder paratrigeminal neuralgia) of childhood: migraine variant. 821 41

In clinical practice herpes zoster infections are common. The cause is the reactivation of the herpes varicella virus that persists in the sensory ganglia after an earlier primary infection with shingles. There are several neurological complications such as meningitis, ventriculitis, encephalitis, myelitis, cerebral angiitis, myositis, paresis of motor nerves, acute polyneuritis, and most commonly post-zoster neuralgia. A proposed reason for these complications is the direct infiltration of the virus or a hematogenous infection. Some of the complications can be treated symptomatically such as post-zoster neuralgia and the occurrence of certain complications that can be prevented by the right choice of acute therapy.
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PMID:[Herpes zoster: follow-up, complications and therapy]. 880 7

This case report first reviews the intracranial tumors associated with symptoms of trigeminal neuralgia (TN). Among patients with TN-like symptoms, 6 to 16% are variously reported to have intracranial tumors. The most common cerebellopontine angle (CPA) tumor to cause TN-like symptoms is a benign tumor called an acoustic neuroma. The reported clinical symptoms of the acoustic neuroma are hearing deficits (60 to 97%), tinnitus (50 to 66%), vestibular disturbances (46 to 59%), numbness or tingling in the face (33%), headache (19 to 29%), dizziness (23%), facial paresis (17%), and trigeminal nerve disturbances (hypesthesia, paresthesia, and neuralgia) (12 to 45%). Magnetic resonance imaging with gadolinium enhancement or computed tomography with contrast media are each reported to have excellent abilities to detect intracranial tumors (92 to 93%). This article then reports a rare case of a young female patient who was mistakenly diagnosed and treated for a temporomandibular disorder but was subsequently found to have an acoustic neuroma located in the CPA.
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PMID:Trigeminal neuralgia due to an acoustic neuroma in the cerebellopontine angle. 1120 49

Three patients, one woman aged 22 and two men aged 54 and 28, presented with scapular winging. In the first patient amyotrophic plexus neuralgia was diagnosed. The second patient most probably suffered from a stretch injury of the long thoracic nerve. The third patient had scapular winging due to an isolated paresis of the trapezius muscle, which was caused by an idiopathic lesion of the accessory nerve. In the first and second patient an improvement was noticeable after 9 months and 1.5 years respectively. There was no improvement in the third patient after 11 years. Paresis of the M. serratus anterior occurs due to paralysis of the N. thoracicus longus, as a result of direct compression, stump trauma, interventions such as thoracic operations, (repeated) stretch injuries or neuralgic brachial plexus amyotrophy; in these cases the scapular winging increases as the arm is lifted forwards. Paresis of the M. trapezius occurs due to the paralysis of the N. accessorius, due to trauma, interventions such as in the neck area, a space-occupying abnormality or an idiopathic abnormality; in these cases the scapular winging increases upon the arm being lifted sideways. Another possible cause of scapular winging is muscular dystrophy, especially fascioscapulohumeral muscular dystrophy (FSHD). Usually the prognosis for recovery from a neuropraxia and an idiopathic lesion of the N. thoracicus longus within a two-year period is good. The prognosis for an isolated lesion of the N. accessorius is much less favourable. An EMG is essential for establishing a diagnosis.
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PMID:[A winged scapula]. 1235 70


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