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)

A case with central nervous symptoms in type V hyperlipoproteinemia was described. The 39-year-old male patient suffered from abdominal pains after fatty meals since childhood. After the age of 31 he developed attacks of cephaleas. Headaches were associated with vertigo, paresis and paresthesia of the limbs and loss of consciousness in some instances. During antilipemic treatment combined with a diet of restricted fat and carbohydrate content the patient became free of complaints. Authors emphasize the impairment of cerebral circulation and tissue hypoxia in the development of cerebral disturbances in hyperlipoproteinemia. The mechanism of the development of hypoxia is discussed.
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PMID:Intermittent cerebral symptoms in type V hyperlipoproteinemia. 18 96

Clinical and histological findings are presented as occurring in a male aged 24 years suffering from relapsing polychondritis (r. p.) of 7 years duration. The presenting symptoms were fever, ataxia, vertigo and vomiting. During the later relapses there also occurred episcleritis, paresis of the glottic muscle and hypertrophic bronchitis. At the age of 22 the patient had had a tracheostomy because of acute respiratory insufficiency. The patient has a typical saddle nose and drooping auricles. Tissues obtained from the auricles showed destructive alterations of the cartilage with fragmentation and homobenization of the elestic fibres. The perichondrium showed fibrosis and a massive round-celled inflammatory infiltration.
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PMID:[Recurrent polychondritis]. 61 34

A 38-year-old man was referred by his general practitioner to our department on 28 October 1991, with a 2-week history of vertigo. A left aural polyp was identified. The audiogram showed a moderate conductive loss on the left side. Computed tomography (CT) and magnetic resonance imaging (MRI) confirmed the presence of the expanding lesion in the descending portion of the facial nerve. However, there was no seventh nerve paresis. At operation, the neurinoma (Schwannoma) filled the middle ear cleft and extended from the genu to the stylomastoid foramen. The floor of the middle ear had been eroded, exposing the jugular bulb. Facial nerve paresis is the usual presenting feature of a facial neurinoma. The case is presented for the reason that the absence of facial palsy as a presenting feature is rather rare, especially in the cases with large tumor and extensive bone erosion.
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PMID:Intratemporal facial nerve neurinoma without facial paralysis. 129 96

Between 1985 and 1991, 36 patients with glomus tumors of the temporal bone were operated. More than 60% of the patients presented with an advanced disease (Class C and D) according to the initially discret and slowly progressive clinical signs. Pulsatile tinnitus, hearing loss and paresis of the lower cranial nerves IV to XII were most often found. The management of the patients requires a complete surgical resection with different approaches depending on the extension of the tumor. High resolution CT of the temporal bone and selective angiography of the tumor feeding vessels proved as reliable and necessary imaging tools to determine the size of the tumor and thereby the surgical procedure. Class A tumors (n = 4) were completely resected by an enaural transmeatal approach. Class B tumors (n = 10) were removed completely in all cases by a combined transmeatal-transmastoid approach. A conductive hearing loss in 2 cases and transient facial paresis in one case were observed. Class C tumors (Glomus jugulare tumors, n = 16) required an infratemporal fossa approach type A. A complete resection was achieved in 87.5%. Class D tumors (n = 6) with intracranial extension were managed in a two stage otoneurosurgical procedure. Due to the tumor size and the required surgical procedure a higher incidence of functional lesions (combined hearing loss, vertigo, cranial nerve pareses) was observed. A facial paresis occurred in all cases but was transient in most of them. The results show that functional conservation surgery for glomus tumors of the temporal bone is only possible in Class A and B and some of the Class C tumors. This requires an early diagnosis.
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PMID:[Glomus tumors of the temporal bone--surgical concept and results]. 131 8

Questionnaires assessing symptoms, disability and handicap, predisposition to anxiety, and current anxiety and depression were completed by 127 people attending neuro-otology clinics with a major complaint of vertigo or dysequilibrium. Definite signs of vestibular dysfunction (spontaneous or positional nystagmus, or canal paresis) were found in 56% of the sample, but the presence or absence of abnormal vestibular test results was unrelated to diagnosis, reported symptoms, handicap and psychological status. Two-thirds of employed respondents admitted to occupational difficulties, and more than one in seven had left work because of vertigo. Although the number of people in the sample with a predisposition to anxiety was not unusually high, over a third of the sample had abnormally elevated levels of current anxiety. Multiple regression analyses indicated that disability was determined mainly by physical factors (vertigo severity and duration, age and sex). Handicap was influenced by a mixture of somatic and psychological variables, including the severity of autonomic symptoms. Anxiety and depression were only indirectly related to the severity and duration of the vertigo, insofar as this contributed to handicap. The partial dissociation between these different aspects of patient well-being suggests a need for separate evaluation and differing management of problems at each level of functioning.
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PMID:Somatic and psychological factors contributing to handicap in people with vertigo. 148 56

Tumoral and functional surgery of the cerebellopontine angle and the internal acoustic meatus has been performed in our department for more than 20 years. Acoustic neurinomas (700 cases operated to date) represent the great bulk of this surgery. Since 1985, we have drastically modified our approach to these tumors (220 cases). Large tumors are now dealt with, regardless of the patient's hearing, through a widened translabyrinthine approach. Small tumors with normal hearing are operated on through a suboccipital or a retrolabyrinthine approach depending on the tumoral extension in the internal acoustic meatus. The facial nerve function was preserved in 83% of the cases. Hearing was saved only 6 times in 45 attempts, despite 23 cases of apparent anatomical conservation of the cochlear nerve. Vestibular neurectomy, carried out through a middle cranial fossa or through a retrolabyrinthine approach, ameliorated vertigo in 95% of cases. The major operative risks are regressive facial paresis and secondary total deafness (10% of cases). Surgical treatment of facial hemispasm by neurovascular decompression is very effective, but not without risk. We now prefer to use botulin toxin therapy.
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PMID:Surgery of the internal acoustic meatus and the cerebello-pontine angle. 159 85

The entity of generalized livedo racemose and cerebrovascular bleeding disorders was introduced in 1965 by I. B. Sneddon describing 5 cases. it is not clear what role oral contraceptives and smoking play in the etiology of this syndrome. The case of a 44-year old multipara is described who had taken pills up to 1980 and smoked 5-10 cigarettes a day. In 1980 just before age 35 she suffered an apoplectic insult with hemisyndrome on the left side that she recovered from. An acute hypoglossal, and trigeminal paresis appeared on the left side. Computer tomogram showed a hypodense field in the area of both hemispheres of the brain. An audible mesosystolic click led to the diagnosis of suspecting cerebral embolism with mitral valve prolapse. Therapy was started with thrombocyte aggregation inhibitors. Although the prolapse could not be showed by echocardiography, the frontal mitral valve was slightly thickened. Another hospitalization in 1985 owing to a recurring attack of vertigo revealed higher blood pressure. She received betablocker treatment. In 1987 sudden weakness in the left arm and speech disorders ensued, and skin color alterations were manifest characteristic of generalized racemose livedo. Skin necrosis appeared on both toes. Sneddon syndrome was diagnosed, and full anticoagulation therapy was started with cumarin. The sensomotoric and speech symptoms receded only slightly. In 1988 a light cerebral insult occurred with the deterioration of the speech disorder. Laboratory finding showed immunoglobulin G (IgG) anticardiolipin antibodies (ACA) with 255 U/ml (normal range 0-10 U/ml), and normal IgM anticardiolipin antibodies with 8 U.ml (range of 0-10 U.ml). ACA has been detected in patients with lupus erythematosus and racemose livedo indicating the possible association of Sneddon syndrome with systemic lupus erythematosus.
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PMID:[Sneddon syndrome]. 187 23

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

Patients with bilateral peripheral vestibular dysfunction present a substantial diagnostic and therapeutic challenge to the otologist. Caloric irrigations that suggest bilateral weakness may mislead the clinician when considerable peripheral function remains. Rotary chair testing at several frequencies is helpful in confirming the degree of residual function and may identify patients who have a better prognosis in rehabilitation. Forty-nine patients with bilateral vestibular paresis were evaluated. The diagnosis was based on caloric responses of less than 5 degrees/sec in both ears and reduced gain on rotary chair trials. Oscillopsia occurred in the minority of patients (35%) and was rare unless severe paresis was present. Episodic vertigo occurred in 43%. All patients had abnormal posturography results, with vestibular dysfunction and severe dysfunction patterns predominating. The treatment outcomes of 22 patients who underwent vestibular rehabilitation are discussed. Prevention of bilateral vestibular paresis remains a high priority.
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PMID:Bilateral vestibular paresis: diagnosis and treatment. 190 Jun 33

A 67-years old woman developed sudden headache and transient vertigo. One week later, left arm paresis appeared and the patient became comatose. Investigations showed thrombocytopenia with hemolytic anemia and the presence of numerous irregularly contracted red cells (schizocytes). This was consistent with the diagnosis of thrombotic thrombocytopenic purpura. As focal neurological manifestations and widespread mental changes were still present when she emerged from coma, magnetic resonance imaging was performed showing numerous small infarcts in the white and grey matters.
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PMID:[Thrombotic thrombocytopenic purpura. A case diagnosed by MRI]. 206 82


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