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

Vestibular dysfunction is a significant differential diagnosis in patients who have unexpected falls without: loss of consciousness, paresis, sensory loss, or cerebellar deficit. Either peripheral or central vestibular disorders cause postural instability with preferred directions of falling, some of which can be attributed to either the particular plane of the affected semicircular canal or a central pathway mediating the 3-dimensional vestibulo-ocular reflex in yaw, pitch, and roll. Ipsiversive falls occur in vestibular neuritis or in Wallenberg's syndrome--where they are known as lateropulsion. Contraversive falls are typical for the otolith Tullio phenomenon, vestibular epilepsy, and thalamic astasia. Predominant fore-aft instability is observed in bilateral vestibulopathy, benign paroxysmal positioning vertigo, as well as in downbeat or upbeat nystagmus syndrome. Falls can be diagonally forward (or backward) and toward or away from the side of the lesion, depending on the site of the lesion (the ocular tilt reaction is ipsiversive in medullary lesions, but contraversive in mesencephalic lesions) and on whether vestibular structures are excited or inhibited.
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PMID:Vestibular falls. 827 42

Morphological vestibular changes caused by barotrauma were studied in guinea pigs. Animals were exposed to rapid decompression from 2 absolute atmospheric pressures (ATA) to 1 ATA, which causes inner ear barotrauma in the guinea pig. During decompression, spontaneous nystagmus was recorded, which consisted of irritative symptoms initially, followed by paralytic nystagmus. After pressure loading and observation to confirm the absence of Preyer's reflex with vertigo, the animals were tested for caloric nystagmus using ice water and then sacrificed at varying intervals. Then, morphological changes in vestibular organs and the organ of Corti were studied. Half of the experimental animals showed canal paresis on caloric testing. Damage to the organ of Corti was severe while that to vestibular organs was very slight. Damage to the sensory cells of the vestibular organs was not clear on light microscopy, despite a partial collapse of labyrinthine membranes. Under scanning electron microscopy, local damage was observed in a portion of the crista ampullaris of the semicircular canals. In this area, incomplete or complete disappearance of kinocilia and stereocilia, similar to that seen after rotatostimulation, was observed. However, no damage to sensory hairs was seen in the utricles and saccules. The observed vestibular organ damage, resulting from inner ear barotrauma, suggested effects on endolymphatic flow.
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PMID:[Vestibular changes due to barotrauma]. 829 63

Report on a huge mucocele of the right maxillary sinus extending into the ethmoid and sphenoid sinuses, and protruding into the contralateral left posterior cranial fossa. The patient, a 45-year old male, had no history of paranasal sinus energy, nasal or paranasal symptoms. He went to his physician because of a slowly developing deafness in his left ear and because of episodes of loss of consciousness when blowing his nose. A reversible episode of vertigo and reversible paresis of the left abducent nerve 17 years previously, were later assumed to have been the first symptoms of endocranial extension of the mucocele. The diagnosis of a mucocele was made by MRI. MRI in T2 weighted spin-echo sequences is the best imaging technique for diagnosing a mucocele. The mucocele was treated primarily with endonasal surgery of the paranasal sinuses, using telescopes and an operating microscope. After opening the right maxillary sinus via the middle meatus liquid contents of the mucocele poured into the nasal cavity. The sack of the mucocele was removed partially. Three months later the patient was reoperated with a combined transfacial and endonasal approach, because of progression from partial hearing loss to total deafness. Postoperatively hearing improved nearly completely and compression of the pons and the posterior fossa had disappeared on MRI. It is concluded that in mucoceles no longer the extirpation of the sack, but endonasal marsupialization, using the operating microscope and telescopes, is the therapy of choice.
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PMID:[Giant mucocele of the paranasal sinuses with extension to the contralateral posterior cranial fossa and reversible retrocochlear deafness]. 832 30

The author reports on the prevalence and stability of the course of neurologically relevant psychogenic symptoms as well as their dependence on age and sex. Altogether 240 probands from the Mannheim Cohort Study on the epidemiology of psychogenic disorders were examined for psychogenic impairment over a 10-year period during three investigation periods. On the whole, seven neurologically relevant groups of symptoms (headache, lumbar and cervical vertebral complaints, non-systematic vertigo, functional hyperkinesia, functional paresis, sleep disturbances, concentration disturbances) differ clearly in frequency, characteristics of the course and clinical relevance.
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PMID:[Incidence and follow-up characteristics of neurologically relevant psychogenic symptoms]. 833 29

A 59-year-old woman with breast cancer and anti-Ri antibodies developed a neurologic paraneoplastic disorder characterized by nausea, vomiting, vertigo, paresis of upward gaze, and gait ataxia, without opsoclonus. The absence of opsoclonus does not rule out the possibility of an anti-Ri-associated paraneoplastic neurologic disorder.
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PMID:Anti-Ri-associated paraneoplastic neurologic disorder without opsoclonus in a patient with breast cancer. 835 Oct 21

A 74-year-old woman, with hypertension and dilated cardiomyopathy, presented with sudden onset of diplopia without vertigo and other neurological symptom. Examination revealed left inferior rectus muscle paresis. Other neurological findings were normal. She had no cerebellar ataxia and sensori-motor dysfunction. Magnetic resonance imaging showed increased signal intensity on T2-weighted and proton density-weighted images in the right ventral midbrain, compatible with infarction involving the fascicular oculomotor fibers. Complete resolution of the diplopia and normal ocular motility were noted 3 months after the onset of the diplopia. Focal ischemic midbrain lesions should be considered in cases of isolated partial oculomotor nerve paresis.
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PMID:[Isolated inferior rectus muscle paresis from midbrain infarction]. 837 Feb 6

Clinical observations were made on 32 patients with vestibular neuronitis in the last 5 years: 14 male and 18 female, ranging from 15-76 years, the average being 46.3. Within the age distribution of the cases, two peaks were observed: a younger and an older group. Five patients (15%) had recently contracted infection of the upper respiratory tract before the onset of the disease, and two developed benign paroxysmal positional vertigo during the recovery period. Spontaneous nystagmus was observed in 19 cases (59%) in the first medical examination. There were several patients in whom there was the possibility of central lesions based upon the findings of equilibrium examinations. No relation was found between the degree of canal paresis and the time required for recuperation; however, the older patients took much longer to recover from the disease. Our results showed that there were considerable individual variations regarding the clinical findings, which may suggest that the pathological entity that creates this disease is not simple.
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PMID:Clinical observation of 32 cases of vestibular neuronitis. 847 Apr 78

Progress of caloric response and subjective symptoms of 60 patients with vestibular neuronitis was evaluated by a long term follow-up study. Normalization of caloric responses was confirmed in 25 (41.7%) out of 60 patients, 20 of whom had recovered within 2 years of the onset of vertigo. The rate of the patients with canal paresis was about 90% after 1 month of the onset, and 80% after 6 months, while 50% of them still showed canal paresis after 5 or 10 years had passed. Complete relief from subjective symptoms was recognized in 34 (56.7%) cases during the follow-up period. We conclude that the prognosis of vestibular neuronitis is not always good, because vestibular function did not recover within normal levels in about half of the patients in spite of complete relief from subjective symptoms in many of them.
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PMID:Progress of caloric response of vestibular neuronitis. 847 Apr 87

Eleven patients with vestibular neuronitis were followed up from 1988 to 1990. The relationship between the GBST and other vestibular examinations was investigated. Vertiginous symptoms showed relative improvement, but in the last medical examination 4 out of 11 cases (36.4%) complained of unsteadiness when their head was rotated and fatigued. Seven patients (63.6%) presented spontaneous and positional nystagmus at the first consultation, but only one patient (9.1%) at the last one. Seven patients (63.6%) showed canal paresis to caloric stimulation, while 3 (27.3%) showed normal responses. In the galvanic body sway test (GBST), 9 patients (81.8%) showed abnormal thresholds. There was no significant relationship between vertiginous symptoms in the last medical examination and prodromes, vertigo type, nystagmus, righting reflex, caloric stimulation or the results of the GBST.
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PMID:Relationship between GBST and equilibrium examination in vestibular neuronitis. 847 Apr 91

Symptoms and incidence of neuroborreliosis (NB) were studied in ambulatory patients visiting the ENT clinic in Helsinki. Especially we tried to search for possible markers indicating the connection between vestibular neuronitis and NB. A total of 350 patients were screened with the enzyme-linked immunosorbent assay (ELISA) technique for possible antibodies against Borrelia burgdorferi (BB). Twelve patients had positive serological reactions for BB with sera titer levels ranging from 640-14700 (normal < 500). In 2 additional cases, NB was clinically confirmed. In 7 cases a history of tick bite and in 4 cases erythema chronicum migrans was confirmed. In 9 cases, vertigo was the predominant symptom, and in 3 cases the symptoms were linked to facial nerve paresis. Six patients suffered from hearing loss. In 7 cases, the diagnosis was initially settled as vestibular neuronitis. NB seems to be present in about 4% of cases with apparent otologic diseases in Finland. In the majority of the cases, the disease resembles vestibular neuronitis in the acute stage. Since NB is tractable, all patients visiting the ENT clinic, especially those with vertigo, should be screened.
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PMID:Neuroborreliosis in the etiology of vestibular neuronitis. 847 May 5


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