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)

Experiences with patients with facial paralysis over the last 25 years and recent efforts to develop objective measures of paresis and synkinesis led us to three hypotheses: (a) dysfunction in certain regions of the face is more disturbing than that in others, (b) there are major psychosocial impacts of facial paralysis, and (c) the impact of facial paralysis is underestimated. An initial questionnaire of 10 open-ended items was submitted to 11 subjects stabilized after acoustic tumor resection. Responses were tabulated qualitatively, and frequency counts were made of responses. These results show that the region of the face that is most disturbing is the mouth; however, early in the time course of paralysis, the eye is most disturbing. Synkinesis above the eye is ultimately more disturbing than paresis in that region, and it may worsen. Major psychosocial impacts of paralysis appear common and underestimated. These pilot data qualitatively support the hypotheses.
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PMID:Defining functional limitation, disability, and societal limitations in patients with facial paresis: initial pilot questionnaire. 872 73

The objective of this paper is to assess synkinesis associated with post paretic voluntary facial movements using the objective OSCAR method and to investigate the correlation between synkinesis and paresis to compare the objective results with the subjective scaling systems of Fisch and House-Brackmann. The development of an objective assessment of synkinesis with the OSCAR method is focused on the clinically most relevant eye-mouth and forehead-mouth synkinetic movements. Thirteen patients with unilateral facial paralysis and synkinesis of the University Hospital Zurich were examined. Two types of clinically relevant facial synkinesis were found: a maximal synkinesis and a relative synkinesis. Neither Synkinesis-Index correlates well with the underlying degree of global facial palsy. The relative Synkinesis-Index (rSI) correlates well with the subjective evaluation of synkinesis according to the Fisch Grading, but shows a poor correlation with the traditional House-Brackmann grading. Therefore a single scaling index combining the degree of facial nerve palsy and synkinesis is inappropriate and we propose the use of two independent scaling systems for the evaluation of facial palsy: one for the voluntary facial movements, the other for the involuntary synkinetic movements. The adequate evaluation of the post paretic face should include the results of both scaling systems.
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PMID:Objective assessment of the reliability of the House-Brackmann and Fisch grading of synkinesis. 2903 19

Synkinetic movements are common among patients with incomplete recovery from facial palsy, with reported rates ranging from 9.1% to almost 100%. The authors propose the separation of the neural stimulus of the orbicularis oculi from that of the zygomatic muscular complex to treat eyelid closure/smiling synkinesis. This technique, associated with an anastomosis between the masseteric nerve and a central branch of the facial nerve, as well as with the use of a cross-facial nerve graft, resolves most of the spasms of the midface musculature, leading to a more relaxed tone when the mimic muscle is at rest and enhancing muscle excursion during voluntary and spontaneous smiling. Between 2011 and 2016, 18 patients affected by segmental paresis of the middle of the face underwent surgical treatment at the Maxillofacial Surgery Department of the San Paolo Hospital (Milan, Italy). Of these patients, 72.22% of cases with hypertone obtained partial to complete relaxation. Synkinesis was completely resolved in 83.33% of cases, and a significant improvement in facial movement was achieved in all patients. Neurorrhaphy of the masseteric nerve and the central branch of the facial nerve appears to produce favorable results. These initial data should be confirmed by further studies.
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PMID:Surgical treatment of synkinesis between smiling and eyelid closure. 2903 8