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 11,717 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Forty-four cases of meningococcal meningitis in children at one hospital between 1971 and 1975 inclusive were studied to document the course and complications of this disease in children in the current therapeutic era. The mortality was 5%. Of the 41 survivors 76% were healthy 1 to 5 years after the episode of meningitis. Permanent severe sequelae (facial palsy, optic atrophy and ptosis) were seen in three (7%) of the survivors, and mild hearing loss, hyperactivity and nervousness were noted in seven (17%). Electroencephalography was not useful in determining management or prognosis. Both the mortality and the frequency of early and late complications among the survivors were lower than those reported from earlier studies.
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PMID:Meningococcal meningitis in children. 76 Nov 43

Three cases (case 1, female, aged 30; case 2, male, aged 32; case 3, male, aged 34) of benign brainstem encephalopathy with truncal ataxia were reported. Two patients had prodromal symptoms Neurological examination revealed truncal ataxia in all cases. As additional neurological signs, anisocoria, mydriasis, nystagmus, ptosis, transient opsoclonus, and facial palsy were seen. There was neither drowsiness nor myoclonus in the three cases. On laboratory examinations, cold agglutination test revealed significant elevation in two cases. The examination of cerebrospinal fluid showed a moderate rise of proteins in one case, but did not revealed pleocytosis in any of the cases. Magnetic resonance imaging of one patient revealed an area of high intensity in the left pontine tegmentum by T2-weighed imaging. The prognosis for all these cases was good, and the reappearance of neurological signs was not present until now. Our cases were different from brainstem encephalitis (Bickerstaff's encephalitis) because of an absence of disturbed consciousness and no pleocytosis in the cerebrospinal fluid. Our cases were also different from "myoclonus-opsoclonus syndrome" because of an absence of myoclonus. We discussed a possibility of a new clinical syndrome which we call "benign brainstem encephalopathy with truncal ataxia".
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PMID:[Benign brainstem encephalopathy with truncal ataxia--a clinical study of 3 cases]. 128 89

Associated movements after facial paralysis (synkinesis), due to unphysiological co-innervation of the facial muscles, often complicates the rehabilitation of patients following facial palsy. Clostridium botulinum toxin is a neurotoxin that interferes with the release of acetylcholine from motor nerve end plates, causing skeletal muscular paralysis. This paper concentrates on its clinical use in treating synkinesis affecting orbicularis oculi function and documents the results of treatment in 4 patients. Control of synkinesis, achieved in all 4 patients, was effective within a few days and lasted for 4-6 months. 2 patients developed transient diplopia and ptosis shortly after injection. However, no lasting complications or systemic side-effects were noted. All patients reported a significant improvement in their symptoms and reinjection at 7 months was carried out successfully.
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PMID:Management of facial synkinesis with Clostridium botulinum toxin injection. 150 88

Blepharospasm is a relatively frequent cranial dystonia which may be seen either alone or related to orofacial-mandibular dystonia (Meige's syndrome). In its maximum degree it can cause functional blindness.Twelve patients with blepharospasm (4 essential and 8 Meige's syndrome) who had been previously treated unsuccessfully with drugs (trihexyphenidyl, biperiden, carbamazepine, lithium, baclofen, lisuride, imipramine, clonazepam and butyrophenones) were treated for 12 months with periocular injections of botulinum toxin (BOTOX). A "low" dose of 12,5 U per eye was employed. With this dose, eleven out of twelve patients experienced significant improvement which lasted from five to fifteen weeks. The only nonresponder obtained complete relief upon duplicating the dose. The only side effect was uni or bilateral ptosis in six patients which improved completely in seven to twenty one days. One patient developed a peripheral facial palsy with complete remission in nineteen days. No systemic side effects were noted. There was only one desertion from this study due to depression enhanced by prolonged (21 days) ptosis. All patients (including the deserter) agreed that treatment with BOTOX provided more relief than any other previous therapeutic method. Our results confirm those obtained by others but a more prolonged study is needed to better evaluate long term effects.
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PMID:[Treatment of blepharospasm with botulinum toxin]. 210 46

Primary objective of multidirectional tractions of the facial muscles for protracted facial paralysis is to restore the facial symmetry. The facial suspension by multiple fascial strips in conjunction with other complemental minor surgical procedures realizes these complex tractions. Deformities requiring surgical procedures, regionally classified, are indicated for surgery as follows: 1) drooping of the eyebrow and upper eyelid, and loss of frontal creases, 2) lagophthalmos and ptosis of the lower eyelid, and 3) drooping of the cheeks and lips, and loss of the nasolabial fold. The multifascial suspension is a valuable adjunct to facial nerve surgery. It is capable of alleviating facial asymmetry due to paralysis and suppresses abnormal associated movements subsequent to surgical repair of facial nerves.
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PMID:Multiple facial suspensions in protracted facial palsy. 344 37

A 21-year old women taking oral contraceptives suffered thromboembolic stroke associated with mitral valve prolapse. She had been using an unspecified oral contraceptive for 3 months postpartum, and had smoked a pack a day for 5 years. She complained of sudden right orbital headache, left-sided weakness and pain. Clinical exam showed left sided anopsia, facial paralysis, tongue protrusion, parietal sensory deficit, and loss of position sense. Computed tomography suggested a lesion near the right middle cerebral artery; and cerebral angiography revealed an 8 x 2 mm filling defect in that artery. A midsystolic click without a murmur was evident in the cardiac exam. Thickened, redundant mitral valve leaflets with marked prolapse, and a mass on the atrial side of the posterior leaflet appeared on the echocardiogram. The atrial thrombus was considered the source of the apparent embolism in the cerebral artery. Oral contraceptives have been found to increase the risk of thrombotic stroke and venous thromboembolism. Therefore, women with known mitral valve prolapse or leaflets may be advised not to use the pill.
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PMID:Embolic stroke in a woman with mitral valve prolapse who used oral contraceptives. 374 65

A patient who presented with posttraumatic ptosis of the right upper eyelid proved to be a case of unilateral blepharospasm with facial palsy of the forehead. He was successfully treated with selective facial neurectomy.
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PMID:Posttraumatic unilateral blepharospasm treated by selective facial neurectomy. 401 62

A very simple procedure, requiring about twenty minutes, accomplishes moderate elevation and support of the eyebrows. It may be utilized for eyebrow ptosis alone, whether unilateral or bilateral; in conjunction with meloplasty and blepharoplasty; for equalizing asymmetrical eyebrows, and for further support of markedly ptotic upper lids. It has been used by the author in instances of partial and complete facial paralysis in conjunction with other procedures about the face to accomplish better symmetry. The duration of results with this procedure varies with tissue quality and healing, surgical technique, care given the area during healing by the patient, amount of frowning and vigorous facial muscle use by the patient, and aging. It is a useful adjunct, especially when used for moderate or subtle brow lifts.
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PMID:A method of direct eyebrow lift. 634 May 86

Essential blepharospasm is an idiopathic, progressively debilitating disease leading to blindness. Years of forceful spasms result in brow ptosis, dermatochalasis, and, frequently, levator aponeurosis and lateral canthal tendon defects. Following standard neurectomy procedures, the facies droop, brow ptosis and dermatochalasis worsen, and ptosis and canthal tendon laxity suddenly become more evident. We describe a procedure involving meticulous extirpation of all accessible orbicularis oculi, procerus, corrugator superciliaris, and facial nerves in postorbicular fascia. This extirpation of eyelid protractors is combined with browplasty with fixation to frontalis and reinforcement of the levator aponeurosis to strengthen the retractors. Our technique opens the eye just as effectively as standard facial neurectomy procedures, simultaneously corrects associated anatomical deformities, and avoids facial paralysis. Gratifying results were obtained in 15 patients followed up for six to 38 months.
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PMID:Blepharospasm surgery. An anatomical approach. 723 3

Leprous facial paralysis appears more frequent in Iran than in other countries. The damaged branch is more often the upper one inducing lagophtalmos and, sometimes, associated with a trigeminal anesthesia. The ocular risk is great. When the lower branch is struck down, it gives an inesthetic deformity and speaking difficulty. As a consequence, surgical treatment is necessary and directed: --against lagophtalmos, with static or dynamic methods, --against the ptosis of commissura labiorum with several techniques available.
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PMID:[Surgical treatment of leprous facial paralysis in Iran (author's transl)]. 738 93


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