scholarly journals Incidence and characteristics of Lyme neuroborreliosis in adult patients with facial palsy in an endemic area in the Netherlands

2019 ◽  
Vol 147 ◽  
Author(s):  
S.M. Bierman ◽  
B. van Kooten ◽  
Y.M. Vermeeren ◽  
T.D. Bruintjes ◽  
B.C. van Hees ◽  
...  
Keyword(s):  
Facial Palsy ◽  
Endemic Area ◽  
Erythema Migrans ◽  
Patient Characteristics ◽  
Lyme Neuroborreliosis ◽  
Adult Patients ◽  
Tick Bite ◽  
Adequate Treatment ◽  
Study Objective ◽  
Idiopathic Facial Palsy

AbstractMaking a distinction between facial palsy due to Lyme neuroborreliosis (LNB) and idiopathic facial palsy (IFP) is of importance to ensure timely and adequate treatment. The study objective was to assess incidence and patient characteristics of facial palsy due to LNB. Hospital records were reviewed of adult patients with facial palsy visiting the departments of neurology and/or otorhinolaryngology of Gelre hospitals between June 2007 and December 2017. Gelre hospitals are located in an area endemic for Lyme borreliosis. Patients with LNB had pleocytosis and intrathecal antibody production or pleocytosis with positive IgG serology. Patients with IFP had negative serology. Clinical characteristics were compared between patients with LNB and patients with IFP. Five hundred and fifty-nine patients presented with facial palsy, 4.7% (26) had LNB and 39.4% (220) IFP. The incidence of facial palsy due to LNB was 0.9/100 000 inhabitants/year. Over 70% of patients with facial palsy due to LNB did not report a recent tick bite and/or erythema migrans (EM). Patients with facial palsy due to LNB presented more often in July to September (69.2% vs. 21.9%, P < 0.001), and had more often headache (42.3% vs. 15.5%, P < 0.01). To reduce the risk of underdiagnosing LNB in an endemic area, we recommend testing for LNB in patients with facial palsy in summer months especially when presenting with headache, irrespective of a recent tick bite and/or EM.

Peripheral facial palsy as an initial symptom of Lyme neuroborreliosis in an Austrian endemic area

2015 ◽  
Vol 128 (21-22) ◽  
pp. 837-840 ◽  
Author(s):  
Wolfgang Kindler ◽  
Hubert Wolf ◽  
Katrin Thier ◽  
Stefan Oberndorfer
Keyword(s):  
Facial Palsy ◽  
Endemic Area ◽  
Lyme Neuroborreliosis ◽  
Initial Symptom ◽  
Peripheral Facial Palsy

Lyme neuroborreliosis: aetiology and diagnosis of facial palsy in children from Tyrol

2013 ◽  
Vol 44 (02) ◽  
Author(s):  
J Brunner ◽  
RW Reinhard ◽  
LB Zimmerhackl
Keyword(s):  
Facial Palsy ◽  
Lyme Neuroborreliosis

Triage Ability of Emergency Medical Services Providers and Patient Disposition: A Prospective Study

1999 ◽  
Vol 14 (3) ◽  
pp. 67-72 ◽  
Author(s):  
John R. Richards ◽  
Stephen J. Ferrall
Keyword(s):  
Chest Pain ◽  
Emergency Medical Services ◽  
Patient Characteristics ◽  
University Hospital ◽  
Medical Services ◽  
Shortness Of Breath ◽  
Study Objective ◽  
Patient Disposition ◽  
Emergency Medical ◽  
Respiratory Complaints

AbstractStudy objective:To determine the ability of emergency medical services (EMS) providers to subjectively triage patients with respect to hospital admission and to determine patient characteristics associated with increased likelihood of admission.Methods:A prospective, cross-sectional study of a consecutive sample of patients arriving by ambulance during the month of February 1997 at an urban, university hospital, Emergency Department. Emergency medical services providers completed a questionnaire asking them to predict admission to the hospital and requested patient demographic information. Predictions were compared to actual patient disposition.Results:A total of 887 patients were included in the study, and 315 were admitted to the hospital (36%). With respect to admission, emergency medical services providers had an accuracy rate of 79%, with a sensitivity of 72% and specificity of 83% (kappa = 0.56). Blunt traumatic injury and altered mental status were the most common medical reasons for admission. Variables significantly associated with high admission rates were patients with age > 50 years, chest pain or cardiac complaints, shortness of breath or respiratory complaints, Medicare insurance, and Hispanic ethnicity. The emergency medical services providers most accurately predicted admission for patients presenting with labor (kappa = 1.0), shortness of breath / respiratory complaints (kappa = 0.84), and chest pain (kappa = 0.77).Conclusion:Emergency medical services providers can predict final patient disposition with reasonable accuracy, especially for patients presenting with labor, shortness of breath, or chest pain. Certain patient characteristics are associated with a higher rate of actual admission.

scholarly journals A Three-Generation Family with Idiopathic Facial Palsy Suggesting an Autosomal Dominant Inheritance with High Penetrance

2015 ◽  
Vol 2015 ◽  
pp. 1-3
Author(s):  
Christian Grønhøj Larsen ◽  
Mette Gyldenløve ◽  
Aia Elise Jønch ◽  
Birgitte Charabi ◽  
Zeynep Tümer
Keyword(s):  
Facial Palsy ◽  
Autosomal Dominant ◽  
Case Series ◽  
Neurologic Disorder ◽  
Complete Penetrance ◽  
Generation Family ◽  
Number Variation ◽  
Microarray Studies ◽  
Idiopathic Facial Palsy ◽  
Chromosome Microarray

Idiopathic facial palsy (IFP), also known as Bell’s palsy, is a common neurologic disorder, but recurrent and familial forms are rare. This case series presents a three-generation family with idiopathic facial palsy. The mode of inheritance of IFP has previously been suggested as autosomal dominant with low or variable penetrance, but the present family indicates an autosomal dominant trait with high or complete penetrance. Chromosome microarray studies did not reveal a pathogenic copy number variation, which could enable identification of a candidate gene.

Recurrent bilateral peripheral facial palsy

1989 ◽  
Vol 103 (1) ◽  
pp. 117-119 ◽  
Author(s):  
N. Stahl ◽  
T. Ferit
Keyword(s):  
Facial Nerve ◽  
Facial Palsy ◽  
Common Finding ◽  
Facial Nerve Paralysis ◽  
Nerve Paralysis ◽  
Peripheral Facial Palsy ◽  
Local Disease ◽  
Idiopathic Facial Palsy

AbstractFacial nerve paralysis is a common otolaryngological diagnosis. Recurrent unilateral peripheral facial palsy is found in about 7 per cent of the cases. Simultaneous bilateral facial palsy is relatively uncommon and occurs in 0.3–2.0 per cent of cases of facial palsy. Recurrent. simultaneous, bilateral, idiopathic facial palsy to the best of our knowledge has never been reported. A case of recurrent, simultaneous, bilateral, idiopathic facial palsy is presented. No evidence of systemic or local disease was found in both attacks of peripheral facial palsies. The association with states of stress is the only common finding between the two attacks.

MRI of the facial nerve in idiopathic facial palsy

1996 ◽  
Vol 6 (5) ◽  
pp. 631-636 ◽  
Author(s):  
I. Saatçi ◽  
F. Şahintürk ◽  
L. Sennaroğlu ◽  
F. Boyvat ◽  
B. Gürsel ◽  
...  
Keyword(s):  
Facial Nerve ◽  
Facial Palsy ◽  
Idiopathic Facial Palsy

Idiopathic facial palsy and physical therapy: an intervention proposal following a review of practice

2011 ◽  
Vol 16 (4) ◽  
pp. 237-243 ◽  
Author(s):  
Margarida Ferreira ◽  
Paula Clara Santos ◽  
José Duarte
Keyword(s):  
Physical Therapy ◽  
Facial Palsy ◽  
Idiopathic Facial Palsy

scholarly journals EPID-21. THE NATIONAL SPECTRUM OF NEWLY-DIAGNOSED BRAIN TUMORS IN ADULT PATIENTS VARIES SIGNIFICANTLY BY PATIENT DEMOGRAPHICS

2019 ◽  
Vol 21 (Supplement_6) ◽  
pp. vi79-vi79
Author(s):  
Matthew Torre ◽  
Mustafa Ascha ◽  
Maya Harary ◽  
Timothy Smith ◽  
Ayal Aizer ◽  
...  
Keyword(s):  
Brain Tumors ◽  
Patient Characteristics ◽  
Intracranial Tumor ◽  
Adult Patients ◽  
Intracranial Tumors ◽  
Newly Diagnosed ◽  
Patient Demographics ◽  
Common Diagnosis ◽  
History Of ◽  
Tumor Types

Abstract INTRODUCTION Herein we examine the epidemiology and outcomes of the entire spectrum of intracranial tumors in the contemporary era. METHODS Adult patients (≥20yo) presenting between 2010–2015 where the first evidence of cancer involves an intracranial tumor were queried from the National Cancer Database, which comprises >70% of cancers newly-diagnosed in the U.S. Tumor types were classified by WHO2016 ICD-O3, and stratified by patient characteristics. RESULTS 361,841 adults without a history of cancer presented with intracranial tumors between 2010–2015. Across all ages, these were comprised of 1) brain metastases (BMs; 25%: 29% in males vs. 23% in females); 2) meningiomas (25%: 15% in males, but 34% in females) including atypical (n=4,565) and anaplastic (n=833); 3) diffuse infiltrative gliomas (21%: 26% in males vs. 17% in females), mostly GBMs (14%); followed by 4) sellar (14%), 5) cranial nerve (6%), and PCNSL (3%) tumors. The remaining types each comprised ≤2 % of brain tumors, including mesenchymal non-meningothelial tumors (2%), intracranial ependymal (0.8%), mixed neuronal-glial (0.7%), circumscribed “other astrocytomas” (0.6%, mostly pilocytic astrocytomas n=1,307 and PXAs n=272), CNS embryonal (0.3%), pineal (0.2%), GCTs (0.1%), and choroid plexus (0.1%) tumors. In the 91,686 patients presenting with a BM, the most common primaries were lung adenocarcinoma (39%), lung SmallCC (14%), lung SqCC (8%), breast (8% of females), melanoma (3%), kidney (3%), colorectal (2%), and esophageal (1%). The distributions of brain tumor types differed significantly by age, sex, race/ethnicity, and insurance status. CONCLUSIONS In adult patients where the first manifestation of cancer includes an intracranial tumor, the most common diagnosis is either metastatic disease (predominantly from NSCLC) in males or benign meningiomas in females; but varies substantially by age group. Notably, our results adjust the traditional teaching that half of all new brain masses are BMs, which in fact represent only ~25% of new intracranial masses.

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