Facial synkinesis: A distressing sequela of facial palsy

2021 ◽  
pp. 014556132110546
Author(s):  
Tom Shokri ◽  
Shivam Patel ◽  
Kasra Ziai ◽  
Jonathan Harounian ◽  
Jessyka G Lighthall
Keyword(s):  
Quality Of Life ◽  
Botulinum Toxin ◽  
Multidisciplinary Approach ◽  
Comprehensive Treatment ◽  
Nerve Grafting ◽  
Muscle Transfer ◽  
Facial Movements ◽  
Optimal Outcomes ◽  
Facial Synkinesis

Introduction Synkinesis refers to abnormal involuntary facial movements that accompany volitional facial movements. Despite a 55% incidence of synkinesis reported in patients with enduring facial paralysis, there is still a lack of complete understanding of this debilitating condition, leading to functional limitations and decreased quality of life. 1 This article reviews the diagnostic assessment, etiology, pathophysiology, rehabilitation, and nonsurgical and surgical treatments for facial synkinesis. Methods A PubMed and Cochrane search was done with no date restrictions for English-language literature on facial synkinesis. The search terms used were “facial,” “synkinesis,” “palsy,” and various combinations of the terms. Results The resultant inability to control the full extent of one’s facial movements has functional and psychosocial consequences and may result in social withdrawal with a significant decrease in quality of life. An understanding of facial mimetic musculature is imperative in guiding appropriate intervention. While chemodenervation with botulinum toxin and neurorehabilitation have continued to be the primary treatment strategy for facial synkinesis, novel techniques such as selective myectomy, selective neurolysis, free-functioning muscle transfer, and nerve grafting techniques are becoming increasingly utilized in treatment regimens. Facial rehabilitation, including neuromuscular retraining, soft tissue massage, and relaxation therapy in addition to chemodenervation with botulinum toxin, remains the cornerstone of treatment. In cases of severe, intractable synkinesis and non-flaccid facial paralysis, surgical interventions, including selective neurectomy, selective myectomy, nerve grafting, or free muscle transfer, may play a more significant role in alleviating symptoms. Discussion A multidisciplinary approach involving therapists, clinicians, and surgeons is necessary to develop a comprehensive treatment regimen that will result in optimal outcomes. Ultimately, therapy should be tailored to the severity and pattern of synkinesis, and each patient approached on a case-by-case basis. A multidisciplinary approach involving therapists, clinicians, and surgeons is necessary to develop a comprehensive treatment regimen that will result in optimal outcomes.

scholarly journals Obvious Reduction of the Tumor Size in Dedifferentiated Liposarcoma in a Lung Metastasis Patient Receiving Individualized Treatment

2021 ◽  
pp. 1080-1084
Author(s):  
Xin-Li Wang ◽  
Jia-Yao Gong ◽  
Yan Xue
Keyword(s):  
Quality Of Life ◽  
Therapeutic Effect ◽  
Tumor Size ◽  
Systemic Treatment ◽  
Treatment Method ◽  
Palliative Surgery ◽  
Dedifferentiated Liposarcoma ◽  
Comprehensive Treatment ◽  
Back Surgery

Abdominal metastasis is relatively rare in dedifferentiated liposarcoma of the shoulder and back. Surgery is the best treatment option, whether it is radical or palliative surgery. Chemotherapy is the standard systemic treatment for advanced unresectable/metastatic patients, but the therapeutic effect is limited. Here, we treat advanced abdominal dedifferentiated liposarcoma through a comprehensive treatment method of targeting, surgery, and chemotherapy, which improves the quality of life of the patient, and shrinks the tumor significantly.

scholarly journals Personalized, Predictive, Participatory, Precision, and Preventive (P5) Medicine in Rotator Cuff Tears

2021 ◽  
Vol 11 (4) ◽  
pp. 255
Author(s):  
Umile Giuseppe Longo ◽  
Arianna Carnevale ◽  
Carlo Massaroni ◽  
Daniela Lo Presti ◽  
Alessandra Berton ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Rotator Cuff ◽  
Environmental Factors ◽  
Multidisciplinary Approach ◽  
Musculoskeletal Disorder ◽  
Scientific Evidence ◽  
Rotator Cuff Tears ◽  
Diagnosis And Therapy

Rotator cuff (RC) disease is a common musculoskeletal disorder of the shoulder entailing pain, with reduced functionality and quality of life. The main objective of this study was to present a perspective of the current scientific evidence about personalized, predictive, participatory, precision, and preventive approaches in the management of RC diseases. The personalized, predictive, participatory, precision and preventive (P5) medicine model is an interdisciplinary and multidisciplinary approach that will provide researchers and clinicians with a comprehensive patrimony of knowledge in the management of RC diseases. The ability to define genetic predispositions in conjunction with the evaluation of lifestyle and environmental factors may boost the tailoring of diagnosis and therapy in patients suffering from RC diseases.

scholarly journals Integrated multidisciplinary diagnostic approach for dementia care: Randomised controlled trial

2008 ◽  
Vol 192 (4) ◽  
pp. 300-305 ◽  
Author(s):  
Claire A. G. Wolfs ◽  
Alfons Kessels ◽  
Carmen D. Dirksen ◽  
Johan L. Severens ◽  
F. R. J. Verhey
Keyword(s):  
Quality Of Life ◽  
Multidisciplinary Approach ◽  
Intervention Group ◽  
Dementia Care ◽  
Clinical Effects ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related

BackgroundAn integrated multidisciplinary approach to dementia is often recommended but has rarely been evaluated.AimsTo evaluate the clinical effects of an integrated multidisciplinary diagnostic facility for psychogeriatric patients.MethodPatients suspected of having complex psychogeriatric problems were randomly allocated to the intervention (n=137) or to treatment as usual (n=93). They were assessed at baseline, and at 6 months and 12 months follow-up by means of personal interviews with the patient's proxy. The primary outcome was health-related quality of life, assessed using the visual analogue scale (VAS) of the EuroQd measure, EQ-5D.ResultsHealth-related quality of life had improved at 6 months in the intervention group, whereas that of the control group had decreased. Furthermore, more patients in the intervention group experienced a clinically relevant improvement of 10 points or more on the VAS at both follow-up measurements.ConclusionsAn integrated multidisciplinary approach improves dementia care.

Behandeling van spasticiteit met enkele overwegingen naar sport toe

2021 ◽  
Author(s):  
K. DECLERCK ◽  
F. HEISTERCAMP ◽  
K. SLABBYNCK ◽  
A. BOSMANS
Keyword(s):  
Quality Of Life ◽  
Central Nervous System ◽  
Nervous System ◽  
Multidisciplinary Approach ◽  
Healthy Lifestyle ◽  
Crucial Aspect ◽  
Limited Function ◽  
Sporting Activities ◽  
Interventional Therapies

Treatment of spasticity with some considerations regarding sport Spasticity is a possible side effect in patients with a central nervous system pathology and it affects more than 12 million people worldwide. Spasticity can have an important impact on the quality of life and sporting activities. Spasticity only needs to be treated if there is spasticity associated pain and/or (expected) limited function. Primarily triggering factors of spasticity must be treated. A multidisciplinary approach containing a combination of medication and physical therapy is recommended in the treatment of spasticity. If this approach remains insufficient, interventional therapies can be taken into consideration, although they should always be combined with rehabilitation to reduce (the) spastic tone/spasticity. Sports and exercising should not be merely seen in the context of therapy and/or rehabilitation but also as a crucial aspect of a healthy lifestyle, in particular for people ‘at risk’ for inactivity. Therefore, it is important to fill the gap between rehabilitation and sustainable sports practice for the rehabilitator.

scholarly journals Quality of life in individuals with cervical dystonia before botulinum toxin injection in a Brazilian tertiary care hospital

2011 ◽  
Vol 69 (6) ◽  
pp. 900-904 ◽  
Author(s):  
Mariana Ribeiro Queiroz ◽  
Hsin Fen Chien ◽  
Egberto Reis Barbosa
Keyword(s):  
Quality Of Life ◽  
Botulinum Toxin ◽  
Cervical Dystonia ◽  
Rating Scale ◽  
Short Form ◽  
Tertiary Care ◽  
Residual Effect ◽  
Care Hospital ◽  
Sf 36

OBJECTIVE: The purpose of this study was to evaluate quality of life (QoL) in a Brazilian population of individuals with cervical dystonia (CD) without effect of botulinum toxin (BTx) or with only residual effect of BTx, and identify possible physical and social aspects that affect their QoL. METHOD: Sixty five out of sixty seven consecutive patients with CD were assessed with two instruments: Short-form Health Survey with 36 questions (SF-36) and Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS). RESULTS: Severity of CD (TWSTRS) correlated moderately with two SF-36 subscale: role-physical (r= -0.42) and body pain (r= -0.43). Women also scored worse in two subscale of SF-36: vitality (p<0.05) and mental-health (p<0.005). CONCLUSION: Severity of CD and gender (female) were the main factors related to a worse QoL perception. These findings may help health professionals to predict which characteristics could lead to worse QoL, and therefore, better target their interventions to lessen the burden caused by CD.

scholarly journals Advances in the Management of Neurogenic Detrusor Overactivity in Multiple Sclerosis

2013 ◽  
Vol 15 (2) ◽  
pp. 66-72 ◽  
Author(s):  
Gael J. Yonnet ◽  
Anette S. Fjeldstad ◽  
Noel G. Carlson ◽  
John W. Rose
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Botulinum Toxin ◽  
Urinary Tract ◽  
Detrusor Overactivity ◽  
Anticholinergic Drugs ◽  
Neurogenic Detrusor Overactivity ◽  
Botulinum Toxin Therapy ◽  
Tract Infections

Bladder dysfunction in multiple sclerosis (MS) can be socially disabling, have negative psychological and economic consequences, and impair patients' quality of life. Knowledge of the functional anatomy and physiology of the urinary tract is essential to understand the symptoms associated with central nervous system lesions and the pharmacotherapies used to treat them. Treatments for neurogenic detrusor overactivity (NDO) have consisted mainly of administration of anticholinergic drugs, which have been shown to provide suboptimal clinical benefits and be poorly tolerated. The US Food and Drug Administration (FDA) approval of intravesicular botulinum toxin therapy provides a second-line option for MS patients with NDO not responsive to anticholinergic drugs. We performed a review of key literature pertaining to the intravesicular application of botulinum toxin. In the management of NDO, administration of intravesicular botulinum toxin using clean intermittent catheterization decreases the incidence of urinary tract infections, promotes urinary continence, and improves quality of life for 9 months after a single injection; moreover, those benefits are maintained with repeated injections over time.

scholarly journals Restoration of oral health as one of the important factors improving the quality of life

2021 ◽  
Vol 105 (1) ◽  
pp. 78-81
Author(s):  
N. Zhachko ◽  
◽  
T. Nespriad’ko-Monborgne ◽  
I. Skrypnyk ◽  
M. Zhachko ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Oral Health ◽  
Periodontal Disease ◽  
Dental Health ◽  
Adult Population ◽  
Communication Process ◽  
Complete Analysis ◽  
Comprehensive Treatment ◽  
The Impact

Summary: The search for and development of methods for determining the quality of life is an urgent problem of foreign and domestic medicine, and the state of dental health plays a very important role. An important role in human communication plays the maxillofacial area. Therefore, the most important areas and defects associated with the communication process – defects in the frontal area, smile, change of pronunciation, spitting during the conversation – all these signs accompany a number of anomalous processes. Objective: to assess the impact of dental status on the quality of life of the adult population in the presence of the disease periodontal disease in combination with musculoskeletal dysfunction in patients with dental anomalies and deformities. Materials and methods. To study this goal, a survey of 283 patients who applied was conducte with complaints of aesthetic defect of the dentition, combined with the presence of joint pain and periodontal disease of varying severity. Results. A complete analysis of factors that significantly affected the quality of life of patients with a number of diseases was obtained oral cavity. Conclusions. Deficiencies related to oral health reduce the quality of life of our patients, and the treatment significantly changes its quality depending on age, sex and method. But for the best results positive changes in the quality of life of the patient dentists can expect only by conducting a comprehensive treatment. Key words: quality of life, dental health correction.

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