INCIDENCE OF CRANIAL NERVE PARALYSIS IN POLIOMYELITIS IN RELATION TO PRESENCE OR ABSENCE OF TONSILS

PEDIATRICS ◽  
1958 ◽  
Vol 21 (1) ◽  
pp. 94-105
Author(s):  
F. H. Top
Keyword(s):  
Facial Nerve ◽  
Cranial Nerves ◽  
Age Group ◽  
Real Difference ◽  
Satisfactory Explanation ◽  
Nerve Paralysis ◽  
Cranial Nerve Paralysis ◽  
Significant Difference ◽  
The Central Nervous System ◽  
The Common

Evidence is presented from data covering the period 1940 to 1952 which corroborates the conclusion of previous studies that prior tonsillectomy probably adversely affects the occurrence of brainstem paralysis (bulbar and bulbospinal) in poliomyelitis. Neither this study nor any preceding studies relating to this problem have proved the contention. On the basis that the hypothesis is correct, an attempt is made to find an answer by studying the incidence of the common paralysis of cranial nerves (VII, IX and X and XI) in bulbar and bulbospinal cases of poliomyelitis on the basis of presence or absence of tonsils. Rates of incidence of paralysis of cranial nerves, not adjusted for age, indicate a decidedly higher proportion of paralysis of the facial nerve (VII) among nontonsillectomized patients whereas tonsillectomized persons are preportionately more affected by palatal and pharyngeal paralysis (nerves IX and X). Paralysis of the facial nerve appears from two studies to occur more commonly at earlier ages, particularly in the age group 0 to 4 years. However, age adjustment did not erase, although it did somewhat lower, the TR/TP ratio. This finding lends credence to a real difference but can only be applied to this study, as Paffenbarger in a smaller study found no significant difference in frequencies of paralysis of the facial nerve between groups with tonsils removed and tonsils present, and Southcott, also in a small study, found paralysis of the facial nerve more common among tonsillectomized patients with bulbar (includes bulbospinal) involvement. The differences noted for palatal and pharyngeal paralyses (nerves IX and X) in the unadjusted rates as between tonsillectomized and nontonsillectomized patients remain statistically different and in some instances significant when corrections for age are made. The results of this study are suggestive but give no entirely satisfactory explanation for the differences noted. Various explanations previously offered are cited and briefly discussed. Perhaps more definitive studies in animals along the approach suggested by Southcott will prove more fruitful, namely, labelling virus by some radioactive element in order to trace the route it takes to the central nervous system.

INCIDENCE OF CRANIAL NERVE PARALYSIS IN POLIOMYELITIS IN RELATION TO PRESENCE OR ABSENCE OF TONSILS

PEDIATRICS ◽  
1958 ◽  
Vol 21 (1) ◽  
pp. 106-111
Author(s):  
F. H. Top
Keyword(s):  
Facial Nerve ◽  
Rural Area ◽  
Cranial Nerve ◽  
Cranial Nerves ◽  
Nerve Paralysis ◽  
Cranial Nerve Paralysis ◽  
Clinical Type ◽  
Composite Study

A study of patients from a largely rural area in Iowa corroborates the evidence of many previous studies that bulbar and bulbospinal types of poliomyelitis occur more commonly in persons whose tonsils have been removed irrespective of the time in life the operation was performed. The tonsillectomy rate for all cases was the lowest encountered thus far. Agreement is not on the same level as noted in the author's Detroit composite study previously reported, and is more marked for bulbospinal than for the bulbar type of poliomyelitis (some studies combine bulbar and bulbospinal cases). Adjustment for age reduces differences between cases with tonsils absent and tonsils present by clinical type and further strengthens the finding of Paffenbarger and of the author's Detroit composite study that age must be reckoned with in an assessment of the problem. Incidence of paralyses of cranial nerves by tonsillectomy status is similar to the Detroit composite study in the case of palatal and pharyngeal paralyses but less strongly; incidence of paralysis of the facial nerve is dissimilar.

scholarly journals Unusual Clinical Presentation of Ethylene Glycol Poisoning: Unilateral Facial Nerve Paralysis

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Eray Eroglu ◽  
Ismail Kocyigit ◽  
Sami Bahcebasi ◽  
Aydin Unal ◽  
Murat Hayri Sipahioglu ◽  
...  
Keyword(s):  
Renal Failure ◽  
Ethylene Glycol ◽  
Facial Nerve ◽  
Cranial Nerves ◽  
Delayed Diagnosis ◽  
Facial Nerve Paralysis ◽  
Nerve Paralysis ◽  
Mortality And Morbidity ◽  
The Central Nervous System ◽  
End Stage

Ethylene glycol (EG) may be consumed accidentally or intentionally, usually in the form of antifreeze products or as an ethanol substitute. EG is metabolized to toxic metabolites. These metabolites cause metabolic acidosis with increased anion gap, renal failure, oxaluria, damage to the central nervous system and cranial nerves, and cardiovascular instability. Early initiation of treatment can reduce the mortality and morbidity but different clinical presentations can cause delayed diagnosis and poor prognosis. Herein, we report a case with the atypical presentation of facial paralysis, hematuria, and kidney failure due to EG poisoning which progressed to end stage renal failure and permanent right peripheral facial nerve palsy.

scholarly journals Conservative versus Surgical Therapy in Managing Patients with Facial Nerve Palsy Due to the Temporal Bone Fracture

2019 ◽  
Vol 12 (1) ◽  
pp. 20-26 ◽  
Author(s):  
Ali Abbaszadeh-Kasbi ◽  
Ali Kouhi ◽  
Mohammad Taghi Khorsandi Ashtiani ◽  
MahtabRabbani Anari ◽  
AlirezaKarimi Yazdi ◽  
...  
Keyword(s):  
Facial Nerve ◽  
Surgical Therapy ◽  
Proper Time ◽  
P Value ◽  
Decompression Surgery ◽  
Facial Nerve Paralysis ◽  
Temporal Bone Fracture ◽  
Nerve Paralysis ◽  
Delayed Onset ◽  
Significant Difference

Facial nerve paralysis is classified into immediate or delayed-onset palsy, and affected patients should be treated through conservative or surgical therapy. Appropriate treatment is somewhat debated as well as proper time for performing surgery. This study aimed to assess treatment outcome between conservatively and surgically treated groups and to determine the appropriate time of surgery in selected patients for surgery. Twenty-four patients from April 2008 to July 2015 were included. Performing decompression surgery within the first 2 months following the trauma accompanies a better prognosis ( p-value < 0.05). Eleven patients were managed conservatively, and 4 of them demonstrated immediate onset and 7 indicated delayed onset. Nine patients obtained normal nerve function, one patient had partial palsy, and one of them had complete palsy. There was no significant difference in the rate of recovery between types of the treatment ( p-value > 0.05). Decompression surgery is recommended in the first 2 months after the trauma for immediate onset and also complete degeneration on electroneuronography.

scholarly journals Comparison of Anxiolytic Drugs of Diazepam and Zolpidem in Patients Undergoing Extraction

2020 ◽  
pp. 178-187
Author(s):  
Anupama Deepak ◽  
Dhanraj Ganapathy ◽  
Visalakshi Ramanathan
Keyword(s):  
Rating Scale ◽  
Extraction Procedure ◽  
Cross Sectional Study ◽  
Age Group ◽  
Cross Sectional ◽  
Significant Difference ◽  
Anxiolytic Drugs ◽  
The Central Nervous System ◽  
Hamilton Anxiety Rating Scale ◽  
Anxiety Levels

Anxiolytic drugs are a class of drugs that reduce the anxiety levels in the individuals by nonspecifically binding to the GABAα located throughout the central nervous system. The aim of this study was to compare the anxiolytic effects of diazepam and Zolpidem in patients undergoing extraction. This was a cross-sectional study conducted at a university setting, with a sample size of 100 patients, of the age group 25-45 years. 50 patients were administered with Tab. Diazepam and 50 patients with Tab. Zolpidem one hour before the surgical procedure. The Hamilton Anxiety Rating Scale (HAM-A Scale) was used to record the patient's anxiety levels before and during the extraction procedure. These data were then recorded in MS Excel Sheet and imported to SPSS for statistical analysis. From this study, it can be seen that most of the patients were females and mainly between the age group 25-35 years. Diazepam had significantly lesser post sedation anxiety levels in comparison with its post sedation levels than zolpidem with, a statistically significant difference (p<0.001). Therefore, it can be concluded that diazepam had better post sedation effects than zolpidem in patients undergoing extraction as patients presented with lesser severity in their anxiety levels.

Hypoglossal-Facial Nerve Anastomosis: A Meta-Analytic Study

2007 ◽  
Vol 116 (7) ◽  
pp. 542-549 ◽  
Author(s):  
Sertac Yetiser ◽  
Ugur Karapinar
Keyword(s):  
Facial Nerve ◽  
Meta Analysis ◽  
Statistical Significance ◽  
Cranial Nerves ◽  
Facial Nerve Paralysis ◽  
Nerve Function ◽  
Facial Nerve Function ◽  
Reliable Technique ◽  
Nerve Paralysis ◽  
Nerve Anastomosis

Objectives: A meta-analysis was conducted on the outcome of facial nerve function after hypoglossal-facial nerve anastomosis in humans. The roles of the timing of and the underlying cause for surgery, the type of the repair, and previous facial nerve function in the final result were analyzed. Methods: Articles were identified by means of a PubMed search using the key words “facial-hypoglossal anastomosis,” which yielded 109 articles. The data were pooled from existing literature written in English or French. Twenty-three articles were included in the study after we excluded those that were technical reports, those describing anastomosis to cranial nerves other than the hypoglossal, and those that were experimental animal studies. Articles that reported facial nerve function after surgery and timing of repair were included. Facial nerve function had to be reported according to the House-Brackmann scale. If there was more than 1 article by the same author(s), only the most recent article and those that did not overlap and that matched the above criteria were accepted. The main parameter of interest was the rate of functional recovery of the facial nerve after anastomosis. This parameter was compared among all groups with Pearson's X2 test in the SPSS program for Windows. Statistical significance was set at a p level of less than .05. Results: Analysis of the reports indicates that early repair, before 12 months, provides a better outcome. The severity of facial nerve paralysis does not have a negative effect on prognosis. Gunshot wounds and facial neuroma are the worst conditions for favorable facial nerve recovery after anastomosis. Transection of the hypoglossal nerve inevitably results in ipsilateral tongue paralysis and atrophy. Modification of the anastomosis technique seems to resolve this problem. Nevertheless, the effect of modified techniques on facial reanimation is still unclear, because the facial nerve function results were lacking in these reports. Conclusions: Hypoglossal-facial nerve anastomosis is an effective and reliable technique that gives consistent and satisfying results.

Facial reanimation with end-to-end hypoglossofacial anastomosis: 20 years’ experience

2009 ◽  
Vol 124 (1) ◽  
pp. 23-25 ◽  
Author(s):  
T Catli ◽  
Y A Bayazit ◽  
O Gokdogan ◽  
N Goksu
Keyword(s):  
Facial Nerve ◽  
Acoustic Neuroma ◽  
Cranial Nerves ◽  
Significant Difference ◽  
Facial Reanimation ◽  
Short And Long Term ◽  
End To End ◽  
Facial Function

AbstractObjective:This study aimed to evaluate retrospectively the results of experience with end-to-end anastomosis of cranial nerves VII and XII, performed due to transection of the facial nerve during acoustic neuroma removal.Methods:We assessed the facial reanimation results of 33 patients whose facial nerves had been transected during acoustic neuroma excision via a retrosigmoid approach, between 1985 and 2006, and who underwent end-to-end hypoglossofacial anastomosis. We compared the facial nerve functions of patients receiving short term (two to three years) and long term (more than three years) follow up, and we assessed any complications of the anastomosis.Results:A House–Brackmann grade III facial function was achieved in 46.2 and 86.4 per cent of the patients in the short and long term, respectively. House–Brackmann grade IV facial function was achieved in 53.8 and 13.6 per cent of the patients in the short and long term, respectively. There was a statistically significant difference between the facial recovery results, comparing the short and long term follow-up periods (p = 0.03). Disarticulation was the most common complication, seen in 19 (57.6 per cent) patients; numbness of the tongue was the next commonest (10 (30.3 per cent) patients). None of the patients developed dysphagia.Conclusion:Despite such morbidities as disarticulation and tongue numbness, end-to-end hypoglossofacial anastomosis is still an effective procedure for the surgical rehabilitation of static and dynamic facial nerve functions. Significant improvement in facial nerve function can occur more than three years post-operatively.

scholarly journals Comparison of normal facial nerve enhancement at 3T MRI using gadobutrol and gadopentetate dimeglumine

2017 ◽  
Vol 30 (6) ◽  
pp. 554-560 ◽  
Author(s):  
Rupa Radhakrishnan ◽  
Shamima Ahmed ◽  
Joshua Cole Tilden ◽  
Humberto Morales
Keyword(s):  
Facial Nerve ◽  
Contrast Agents ◽  
Spin Echo ◽  
Cranial Nerves ◽  
Gadopentetate Dimeglumine ◽  
Gradient Echo ◽  
3D Inversion ◽  
Post Contrast ◽  
Significant Difference ◽  
Facial Nerves

Background and purpose The facial nerve is unique among cranial nerves in demonstrating normal enhancement of particular segments. The effect of varying T1 relaxivities of gadolinium-based contrast agents on facial nerve enhancement is unclear. In this study, we assess differences in normal facial nerve enhancement with two different gadolinium-based contrast agents, gadobutrol and gadopentetate dimeglumine. In addition, we evaluate differences in facial nerve enhancement with spin-echo (SE) T1 versus 3D inversion recovery prepared fast spoiled gradient-echo (FSPGR) post-contrast sequences. Methods A total of 140 facial nerves in 70 individuals were evaluated (70 with gadobutrol and 70 with gadopentetate dimeglumine) by two blinded reviewers. Differences in enhancement of facial nerve segments between the two agents were analyzed. Differences in enhancement between SE T1 and FSPGR imaging were also evaluated. Results There was no significant difference in facial nerve enhancement between gadobutrol and gadopentetate dimeglumine. Enhancement was commonly observed in the geniculate, tympanic and mastoid segments (98%–100%) with either contrast agent; enhancement was less common in the labyrinthine segments (9%–14%) and lateral canalicular segment (2%–5%). There was a smaller enhancing proportion of labyrinthine and tympanic segments with FSPGR as compared to SE T1 images with gadobutrol. Conclusion There is no significant difference in overall enhancement of the facial nerve between gadobutrol and gadopentetate dimeglumine. Mild enhancement of the lateral canalicular portion of the facial nerve may be a normal finding. With FSPGR sequence, there is lesser perceived enhancement of the labyrinthine and tympanic segments of the facial nerve with gadobutrol.

scholarly journals Facial Palsy, Hypoacusis and Vertigo as Inaugural Symptoms of Neuroborreliosis - Case Report

2021 ◽  
Vol 2 (5) ◽  
pp. 323-327
Author(s):  
JB da Costa
Keyword(s):  
Case Report ◽  
Facial Nerve ◽  
Facial Palsy ◽  
Cranial Nerves ◽  
Cranial Neuropathy ◽  
Common Causes ◽  
Oral Corticosteroids ◽  
The Central Nervous System ◽  
Magnetic Resonance Imaging Mri ◽  
The Right

Introduction: Facial Palsy (FP) is the most common acute mononeuropathy and consists of a decrease in facial muscle strength due to facial nerve damage. Peripheral FP (PFP) can result from a wide variety of disorders and aetiologies, with Lyme Disease (LD) being considered one of the most common causes of FP. LD is an infectious disease that affects the central nervous system, causing Neuroborreliosis (NB) in 15% of cases. Cranial neuropathy is the most common form of presentation of NB, as uni or bilateral PFP. We describe a case of PFP with hypoacusis and vertigo as the inaugural presentation of neuroborreliosis. Case Report: We present a case report of a 75-year-old female patient, referred to ENT consultation due to a 3-day course of a grade 4 right PFP, moderate right sensorineural hearing loss and right vestibular hypofunction. The patient underwent cranioencephalic Computed Tomography (CT-CE) which excluded a central event and was treated with 2 cycles of oral corticosteroids, without any clinical improvement. A Magnetic Resonance Imaging (MRI) was performed, which showed an abnormal inflammatory uptake of the right facial nerve. An analytical positivity for Borrelia IgM was found and the diagnosis of polyneuropathic NB with involvement of the VII and VIII right cranial pairs was assumed. The patient completed 28 days of doxycycline, with FP and vertigo improvement and normalization of hearing acuity. Discussion/Conclusion: In the presented case, the absence of the classical migratory erythema or painful meningopolyneuritis didn’t exclude the diagnosis of NB. FP associated to signs of other cranial nerves involvement raised the hypothesis of a systemic polyneuropathic disease, which motivated the etiological investigation carried out.

scholarly journals Acoustic Neurinoma with Synchronous Ipsilateral Cerebellopontine Angle Lipoma: A Case Report and Review of the Literature

Diagnostics ◽  
2022 ◽  
Vol 12 (1) ◽  
pp. 120
Author(s):  
Takahiro Kanaya ◽  
Yasuo Murai ◽  
Kanako Yui ◽  
Shun Sato ◽  
Akio Morita
Keyword(s):  
Hearing Loss ◽  
Facial Nerve ◽  
Cerebellopontine Angle ◽  
Cranial Nerves ◽  
Internal Auditory Canal ◽  
Surgical Removal ◽  
Acoustic Neurinoma ◽  
Facial Nerve Paralysis ◽  
Nerve Paralysis ◽  
Nerve Preservation

Lipomas of the cerebellopontine angle (CPA) and internal auditory canal (IAC) are relatively rare tumors. Acoustic neurinoma is the most common tumor in this location, which often causes hearing loss, vertigo, and tinnitus. Occasionally, this tumor compresses the brainstem, prompting surgical resection. Lipomas in this area may cause symptoms similar to neurinoma. However, they are not considered for surgical treatment because their removal may result in several additional deficits. Conservative therapy and repeated magnetic resonance imaging examinations for CPA/IAC lipomas are standard measures for preserving cranial nerve function. Herein, we report a case of acoustic neurinoma and CPA lipoma occurring in close proximity to each other ipsilaterally. The main symptom was hearing loss without facial nerve paralysis. Therefore, facial nerve injury had to be avoided. Considering the anatomical relationships among the tumors, cranial nerves, and CPA/IAC lipoma, we performed total surgical removal of the acoustic neurinoma. We intentionally left the lipoma untreated, which enabled facial nerve preservation. This report may be a useful reference for the differential diagnosis of similar cases in the future.

Evaluation of Candidal Carriage Among Smokers and Non-Smokers

2020 ◽  
Vol 10 (4) ◽  
pp. 266-270
Author(s):  
Umar Irfan ◽  
Salik Rasool ◽  
Perveen Memon ◽  
Shazia Irum ◽  
Bushra Jabeen ◽  
...  
Keyword(s):  
Candida Albicans ◽  
Candida Glabrata ◽  
Health Sciences ◽  
P Value ◽  
Age Group ◽  
Cotton Swab ◽  
Cross Sectional ◽  
Significant Difference ◽  
The Common ◽  
Sterile Cotton Swab

Objectives: To determine the Candidal carriage among smokers and non-smokers and with different intra-oral sites including examination of various biotypes of Candida. Study design and setting: Cross-sectional based study conducted at Dr. Ishrat ul Ebad Khan Institute of Oral Health Sciences and Dow International Dental College, Karachi, from May 2017 till April 2018. Methodology: Comprised 100 patients (50 smokers and 50 nonsmokers) between 20 and 60 years of age. The collection was performed through sterile cotton swab to evaluate oral Candidal carriage and the colonizing Candida species using Sabouraud Dextrose Agar (SDA) and API20C AUX (BIOMERIEUX). Data was analyzed Spss version 20. Results: A total of 100 participants (50 smokers and 50 non-smokers) were evaluated for candidal carriage. The common age group was 20-30 years in both the groups, without significant difference (p-value 0.79). Frequency of candidal carriage was comparable among smokers 14 (28.0%) to non-smokers 10 (20.0%), with a statistically insignificant p-value 0.35. Based on various biotypes among smokers and non-smokers, Candida albicans was 9(18%) and 7(14%), Candida glabrata was 4(8%) and 2(4%); and Candida tropicallis was 1(2%) each for both smokers and non smokers. Dorsum of tongue harbored all prevalent biotypes i.e. Candida albicans, Candida glabrata and Candida tropicalis as statistically significant among smokers (p-value 0.04). Conclusion: Candidal carriage was comparable among smokers and non-smokers. Candida albicans and Candida glabrata were the common biotypes predominantly among smokers

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