scholarly journals Surgical treatment of dropped head syndrome secondary to fascioscapulohumeral muscle dystrophy: a case report

2021 ◽  
Vol 6 (10) ◽  
Keyword(s):  
Conservative Treatment ◽  
Neck Pain ◽  
Signs And Symptoms ◽  
Muscle Dystrophy ◽  
Dropped Head Syndrome ◽  
Cervical Surgery ◽  
The Face ◽  
Hereditary Myopathy ◽  
Clinical And Radiological Results ◽  
Posterior Cervical Surgery

Fascioscapulohumeral muscular dystrophy is an uncommon hereditary myopathy which affects mainly the muscle of the face and upper limb girdle. We present a rare case with dropped head syndrome as the prominent manifestation of that disease and successfully treated by surgical management. It was a 25-year-old male patient with the chief complaint of neck pain and inability to maintain his horizontal gaze for long periods and as a result he had to quit his job as a shipper. His mother also had signs and symptoms of fascioscapulohumeral muscle dystrophy. Conservative treatment consisting of physical therapy and hard collar was the first attempt in order to reduce the neck pain and had limited result. We then performed a posterior cervical surgery including C2 to T2 instrumentation and kyphotic correction for the patient. The ten-month postop clinical and radiological results were satisfactory and the patient could return to his previous job. Dropped head syndrome with failed conservative treatment can be surgically treated after considering all clinical and radiographic factors.

scholarly journals Dropped Head Syndrome Treated with Physical Therapy Based on the Concept of Athletic Rehabilitation

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Toshio Mori ◽  
Kentaro Mataki ◽  
Yukiyo Shimizu ◽  
Kai Matsuba ◽  
Kosei Miura ◽  
...  
Keyword(s):  
Physical Therapy ◽  
Conservative Treatment ◽  
Neck Pain ◽  
Daily Living ◽  
Cervical Spondylosis ◽  
Special Program ◽  
Cervical Kyphosis ◽  
Dropped Head Syndrome ◽  
Extensor Muscles ◽  
Chest Deformity

Patients with dropped head syndrome (DHS) show severe cervical kyphosis, i.e., chin-on-chest deformity, and their activities of daily living are impaired considerably. However, the therapeutics for DHS, especially conservative treatment, have not been fully established. A 75-year-old woman suffered from DHS, which she developed from neck pain due to cervical spondylosis. Examinations showed atrophy and dysfunction of her cervical extensor muscles. For this patient, we created a special program of physical therapy based on the concept of athletic rehabilitation and provided her the athletic rehabilitation-based physical therapy (AR-PT). After starting AR-PT, the patient’s neck pain was relieved. She recovered from DHS, and the atrophy of her cervical extensor muscles improved. This study suggests that our program of AR-PT improves cervical extensor muscle insufficiency in patients with DHS and corrects their cervical kyphosis.

Radiological influencing factors of the effectiveness of posterior cervical surgery for multilevel ossification of the posterior longitudinal ligament

2021 ◽  
Author(s):  
Cheng Li ◽  
Liang Zhu ◽  
Guochun Zha ◽  
Yong Pang ◽  
Xin Zheng ◽  
...  
Keyword(s):  
Cobb Angle ◽  
Neck Disability Index ◽  
Posterior Longitudinal Ligament ◽  
Cervical Kyphosis ◽  
Posterior Surgery ◽  
Cervical Surgery ◽  
Neck Disability ◽  
Clinical And Radiological Results ◽  
Posterior Cervical Surgery

Abstract Background In patients with multilevel cervical ossification of posterior longitudinal ligament (OPLL), whether radiological factors affect the efficacy of posterior cervical surgery and which posterior surgery is more suitable and better in patients with different imaging manifestations remain to be elucidated. Methods From January 2012 to January 2018, 141 patients with multi-segmental OPLL underwent posterior cervical surgery, including 73 cases of laminoplasty (LP group) and 68 cases of laminectomy with fusion (LF group). Clinical and radiological results were compared between the groups. Patients were followed up for at least 2 years. Results At the last follow-up, significant differences in neck disability index (NDI), cervical range of motion, and C2–C7 Cobb angle were found between the two groups (P < 0.05). In the cervical kyphosis, K-line-negative, and OPLL occupying ratio(OR) > 60% groups, the

Residual numbness of the upper extremity after cervical surgery in patients with cervical spondylotic myelopathy

2020 ◽  
Vol 33 (6) ◽  
pp. 734-741
Author(s):  
Masayoshi Iwamae ◽  
Akinobu Suzuki ◽  
Koji Tamai ◽  
Hidetomi Terai ◽  
Masatoshi Hoshino ◽  
...  
Keyword(s):  
Neck Pain ◽  
Upper Extremity ◽  
Cervical Spondylotic Myelopathy ◽  
Multivariate Linear Regression Analysis ◽  
Vas Score ◽  
Radiographic Parameters ◽  
Clinical Scores ◽  
Sf 36 ◽  
Cervical Surgery ◽  
Preoperative Factors

OBJECTIVEAlthough numbness is one of the chief complaints of patients with cervical spondylotic myelopathy (CSM), preoperative factors relating to residual numbness of the upper extremity (UE) and impact of the outcomes on cervical surgery are not well established. The authors hypothesized that severe preoperative UE numbness could be a risk factor for residual UE numbness after surgery and that the residual UE numbness could have a negative impact on postoperative outcomes. Therefore, this study aimed to identify the preoperative factors that are predictive of residual UE numbness after cervical surgery and demonstrate the effects of residual UE numbness on clinical scores and radiographic parameters.METHODSThe study design was a retrospective cohort study. The authors analyzed data of 103 patients who underwent cervical laminoplasty from January 2012 to December 2014 and were followed up for more than 2 years postoperatively. The patients were divided into two groups: the severe residual-numbness group (postoperative visual analog scale [VAS] score for UE numbness > 40 mm) and the no/mild residual-numbness group (VAS score ≤ 40 mm). The outcome measures were VAS score, Japanese Orthopaedic Association scores for cervical myelopathy, physical and mental component summaries of the 36-Item Short-Form Health Survey (SF-36), radiographic film parameters (C2–7 sagittal vertical axis, range of motion, C2–7 lordotic angle, and C7 slope), and MRI findings (severity of cervical canal stenosis, snake-eye appearance, severity of foraminal stenosis). Following univariate analysis, which compared the preoperative factors between groups, the variables with p values < 0.1 were included in the multivariate linear regression analysis. Additionally, the changes in clinical scores and radiographic parameters after 2 years of surgery were compared using a mixed-effects model.RESULTSAmong 103 patients, 42 (40.8%) had residual UE numbness. In the multivariate analysis, sex and preoperative UE pain were found to be independent variables correlating with residual UE numbness (p = 0.017 and 0.046, respectively). The severity of preoperative UE numbness did not relate to the residual UE numbness (p = 0.153). The improvement in neck pain VAS score and physical component summary of the SF-36 was significantly low in the severe residual-numbness group (p < 0.001 and 0.040, respectively).CONCLUSIONSForty-one percent of the CSM patients experienced residual UE numbness for at least 2 years after cervical posterior decompression surgery. Female sex and preoperative severe UE pain were the predictive factors for residual UE numbness. The patients with residual UE numbness showed less improvement of neck pain and lower physical status compared to the patients without numbness.

Factors Associated With Violence Against Women and Facial Trauma of a Representative Sample of the Brazilian Population: Results of a Retrospective Study

2020 ◽  
pp. 194338752094933
Author(s):  
Gabriela Mayrink ◽  
Stella Araújo ◽  
Laisa Kindely ◽  
Renato Marano ◽  
Aguimar Bourguinon de Mattos Filho ◽  
...  
Keyword(s):  
Violence Against Women ◽  
Health Care Professionals ◽  
Mixed Race ◽  
Signs And Symptoms ◽  
Epidemiological Survey ◽  
Facial Trauma ◽  
Health It ◽  
Tertiary Referral Hospital ◽  
The Face ◽  
Important Marker

Study Design: Violence against women is a challenge in public health. It involves women of all ages, socioeconomic statuses, cultures, and religions. Objective: The objective of this study was to perform an epidemiological survey of facial trauma among women who experienced physical aggression by an intimate partner. Methods: Electronic medical records from a public tertiary referral hospital for trauma in the Brazilian state of Espírito Santo were analyzed between 2013 and 2018. Results: Patients were most commonly between 20 and 29 years of age (33.9%), and 50% of the patients were of mixed race. When separated by days of the week, facial trauma was most commonly inflicted on Sundays (24.2%) and on Saturdays (22.6%). Of the 62 women included in the study, 47 had facial fractures, and 7 had more than 1 concomitant fracture. Forty of the total fractures (72.7%) were on the middle and upper thirds of the face, while 15 fractures (27.3%) were on the lower third of the face. The most commonly observed signs and symptoms of these injuries were edema (56.5%), periorbital ecchymosis (35.5%), deviated nasal dorsum (22.6%), and hematoma (16.1%). Conclusions: Facial trauma may be considered an important marker of attempted femicide. Health care professionals must be aware of and attentive to this correlation, since many cases of attempted femicide go unnoticed or are attributed to another etiology.

scholarly journals Clinical And Radiological Results Of Conservative Treatment In Fractures Of Distal Radius In The Patients 60 Or More Years Old

2014 ◽  
Vol 3 (1) ◽  
pp. 27-33
Author(s):  
Ali Turgut ◽  
Cemil Kayali ◽  
Burak Gunaydin ◽  
Seydi Ahmet Eren ◽  
Levent Surer ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Distal Radius ◽  
Radiological Results ◽  
Clinical And Radiological Results

scholarly journals ROLE OF AYURVEDA IN THE MANAGEMENT OF ARDITA (BELL’S PALSY) – A CASE REPORT

2021 ◽  
Vol 9 (8) ◽  
pp. 1898-1903
Author(s):  
Seema Bahatkar ◽  
Rajiv Tarpe ◽  
Kinjal H. Daiyya
Keyword(s):  
Signs And Symptoms ◽  
Bell’S Palsy ◽  
Point Of View ◽  
Bell's Palsy ◽  
Oral Medications ◽  
Angle Deviation ◽  
The Face ◽  
Ayurvedic Treatment ◽  
Modern Perspective

Ardita is considered as one amongst the vata nanatmaj vyadhis described in Ayurvedic classics. Ardita is a condition caused due to the unusual functioning of vata dosha which results in loss of functioning of one half of the face. It can be correlated with Bell's Palsy from modern perspective. This disease proves to be disturbing from a functional and cosmetic point of view. A 27year old male patient came to OPD with a chief complaint of difficulty in closing right eye, angle deviation of the mouth towards left, difficulty while eating, unable to whistle as well as puffing of cheeks, drooling of saliva, etc. from 20 days. History and examination lead to the diagnosis of Bell's Palsy. Consid- ering the signs and symptoms, the patient was treated as per the ayurvedic line of treatment for Ardita. The patient was admitted and ayurvedic treatment (Panchakarma + Oral medications) i.e. Nasya, Pindasweda, Kukkutanda sweda, Akshitarpan was given for 21days. The patient had great relief with marked improvement in the above said symptoms. Thus, Ayurveda is fruitful in treating patients with Ardita. Keywords: Ardita, Nasya, Pindasweda, Kukkutanda sweda, Akshitarpan

scholarly journals Posterior Ligamentous Complex Reconstruction for Cervical Dislocation and Instability in Patients without Vertebral Fracture with Artificial Ligaments: A Technical Note

2020 ◽  
Author(s):  
Chengyi Huang ◽  
Beiyu Wang ◽  
Hao Liu ◽  
Tingkui Wu ◽  
Kangkang Huang ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Vertebral Fracture ◽  
Neck Pain ◽  
Facet Joint ◽  
Spinous Process ◽  
Posterior Ligamentous Complex ◽  
Reconstruction Surgery ◽  
Artificial Ligaments ◽  
Cervical Surgery ◽  
Patient Reported

Abstract Introduction: The posterior ligamentous complex (PLC) offers restraints to deformation in a complex and interconnected manner. The stability and range of motion (ROM) of the posterior cervical spine is greatly restricted when the PLC is damaged, even without bone disruptions. We describe a novel surgical technique, its advantages, and the postoperative condition of the first patient to use artificial ligament in a reconstruction surgery of PLC injuries in patients without lower cervical vertebral fracture. This technique aimed to fully retain the mobility of the injured segment based on spinal stability and apply dynamic reconstruction in patients’ treatment.Method: We present a detailed description of the reconstruction surgery with artificial ligaments performed on C4-6 PLC injuries in a 27-year-old male presented with neck pain and restricted movement following a high fall injury accompanied by impaired movement of limbs. Results: Immediately postsurgery, the patient’s neck pain and quadriparesis had been improved. The spinal canal decompression and cervical spine sequence results were satisfactory, the facet joint face was in a good position, and the spinous process spacing returned to normal. After three months of rehabilitation, the patient reported improvement of symptoms and the physical and imaging examination showed a significant improvement in the patient’s condition. The patient’s neck mobility motor function had improved further.Conclusion: The present data demonstrate that the novel technique for reconstruction of PLC injury is feasible and safe. However, familiarity with cervical anatomy and adequate experience in lateral mass screws placement during surgery is crucial for this procedure. Therefore, a highly experienced cervical surgery team is recommended to perform the surgery.

scholarly journals Extraoral Sinus Tracts of Odontogenic Origin: A Case Series

2020 ◽  
Author(s):  
Ellahe Azizlou ◽  
Mohsen AminSobhani ◽  
Sholeh Ghabraei ◽  
Mehrfam Khoshkhounejad ◽  
Abdollah Ghorbanzadeh ◽  
...  
Keyword(s):  
Correct Diagnosis ◽  
Case Series ◽  
Signs And Symptoms ◽  
Complete Recovery ◽  
Cutaneous Lesions ◽  
Odontogenic Origin ◽  
The Face ◽  
History Of ◽  
Relationship Of ◽  
Dental Infections

Extraoral sinus tracts of odontogenic origin often develop as the result of misdiagnosis of persistent dental infections due to trauma, caries, or periodontal disease. Due to these lesions' imitation from cutaneous lesions, misdiagnosis, and mismanagement, which we frequently encounter, this article aims to describe four cases with manifestations in different parts of the face and the neck. Patients were referred to an endodontist with a history of several surgical procedures and/or antibiotic therapy due to misdiagnosis. After comprehensive examinations, root canal treatment was performed. The resolution of signs and symptoms during the follow-up period confirmed the correct diagnosis. Dermatologists and other physicians should be aware of the possibility of the relationship of extraoral sinus tracts with dental infections. Precise examination and taking a comprehensive history can aid to prevent unnecessary and incorrect therapeutic and/or pharmaceutical interventions. Elimination of dental infection leads to complete recovery in such patients.

Vancomycin-Induced Red Man Syndrome

PEDIATRICS ◽  
1990 ◽  
Vol 86 (4) ◽  
pp. 572-580
Author(s):  
Maurice Levy ◽  
Gideon Koren ◽  
Lee Dupuis ◽  
Stanley E. Read
Keyword(s):  
Signs And Symptoms ◽  
The Body ◽  
Control Group ◽  
Severe Hypotension ◽  
The Face ◽  
Red Man Syndrome ◽  
History Of ◽  
Serum Vancomycin ◽  
Mild Temperature ◽  
Cold Extremities

A total of 11 cases of red man syndrome collected among 650 children who had received vancomycin in our hospital between 1986 and 1988 (estimated prevalence 1.6%) were retrospectively analyzed. These 11 children were compared with 11 age-matched children who received vancomycin in whom red man syndrome did not develop. Of the patients with red man syndrome, 73%, and of the patients with no reaction, 45.4% received vancomycin for penicillin-resistant Staphylococcus epidermidis-positive cultures, or because of history of penicillin allergy. No difference was observed in the dose per kilogram given to both groups (12.9 ± 3.5 mg/kg per dose in those with red man syndrome vs 12.3 ± 6.9 mg/kg per dose in control childrens. The duration (mean ± standard deviation) of vancomycin infusion was 45.9 ± 16.7 minutes (range 10 to 90 minutes) in patients with red man syndrome and 54.5 ± 7.6 minutes (range 45 to 65 minutes) in the control group (P = .07). In the 5 children with red man syndrome rechallenged with vancomycin, slower infusion rates prevented or reduced the syndrome, which emphasized the fact that the rate of administration is the important determinant of red man syndrome in susceptible cases. Clinically, the syndrome developed at the end of the infusion in most patients, but appeared as early as 15 minutes after initiation of the infusion. It was mostly manifested as a flushed, erythematous rash on the face, neck, and around the ears. Less frequently, the rash was distributed all over the body. Pruritus was usually localized to the upper trunk but was also generalized (2 of 11 children). Associated signs and symptoms were hypotension, watery puffy eyes, tachycardia, respiratory distress, dizziness, agitation, and mild temperature increase. A premature infant with the red man syndrome had skin rash associated with poor perfusion, cold extremities, increased need for oxygen, and severe hypotension. The rash disappeared within 20 minutes (range 5 minutes to 7 hours) after vancomycin infusion was stopped. There was no association between serum vancomycin concentrations and red man syndrome; in both groups of patients therapeutic as well as subtherapeutic concentrations were observed, suggesting that this is an idiosyncratic and not a concentration-dependent phenomenon.

STURGE WEBER SYNDROME- A RARE CASE REPORT ORIGINAL

2021 ◽  
pp. 4-5
Author(s):  
Om Prakash Singh ◽  
Vikas Kumar ◽  
Pushp Kant Tiwari
Keyword(s):  
Rare Case ◽  
Signs And Symptoms ◽  
Port Wine ◽  
Occipital Area ◽  
Weber Syndrome ◽  
Rare Case Report ◽  
The Face ◽  
Sturge Weber Syndrome ◽  
The Brain ◽  
Embryonic Vessels

Sturge-Weber Syndrome (SWS) is one of the encephalotrigeminal angiomatosis and one of the important segmental vascular neurocutaneous disorders .The occurrence is not very uncommon and the prevalence is 1:20000 to 1:50000.(1) SWS occurs due to the presence of residual embryonic vessels . The various signs and symptoms include capillary malformation in the face a port wine birthmark and similar malformation in the brain involving leptomeniges as well as blood vessels of the eye causing glaucoma. The patient presents with seizures , hemiparesis and stroke like symptoms, headaches and developmental delay.(2) The imaging nding in SWS children is the calcication in the parietal and occipital area of the brain. The EEG ndings in SWS are the attenuation and the excess of slow activities.We are presenting here a rare case of , a fourteen year old male child who presented to our emergency department with status epilepticus. The aim of presenting this case is to share the classical presentation and the challenges involved in the management

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