ASYMMETRIC CRYING FACIES: A CLINICAL ODDITY

2021 ◽  
pp. 7-8
Author(s):  
Dilesh Kohat ◽  
Vishwanath Patil ◽  
Kusum Mahajan

Background – Congenital hypoplasia of depressor angularis oris muscle (CHDAOM), which is often confused with unilateral facial nerve palsy, is a rare congenital disorder presenting with asymmetric crying facies in a newborn. Accurate diagnosis of this condition is imperative in order to ensure further screening to rule out associated anomalies and appropriate management. We report a late preterm male Clinical description – neonate who was noticed to have facial asymmetry selectively during episodes of crying. During quiet or sleeping state, the face was symmetrical. Clinical examination did not reveal any other facial abnormality or any evidence of facial nerve palsy. Associated anomalies were Management – ruled out by thorough evaluation. In view of isolated CHDAOM, parents were explained regarding benign course of the condition. The neonate was discharged after an uneventful hospital stay. This case report emphasizes the importance of a Conclusion – detailed clinical examination in the diagnosis of CHDOAM. CHDOAM, if occurring in isolation, is a benign condition and does not require any intervention. Parental counselling is the cornerstone of management. However, the diagnosis of CHDAOM should raise suspicion for other associated congenital anomalies and warrants a thorough evaluation.

Author(s):  
Daphine Caxias Travassos ◽  
Heitor Albergoni Silveira ◽  
Evânio Vilela Silva ◽  
Beatriz Zamboni Martins Panucci ◽  
Nilson Coelho da Silva Filho ◽  
...  

2021 ◽  
Vol 15 (11) ◽  
pp. 1770-1773
Author(s):  
Armen Kishmiryan ◽  
Jeevan Gautam ◽  
Deeksha Acharya ◽  
Bishnu Mohan Singh ◽  
Armen Ohanyan ◽  
...  

Cephalic tetanus is a rare clinical form of tetanus, clinically characterized by trismus and cranial nerve palsy involving one or more cranial nerves, facial nerve being the most common. We report a case of cephalic tetanus with left-sided lower motor facial nerve palsy in a 66-year-old non-immunized patient after an untreated laceration injury. The patient had dysphagia, spasm of the muscles of mastication, asymmetry of the left side of the face, cough, shortness of breath, and stiffness of neck muscles. The presentation was unique given that the facial nerve palsy appeared prior to the occurrence of trismus, which misled the initial diagnosis towards Bell's palsy. He was successfully treated with tetanus antitoxin without any adverse events. Although widespread use of tetanus vaccine has led to a dramatic decline in this fatal disease, sporadic disease occurrence is still possible, particularly in individuals without up-to-date vaccinations. In this case report we illustrate the importance of early recognition of cephalic tetanus prior to the development of the full clinical picture. The early initiation of therapy is the key to recovery from this deadly disease. Physicians are encouraged to include cephalic tetanus as a cause of facial nerve palsy in their differential. In particular, paying attention to cases manifesting early after head or neck injury.


1994 ◽  
Vol 8 (3) ◽  
pp. 327-332 ◽  
Author(s):  
Andrzej Kukwa ◽  
Andrzej Marchel ◽  
Miroslawa Pietniczka ◽  
Maria Rakowicz ◽  
Romuald Krajewski

1970 ◽  
Vol 28 (1) ◽  
pp. 53-58
Author(s):  
MG Hafiz ◽  
A Islam ◽  
MA Mannan ◽  
F Rahman

Case report-1: Sabarna, a female baby of fifteen months old was admitted in Pediatric Hematology and Oncology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh with the complaints of deviation of the angle of mouth to right side and inability to close the left eye for five days. Systemic examination revealed an incision scar mark on the left mastoid region. Facial asymmetry as evidenced by smooth forehead, absence of nasolabial fold, drooping of the angle of mouth and nonclosure of eyelid on left side. She was mildly pale, mild hepatomegaly, no lymphadenopathy, bone pain or bleeding manifestation. Physical, hematological and histopathological investigations the features were suggestive of facial nerve palsy due to granulocytic sarcoma (GS) with acute myeloid leukemia (AML). Following second day of chemotherapy her vital signs suddenly deteriorated and succumbed probably due to the leukostasis or intracranial hemorrhage. Case report-2: Chayon, another nine month old female baby was admitted in the same unit with the history of fever, proptosis of both eye balls, deviation of the angle of mouth to the right side and unable to close the left eye for one month. Physical examination revealed facial asymmetry with the features of left sided facial nerve palsy along with proptosis of eyeballs. She was moderately pale, moderate hepatosplenomegaly, no bleeding manifestation or bone pain. Physical, hematological and cerebrospinal fluid (CSF) examination the features were suggestive of facial nerve palsy due to leukemic cell infiltration with AML. Following induction and consolidation the baby is on continuation phase with regular follow up for last 9 month having significant improvement of her facial nerve palsy along with hematological remission. DOI: 10.3329/jbcps.v28i1.4646 J Bangladesh Coll Phys Surg 2010; 28: 53-58


2021 ◽  
Vol 25 (11) ◽  
pp. 1239-1239
Author(s):  
E. Sukhova

Herzog, (Zeitschr fr die gesamte N. und P. 119 Band. 1929), excluding cases of paralysis n. facialis, as a separate symptom in diseases of the middle ear, brain tumors or luese, as well as in cases of infection with herpes zoster, stops at the group of peripheral lesions n. facialis of an epidemic nature. The symptomatology of this form is characterized by a slight swelling of the skin of the face in front of and under the ear, a slight increase in the area of ​​the salivary glands, and a slight rise in temperature. In some cases, a. finds inflammation of the salivary glands of the mouth, especially gl. parotis, which is often the starting point of facial nerve disease. The author gives 4 cases of paralysis n. facialis observed by him in the same autumn month.


2015 ◽  
Vol 4 (3) ◽  
pp. 213 ◽  
Author(s):  
Srinivas Murki ◽  
Ginnavaram Dhanraj ◽  
Deepak Sharma

Author(s):  
Wajida Perveen

Facial nerve palsy is a common condition affecting both genders and all age group. However, its incidence in pregnant females needs greater care. It may affect only lower half of the face or full one side of the face or in extreme condition bilateral sides. Symptoms include deviation of angle of mouth towards sound side, flattening of nasolabial folds, loss of forehead wrinkles and inability to completely close the eyelid along with loss of taste on anterior two third of tongue. Here we present a rare case report of facial nerve palsy in a pregnant woman in third trimester of pregnancy. She was offered an evidence based physiotherapy treatment regime along with pharmacological treatment and she recovered; however late complication of “Ptosis” was reported.


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