Cases reported "Facial Nerve Diseases"

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1/184. Facial trigeminal synkinesis associated with a trigeminal schwannoma.

    The authors describe the clinical and electrophysiologic findings in a patient with synkinesis between muscles innervated by the facial and trigeminal nerves after resection of a trigeminal schwannoma. Conventional facial nerve conduction and blink reflex studies were normal. Stimulation of the supraorbital and facial nerves elicited reproducible responses in the masseter and pterygoid muscles, confirming a peripheral site of aberrant regeneration of the facial and trigeminal nerves.
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2/184. Greater superficial petrosal nerve neurinoma. Case report.

    The authors report a case of middle cranial fossa neurinoma arising from the left greater superficial petrosal nerve in a 21-year-old woman who presented with a left-sided otitis media that chronically recurred over a period of 5 years. On examination, the patient had a left-sided mild conductive hearing impairment and a slight disturbance in tear secretion on the left side, with sensory disturbance in the left palate. Three-dimensional computerized tomography scans clearly demonstrated the enlargement of the foramen lacerum and foramen ovale, and heavily T2-weighted magnetic resonance images revealed the tumor's location along with the course of the greater superficial petrosal nerve and its extension into the tympanic cavity. Following complete surgical excision of the tumor and tympanoplasty via a middle cranial fossa approach, the patient retained useful hearing without facial palsy.
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3/184. Segmental facial myoclonus in moebius syndrome.

    Moebius syndrome is characterized by sixth and seventh nerve palsy and is usually the result of bilateral hypoplasia or aplasia of the respective brain stem nuclei. There have been no reports of involuntary facial movements associated with this malformative complex. We report on a 6-year-old boy affected by Moebius syndrome with asymmetric involvement and segmental facial myoclonus with onset at age 2 years, affecting the side with partially conserved motility. Clinical presentation included congenital peripheral palsy of the right seventh cranial nerve and left-sided rhythmic rising of the upper lip and eyebrow. Surface-electromyography (EMG) of the left levator labii and frontalis muscles showed rhythmic bursting (duration: 150-450 ms; frequency: 1-3 Hz). Electroencephalographic (EEG)-polygraphic recordings and burst-locked EEG averaging failed to show any consistent EEG activity preceding the EMG bursts. Study of the blink reflex, somatosensory and motor-evoked potentials showed findings consistent with pontine pathology. Segmental facial myoclonus, although extremely rare in children, must be differentiated from several other paroxysmal motor manifestations associated with structural lesions involving the brain stem. Segmental facial myoclonus stem-Structural lesion.
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4/184. facial nerve schwannoma in the cerebellopontine cistern. Findings on high resolution CT and MR cisternography.

    We report a case of facial nerve schwannoma originating in the cerebellopontine cistern, diagnosed by cochlear sensorineural hearing loss, and involvement in the facial nerve canal and the anterior epitympanic recess. Precise analyses of neuro-otological and neuroradiological studies are crucial to obtain an accurate preoperative diagnosis.
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5/184. Primary brain stem tethering: a rare cause of geniculate neuralgia.

    This rare case of brain stem tethering presented with chronic and progressive geniculate neuralgia. In view of the fact that an occipital subcutaneous lipoma had been resected in childhood, it probably concerned a primary tethering, fitting in with an occult occipital dysraphism. magnetic resonance imaging (MRI) clearly demonstrated an underlying tethering, causing a distortion of the brain stem. Consequently, this led to the hypothesis that the geniculate neuralgia could be explained by traction on the lower cranial nerves secondary to the brain stem displacement. Untethering resulted in a considerable decrease of the neuralgia. MRI proved to be essential in the diagnosis and treatment of this unusual case.
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6/184. Intraparotid facial nerve schwannoma.

    Intraparotid facial nerve schwannoma are uncommon. Preoperative diagnosis of parotid tumour as schwannoma is difficult when facial nerve function is normal. A rare case of solitary schwannoma involving the upper branch of the facial nerve is described and the literature on the subject is reviewed.
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7/184. Benign glandular peripheral nerve sheath tumor of the seventh and eighth cranial nerve complex.

    A unique, deep-seated, benign, glandular peripheral nerve sheath tumor (PNST) of the cerebellopontine angle is described. The tumor arose from the seventh and eighth cranial nerve complex in a 15-year-old boy without neurofibromatosis. Histologically, benign glands were embedded in a bland spindle cell stroma. The epithelial cells were immunoreactive for CAM 5.2, and focally for chromogranin. The spindle cells were positive for S100P. The benign glandular PNST unassociated with neurofibromatosis is a controversial entity. The superficial location of most reported cases has made it difficult to exclude entrapped adnexae as a source for the glands. This tumor was separate from the internal auditory meatus on MRI scan, the most likely source of entrapped glands at this site. This case is the first report of a deep-seated, benign, glandular peripheral nerve sheath tumor. It suggests that glandular differentiation in PNSTs, while unusual, is not synonymous with neurofibromatosis or malignancy.
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8/184. Intracanalicular schwannoma of the facial nerve: a manifestation of neurofibromatosis type 2.

    Primary facial nerve tumors, which are relatively uncommon, can present a diagnostic dilemma based on their location and variable pattern of symptoms. Of primary cranial nerve tumors, schwannomas of the facial nerve rank third in frequency after those of the eighth and fifth cranial nerves. We report an illustrative case of an intracanalicular schwannoma associated with several central nervous system tumors, consistent with neurofibromatosis type 2. Initially assumed to be an eighth cranial nerve tumor, the schwannoma was found intraoperatively to arise from the facial nerve. early diagnosis and treatment enabled excision of the tumor without sacrifice of the facial nerve. facial nerve schwannomas can resemble acoustic schwannomas in their clinical presentation. Only a heightened level of clinical vigilance will point to the correct diagnosis and result in an optimal therapeutic outcome for patients with these rare tumors.
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9/184. Primary meningioma of the fallopian canal.

    Meningiomas are slow-growing lesions that represent approximately 20% of all intracranial tumors and are the second most common tumor of the cerebellopontine angle. In contrast, primary extracranial meningiomas are found relatively infrequently, and most cases have inadequate radiologic studies to determine if they were actually an extension from a primary intracranial source. Meningiomas of the intratemporal segment of the facial nerve have also been reported, but they are exceedingly rare and their pathophysiology remains unclear. We report a case of a meningioma of the facial nerve in the fallopian canal of a 7-year-old girl and review pertinent literature.
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10/184. neurosyphilis as a cause of facial and vestibulocochlear nerve dysfunction: MR imaging features.

    The prevalence of syphilis increased for several decades before the mid-1990s in the united states, particularly in the southern states. We report a case of neurosyphilis causing bilateral facial and vestibulocochlear nerve dysfunction in which the diagnosis was not initially suspected based on the patient's demographics and history. The MR imaging features helped to make the diagnosis in this case and to exclude other possible causes of multiple cranial nerve dysfunction in this patient. hearing loss associated with neurosyphilis is one of the few treatable forms of progressive hearing loss, and it is essential that a diagnosis of neurosyphilis be made expeditiously.
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