1/16. Neurotologic evaluation of facial nerve paralysis caused by gunshot wounds.facial nerve injury is one of the most common neurotologic sequelae of a gunshot wound (GSW) to the head or neck. However, few neurotologic studies have been performed on the nature and time course of such facial nerve impairments. This study was designed to characterize the neurotologic manifestations and time course of facial nerve paralysis caused by GSWs to the head and neck. We conducted a battery of electrodiagnostic tests on 10 patients who had experienced traumatic facial paralysis due to a GSW to the head or neck. The etiologies of facial nerve paralysis--including direct injury, compression, fracture, and concussion of the temporal bone--were demonstrated by audiologic, radiologic, and surgical findings. hearing loss and other cranial nerve injuries were also seen. Six of the 10 patients experienced a complete paralysis of the facial nerve and a poor recovery of its function. We also present a comprehensive case report on 1 patient as a means of discussing the evaluation of facial nerve function during the course of management.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
2/16. Effects of facial paralysis and audiovisual information on stop place identification.This study investigated how listeners' perceptions of bilabial and lingua-alveolar voiced stops in auditory (A) and audiovisual (AV) presentation modes were influenced by articulatory function in a girl with bilateral facial paralysis (BFP) and a girl with normal facial movement (NFM). The fuzzy logic Model of perception (FLMP) was used to make predictions about listeners' identifications of stop place based on assumptions about the nature (clear, ambiguous, or conflicting) of the A or AV cues produced by each child during /b/ and /d/ CV syllables. As predicted, (a) listeners' identification scores for NFM were very high and reliable, regardless of presentation mode or stop place, (b) listeners' identification scores for BFP were high for lingua-alveolar place, regardless of presentation mode, but more variable and less reliable than for NFM; significantly lower (overall at a chance level) for bilabial place in the A mode; and lowest for bilabial place in the AV mode. Conflicting visual cues for stop place for BFP's productions of /bV/ syllables influenced listeners' perceptions, resulting in most of her bilabial syllables being misidentified in the AV mode. F2 locus equations for each child's /bV/ and /dV/ syllables showed patterns similar to those reported by previous investigators, but with less differentiation between stop place for BFP than NFM. These acoustic results corresponded to the perceptual results obtained. (That is, when presented with only auditory information, on average, listeners perceived BFP's target /b/ syllables to be near the boundary between /b/ and /d/.)- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
3/16. Cerebral tuberculoma localized by EMI scan.A case of isolated supratentorial tuberculoma is described. The patient had a left facial palsy, left hemiplegia, and left proprioceptive and stereognostic deficits with negative studies until the lesion was delineated with computerized axial tomography (EMI scan). The characteristics EMI scan is helpful in delineating the nature and precise location of the lesion prior to surgery.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
4/16. Cranial polyneuritis and bell palsy.In view of the specific nature of the clinical and neurologic findings in bell palsy and other acute benign cranial neuritides, the neural component of cutaneous herpes simplex, the predilection of the herpesvirus for sensory nerves, and intrinsic behavior and immunologic interreactions of the herpesvirus within ganglion cells, it is suggested that (1) the entity that has been termed "idiopathic facial paralysis" be recognized as an acute benign cranial polyneuritis; and (2) other acute benign cranial neuritides be recognized as formes frustes of bell palsy.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
5/16. Aneurysmal expansion presenting as facial weakness: case report and review of the literature.OBJECTIVE AND IMPORTANCE: facial paralysis and hemifacial spasm are rare presentations of aneurysms in the posterior fossa. We report an unusual case of rapidly progressive facial palsy caused by the acute expansion of an arteriovenous malformation-associated anteroinferior cerebellar artery aneurysm. The case is notable for the rapid progression of symptoms and their precise correlation with radiographic changes, emphasizing the potential dynamic nature of aneurysms associated with arteriovenous malformations. CLINICAL PRESENTATION: A 56-year-old woman with severe headache and nausea was seen in a local emergency room, where she underwent a neurological examination with unremarkable results and a head computed tomographic scan demonstrating acute hemorrhage in the ambient cisterns. Conventional and computed tomographic angiograms demonstrated an arteriovenous malformation in the right cerebellopontine angle fed by the anteroinferior cerebellar and superior cerebellar arteries. A micro-aneurysm measuring 3 mm was noted within the internal carotid artery on the meatal loop of the anteroinferior cerebellar artery. Two weeks later, a rapidly progressive right facial weakness developed in the patient, progressing to complete facial plegia over 12 hours, and complete sensory neural hearing loss. Repeat angiography demonstrated expansion of the previously visualized aneurysm to 8 x 4 mm. INTERVENTION: The patient was taken to surgery for clipping of the aneurysm, which required petrous drilling to unroof the canal. She has experienced substantial recovery of facial nerve function. CONCLUSION: Although compression of the VIIth-VIIIth nerve complex is an unusual presentation for posterior fossa aneurysms, it represents an important potential complication of vascular pathological features. The rapid aneurysmal expansion, confirmed by imaging and correlating with the rapid onset of symptoms, gives an impressive demonstration of the anatomic changes that can occur in an aneurysm associated with an arteriovenous malformation.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
6/16. facial nerve management in temporal bone hemangiomas.Eight patients with intratemporal hemangiomas involving the facial nerve are reported to present their symptoms, pathology, surgical management, and results. These unusual tumors have a predilection to involve the facial nerve, usually at the geniculate ganglion, internal auditory canal, or middle ear. patients presented with facial palsy that was sudden, gradual in onset, recurrent, or associated with hemifacial spasm. Symptoms often progressed for years before the diagnosis was made. In two cases the tumor caused bony remodeling with an expansile honeycombed appearance, but no neoplastic production of bone. The facial nerve was comprised either by tumor compression or nerve invasion, as seen in two of our patients. Complete removal of the tumor and rehabilitation of the facial nerve function was attained in each case. Because of the destructive nature of these benign tumors, intratemporal facial nerve grafting was required in five of the eight cases. Results of facial nerve repair were good except in cases of long-standing facial dysfunction.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
7/16. Horner's syndrome and trigeminal nerve palsy following epidural anaesthesia for obstetrics.While Horner's syndrome is a rare but occasionally reported side-effect of epidural block administered for labour, trigeminal nerve palsy has been described only once. The cases described in this report confirmed the benign nature of these neurological complications of epidurally administered anaesthetics which were not detrimental to fetal viability. The complications may be attributed to extensive cephalad spread of local anaesthetic, sometimes via unexplained routes and with surprisingly selective targeting effect (unilateral trigeminal nerve palsy). The atypical and unusually high cephalad spread of local anaesthetic in pregnant women at term is believed to be due to pregnancy-related altered anatomy and physiology of the epidural space.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
8/16. MRI findings in two cases of acute facial paralysis.This article describes the use of magnetic resonance imaging (MRI) in the evaluation of the facial nerve paralysis of Bell's palsy and herpes zoster oticus. Identification of the nature of inflammatory facial nerve paralysis often presents a diagnostic dilemma. The site of involvement along the course of the nerve may have importance when treatment options are being considered. We have found MRI to be a unique method for localizing the site of nerve injury in both Bell's palsy and Ramsay Hunt syndrome.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
9/16. adult T-cell leukemia initially manifesting as facial diplegia.We report an unusual case of adult T-cell leukemia (ATL) initially manifesting as facial palsy due to ATL meningitis, which was caused by lymphoid cells in the cerebrospinal fluid (CSF) with a different phenotype from those in the blood. A dna southern blot analysis of the blood cells confirmed the diagnosis of ATL. The aberrant cells in the CSF contained nuclei with simple indentations and responded well to the initial chemotherapy, while leukemic cells in the blood showed lobulated or convoluted nuclei and were resistant to treatment. flow cytometry performed before treatment demonstrated that the majority of the cells in the CSF were CD3 CD4 CD8-CD25 , consistent with ATL, whereas they expressed the CD45R antigen, which the blood ATL cells did not. These differences in the subphenotype, cell morphology, and responsiveness to treatment among the ATL cells in blood and CSF suggest that a single clone or subclone with heterogeneous nature was not generated, before the final development of ATL.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
10/16. Intratemporal schwannoma of the facial nerve.Two patients with schwannomas that originated from the region of the geniculate ganglion of the facial nerve are reported. They presented with progressive facial nerve paralysis and variable disturbance of hearing. Computed tomograms demonstrated a mass lesion eroding the temporal bone (petrous portion) and extending into the middle fossa. The treatment consisted of complete excision of the tumor, and a hypoglossal-facial nerve anastomosis. Computed tomography should be performed on all patients with facial palsy of a progressive nature. early diagnosis and surgical treatment of facial schwannoma should permit preservation of function of the facial and the acoustic nerves.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
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