1/29. Simultaneous vocal fold and tongue paresis secondary to Epstein-Barr virus infection.dysphonia is a common presenting symptom in cases referred for otolaryngologic evaluation. Similarly, primary care physicians frequently see adolescents or young adults with symptomatic Epstein-Barr virus infection. Some of the patients with active Epstein-Barr virus infection who have severe clinical manifestations of infectious mononucleosis will be referred for otolaryngologic evaluation. voice abnormalities in these patients, though, are usually limited to altered resonance due to pharyngeal crowding by hyperplastic lymphoid tissue. We describe a patient with infectious mononucleosis who was referred for evaluation of dysphonia and was diagnosed with unilateral tongue and vocal fold paresis. We also discuss the patient's clinical course and review the related literature. Although uncommon, cranial nerve palsies must be considered in the patient with Epstein-Barr virus infection who presents with voice or speech disturbance. Arch Otolaryngol head Neck Surg. 2000;126:1491-1494- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/29. Desmoid tumor of the spinal canal causing scoliosis and paralysis.STUDY DESIGN: This report describes a case of successful surgical excision of an intrathoracic paraspinal desmoid tumor with an intraspinous extension causing scoliosis and paralysis in a 12-year-old girl. OBJECTIVES: The purpose of this report is to illustrate the potential spectrum of disease of a desmoid tumor and to make physicians aware of the rare possibility of an intraspinal extension of a paraspinal desmoid tumor. SUMMARY OF BACKGROUND DATA: Surgical excision of desmoid tumors in the pediatric population is the standard of care for initial treatment. There have been no clinical reports in the spine literature of a desmoid tumor causing scoliosis or of a desmoid tumor with an intraspinous extension causing paralysis. methods: The tumor was decompressed from a posterior approach followed by an anterior resection and an anterior spinal fusion. Two weeks later a posterior spinal fusion was performed to correct the spinal deformity. The patient also received radiation therapy after surgery for 5 weeks. RESULTS: The patient tolerated the procedure well, has been free of recurrence for 9 years, and is currently doing well. CONCLUSION: This case report should help expand the understanding of the spectrum of this uncommon tumor.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
3/29. Motor sensory dysfunction of upper limb due to conversion syndrome.Seven patients had functional paralysis that occurred in the dominant limb together with joint contracture and sensory disturbances associated with emotional problems. In five of these patients, the syndrome was preceded by trauma to the affected upper limb and in one patient by a myocardial infarction. The treatment consisted of persuasion, suggestion, general rhythmic exercises and emotional support given by the physiatrist (not a psychiatrist). In five of the subjects treated, the symptoms disappeared and the patients soon returned to work. In two patients the treatment did not succeed since no satisfactory rapport could be established between the patient and the physician.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
4/29. Bilateral sixth nerve palsy after head trauma.Gaze deficits are not uncommon after head trauma and might be caused by injury to the central nervous system, the peripheral nerve, or the motor unit. Traumatic bilateral sixth cranial nerve palsies are a rare condition and are typically associated with additional intracranial, skull, and cervical spine injuries. We describe a case of a complete bilateral sixth nerve palsy in a 44-year-old male patient with trauma with no intracranial lesion, no associated skull or cervical spine fracture, and no altered level of consciousness. The emergency physician should be aware of the differential diagnosis, initial workup, and injuries associated with a traumatic gaze deficit.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
5/29. Licorice consumption causing severe hypokalemic paralysis.Hypokalemic paralysis due to licorice consumption is extremely rare, with only 40 cases in the English literature describing paralysis secondary to exposure to licorice in candies, medications, chewing tobacco, and herbal preparations. We describe a patient who suffered life-threatening hypokalemic paralysis caused by consumption of licorice in the form of a tea sweetener superimposed on long-term consumption of licorice candy. Aggressive fluid and potassium replenishment produced complete and lasting recovery. To our knowledge, this is the first report of hypokalemic paralysis due to exposure to licorice as a tea sweetener, a common custom among the Arab population. The case emphasizes the importance of considering patients' cultural backgrounds and local customs, which often may lead the treating physician to the correct clinical diagnosis.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
6/29. Thyrotoxic hypokalaemic paralysis in a pregnant Afro-Caribbean woman. A case report and review of the literature.This paper reports the case of a 21-year-old Afro-Caribbean pregnant woman with hyperthyroidism and hypokalaemic quadriparesis and reviews the literature on the topic. Thyrotoxic periodic paralysis is a very rare condition in the Caribbean. This case reminds West Indian physicians to consider this rare condition in any patient that presents with paralysis.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
7/29. lightning strikes: nature of neurological damage in patients evaluated in hospital emergency departments.Emergency physicians and staff are usually the first to evaluate and manage victims of lightning strikes. Damage to the nervous system is often the most devastating consequence of lightning strikes. Contrary to most articles in the literature in which neurological disorders are said to be either transient or delayed, we report the cases of six patients with severe, immediate, and in at least three, permanent clinical problems. patients with signs of spinal cord lesions are most likely to have permanent disabilities.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
8/29. A case report and review of hypokalemic paralysis secondary to renal tubular acidosis.A 5-year-old girl with distal renal tubular acidosis (RTA) and hypokalemic muscle paralysis is reported. RTA is a known cause of hypokalemia, but in spite of the presence of persistent hypokalemia muscular paralysis is uncommon, rarely described in children, and the onset of paralysis may initially be misinterpreted particularly if the patient is attended by a physician who is not a pediatric nephrologist. Therefore parents must be informed about this possibility. Still, as the clinical appearance of hypokalemic paralysis is quite similar to familial hypokalemic periodic paralysis, and because the emergent and prophylactic treatment of the two disorders are quite different, we discuss the diagnostic evaluation and the treatment for both of them.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
9/29. An overlooked association of brachial plexus palsy: diaphragmatic paralysis.Diaphragmatic paralysis in newborns is related to brachial plexus palsy. It can be overlooked if thorough examination isn't done. We present a two-weeks-old baby with a birth weight of 3800 grams who had a left-sided brachial plexus palsy and torticollis with an undiagnosed left diaphragmatic paralysis even though he was examined by different physicians several times. The role of physical examination, the chest x-rays of patients with brachial paralysis and the treatment modalities of diaphragmatic paralysis due to obstetrical factors are discussed.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
10/29. The "intermediate syndrome" as critical sequelae of organophosphate poisoning: the first report of two cases in thailand.The authors report 2 cases of organophosphate poisoning which developed intermediate syndrome. The first case was a man who took an organophosphate insecticide, monocrotophos, and developed severe organophosphate poisoning. Respiratory support was needed. He was treated with atropine and 2-PAM. Weakness of neck muscles, proximal limb and respiratory muscle developed in the 3rd day after ingestion. By supportive treatment and careful monitoring, however, he recovered after 11 days of the poisoning. The second case was a lady who took dicrotophos. She developed severe organophosphate poisoning for which respiratory support was also needed High dose of atropine, but without 2-PAM, was administered. She developed bulbar palsy, proximal muscle and respiratory weakness 3 day after the ingestion. ventilation support was needed for 13 days before weaning was successful. This report did not support an efficacy of pralidoxime (2-PAM) in alleviation of the intermediate syndrome, but aims to alert physicians to recognize the intermediate syndrome for which adequate respiratory care is the crucial key for its management.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
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