1/18. Malignant pilocytic astrocytoma in the medulla oblongata: case report.A 27-year-old woman visited our hospital with chief complaints of abducens nerve palsy and cerebellar symptoms. On computerized tomographic scanning and magnetic resonance imaging, a tumor with strong enhancement was found on the dorsal side of the medulla oblongata. A tumor was excised by suboccipital craniotomy and C1 laminectomy. Histologically, many Rosenthal fibers together with pilocytic tumor cells were found in some regions, but a very high Ki-67 labeling rate accompanied by cells with nuclei of irregular size and giant cells was observed in other regions. The tumor was diagnosed as malignant pilocytic astrocytoma originating from pilocytic astrocytoma by transformation. The biological behavior of pilocytic astrocytoma is obscure in several respects. We report our experience of a case of malignant pilocytic astrocytoma that developed in the brain stem and progressed extremely rapidly.- - - - - - - - - - ranking = 1keywords = nerve (Clic here for more details about this article) |
2/18. dizziness and panic in china: associated sensations of zang fu organ disequilibrium.In china, distress is commonly experienced as dizziness that can develop into acute episodes resembling Western panic attacks. These distressing sensations occur in a unique cultural context with a distinctive set of associated symptoms, beliefs and purported etiologies. The experience of illness is informed by traditional Chinese medicine (TCM), an indigenous theory that elaborates a system of organ functioning called zang fi. Depending on the implicated zang fi organ disequilibrium, dizziness and panic present with a specific constellation of associated physical and mental symptoms. This paper presents a clinical survey of psychiatric disorders that demonstrates dizziness to be characteristic of Chinese anxiety states, most particularly panic. Three specific cases of dizziness-focused panic ascribed to different states of zangfu disequilibrium are described. In a typical pattern, initial dizziness and associated symptoms intensify until they generalize into panic attacks. The degree of dizziness and panic corresponds to the state of disequilibrium of the zang fu organ system as well as instability of the social, interpersonal and environmental context of the patient. This paper elucidates the dynamic interpretants of dizziness in the Chinese context to contribute to a medical anthropology of this sensation.- - - - - - - - - - ranking = 0.21794645752864keywords = organ (Clic here for more details about this article) |
3/18. multiple sclerosis and oral care.multiple sclerosis is a complex neurological condition affecting sensory and motor nerve transmission. Its progression and symptoms are unpredictable and vary from person to person as well as over time. Common early symptoms include visual disturbances, facial pain or trigeminal neuralgia and paraesthesia or numbness of feet, legs, hands and arms. These, plus symptoms of spasticity, spasms, tremor, fatigue, depression and progressive disability, impact on the individual's ability to maintain oral health, cope with dental treatment and access dental services. Also, many of the medications used in the symptomatic management of the condition have the potential to cause dry mouth and associated oral disease. There is no cure for multiple sclerosis, and treatment focuses on prevention of disability and maintenance of quality of life. Increasingly a multi-disciplinary team approach is used where the individual, if appropriate his/her carer, and the specialist nurse are key figures. The dental team plays an essential role in ensuring that oral health impacts positively on general health.- - - - - - - - - - ranking = 1keywords = nerve (Clic here for more details about this article) |
4/18. Sympathoinhibition and hypotension in carotid sinus hypersensitivity.carotid sinus reflex hypersensitivity is a known cause of syncope in humans. The condition is characterized by cardioinhibition and vasodepression, each to varying degrees. The extent and importance of sympathoinhibition has not been determined in patients with carotid sinus hypersensitivity. This study reports on the extent of sympathoinhibition measured directly directly during carotid massage with and without atrioventricular sequential pacing, in a patient with symptomatic carotid sinus reflex hypersensitivity. Carotid massage elicited asystole, hypotension and complete inhibition of muscle sympathetic nerve activity. Carotid massage during atrioventricular pacing produced similar sympathoinhibition, but with minimal hypotension. Therefore, sympathoinhibition did not contribute importantly to the hypotension during carotid massage in the supine position in this patient. Further investigations are required to elucidate the relation of sympathoinhibition to hypotension in patients with carotid sinus hypersensitivity in the upright position.- - - - - - - - - - ranking = 1keywords = nerve (Clic here for more details about this article) |
5/18. Acute multiple cranial neuropathy: a variant of guillain-barre syndrome?Three patients with acute multiple cranial neuropathy following benign infectious disease are reported. Complete or partial ophthalmoplegia, as well as facial and bulbar dysfunction, were noted in all. Cranial nerve involvement was bilateral. Other neurological deficits included sensory loss in two patients and transiently reduced tendon reflexes in the left arm in one. One patient had positive serum anti-GQ1b immunoglobulin g antibody during the acute phase of the illness. The cerebrospinal fluid had a normal cell count in all three patients, with raised protein concentrations in two. Electrophysiological evaluation showed peripheral nerve dysfunction in two patients. All three patients improved either spontaneously or coincident with immunotherapy. Our patients had many clinical features resembling those of typical guillain-barre syndrome (GBS), and hence their disorder may represent a regional variant, that is, a cranial form, of GBS. This form of GBS accounted for 5% of the GBS patient population in our series.- - - - - - - - - - ranking = 2keywords = nerve (Clic here for more details about this article) |
6/18. Cavernous malformation of the trigeminal nerve manifesting with trigeminal neuralgia: case report.OBJECTIVE AND IMPORTANCE: We describe a patient with a cavernous malformation within the trigeminal nerve at the nerve root entry zone who presented with trigeminal neuralgia. CLINICAL PRESENTATION: A 52-year-old woman sought treatment after experiencing dizziness and lancinating left facial pain for almost a year. Neurological examination revealed diminished sensation in the distribution of the trigeminal nerve on the left. magnetic resonance imaging demonstrated a minimally enhancing lesion affecting the trigeminal nerve. INTERVENTION: The patient underwent a retrosigmoid craniotomy. At the nerve root entry zone, the trigeminal nerve was edematous with hemosiderin staining. The lesion, which was resected with microsurgical technique, had the appearance of a cavernous malformation on gross and histological examination. The patient's pain improved significantly after resection. CONCLUSION: Cavernous malformations can afflict the trigeminal nerve and cause trigeminal neuralgia. Microsurgical excision can be performed safely and is associated with improvement in symptoms.- - - - - - - - - - ranking = 11keywords = nerve (Clic here for more details about this article) |
7/18. Incomplete oculomotor nerve palsy caused by an unruptured internal carotid-anterior choroidal artery aneurysm--case report--.A 59-year-old woman visited our institute with the chief complaint of dizziness which persisted whenever she tried to focus on objects. She had not experienced apparent double vision and had no history of intracranial bleeding. Neurological examination revealed no abnormality except for exotropia at the mid-position and at upper gaze. cerebral angiography revealed that the intracranial portion of the left internal carotid artery ran more horizontally and also identified an unruptured left internal carotid-anterior choroidal artery (IC-AChA) aneurysm of 3.0 mm diameter. The aneurysm at the origin of the AChA was confirmed during surgery. The proximal lateral wall of the aneurysm was in contact with the oculomotor nerve. This contact was released after complete obliteration of the aneurysm. The exotropia resolved 3 months later. oculomotor nerve palsy usually indicates the presence of internal carotid-posterior communicating artery (IC-PcomA) aneurysm. Since sacrifice of the AChA will result in severe neurological deficits, accurate neuroimaging information is needed prior to the operation. Conventional angiography and/or three-dimensional computed tomography angiography should be performed to ascertain whether the aneurysm is an IC-PcomA or IC-AChA aneurysm, even if some neurosurgeons insist that conventional angiography is not always needed before surgery for an unruptured aneurysm.- - - - - - - - - - ranking = 6keywords = nerve (Clic here for more details about this article) |
8/18. Lesion site in idiopathic bilateral vestibulopathy: a galvanic vestibular-evoked myogenic potential study.CONCLUSION: The result suggests that patients with idiopathic bilateral vestibulopathy may have nerve lesions when the inferior nerve system is affected, while the inferior vestibular nerve system may be spared. OBJECTIVE: To clarify the lesion site in idiopathic bilateral vestibulopathy, an acquired bilateral vestibulopathy of unknown cause. MATERIAL AND methods: Two 75-year-old males diagnosed with idiopathic bilateral vestibulopathy were enrolled. Both showed absent or highly decreased responses on the caloric test on both sides. They underwent vestibular-evoked myogenic potential (VEMP) testing by means of acoustical and electrical stimulation. As acoustic stimulation, 95 dB nHL clicks and short tone bursts (500 Hz) were presented, while 3 mA (1 ms) short-duration galvanic stimuli were presented as electrical stimulation. Responses were recorded on the sternocleidomastoid muscles. RESULTS: Both patients showed unilateral absence of VEMPs with both acoustic and short-duration galvanic stimuli.- - - - - - - - - - ranking = 3keywords = nerve (Clic here for more details about this article) |
9/18. Weber's syndrome and sixth nerve palsy secondary to decompression illness: a case report.We describe the first case of Weber's Syndrome to present as a manifestation of decompression illness in a recreational scuba diver. Weber's Syndrome is characterized by the presence of an oculomotor nerve palsy and contralateral hemiparesis. The patient was a 55 year-old male with a past medical history of a pulmonary cyst, in whom symptoms developed after a multilevel drift dive to a depth of 89 feet for 53 minutes, exceeding no-decompression limits. Symptom onset was within 30 minutes of surfacing and included the Weber's Syndrome, a sixth nerve palsy, dizziness, nausea, sensory loss, and ataxia. The patient received four U.S. Navy Treatment tables with complete resolution of all neurological signs and symptoms. The mechanism of injury remains unclear, but may involve aspects of both air gas embolism and decompression sickness. Individuals with pre-existing pulmonary cysts may be at increased risk for dive-related complications.- - - - - - - - - - ranking = 6keywords = nerve (Clic here for more details about this article) |
10/18. temporal bone findings in central nervous system leukemia.central nervous system (CNS) leukemia is a pathologic condition whereby leukemic cells enter the cerebrospinal fluid (CSF) causing meningeal irritation syndrome. temporal bone findings in the case of a 32-year-old man who died of CNS leukemia are presented. He complained of fullness of the ear 4 months prior to death and of dizziness 1 month prior to death. Leukemic cells were seen to have infiltrated the scala tympani of the basal turn in the cochlea, the saccule, and posterior semicircular canal along the vestibulocochlear nerve.- - - - - - - - - - ranking = 1keywords = nerve (Clic here for more details about this article) |
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