1/30. Herpes zoster: a cause of acute detrusor muscle paralysis.The essence of this report is to apprise the dermatologist of this fascinating but unusual complication of herpes zoster and to underscore the help he may give in establishing the diagnosis along with assisting in the management of this disorder.- - - - - - - - - - ranking = 1keywords = paralysis (Clic here for more details about this article) |
2/30. Delayed facial paralysis after stapedotomy using KTP laser.OBJECTIVE: Delayed facial paralysis after stapes surgery is uncommon and has been reported after traditional, nonlaser techniques for stapedotomy. The purpose of this paper is to inform the reader of the potential risk of delayed facial nerve paralysis associated with the use of the potassium titanyl phosphate (KTP) laser for stapedotomy. Etiologic mechanisms are discussed. STUDY DESIGN: The study was a descriptive study-case report. SETTING: The study was conducted at a university-based otologic practice. patients: Two patients with otosclerosis and delayed onset facial palsy 5 to 7 days after uncomplicated stapedotomy using the KTP laser were included in the study. INTERVENTION: potassium titanyl phosphate laser stapedotomy was performed. patients received treatment of facial palsy with a tapering course of oral steroids. MAIN OUTCOME MEASURE: House-Brackmann facial nerve grade scores were used. RESULTS: Improvement of House-Brackmann facial nerve scores from Grade VI to Grade I-II in one patient, and improvement from Grade IV to Grade I-II in the other was seen. CONCLUSION: The probable etiology of delayed facial palsy is viral neuritis from reactivation of dormant virus within the facial nerve, initiated by thermal stress of the KTP laser. Presentation and resolution of the facial palsy is similar to other types of delayed facial palsy resulting from nonlaser techniques of stapes surgery and other types of middle ear and neurotologic surgeries previously reported.- - - - - - - - - - ranking = 1.5keywords = paralysis (Clic here for more details about this article) |
3/30. Zoster paresis of the shoulder. Case report and review of the literature.More than 95% of people in the united states are infected with the varicella zoster virus at some time in life, and this infection usually is manifested as chicken pox during childhood. The virus then establishes a latent infection of sensory ganglia, from which it may reactivate many years later to cause herpes zoster (shingles), a cutaneous painful rash along a dermatomal distribution. Less commonly, the varicella zoster virus may result in myotomal motor weakness or paralysis in addition to a painful dermatomal rash. A case of unilateral left C5-C6 segmental paresis attributable to herpes zoster in an otherwise healthy individual and a current review of the literature are presented. A case of zoster paresis of the shoulder muscles is presented to remind the orthopaedic community that this diagnosis may be confused with other diagnoses, including rotator cuff tear, and should be considered in the differential diagnosis of shoulder pain and shoulder girdle muscle weakness.- - - - - - - - - - ranking = 0.25keywords = paralysis (Clic here for more details about this article) |
4/30. Abdominal-wall pseudohernia secondary to herpes zoster.We present a case of a 78-year-old woman with abdominal-wall muscle paralysis following cutaneous herpes zoster in the T12-L1 dermatomes. An EMG confirmed paralysis, and a CT scan ruled out fascial defect. The paralysis had completely resolved 1 year later. A review of the literature regarding these unusual sequelae of herpes zoster is presented.- - - - - - - - - - ranking = 0.75keywords = paralysis (Clic here for more details about this article) |
5/30. Ramsay Hunt syndrome: pathophysiology of cochleovestibular symptoms.Ramsay Hunt's hypothesis that herpes zoster oticus results from reactivation of the varicella zoster virus (VZV) in the geniculate ganglion is supported by the detection of viral genome in archival temporal bones of normals and Ramsay Hunt patients by the polymerase chain reaction. Ramsay Hunt syndrome is characterized by the presence of cochleovestibular symptoms in association with facial paralysis. VZV has also been demonstrated in the spiral and/or vestibular ganglion. Two cases are reported in which cochleovestibular symptoms outweighed the facial nerve symptoms, presumably representing VZV reactivation in the spiral and/or vestibular ganglion. From these observations and the known dormancy of VZV in non-neuronal satellite cells, it is argued that the cochleovestibular symptoms in Ramsay Hunt syndrome may result from VZV transmission across the nerves inside the internal auditory canal and that prompt treatment with an antiviral-corticosteroid combination might be justified in the management of any acute non-hydropic cochleovestibular syndrome.- - - - - - - - - - ranking = 0.25keywords = paralysis (Clic here for more details about this article) |
6/30. Isolated bilateral paralysis of the soft palate in an adult.A case of bilateral paralysis of the soft palate occurring in a 42-year-old patient is presented. Idiopathic paralysis of the soft palate as an isolated clinical entity was first described by Edin et al. 1976. Since then 22 similar cases have been reported, all in children and all unilateral. A search of the English language literature has not revealed a case of bilateral palatal palsy in an adult.- - - - - - - - - - ranking = 1.5keywords = paralysis (Clic here for more details about this article) |
7/30. Herpes zoster laryngis with prelaryngeal skin erythema.A 74-year-old man came to our hospital with complete left vocal cord paralysis and erythema of the prelaryngeal skin. The patient also had mucosal swelling and erosions in the left arytenoid cartilage, aryepiglottic fold, and pyriform sinus. Herpetic vesicles developed over the prelaryngeal erythema 4 days after admission. An increase in the varicella-zoster immunoglobulin g level to 3,294 IU/mL confirmed varicella-zoster virus infection of the larynx and prelaryngeal skin. The patient was treated with acyclovir without marked effect. Nevertheless, in cases of unilateral vocal cord paralysis and erythema of the ipsilateral prelaryngeal skin, we advise that herpes zoster laryngis must be considered and treatment with early intravenous acyclovir started.- - - - - - - - - - ranking = 0.5keywords = paralysis (Clic here for more details about this article) |
8/30. Abdominal muscle paralysis associated with herpes zoster.We describe a 77-year-old women with cutaneous herpes zoster in the area of the right T9-T11 dermatomes complicated by abdominal muscle paralysis. Four months after onset of paralysis, stimulation of appropriate intercostal nerves failed to evoke responses from the corresponding segments of the rectus abdominis muscle. Three months later EMG of these muscle segments revealed profuse denervation activity and spontaneous long-lasting burst of high frequency discharges. Magnetic stimulation applied transcranially and peripherally at T10 evoked responses from the left, but not from the right paralytic rectus abdominis muscle. electric stimulation of right T10 elicited a markedly delayed, prolonged and polyphasic response in the transverse abdominis muscle and EMG revealed polyphasia and increased motor unit potential duration in muscle segments underlying herpes zoster eruption. One and a half years after onset, the paralysis of the rectus abdominis muscle was still present. A survey of the literature concerning this rare type of zoster paralysis is presented.- - - - - - - - - - ranking = 2keywords = paralysis (Clic here for more details about this article) |
9/30. Diaphragmatic paralysis following cervical herpes zoster.A 74-year-old man was found to have a paralysed left hemidiaphragm within four months of the appearance of a typical herpes zoster rash involving his left shoulder and neck. Investigations, including bronchoscopy and computed tomography of the chest, failed to detect a cause for the diaphragmatic paralysis. We believe that the cervical zoster and diaphragmatic paralysis were causally related, a rare but recognised association.- - - - - - - - - - ranking = 1.5keywords = paralysis (Clic here for more details about this article) |
10/30. Pathologic findings in the labyrinthine segment of the facial nerve in a case of facial paralysis.The histopathologic findings for a patient with acute facial paralysis caused by herpes zoster oticus who obtained no return of active facial function after 1 year are presented. All imaging studies were nondiagnostic. biopsy of the labyrinthine segment was performed. Histopathologic analysis showed a sharp line of demarcation between sclerotic nerve proximal to and necrotic nerve distal to the meatal foramen area of the fallopian canal. This finding is consistent with observations that the lesion producing Bell's palsy and herpes zoster oticus usually is situated at the meatal foramen.- - - - - - - - - - ranking = 1.25keywords = paralysis (Clic here for more details about this article) |
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