1/19. 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) |
2/19. Delayed hypoglossal palsy following occipital condyle fracture--case report.Occipital condyle fractures are rare. When present, they produce lower cranial palsies and/or brainstem dysfunction. A 32 year old man sustained multiple injuries. At the time of admission the patient had no neurological deficits. Three weeks after the accident, the patient complained of slurring of speech. Clinical examination revealed an isolated hypoglossal palsy. Radiological evaluation revealed an occipital condyle fracture. The patient was treated with a rigid collar. Eighteen months after the injury, the patient noted slight improvement in his speech. However, clinical examination showed a persistent hypoglosssal palsy. Occipital condyle fractures are rare. They may be associated with lower cranial nerve palsies. As demonstrated by this case, this entity should be included in the differential diagnosis of hypoglossal palsy. Since occipital condyle fractures can exist without neurological deficits, special attention should be paid to imaging of the craniovertebral junction in patients with head injury.- - - - - - - - - - ranking = 1keywords = nerve (Clic here for more details about this article) |
3/19. syndrome of Dejerine's Fourth Reich.Dejerine's (1914) precise description of the human corticobulbar tracts is now doubted and forgotten for want of clinical significance. He described them as five bundles of aberrant pyramidal fibres which separate out as leashes from the corticospinal fibres at different levels and each had its territory of bulbar nuclei (like the Reich which is the territory of the German empire of which there were only three). Five cases are described who presented with uppermotor neurone lesion of the 7th, 10th and 12th cranial nerves without evidence of involveement of the pyramidal fibres to the limbs. It is postulated that this is caused by a lesion of the 4th Reich described by Dejerine.- - - - - - - - - - ranking = 1keywords = nerve (Clic here for more details about this article) |
4/19. Speech, language and hearing in Moebius syndrome: a study of 22 patients.A comprehensive profile of communicative disorders in patients with Moebius syndrome was attempted. Seven patients were evaluated by the authors and the findings were added to 15 contributed case-histories. Most patients demonstrated some degree of dysarthria due to congenital paralysis of the facial nerves. Other problems such as cleft palate, hearing loss, mental retardation and delayed development of language were found in a few of the patients. As most of the older children in the sample and in reports in the literature eventually developed intelligible speech, a program of oral language stimulation and compensatory articulatory adjustments would appear to be the procedure of choice.- - - - - - - - - - ranking = 1keywords = nerve (Clic here for more details about this article) |
5/19. The case of the gray optic disc!A child with interstitial deletion of chromosome 17, right optic nerve hypoplasia, and impaired speech had bilateral congenital optic disc pigmentation, giving the appearance of gray optic discs. This appearance did not change over a period of two-and-a-half years. Previous cases of gray optic discs in neonates have been notable for 1) absence of visible pigmentation within the optic discs, 2) resolution of the gray discoloration over a period of months, and 3) development of albinotic features in several infants. This suggests that congenital optic disc pigmentation is a rare cause of gray optic discs. Congenital optic disc pigmentation is compatible with good vision.- - - - - - - - - - ranking = 1keywords = nerve (Clic here for more details about this article) |
6/19. Neuronal intranuclear inclusion disease. Clinical ophthalmological features and ophthalmic pathology.Monozygotic twin sisters were afflicted by a chronic progressive neurological disease characterized by slurred speech, nystagmus and oculogyral spasms as well as further extrapyramidal and lower motor neuron abnormalities. At autopsy severe loss of nigral and craniospinal motor neurons was noted. In the nuclei of most nerve cell types of the central and peripheral nervous system, roundish inclusion bodies of 3 to 10 microns in diameter were found. Ocular pathology revealed the presence of identical inclusion bodies in the ganglion cells and ganglion cell loss in the posterior retina. Retinal astrocytosis and loss of myelinated axons of the optic nerve were interpreted as reactive features. No inclusions were found in the retinal pigment epithelium. Careful neuro-ophthalmological studies of the first-degree relatives revealed low b-wave of the ERG with other slight aberrations. These were assumed to represent either a carrier or a subclinical state of this presumably inherited disorder.- - - - - - - - - - ranking = 2keywords = nerve (Clic here for more details about this article) |
7/19. Intrinsic laryngeal muscle activity in a spastic dysphonia patient.EMG activity from four intrinsic laryngeal muscles (thyroarytenoid, posterior cricoarytenoid, interarytenoid, and cricothyroid) was obtained from one female spastic dysphonia patient while she performed a variety of speech and nonspeech tasks. These tasks were performed before and during a period of temporary unilateral laryngeal muscle paralysis. In the nonparalyzed condition, adductory muscle activity showed intermittent sudden increases that coincided with momentary voice arrests. These muscle patterns and accompanying voice interruptions were not present either when speech was produced in falsetto register or at anytime during the paralysis condition. The data suggest that individuals with this type of spastic dysphonia have normal morphology of recurrent laryngeal nerves and intrinsic laryngeal muscles, which means that the triggering mechanism(s) for spastic dysphonia symptoms must be located at some point neurologically upstream from the larynx.- - - - - - - - - - ranking = 1keywords = nerve (Clic here for more details about this article) |
8/19. Isolated temporary pharyngeal paralysis in childhood.Three children developed dysphagia and rhinolalia indicating isolated paralysis of the ninth and tenth cranial nerves. They recovered completely after three to four weeks. The clinical features suggested an infectious aetiology.- - - - - - - - - - ranking = 1keywords = nerve (Clic here for more details about this article) |
9/19. EMG feedback and recovery of facial and speech gestures following neural anastomosis.A case report is presented of an attempt to increase muscle activity during nonspeech and speech activities through surface electromyographic feedback. The subject, a 25-year-old male, had a surgical anastomosis of the seventh cranial to the twelfth cranial nerve five years prior to the initiation of this therapy. The right side of the face was immobile. Frequency analogs of muscle action potentials from the right lower lip during pressing, retraction, eversion, and speech were presented to the subject. His task was to increase the frequency of the tone thereby increasing muscle activity. The subject made substantial improvement in the gestures listed above. electrodes also were placed in various infraorbital positions for an upper lip lifting task. This gesture was unimproved. Pre- and posttherapy independence of facial gestures from conscious tongue contraction was found. Possible explanations were proposed for (1) increases of muscle activity in the lower lip, (2) lack of change of maps in the upper lip, (3) independence of the facial muscle activity from conscious tongue contraction, and (4) effectiveness of this feedback training.- - - - - - - - - - ranking = 1keywords = nerve (Clic here for more details about this article) |
10/19. dysarthria and aphagia: a case study of neuromuscular treatment.This case study involves a 44-year-old man with flaccid dysarthria, right hemiparesis, left facial paresis, left vocal fold paralysis, and aphagia following multiple gunshot wounds. He was treated surgically with a tracheostomy, feeding gastrostomy, left temporalis muscle sling, left cricopharyngeal myotomy, hypoglossal nerve anastomosis, and left true vocal fold Teflon injection. After seven years, the patient was referred for speech therapy. The areas of glottic closure, velopharyngeal closure, and tongue strength and mobility were stressed initially in speech therapy. Since these mechanisms were related to his aphagia, it was hypothesized that the oral motor activities used for speech would also aid in swallowing. After nine weeks of intensive practice, gains were noted in strength and movement for the tongue, velum and larynx. Shortly thereafter, he swallowed blender-texture food.- - - - - - - - - - ranking = 1keywords = nerve (Clic here for more details about this article) |
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