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Facial Nerve Paralysis Causes

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181. Radiation Exposure and Bell’s Palsy: A Hypothetical Association Full Text available with Trip Pro

Radiation Exposure and Bell’s Palsy: A Hypothetical Association Bell's palsy is an idiopathic peripheral nerve palsy involving the facial nerve. It accounts for 60 to 75% of all cases of unilateral facial paralysis. The main mechanisms to induce BP remain unclear, but infection, ischemic condition and immunodeficiency may contribute to the development of Bell's palsy. Accumulating evidence has shown several factors can trigger the reactivation of latent HSV including psychological stressors (...) , physical stressors and immunosuppression. Ionization and non-ionization radiations are of importance of physical stressors. Some data have shown radiation can reactivate HSVs. Based on preliminary studies showing radiation reactivation of HSVs, we aimed to hypothesize radiation (in both forms of ionization and non-ionization) may cause Bell's palsy. In the future, the role of radiotherapy, radiofrequency radiation from mobile phones and wireless devices in HSV reactivation and Bell's palsy should

2018 Journal of Biomedical Physics & Engineering

182. Evidence-based Guidelines for Treating Bipolar Disorder

not to dismiss or minimize mood elevation when it is the cause of disturbed behaviour; personality problems or situ- ational disturbance should be invoked only if mania (or hypoma- nia) is absent (IV). Bipolar patients may present with depression, especially in adolescence (I). Ask about a history of distinct periods of elated, excited or irritable mood of any duration and a family history of mania in all patients with depression (S). Anxiety disorders are highly co-morbid with bipolar disor- der (I) from (...) , follow the same principles as for a first episode or an episode occurring off long-term treatment. If the current episode is due to poor adherence, establish the cause and offer appropriate intervention (S). For example, if non- adherence is associated

2016 British Association for Psychopharmacology

184. Prevention of skin cancer

. Methodology 18 2.4.1. Modified SIGN evidence grading system 18 2.4.2. System of grading recommendations 19 2.4.3. Statements 19 © German Guideline Program in Oncology | Evidence-based Guideline on Prevention of Skin Cancer | April 2014 3 2.4.4. Expert Consensus (EC) 19 2.4.5. Independence and disclosure of possible conflicts of interest 20 2.5. Abbreviations used 21 3. Status quo of skin cancer 25 3.1. The aetiology of skin cancer 25 3.1.1. The causes of basal cell carcinoma (BCC), squamous cell carcinoma (...) NNE Number needed to excise OCT Optical coherence tomography OR Odds ratio OStrV Ordinance on the Protection of Employees against Hazards caused by Artificial Optical Radiation PPV Positive predictive value QI Quality indicators QLQ Quality of Life Questionnaire QOL Quality of life RCT Randomised controlled trial ROS Reactive oxygen species RR Relative risk SAB Scientific Advisory Board SCC Squamous cell carcinoma SCREEN Skin Cancer Research to Provide Evidence for Effectiveness of Screening

2014 German Guideline Program in Oncology

185. Pharmacologic Interventions for Bell's Palsy

is to encourage the use of oral corticosteroids for patients 16 years and older with new-onset Bell's palsy. Goals of treatment for Bell's palsy patients include decreasing recovery time and improving facial nerve functional recovery. Inflammation and edema causing compression of the facial nerve as it travels through the fallopian (facial) canal is the leading posited mechanism of Bell's palsy. Potent anti-inflammatory agents, such as oral corticosteroids, target the inflammatory process, presumably (...) are recommended for new-onset Bell's palsy patients to increase the probability of recovery of facial nerve function. Both developers make the strongest possible recommendation according to their respective grading schemes. AAO-HNSF specifies that steroids should be prescribed within 72 hours of symptom onset for patients 16 years and older. AAN does not cite a specific timeframe in its recommendation, but is in agreement that steroids should be initiated as soon as possible. The developer notes that, because

2014 National Guideline Clearinghouse (partial archive)

186. Royal Flying Doctor Service Western Operations Clinical manual part 1.Clinical guidelines

. Whatever the cause, the pilot has an obligation to ensure the safety of the aircraft and is legally entitled to request restraint of a patient or passenger where required, medical authorisation for this restraint is not a pre-requisite rather an aviation safety duty of care if directed by the pilot. Patients referred under the mental health act will generally have medical authorisation for physical restraint in-flight. Warning signs: ? Facial and body language, suggesting anger and restlessness (...) Tamponade Toxins Thrombosis (pulmonary/coronary) Post Resuscitation Care Re-evaluate ABCDE 12 lead ECG Treat precipitating causes Re-evaluate oxygenation and ventilation Temperature control (cool) Start CPR 30 compressions @ 100/min : 2 breaths Minimise Interruptions Attach Defibrillator / Monitor Assess Rhythm Non Shockable Shockable Shock CPR For 2 minutes CPR For 2 minutes Return of Spontaneous Circulation? Post Resuscitation Care RFDS Western Operations Version 6.0 Clinical Manual Issue Date

2014 Clinical Practice Guidelines Portal

187. Evidence-Based Guideline: Diagnosis and Treatment of Limb-Girdle and Distal Dystrophies

Alliance and Northeast ALS Consortium. Dr. Selcen has served as an editorial board member for Neuromuscular Disorders and has received funding for research from the National Institutes of Health (NIH). Dr. David reports no relevant disclosures. Dr. Raynor reports no relevant disclosures. Dr. Carter has served as the senior associate editor for Muscle & Nerve, has received honoraria from the AANEM and the Canadian Association of Physical Medicine and Rehabilitation, has received funding for research (...) Pharmaceuticals, Taro Pharmaceuticals, and Viromed (DSMB); receives funding from the NIH, the Italian Telethon (DSMB Chair), the Muscular Dystrophy Association, the Parent Project for Muscular Dystrophy, and the AAN; and receives royalties from Elsevier (for Cecil Essentials and Cecil Textbook of Medicine). 8 Dr. Amato has served as a consultant or on scientific advisory boards for MedImmune, Amgen, Biogen, DART, and Baxter; serves as an associate editor for Neurology and Muscle & Nerve; has received

2013 American Association of Neuromuscular & Electrodiagnostic Medicine

188. Improving Voice Outcomes After Thyroid Surgery

of procedure. The most common site of injury is damage to 1 or both recurrent laryngeal nerves (RLN), which are close to the thyroid gland and are the main nerves that control vocal fold (VF) mobility. The other nerves of major interest, and frequently less directly addressed during thyroid surgery, are the bilateral superior laryngeal nerves (SLN), injury to which can impair the ability to change pitch and reduce voice projection. Another less common surgical cause for post-thyroidectomy voice change (...) %, with a wide range from 2.3% to 26%, in part related to the timing and method of laryngeal examination. The Scandinavian quality register reported a vocal fold paralysis rate of 4.3% nerves at risk, based on 3660 thyroid operations performed in 2008 in 26 endocrine surgical units from Sweden and Denmark. , Further, the detection of vocal fold paralysis doubled when patients were submitted to routine laryngeal exam after surgery as compared to laryngoscopy performed only in patients with persistent

2013 American Academy of Otolaryngology - Head and Neck Surgery

189. Bell's palsy

, or disorder affecting a single nerve, and is the most common diagnosis associated with facial nerve weakness/paralysis. Bell’s palsy is a rapid unilateral facial nerve paresis (weakness) or paralysis (complete loss of movement) of unknown cause. The condition leads to the partial or complete inability to voluntarily move facial muscles on the affected side of the face. Although typically self-limited, the facial paresis/paralysis that occurs in Bell’s palsy may cause significant temporary oral (...) palsy is a rapid unilateral facial nerve paresis (weakness) or paralysis (complete loss of movement) of unknown cause. The condition leads to the partial or complete inability to voluntarily move facial muscles on the affected side of the face. Although typically self-limited, the facial paresis/paralysis that occurs in Bell’s palsy may cause significant temporary oral incompetence and an inability to close the eyelid, leading to potential eye injury. Additional long-term poor outcomes do occur

2013 American Academy of Otolaryngology - Head and Neck Surgery

190. Tympanostomy Tubes in Children Full Text available with Trip Pro

in intubated ears than in controls, , , is usually confined to the drum, and very rarely causes clinically significant hearing issues. Tympanic membrane atrophy, atelectasis, and retraction pockets are all more commonly observed in children with otitis media who are treated with tympanostomy tubes than in those who are not. These tympanic membrane changes, with the exception of tympanosclerosis, appear to resolve over time in many children and rarely require medical or surgical treatment. Persistent (...) -frequency tones. In summary, tympanostomy tubes do produce visible changes in the appearance of the tympanic membrane and may cause measurable long-term hearing loss. These outcomes do not appear to be clinically important or require intervention in the overwhelming majority of patients. The post–tympanostomy tube sequela most likely to require intervention is persistent perforation, with 80% to 90% success rates for surgical closure with a single outpatient procedure. Some investigators have questioned

2013 American Academy of Otolaryngology - Head and Neck Surgery

191. Occipital Condyle Fractures Full Text available with Trip Pro

; 33 ( 3 ): 171 – 173 . 16. Deeb ZL , Rothfus WE , Goldberg AL , Dafner RH Occult occipital condyle fractures presenting as tumors . J Comput Tomogr . 1988 ; 12 ( 4 ): 261 – 263 . 17. Demisch S , Lindner A , Beck R , Zierz S The forgotten condyle: delayed hypogloassal nerve palsy caused by fracture of the occipital condyle . Clin Neurol Neurosurg . 1998 ; 100 ( 1 ): 44 – 45 . 18. Orbay T , Aykol S , Seçkin Z , Ergün R Late hypoglossal nerve palsy following fracture of the occipital condyle . Surg (...) Neurol . 1989 ; 31 ( 5 ): 402 – 404 . 19. Paley MD , Wood GA Traumatic bilateral hypoglossal nerve palsy . Br J Oral Maxillofac Surg . 1995 ; 33 ( 4 ): 239 – 241 . 20. Urculo E , Arrazola M , Arrazola M Jr , Riu I , Moyua A Delayed glossopharyngeal and vagus nerve paralysis following occipital condyle fracture . Case report. J Neurosurg . 1996 ; 84 ( 3 ): 522 – 525 . 21. Wasserberg J , Bartlett RJ Occipital condyle fractures diagnosed by high-definition CT and coronal reconstructions . Neuroradiology

2013 Congress of Neurological Surgeons

192. An Update of Comprehensive Evidence-Based Guidelines for Interventional Techniques in Chronic Spinal Pain - Part 2 - Guidance and Recommendations

on history, physical examination, imaging, and nerve conduction studies in non-radicular pain, a precise cause of pain may be identified in only approxi- mately 15% of patients (184-189,367-504). However, it has been described that with application of controlled diagnostic interventional techniques, a diagnosis may become a reality in 85% of the patients rather than 15% (11,13,15,17,26,33,36-38,111,383,384). Consequently, precision diagnostic blocks are used to clarify multiple challenging situations (...) An Update of Comprehensive Evidence-Based Guidelines for Interventional Techniques in Chronic Spinal Pain - Part 2 - Guidance and Recommendations Objective: To develop evidence-based clinical practice guidelines for interventional techniques in the diagnosis and treatment of chronic spinal pain. Methodology: Systematic assessment of the literature. Evidence: I. Lumbar Spine • The evidence for accuracy of diagnostic selective nerve root blocks is limited; whereas for lumbar provocation

2013 American Society of Interventional Pain Physicians

193. Management of suspected viral encephalitis in children Full Text available with Trip Pro

-infectious encephalitis, sub-acute encephalitis and sub-acute sclerosing panencephalitis Mumps virus Parotitis, orchitis or pancreatitis may occur before, during or after meningoencephalitis Others (rarer causes) Influenza viruses, adenovirus, Erythrovirus B19, lymphocytic choreomeningitis virus, rubella virus, Arthropod-borne and zoonotic viruses Flaviviruses (family Flaviviridae) West Nile virus North America, Southern Europe, Africa, Middle East, West and Central Asia associated with flaccid paralysis (...) and Parkinsonian movement disorders Japanese encephalitis virus Asia, associated with flaccid paralysis and Parkinsonian movement disorders Tick-borne encephalitis virus Travel in Eastern Europe, Former USSR; tick bite; upper limb flaccid paralysis Dengue viruses (types 1–4) Causes fever, arthralgia, rash and haemorrhagic disease, occasional CNS disease Alphaviruses (family Togaviridae) Western, Eastern and Venezuelan equine encephalitis viruses Found in the Americas; encephalitis of horses and humans

2012 British Infection Association

194. AAN Guideline on Intraoperative Monitoring

multicenter survey . 3. Sala F , Palandri G , Basso E , et al . Motor evoked potential monitoring improves outcome after surgery for intramedullary spinal cord tumors: a historical control study . 4. Harner SG , Daube JR , Ebersold MJ , Beatty CW . Improved preservation of facial nerve function with use of electrical monitoring during removal of acoustic neuromas . 5. Radtke RA , Erwin CW , Wilkins RH . Intraoperative brainstem auditory evoked potentials: significant decrease in postoperative morbidity (...) by the Therapeutics and Technology Assessment Subcommittee (see appendices e-1 and e-2 on the Neurology ® Web site at ) of the American Academy of Neurology (AAN) and the American Clinical Neurophysiology Society (ACNS). Five additional panel members (D.S.G., C.A., V.C., G.S.G., and C.L.H.) served as methodology experts. A research librarian performed literature searches of the MEDLINE and EMBASE databases using the following keywords: monitoring, intraoperative, evoked potentials, paralysis, and intraoperative

2012 American Association of Neuromuscular & Electrodiagnostic Medicine

195. Guidelines for the Evaluation and Management of Status Epilepticus

-convulsive and refractory SE. Convulsive Status Epilepticus – De?ned as convulsions that are associated with rhythmic jerking of the extremities. – Characteristic ?ndings of generalized convulsive status epilepticus (GCSE): • Generalized tonic–clonic movements of the extremities • Mental status impairment (coma, lethargy, confusion) • May have focal neurological de?cits in the post ictal period (e.g., Todd’s paralysis, a temporary neurological de?cit lasting hours to days follow- ing a seizure) – Focal (...) -convulsive seizures is highly variable [31, 32]. • Negative symptoms include anorexia, aphasia/ mutism, amnesia, catatonia, coma, confusion, lethargy, and staring. • Positive symptoms include agitation/aggression, automatisms, blinking, crying, delirium, delu- sions, echolalia, facial twitching, laughter, nausea/vomiting, nystagmus/eye deviation, per- severation, psychosis, and tremulousness. Refractory SE (RSE) – Patients who do not respond to standard treatment regimens for status epilepticus

2012 Neurocritical Care Society

196. Intraoperative spinal monitoring with somatosensory and transcranial electrical motor evoked potentials

after scoliosis surgery: results of a large multicenter survey . 3. Sala F , Palandri G , Basso E , et al . Motor evoked potential monitoring improves outcome after surgery for intramedullary spinal cord tumors: a historical control study . 4. Harner SG , Daube JR , Ebersold MJ , Beatty CW . Improved preservation of facial nerve function with use of electrical monitoring during removal of acoustic neuromas . 5. Radtke RA , Erwin CW , Wilkins RH . Intraoperative brainstem auditory evoked potentials (...) , intraoperative, evoked potentials, paralysis, and intraoperative complications. Additional articles were found from among the references cited in the reports reviewed. Each article was reviewed independently by at least 2 panel members. Appendix e-3 presents the complete MEDLINE search strategy, and appendix e-4 presents the complete EMBASE search strategy. The panel elected to focus on the 2 most common current spinal cord IOM techniques. The SEP technique evaluated was ankle-wrist stimulation with neck

2012 American Academy of Neurology

197. 2012 ACCF/AHA/ACR/SCAI/SIR/STS/SVM/SVN Key Data Elements and Definitions for Peripheral Atherosclerotic Vascular Disease

and compare care patterns and outcomes, the data elements that characterize them must be clearly defined, consistently used, and properly interpreted, now more than ever before. Robert C. Hendel, MD, FACC, FASNC, FAHA Chair, ACCF/AHA Task Force on Clinical Data Standards 1. Introduction Atherosclerotic vascular disease refers to disorders of the arteries caused by atherosclerosis. 2 This document provides datastandardsforperipheralatheroscleroticvasculardiseases (PAVDs (...) causal. For this reason, it is included in this document as a PAVD, although there are other much less common causes of AAA, such as aortitis, infection, aortic dissection, and inherited disorders of con- nective tissue. The data elements defined in Table 3 enable documentation of symptoms, relevant medical history, and the physical assessment of AAA. The table comprises de- tailed elements of diagnostic imaging tests, including ultra- sonography, magnetic resonance imaging, and computed tomography

2012 Society for Cardiovascular Angiography and Interventions

198. Treatment of Bell's Palsy - Should antivirals be added to prednisolone?

by other analysts were included. Outcome defined as unsatisfactory recovery, in contrast to the other meta-analyses which used full recovery at 3 months. Risk of unsatisfactory recovery >/=4 months Corticosteroid plus antiviral vs corticosteroid alone RR 0.75 (95% CI 0.56-1.00), P=0.05. Goudakos et al, 2009, Greece 738 patients with unilateral facial nerve weakness of no identifiable cause treated with either steroids or steroids with any antiviral agent. Systematic review of five trials. Adequate data (...) , UK and Manchester Royal Infirmary, Manchester, UK Date Submitted: 31st July 2011 Date Completed: 12th June 2012 Last Modified: 12th June 2012 Status: Green (complete) Three Part Question Is [Bell’s Palsy] best treated with [prednisolone] or [prednisolone combined with an antiviral agent]? Clinical Scenario A 49 year old gentleman presents with weakness of the entire right side of his face. He has no other neurological features to suggest a stroke. You diagnose idiopathic facial paralysis (Bell’s

2012 BestBETS

199. Botulinum Toxin for Trigeminal Neuralgia

that causes flaccid paralysis by blocking neurotransmitter release by axonal terminals. As a contaminant, it is the cause of potentially lethal botulism poisoning; however, as a drug, it has been widely used in the treatment of dystonia, as well as for non-surgical cosmetic treatment. More recently, studies investigating the ability of BoNT-A to treat pain have been increasing. In 2012, the investigators reported the results of a randomized, double-blind, and placebo-controlled trial in which subcutaneous (...) -regulated Drug Product: No Studies a U.S. FDA-regulated Device Product: No Additional relevant MeSH terms: Layout table for MeSH terms Neuralgia Trigeminal Neuralgia Peripheral Nervous System Diseases Neuromuscular Diseases Nervous System Diseases Pain Neurologic Manifestations Signs and Symptoms Trigeminal Nerve Diseases Facial Neuralgia Facial Nerve Diseases Mouth Diseases Stomatognathic Diseases Cranial Nerve Diseases Botulinum Toxins Botulinum Toxins, Type A abobotulinumtoxinA Acetylcholine Release

2017 Clinical Trials

200. The Protean Neuropsychiatric and Vestibuloauditory Manifestations of Neurosarcoidosis. (Abstract)

The Protean Neuropsychiatric and Vestibuloauditory Manifestations of Neurosarcoidosis. A rare subset of sarcoidosis, neurosarcoidosis, is reported to occur in 5-7% of sarcoid patients and can manifest in a variety of ways. The most common are facial paralysis and optic neuritis, less commonly causing cochleovestibulopathy, blindness, anosmia, and other cranial nerve (CN) palsies. The sensory deficit may be severe and psychiatric symptoms may result from the effects of the disease or steroid (...) and XI, with altered mental status requiring admission following high-dose intravenous corticosteroids. The third is a 15-year-old boy who presented with sudden, bilateral, profound SNHL, recurrent headaches, and left facial weakness refractory to antivirals, ultimately diagnosed with neurosarcoidosis following an aborted cochlear implantation where diffuse inflammation was found, and histopathology revealed Schaumann bodies; he was treated with methotrexate and later underwent successful cochlear

2017 Audiology & Neuro-Otology

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