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Facial Nerve Paralysis Causes

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81. Bilateral Facial Nerve Palsy: A Diagnostic Dilemma (PubMed)

Bilateral Facial Nerve Palsy: A Diagnostic Dilemma Introduction. Bilateral facial nerve palsy (FNP) is a rare condition, representing less than 2% of all cases of FNP. Majority of these patients have underlying medical conditions, ranging from neurologic, infectious, neoplastic, traumatic, or metabolic disorders. Objective. The differential diagnosis of its causes is extensive and hence can present as a diagnostic challenge. Emergency physicians should be aware of these various diagnostic (...) possibilities, some of which are potentially fatal. Case Report. We report a case of a 43-year-old female who presented to the emergency department with sequential bilateral facial nerve paralysis which could not be attributed to any particular etiology and, hence, presented a diagnostic dilemma. Conclusion. We reinforce the importance of considering the range of differential diagnosis in all cases presenting with bilateral FNP. These patients warrant admission and prompt laboratory and radiological

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2012 Case Reports in Emergency Medicine

82. Evidence-based Guideline: Vagus nerve stimulation for the treatment of epilepsy

explanted, and one was reimplanted later in the study (time frame unspecified). Left vocal cord paralysis occurred in 2, lower facial muscle paresis occurred in 2, and fluid accumulation over the gen- erator requiring aspiration occurred in one. The fre- quency of other AEs was “dose”-related; that is, greater at the highest-tolerated stimulation intensity vs the lowest-perceptible stimulation intensity: voice alteration 47.4% vs 9.7%, dyspnea 11.6% vs 1.0%, pharyngitis 15.8% vs 3.9%. Two additional (...) Evidence-based Guideline: Vagus nerve stimulation for the treatment of epilepsy DOI 10.1212/WNL.0b013e3182a393d1 2013;81;1453-1459 Published Online before print August 28, 2013 Neurology George L. Morris III, David Gloss, Jeffrey Buchhalter, et al. Subcommittee of the American Academy of Neurology treatment of epilepsy: Report of the Guideline Development Evidence-based guideline update: Vagus nerve stimulation for the This information is current as of August 28, 2013 http://www.neurology.org

2013 American Epilepsy Society

83. Vagus nerve stimulation for the treatment of epilepsy

patient died from unrelated causes. The clinical trial leading to FDA approval of the VNS device was used for comparison. e16 It included 254 adult patients with refractory partial epilepsy (mean age 32 years, range 13–60 years). Surgical infectious complications occurred in 3 patients; all were explanted, and one was reimplanted later in the study (time frame unspecified). Left vocal cord paralysis occurred in 2, lower facial muscle paresis occurred in 2, and fluid accumulation over the generator (...) Vagus nerve stimulation for the treatment of epilepsy Evidence-based guideline update: Vagus nerve stimulation for the treatment of epilepsy | Neurology Advertisement Search for this keyword Main menu User menu Search Search for this keyword The most widely read and highly cited peer-reviewed neurology journal Share October 15, 2013 ; 81 (16) Special Article Evidence-based guideline update: Vagus nerve stimulation for the treatment of epilepsy Report of the Guideline Development Subcommittee

2013 American Academy of Neurology

84. Dermoid cyst in the facial nerve--A unique diagnosis. (PubMed)

Dermoid cyst in the facial nerve--A unique diagnosis. Facial nerve paralysis in children may occur as a complication of infections, trauma, or rarely from benign or malignant tumors of the facial nerve. We present the first reported case of a dermoid tumor in the facial nerve causing facial paralysis in a child. Case report at a tertiary Children's Hospital. A 9-month-old was referred to our institution for evaluation of persistent, complete right sided facial paralysis three months after (...) was cable grafted. Histological examination of the tumor confirmed a ruptured dermoid cyst in the facial nerve. Facial nerve tumors are rare causes of facial paralysis in children, accounting for fewer than 10% of cases of facial paralysis in the pediatric population. Dermoid cyst can occur throughout the head and neck region in children, but a dermoid tumor in the facial nerve has not been described in the literature prior to this report. This represents a new and uncommon diagnostic entity

2011 International Journal of Pediatric Otorhinolaryngology

85. Use of Computed Tomography to Predict the Possibility of Exposure of the First Genu of the Facial Nerve Via the Transmastoid Approach. (PubMed)

the tympanic and labyrinthine segments. The other group included patients with facial paralysis who required facial nerve exploration, especially distal to the geniculate ganglion. Facial nerve decompression was performed in all patients as far proximal in the transmastoid view as was possible without causing damage to the semicircular canals.We correlated the temporal bone CT images and surgical findings in 11 patients who underwent facial nerve decompression via the transmastoid approach. The facial (...) Use of Computed Tomography to Predict the Possibility of Exposure of the First Genu of the Facial Nerve Via the Transmastoid Approach. The purpose of this study was to investigate whether computed tomography (CT) could predict the possibility of first genu exposure of the facial nerve via the transmastoid approach in patients with acute facial paralysis.Temporal bone CT is the best method for visualizing the intratemporal segment of the facial nerve canal, which is known to have diverse

2011 Otology and Neurotology

86. Vertebral artery pexy for microvascular decompression of the facial nerve in the treatment of hemifacial spasm. (PubMed)

Vertebral artery pexy for microvascular decompression of the facial nerve in the treatment of hemifacial spasm. Hemifacial spasm (HFS) is caused by arterial or venous compression of cranial nerve VII at its root exit zone. Traditionally, microvascular decompression of the facial nerve has been an effective treatment for posterior inferior and anterior inferior cerebellar artery as well as venous compression. The traditional technique involves Teflon felt or another construct to cushion (...) ). All 6 patients had complete resolution of their HFS. Facial function was tested postoperatively, and was stable when compared with the preoperative baseline. Two of the 3 patients with preoperative tinnitus had resolution of this symptom after the procedure. Postoperative imaging demonstrated VA decompression of the facial nerve and no evidence of stroke in all patients. One patient suffered from hearing loss, another developed a postoperative transient unilateral vocal cord paralysis, and a third

2011 Journal of Neurosurgery

87. Cranial Nerve 7

, Cranial Nerve VII , Facial Nerve , CN 7 , Geniculate Ganglion , Superior Salivatory Nucleus , Superior Salivary Nucleus II. Causes: Paralysis Neoplasm (Infectious polyneuritis) Melkersson's Syndrome (Recurrent ) Poliomyelitis (ALS) III. Anatomy: Course to Geniculate Ganglion ral Facial Nerve originates in four nucleii in pons and All combine to travel via internal auditory meatus into Geniculate Ganglion Each side of the forehead is innervated by both s (but only one peripheral Facial Nerve) Forehead (...) IS involved with a peripheral Facial Nerve lesion (LMN) such as in Forehead IS NOT involved with an UMN deficit from a central lesion such as a CVA Most important of the four components Innervates muscles of facial expression (and stapedius) Originates in pons at facial nucleus (in the somatovisceral region) First courses medially within the pons (paradoxical) Circles clockwise around 6th Passes anterior to the Then exits the pons Innervates lacrimal glands (via pterygopalatine ) Innervates submaxillary

2018 FP Notebook

88. Goitre causes, investigation and management

thyroid conditions should seek advice from their medical practitioner before commencing a supplement. Clinical presentation nodular goitre is most often detected simply as a mass in the neck, but an enlarging gland may also produce pressure symptoms on the trachea and the oesophagus. As well as discomfort, there may be difficulty in breathing, dysphagia, cough and hoarseness. Paralysis of the recurrent laryngeal nerve may occur when the nerve Table 1. Common causes of goitre • Hashimoto thyroiditis (...) Goitre causes, investigation and management Thyroid 572 Reprinted from AustRAliAn F Amily PhysiciAn Vol. 41, no. 8, August 2012 Kiernan Hughes Creswell Eastman Goitre Causes, investigation and management Background Goitre refers to an enlarged thyroid. Common causes of goitre include autoimmune disease, thyroid nodules and iodine deficiency. Objective This article outlines the causes, investigation and management of goitre in the Australian general practice setting. Discussion Patients

2012 Clinical Practice Guidelines Portal

89. Infrared-Based Blink-Detecting Glasses for Facial Pacing: Toward a Bionic Blink. (PubMed)

Infrared-Based Blink-Detecting Glasses for Facial Pacing: Toward a Bionic Blink. IMPORTANCE Facial paralysis remains one of the most challenging conditions to effectively manage, often causing life-altering deficits in both function and appearance. Facial rehabilitation via pacing and robotic technology has great yet unmet potential. A critical first step toward reanimating symmetrical facial movement in cases of unilateral paralysis is the detection of healthy movement to use as a trigger (...) for stimulated movement. OBJECTIVE To test a blink detection system that can be attached to standard eyeglasses and used as part of a closed-loop facial pacing system. DESIGN, SETTING, AND PARTICIPANTS Standard safety glasses were equipped with an infrared (IR) emitter-detector unit, oriented horizontally across the palpebral fissure, creating a monitored IR beam that became interrupted when the eyelids closed, and were tested in 24 healthy volunteers from a tertiary care facial nerve center community. MAIN

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2014 JAMA facial plastic surgery

90. Endoscopic Management of Facial Fractures

and avoidance of electrocautery reduces this risk. Facial nerve paralysis is possible but highly unlikely because the entire dissection is performed in a subperiosteal plane. Whenever alloplastic implants are used, implant infection or extrusion is a risk. However, porous polyethylene has been used extensively in the maxillofacial skeleton with good clinical results. Also, while a potential for delayed fragmentation of HA cements exists, this has thus far not been reported for this type of reconstruction (...) table fractures are primarily an aesthetic problem. They do not involve the posterior table and are therefore felt to carry a low risk of long-term complications. Traditional open reduction of isolated anterior table fractures requires a coronal incision for adequate exposure and fracture repair. Success rates are very high, but the procedure produces surgical stigmata, including a large scar, possible alopecia, paresthesias, and even facial nerve injury (temporal branch). The endoscopic approach

2014 eMedicine Surgery

91. Facial Nerve Palsy

the geniculate ganglion or along the entire course of the nerve. However, its enhancement may reflect other causes, such as meningeal tumor. If the paralysis progresses over weeks to months, the likelihood of a tumor (eg, most commonly schwannoma) compressing the facial nerve increases. MRI can also help exclude other structural disorders causing facial nerve palsy. CT, usually negative in Bell palsy, is done if a fracture is suspected or if MRI is not immediately available and stroke is possible (...) , serum ACE level) are done to diagnose treatable causes. Treatment may include lubrication of the eye, intermittent use of an eye patch, and, for idiopathic facial nerve palsy, corticosteroids. (See also .) Etiology Historically, Bell palsy was thought to be idiopathic facial nerve (peripheral 7th cranial nerve) palsy. However, facial nerve palsy is now considered a clinical syndrome with its own differential diagnosis, and the term "Bell palsy" is not always considered synonymous with idiopathic

2013 Merck Manual (19th Edition)

92. Delayed facial nerve paresis after using the KTP laser in the treatment of cholesteatoma despite inter-operative facial nerve monitoring. (PubMed)

nerve injury was identified. Intra-operatively, the facial nerve was not encountered or exposed, and the KTP laser was not used directly on the nerve. The facial nerve monitor did not alarm. The three patients began experiencing a paresis from POD #7-9, with House-Brackmann facial nerve score of II-III at maximum severity. This resolved fully between 4 and 7 weeks after the onset of the paralysis. The KTP laser during cholesteatoma surgery has been shown to decrease residual disease but may however (...) also cause a temporary, delayed, mild facial nerve paresis. We discuss the mechanisms for injury and the role of intra-operative facial nerve monitoring in the context of this uncommon and unforeseen complication.Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

2010 International Journal of Pediatric Otorhinolaryngology

93. Bilateral recurrent laryngeal nerve injury in total thyroidectomy with or without intraoperative neuromonitoring. Systematic review and meta-analysis. (PubMed)

Bilateral recurrent laryngeal nerve injury in total thyroidectomy with or without intraoperative neuromonitoring. Systematic review and meta-analysis. The risk of producing bilateral laryngeal paralysis (BLP) in total thyroidectomy (TT) is low, but it is a concern for the surgeon and a serious safety incident that may compromise the airway, require reintubation or tracheostomy and cause serious sequelae or death. Neuromonitoring (NM), as an early diagnostic tool for the existence of injury (...) to the recurrent laryngeal nerve (RLN), has not been shown to have reduced the risk, even though published series show lower incidences. Our objective was to estimate the risk of bilateral RLN paralysis with and without NM TT by systematic review and meta-analysis.We performed a systematic review of clinical trials, cohort studies and case series with total thyroidectomy without NM published in the period 2000-2014. A database search was performed using PubMed, Scopus (EMBASE) and the Cochrane Library

2015 Acta Otorrinolaringologica Espanola

94. Reinnervation of Facial Muscles After Lengthening Temporalis Myoplasty

Pathology cause of facial paralysis evolving Pregnant or lactating Patient incapacitated adult Patient undergoing another study at the same time Contacts and Locations Go to Information from the National Library of Medicine To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor. Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT01833221 Locations Layout table for location information (...) : University Hospital, Caen Information provided by (Responsible Party): University Hospital, Caen Study Details Study Description Go to Brief Summary: The purpose of this study is to determine the physiology of nerve healing and the neurotization of the facial muscles after lengthening temporalis myoplasty. Condition or disease Intervention/treatment Phase Facial Paresis Drug: injection of 1% lidocaine, 2mL for facial nerve block Phase 4 Detailed Description: The investigators want to study the physiology

2013 Clinical Trials

95. Trochlear Nerve Palsy (Diagnosis)

. Curr Opin Ophthalmol . 2008 Sep. 19(5):379-83. . Dosunmu EO, Hatt SR, Leske DA, Hodge DO, Holmes JM. Incidence and Etiology of Presumed Fourth Cranial Nerve Palsy: A Population-based Study. Am J Ophthalmol . 2018 Jan. 185:110-114. . Richards BW, Jones FR Jr, Younge BR. Causes and prognosis in 4,278 cases of paralysis of the oculomotor, trochlear, and abducens cranial nerves. Am J Ophthalmol . 1992 May 15. 113(5):489-96. . Holmes JM, Mutyala S, Maus TL, et al. Pediatric third, fourth, and sixth (...) . Fourth nerve palsy: historical review and study of 215 inpatients. Neurology . 1993 Dec. 43(12):2439-43. . Robb RM. Idiopathic superior oblique palsies in children. J Pediatr Ophthalmol Strabismus . 1990 Mar-Apr. 27(2):66-9. . Rush JA, Younge BR. Paralysis of cranial nerves III, IV, and VI. Cause and prognosis in 1,000 cases. Arch Ophthalmol . 1981 Jan. 99(1):76-9. . Son S, Park CW, Yoo CJ, Kim EY, Kim JM. Isolated, contralateral trochlear nerve palsy associated with a ruptured right posterior

2014 eMedicine.com

96. Trochlear Nerve Palsy (Overview)

. Curr Opin Ophthalmol . 2008 Sep. 19(5):379-83. . Dosunmu EO, Hatt SR, Leske DA, Hodge DO, Holmes JM. Incidence and Etiology of Presumed Fourth Cranial Nerve Palsy: A Population-based Study. Am J Ophthalmol . 2018 Jan. 185:110-114. . Richards BW, Jones FR Jr, Younge BR. Causes and prognosis in 4,278 cases of paralysis of the oculomotor, trochlear, and abducens cranial nerves. Am J Ophthalmol . 1992 May 15. 113(5):489-96. . Holmes JM, Mutyala S, Maus TL, et al. Pediatric third, fourth, and sixth (...) . Fourth nerve palsy: historical review and study of 215 inpatients. Neurology . 1993 Dec. 43(12):2439-43. . Robb RM. Idiopathic superior oblique palsies in children. J Pediatr Ophthalmol Strabismus . 1990 Mar-Apr. 27(2):66-9. . Rush JA, Younge BR. Paralysis of cranial nerves III, IV, and VI. Cause and prognosis in 1,000 cases. Arch Ophthalmol . 1981 Jan. 99(1):76-9. . Son S, Park CW, Yoo CJ, Kim EY, Kim JM. Isolated, contralateral trochlear nerve palsy associated with a ruptured right posterior

2014 eMedicine.com

97. Schwannoma, Cranial Nerve

in 12 patients as facial nerve weakness or paralysis and in 8 patients as involuntary movements of the facial musculature. [ ] Trigeminal schwannomas can arise in the Meckel cave or in the cistern along the course of the nerve. [ ] Extension and expansion of the foramen rotundum or ovale is common, and the masses can have a bilobed appearance. Tumors can also grow posteriorly to involve the posterior fossa, or they can grow anteriorly into the cavernous sinus. Trigeminal schwannomas tend to have (...) of a cystic hypoglossal schwannoma causing unilateral tongue atrophy. Br J Neurosurg . 2013 Jul 15. . Chung SY, Kim DI, Lee BH, et al. Facial nerve schwannomas: CT and MR findings. Yonsei Med J . 1998 Apr. 39(2):148-53. . Behuria S, Rout TK, Pattanayak S. Diagnosis and management of schwannomas originating from the cervical vagus nerve. Ann R Coll Surg Engl . 2015 Mar. 97 (2):92-7. . Bittencourt AG, Alves RD, Ikari LS, Burke PR, Gebrim EM, Bento RF. Intracochlear schwannoma: diagnosis and management. Int

2014 eMedicine Radiology

98. Corticosteroids for Bell's palsy (idiopathic facial paralysis). (PubMed)

Corticosteroids for Bell's palsy (idiopathic facial paralysis). Inflammation and oedema of the facial nerve are implicated in causing Bell's palsy. Corticosteroids have a potent anti-inflammatory action which should minimise nerve damage.The objective of this review was to assess the effect of corticosteroid therapy in Bell's palsy.We searched the Cochrane Neuromuscular Disease Group Trials Specialized Register (9 December 2008) for randomised trials, as well as MEDLINE (January 1966 (...) %) of the participants allocated to corticosteroids had incomplete recovery of facial motor function six months or more after randomisation, significantly less than 245/753 (33%) in the control group (risk ratio (RR) 0.71, 95% confidence interval (CI) 0.61 to 0.83). There was, also, a significant reduction in motor synkinesis during follow-up in those receiving corticosteroids (RR 0.6, 95% CI 0.44 to 0.81). The reduction in the proportion of patients with cosmetically disabling sequelae six months after

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2010 Cochrane database of systematic reviews (Online)

99. What Really Decides the Facial Function of Vestibular Schwannoma Surgery? (PubMed)

What Really Decides the Facial Function of Vestibular Schwannoma Surgery? To find the main cause of facial nerve dysfunction in vestibular schwannoma (VS) surgery and review the prognosis of facial function in relation to tumor size, preoperative facial function and surgical approach.We reviewed the surgical outcome of 134 patients with VS treated in our department between 1994 and 2008. All patients included in the study had postoperative facial paralysis after surgical management of their VS (...) . There were 14 women and 7 men. The mean age was 48.5 years, with a mean follow-up period of 57 months.Twenty-one patients (sustained facial palsy, 4; newly developed facial palsy, 17) had facial nerve paralysis after surgery: ten patients in large VS and eleven patients in small VS. In large VS group, 4 patients had facial nerve function of HB grade II, 3 patients had HB grade III, and 3 patients had HB grade IV. In small VS group, 9 patients had HB grade II and 2 patients had HB grade IV. Middle cranial

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2011 Clinical and experimental otorhinolaryngology

100. Cranial Nerve 7

, Cranial Nerve VII , Facial Nerve , CN 7 , Geniculate Ganglion , Superior Salivatory Nucleus , Superior Salivary Nucleus II. Causes: Paralysis Neoplasm (Infectious polyneuritis) Melkersson's Syndrome (Recurrent ) Poliomyelitis (ALS) III. Anatomy: Course to Geniculate Ganglion ral Facial Nerve originates in four nucleii in pons and All combine to travel via internal auditory meatus into Geniculate Ganglion Each side of the forehead is innervated by both s (but only one peripheral Facial Nerve) Forehead (...) IS involved with a peripheral Facial Nerve lesion (LMN) such as in Forehead IS NOT involved with an UMN deficit from a central lesion such as a CVA Most important of the four components Innervates muscles of facial expression (and stapedius) Originates in pons at facial nucleus (in the somatovisceral region) First courses medially within the pons (paradoxical) Circles clockwise around 6th Passes anterior to the Then exits the pons Innervates lacrimal glands (via pterygopalatine ) Innervates submaxillary

2015 FP Notebook

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