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Facial Nerve Paralysis Causes

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101. Nosebleed (Epistaxis) Full Text available with Trip Pro

of the head and neck, a history of recent facial trauma, or who have undergone nasal and/or sinus surgery in the past 30 days. The management of nosebleeds in such excluded patients centers on the treatment of these causative factors, and the recommendations within this guideline may not consistently apply in such cases. Patients with intranasal telangiectasias associated with HHT are not excluded, as the GDG noted opportunity for improved care of these patients with specific recommendations based (...) was 53.4 years, and 52.7% were male. In the audit of epistaxis cases managed in the United Kingdom during November 2016, 13.9% of patients treated for epistaxis presented again for treatment within 30 days. These investigators also found a 30-day all-cause mortality rate of 3.4% in these patients. Nosebleeds seem to affect the population in a bimodal age distribution, with more nosebleeds seen in children and the elderly. A review of the National Hospital Ambulatory Medical Care Survey from 1992

2020 American Academy of Otolaryngology - Head and Neck Surgery

102. Guidance for Return to Practice for Otolaryngology-Head and Neck Surgery: Part Two

injury Diagnoses Necessitating “Urgent” Operative Management (Tier 2) These are diagnoses where timely surgery is indicated but where surgery may be delayed for clarification or resolution of acute COVID-19 infection. Examples include: • Chronic ear disease associated with acute facial nerve paresis or paralysis • Temporal bone malignancy or adjacent malignancy requiring temporal bone resection • Impending cochlear ossification (e.g., from bacterial meningitis) requiring cochlear implant surgery due (...) if not addressed immediately. Surgery may be undertaken regardless of COVID-19 status, although rapid testing, if available, may inform the use of appropriate PPE. Examples include: • Coalescent mastoiditis with or without extra- or intracranial complications (sigmoid sinus thrombosis, epidural abscess, brain abscess, labyrinthitis, facial palsy) • Cerebellopontine angle tumor with neurological deterioration and/or threatened brainstem herniation • Temporal bone trauma with vascular or severe facial nerve

2020 American Academy of Otolaryngology - Head and Neck Surgery

103. Overview of musculoskeletal pain

=bestpractice.com Most commonly results from motor vehicle accidents, gunshot or stab wounds, contact sports, or workplace accidents during heavy physical labour. The effects of the injury include paralysis, loss of sensation, and pain. The specific clinical presentation will depend on the nerve roots involved and the degree of injury to each root. A bursa is a sac containing a small amount of synovial fluid that lies between a tendon and either skin or bone to act as a friction buffer. In bursitis (...) Overview of musculoskeletal pain Overview of musculoskeletal pain - Summary of relevant conditions | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Overview of musculoskeletal pain Last reviewed: February 2019 Last updated: July 2018 Introduction Musculoskeletal pain is very common, may be acute or chronic, and is a major cause of morbidity and occupational sickness absence. Studies have found a prevalence of chronic musculoskeletal pain

2018 BMJ Best Practice

104. Corticosteroids

), African Index Medicus (up to January 2015), the Cumulative Index to Nursing and Allied Health Literature (CINAHL) (up to July 2015), EMBASE (up to July 2015) and the metaRegister of Controlled Trials (mRCT) for ongoing trials. SELECTION CRITERIA: All randomised 2015 14. Antiviral Agents Added to Corticosteroids for Early Treatment of Adults With Acute Idiopathic Facial Nerve Paralysis (Bell Palsy). CLINICAL QUESTION: Compared with oral corticosteroids alone, are oral antiviral drugs associated (...) Discover NIHR Signal Corticosteroids improve recovery rates after Bell’s palsy Published on 29 November 2016 Taking a corticosteroid within 72 hours of Bell’s palsy first appearing reduces the number of people with incomplete facial recovery after six months. Bell’s palsy is a sudden onset of weakness or paralysis (...) of the muscles on one side of the face. Most people recover completely within nine months, often with no treatment, but about three in 10 people are left with some weakness or unwanted

2018 Trip Latest and Greatest

105. Acyclovir

have questions please contact us via jon.brassey@tripdatabase.com Top results for acyclovir 1. Valacyclovir versus acyclovir for the treatment of herpes zoster ophthalmicus in immunocompetent patients. BACKGROUND: Herpes zoster ophthalmicus affects the eye and vision, and is caused by the reactivation of the varicella zoster virus in the distribution of the first division of the trigeminal nerve. An aggressive management of acute herpes zoster ophthalmicus with systemic antiviral medication (...) . 17942873 2007 10 18 2007 10 25 2013 11 21 1533-4406 357 16 2007 Oct 18 The New England journal of medicine N. Engl. J. Med. Early treatment with prednisolone or acyclovir in Bell's palsy. 1598-607 Corticosteroids and antiviral agents are widely used to treat the early stages of idiopathic facial paralysis (i.e., Bell's palsy), but their effectiveness is uncertain. We conducted a double-blind, placebo-controlled, randomized (...) , factorial trial involving patients with Bell's palsy who were recruited

2018 Trip Latest and Greatest

106. Management of Stroke Rehabilitation

individuals annually in the United States (U.S.). Approximately 75% of these are first-time strokes, while the remaining 25% are recurrent strokes.[2] While often viewed as a disease of the elderly, stroke can occur at any age. Approximately 10% of all strokes occur in individuals aged 18-50.[2] Currently, stroke is the fifth most common cause of death in the U.S. and a leading cause of long-term disability.[2] While younger patients may be more physically capable of recovering from stroke than older (...) in the form of medical, surgical, or rehabilitation interventions is essential to help reduce disability severity, decrease the risk of further complications, and lessen potentially life-long deficits.[5,6] Unfortunately, in approximately 30% of ischemic stroke cases, the cause of the stroke remains unknown.[7] Ischemic strokes with no obvious cause are labelled as “cryptogenic” strokes and are more common in younger patients than in the elderly.[8] This is largely due to the lack of comorbidities

2019 VA/DoD Clinical Practice Guidelines

107. Management of Stroke in Neonates and Children Full Text available with Trip Pro

scientific statement on pediatric stroke was published 10 years ago. Although stroke has long been recognized as an adult health problem causing substantial morbidity and mortality, it is also an important cause of acquired brain injury in young patients, occurring most commonly in the neonate and throughout childhood. This scientific statement represents a synthesis of data and a consensus of the leading experts in childhood cardiovascular disease and stroke. Methods— Members of the writing group were (...) health problem causing substantial morbidity and mortality, it is also an important cause of acquired brain injury in young patients, occurring most commonly in the neonate and throughout childhood. This scientific statement represents a synthesis of data and a consensus of the leading experts in childhood cardiovascular disease and stroke. Overview of Childhood and Perinatal Stroke Introduction and Definition The standard adult definition of stroke—an acute onset neurological sign or symptom

2019 American Heart Association

108. Head and neck imaging

Laryngeal edema 17 Osseous lesions 17 Osteonecrosis of the jaw 17 Salivary gland ductal calculi 17 Torticollis (Pediatric only) 17 Tracheal stenosis or upper airway obstruction 18 Signs and Symptoms 18 Dizziness or vertigo 18 Hearing loss 18 Hoarseness, dysphonia, and vocal cord weakness/paralysis 19 Horner’s syndrome 20 Localized facial pain 20 Lymphadenopathy 20 Stridor 21 Tinnitus 21 Pulsatile tinnitus (Pediatric only) 21 Visual disturbance or visual field defect 22 References 22 Codes 24 History 24 (...) hearing loss PEDIATRIC Advanced imaging is considered medically necessary to evaluate for a structural cause of sensorineural, conductive, or mixed hearing loss. IMAGING STUDY - MRI brain preferred for evaluation of sensorineural hearing loss - CT orbit/sella/posterior fossa preferred for evaluation of conductive or mixed hearing loss Rationale The primary purpose of imaging sensorineural hearing loss is to detect retrocochlear pathology, typically a tumor of the vestibular nerve (cranial nerve 8

2019 AIM Specialty Health

109. Appropriate Use Criteria: Imaging of the Brain

sclerosis and other white matter diseases 11 Inflammatory conditions, unspecified 11 Trauma 11 Trauma 11 Tumor or Neoplasm 12 Acoustic neuroma (Adult only) 12 Pituitary adenoma (Adult only) 13 Tumor – not otherwise specified 13 Miscellaneous Conditions 14 Bell’s palsy (peripheral facial nerve palsy) 14 Cerebrovascular accident or transient ischemic attack 14 Dementia (Adult only) 15 Horner’s syndrome 16 Hydrocephalus/ventricular assessment 16 Mental status change and encephalopathy 17 Movement disorders (...) (Adult only) 17 Neurocutaneous disorders 18 Pseudotumor cerebri (Pediatric only) 18 Seizure disorder 18 Seizure, refractory 19 Imaging of the Brain Copyright © 2019. AIM Specialty Health. All Rights Reserved. 3 Trigeminal neuralgia and persistent idiopathic facial pain (Adult only) 20 Perioperative/Periprocedural Imaging 20 Lumbar puncture risk assessment 20 Signs and Symptoms 20 Dizziness or vertigo 21 Headache 21 Hearing loss 25 Papilledema 25 Syncope 26 Tinnitus (Adult only) 26 Visual disturbance

2019 AIM Specialty Health

110. The Utility and Practice of Electrodiagnostic Testing in the Pediatric Population: An AANEM Consensus Statement

. In contrast to adults, radial neuropathy in childhood does not typically localize to the spiral groove; the posterior interosseous nerve and distal main radial trunk are more common sites of injury 15 . In the lower limbs, sciatic neuropathy in childhood has been associated with trauma 16 , iatrogenic causes 16 , compression 16 , various tumors 16,17 , including perineurioma 18 , and sometimes has vascular causes 16 , including occlusion of the inferior gluteal artery 19 . The other major mononeuropathy (...) in the lower limbs, fibular (peroneal) neuropathy, has been associated with compression, trauma, and entrapment 20 . One cause of compression of the fibular nerve is osteochondroma at or near the fibular head 21 . As in adults, fibular neuropathy in children is frequently associated with axonal and fascicular injury 22 . Clubfoot has on occasion been associated with EDX abnormalities, most commonly fibular neuropathy 23,24 . There is ongoing debate in the literature regarding the utility of EDX studies

2019 American Association of Neuromuscular & Electrodiagnostic Medicine

111. Treatment for Acute Pain: An Evidence Map

associated with drugs, a wide variety of nondrug therapies for pain are becoming more widely used, including ice, heat, acupuncture, chiropractic manipulation, physical therapy, transcutaneous electrical nerve stimulation, massage therapy, exercise, and psychological approaches (cognitive behavioral therapy, mindfulness-based stress reduction). Purpose of Technical Brief This evidence map identifies and describes the current research on treatment for pain attributable to acute pain conditions selected (...) . Musculoskeletal pain, including back and neck pain, is frequently seen in a variety of settings. Back problems and headaches (including migraines) are two of the most common reasons people visit their healthcare providers. 33 Treating musculoskeletal pain appropriately requires identifying the cause (pain pathway). • KIs agreed on the importance of the acute pain conditions in the statement of work, but mentioned other conditions not as thoroughly addressed in available research, including compression

2019 Effective Health Care Program (AHRQ)

112. Skull fractures

fragments. See also the corresponding sagittal CT image From the teaching collection of Demetrios Demetriades; used with permission [Citation ends]. History and exam presence of risk factors open fracture palpable discrepancy in bone contour Battle's sign periorbital ecchymosis bloody otorrhoea CSF rhinorrhoea facial paralysis, nystagmus, or paraesthesia evidence of trauma cranial pain or headache nausea altered mental state/loss of consciousness abnormal pupillary reflexes hearing loss male sex fall (...) Skull fractures Skull fractures - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Skull fractures Last reviewed: February 2019 Last updated: December 2017 Summary Most common causes include a fall, a traffic accident, or an assault. Skull fractures may be linear or comminuted with multiple fracture lines, may be located on the cranial vault or in the basilar skull, may have a varying degree of depression or elevation

2017 BMJ Best Practice

113. Trigeminal nerve Full Text available with Trip Pro

to a peripheral nerve can cause paralysis of muscles on one side of the jaw, with the jaw deviating towards the paralyzed side when it opens. This direction of the mandible is due to the action of the functioning pterygoids on the opposite side. Sensation [ ] Main article: The two basic types of sensation are touch-position and pain-temperature. Touch-position input comes to attention immediately, but pain-temperature input reaches the level of consciousness after a delay; when a person steps on a pin (...) in the . Thalamic nuclei, in turn, send information to specific areas in the . Each pathway consists of three bundles of nerve fibers connected in series: The secondary neurons in each pathway (cross the spinal cord or brainstem), because the spinal cord develops in segments. Decussated fibers later reach and connect these segments with the higher centers. The is the primary cause of decussation; nasal fibers of the optic nerve cross (so each cerebral hemisphere receives contralateral—opposite—vision) to keep

2012 Wikipedia

114. Shingles

onset: 40% 3 months after rash onset: 13% 1 year after rash onset: 7% Risk factors for developing PHN: Older age More severe pain during prodrome and onset of rash Larger rash surface area Skin changes, such as secondary bacterial infection, scarring or pigmentation changes Ophthalmic complications (herpes zoster ophthalmicus) such as periorbital rash, conjunctivitis, keratitis or uveitis, which can lead to vision loss and debilitating pain. May occur in 25% of herpes zoster cases Facial paralysis (...) Shingles Shingles - medSask Home - College of Pharmacy and Nutrition - University of Saskatchewan Toggle Menu Search the U of S Search Shingles Neuralgic pain and blistering skin eruptions that occur due to reactivation of the chicken pox virus - varicella zoster virus (VZV). Incidence of herpes zoster (shingles) increases with decline in T-cell-mediated immunity, which may occur with age or immunosuppression. Rash typically resolves in 2 to 4 weeks, but nerve pain may continue for months

2018 medSask

115. Guidelines for the Management of Genital Herpes in New Zealand

2017 Only available online at www.herpes.org.nz 2. Sexually Transmitted Infections – Summary of Guidelines 2017 Patient information pamphlets 1. The Facts: A guide for people with Herpes Simplex Includes – Genital Herpes – The Facts Herpes and Relationships Herpes and Pregnancy Facial Herpes 2. Herpes: Myth vs Facts Helpline Website Resources New Zealand Sexual Health Society (NZSHS) resources Comprehensive STI Management Guidelines and Patient Information handouts are available on www.nzshs.org (...) and reduce asymptomatic shedding. Suggest prescribing for 12 months, followed by a break of 3 months to see if recurrences are still frequent and/or bothersome. • Oral valaciclovir 500mg daily (increase to 500mg BD on individual basis of clinical presentation and/or having breakthrough recurrences on 500mg daily). • Alternative: oral aciclovir 400mg twice daily. GENITAL HERPES – COMMON MISCONCEPTIONS • MYTH: Most, if not all, genital herpes infections are due to HSV-2. FACT: Genital herpes is caused

2017 New Zealand Sexual Health Society

116. Interventional Spine and Pain Procedures in Patients on Antiplatelet and Anticoagulant Medications

of Anesthesiology Critical Care and Pain Management, General University Hospital, Valencia, Spain; **Spine and Nerve Center of The Virginias, Charleston, WV; ††Carolinas Pain Institute, Winston-Salem, NC; and ‡‡Department of Anesthesiology, Virginia Commonwealth University, Richmond, VA. Accepted for publication September 1, 2017. Address correspondence to: Samer Narouze, MD, PhD, Center for Pain Medicine, Western Reserve Hospital, 1900 23rd St, Cuyahoga Falls, OH 44223 (e-mail: ). Brian D. Sites, MD (...) broader than that for regional anesthesia, with diverse targets and objectives. Pain procedures vary from minimally invasive procedures with high-risk targets (eg, percutaneous SCS lead placement, vertebral augmentation, deep visceral blocks, and spine interventions) to low-risk peripheral nerve blocks ( ). The ASRA regional anesthesia and acute pain guidelines may be appropriate for the low- or intermediate-risk category, but the high-risk targets require a more intensive look at the issues specific

2018 American Society of Regional Anesthesia and Pain Medicine

117. CRACKCast E175 – Neurologic Disorders

incontinence. Management: Based on the underlying process – surgery vs antibiotics vs steroids. [2] Guillain- Barré Syndrome Definition: An acute, demyelinating polyneuropathy that typically presents as transient, symmetric, ascending paralysis in the setting of a recent infection. It is thought to be autoimmune-mediated and classically causes demyelination of motor and sensory nerves. Children of all ages may be affected; however, it is uncommon in young toddlers and infants. Often, there is a history (...) of vertigo in children? REMEMBER: Vertigo = illusion of movement . Disease processes that effect the balance of the vestibular, visual, and proprioceptive systems can cause vertigo by impairing the neural activity of the vestibular nucleus. Diseases of the ear, eighth cranial nerve, neck, brainstem, or eye can lead to vertiginous symptoms. Vertigo is characterized as central or peripheral, depending on whether the cause is in the CNS. NOTE: Key things to ask about on history: Ear symptoms

2018 CandiEM

118. Appropriate Use Criteria: Imaging of the Head & Neck

bones, including detection of calvarial and facial bone fractures Common Diagnostic Indications This section begins with general indications for CT Head, followed by Neurologic Signs and Symptoms and Vascular indications. General Head/Brain Abnormal imaging findings Follow up of abnormal or indeterminate findings on a prior imaging study when required to direct treatment Acoustic neuroma Management of known acoustic neuroma when at least one of the following applies: ? Symptoms suggestive (...) of recurrence or progression ? Following conservative treatment or incomplete resection at 6, 18, 30, and 42 months ? Post resection, baseline imaging and follow up at 12 months after surgery Congenital or developmental anomaly Diagnosis or management (including perioperative evaluation) of a suspected or known congenital anomaly or developmental condition Examples include Chiari malformation, craniosynostosis, macrocephaly, and microcephaly. Dementia** ? Initial evaluation to exclude a secondary cause

2018 AIM Specialty Health

119. Imaging Guidelines

treatment 9delay and definitively identifying presence or absence of ongoing bleeding that warrants intervention. Part 3: Sedation Key Points z Agitated adult trauma patients may require intubation with sedation and chemical paralysis to expedite radiographic work- up and ensure adequate quality. Short acting drugs are preferred along with careful monitoring of cardiac and respiratory status. z Consider physiologic parameters (heart rate, blood pressure, and other existing injuries) and the child’s age (...) , size, and cognitive level to provide safe sedation administration. z Patient age and cognitive developmental stage can significantly affect the amount and type of sedation administered. z A dedicated provider and resuscitation equipment must be with the sedated patient at all times. Sedation for Adult Patient Imaging Adult trauma patients may require light to moderate sedation to obtain adequate CT and MRI images. Agitated patients may require intubation with sedation and chemical paralysis

2018 American College of Surgeons

120. Trumenba - meningococcal group b vaccine (recombinant, adsorbed)

caused by Neisseria meningitidis serogroup B. See section 5.1 for information on protection against specific group B strains. Dosing of Trumenba should be determined taking into consideration the risk of invasive meningococcal B disease by each country or region. The use of this vaccine should be in accordance with official recommendations. The legal basis for this application refers to: Article 8.3 of Directive 2001/83/EC - complete and independent application. The Applicant indicated that Neisseria (...) within the Committee, issued a positive opinion for granting a marketing authorisation to Trumenba on 23 March 2017. Assessment report EMA/CHMP/232746/2017 Page 8/139 2. Scientific discussion 2.1. Problem statement 2.1.1. Disease or condition Trumenba is intended for active immunisation to prevent invasive meningococcal disease caused by Neisseria meningitidis serogroup B in individuals 10 years and older. N. meningitidis is an obligate human pathogen that colonizes the upper respiratory tract

2017 European Medicines Agency - EPARs

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