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Facial Nerve Paralysis Causes

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141. Imaging Program Guidelines: Pediatric Imaging

lesions ? osseous assessment of the calvarium, skull base and maxillofacial bones, including detection of calvarial and facial bone fractures Common Diagnostic Indications This section begins with general pediatric 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 Ataxia, congenital or hereditary Examples (...) – Pediatrics | Copyright © 2017. AIM Specialty Health. All Rights Reserved. 8 Common Diagnostic Indications Developmental delay Evaluation of either of the following conditions: ? Cerebral palsy ? Global developmental delay, defined as significant delay or loss of milestones in at least two of the following domains: ? Activities of daily living ? Cognition ? Motor skills (gross/fine) ? Social/personal ? Speech/language Hearing loss Evaluation for a structural cause of conductive, sensorineural or mixed

2017 AIM Specialty Health

142. Management of Cardiac Involvement Associated With Neuromuscular Diseases: A Scientific Statement From the American Heart Association

cause of morbidity and mortality. The management of cardiac disease in NMDs is made challenging by the broad clinical heterogeneity that exists among many NMDs and by limited knowledge about disease-specific cardiovascular pathogenesis and course-modifying interventions. The overlay of compromise in peripheral muscle function and other organ systems, such as the lungs, also makes the simple application of endorsed adult or pediatric heart failure guidelines to the NMD population problematic (...) phenotypes. Common to many NMDs is cardiac involvement. Although the past 3 decades have seen marked advances in our understanding of many NMDs, significant gaps in knowledge remain on how best to approach cardiac care in these patients. For example, survival in Duchenne muscular dystrophy (DMD) has been extended through the use of glucocorticoid use and respiratory support, yet cardiac complications remain a significant cause of morbidity and mortality. To achieve further gains in care, we will need

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2017 American Heart Association

143. Management of Diabetes Mellitus in Primary Care

, the treatment methods to achieve the goals. • Reduce the risk of preventable complications while improving quality of life (QoL). II. Background A. Description of Diabetes Mellitus Diabetes mellitus is a disease caused by an absolute or relative insulin deficiency resulting in hyperglycemia. Type 1 DM (T1DM) is due to insulin secretion deficiency not resulting from insulin resistance, while type 2 DM (T2DM) is due to insulin resistance that can eventually also result in insulin secretion deficiency (...) are receiving care from the VA has DM. Veterans 65 years and older comprise 70% of those with diabetes, reflecting the older age distribution of this population.[12] 1 Associated with insulin resistance VA/DoD Clinical Practice Guideline for the Management of Type 2 Diabetes Mellitus in Primary Care April 2017 Page 8 of 160 DM can cause microvascular complications such as retinopathy, nephropathy, and neuropathy as well as macrovascular complications, including ischemic heart disease, stroke, and peripheral

2017 VA/DoD Clinical Practice Guidelines

144. A Case of Acute Arterial Thrombosis Caused by Nephrotic Syndrome (PubMed)

A Case of Acute Arterial Thrombosis Caused by Nephrotic Syndrome Venous thromboembolic complications are frequently caused by nephrotic syndrome, while arterial thrombosis has rarely been reported. We report the successful treatment of a 53-year-old man who suffered from sudden severe pain of the left lower limb and facial edema. Abdominal computed tomography showed that the left common iliac artery was occluded from its origin. Although he had left peroneal nerve paralysis, thrombectomy (...) and fasciotomy were performed for limb salvage. Renal biopsy revealed minimal change nephrotic syndrome after the operation. No recurrence has been observed. Nephrotic syndrome might be considered as a cause of acute arterial thrombosis.

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2010 Annals of vascular diseases

145. CRACKCast E044 – Neck Trauma

Brown sequard syndrome: Ipsilateral hemiplegia and contralateral sensory changes Direct injury to the spinal cord – more common in GSW’s but still quite rare Direct injury to the recurrent laryngeal nervecausing hoarseness with paralysis of the ipsilateral vocal cord Thoracic Duct/glandular/retropharyngeal injuries Thoracic duct damage presents as a chylothorax Endocrine gland damage – rare This episode was copy-edited and uploaded by Ross Prager (@ross_prager) (Visited 3,683 times, 3 visits (...) with neck trauma → this may lead to massive SC emphysema and possible air embolism 5) Describe techniques for airway management in penetrating neck trauma Airway considerations: Orotracheal RSI Should be considered the first line technique Usually successful even in neck trauma with airway distortion contraindications to oro-RSI: Massive facial trauma Laryngotracheal injury ***consider doing an awake look (+/- inline stabilization if C-spine injury) prior to paralysis Important to have backup plans

2016 CandiEM

146. CRACKCast E041 – Head Injury

of elevated hydrostatic forces and and increased capillary permeability due to the primary brain injury A systemic inflammatory reaction Key goal is to lower ICP CLOSE ventilator management is essential 7) What are 7 clinical features of basal skull fracture? Basilar skull fracture findings: see box 41-1: Blood in ear canal Hemotympanum Rhinorrhea Otorrhea Battle’s sign (retro auricular hematoma) Raccoon’s sign (periorbital ecchymosis) Cranial nerve deficits: Facial paralysis Decreased auditory acuity (...) to assess seizure activity because of: low GCS, paralysis, Meds: Phenytoin or fosphenytoin No recommendations to suggest long term prophylaxis – this depends on their clinical course TBI is thought to account for 20% of adults with epilepsy – and late seizures may present up to 12 yrs post injury CNS infections Meningitis after basilar skull fractures Fever, AMS, focal findings, Common in people with CSF leaks Fever occurs within 3 days of injury Caused by pneumococcus Trxt: ceftriaxone and vancomycin

2016 CandiEM

147. Clinical Practice Guidelines for Sustained Neuromuscular Blockade in the Adult Critically Ill Patient

, pyridostigmine, and edrophonium all inhibit acetylcholinesterase; the concentration of acetylcholine increases and competes with an NMBA at the nicotinic receptor, thereby antagonizing NMBA action ( ). The organophosphate pesticides and the chemical nerve agents (e.g., sarin) bind more permanently to and inhibit acetylcholinesterase, producing weakness, fasciculations, and paralysis due to the unopposed actions of acetylcholine on the nicotinic receptor ( ). | Up-Regulation and Down-Regulation (...) ( , , ). The effect on heart rate depends on the patient’s dominant tone, which, at rest, is generally vagal (M 2 muscarinic), thus resulting in tachycardia ( ). | Sympathetic, Ganglionic, or Muscarinic Stimulation. Sympathetic stimulation from pancuronium releases norepinephrine, causing tachycardia ( , ). Vecuronium causes bradycardia via ganglionic or muscarinic stimulation of the vagus nerve ( , ). | INDICATIONS FOR THE USE OF NMBAs Acute ARDS. I. Among adult patients with ARDS, should an NMBA be administered

2016 Society of Critical Care Medicine

148. Corticosteroids improve recovery rates after Bell’s palsy

are supported by NIHR infrastructure funding. Bibliography Clinical Knowledge Summaries. . London: National Institute for Health and Care Excellence; 2012. NHS Choices. . London. Department of Health; 2014. Corticosteroids for Bell's palsy (idiopathic facial paralysis) Published on 19 July 2016 Madhok, V. B.,Gagyor, I.,Daly, F.,Somasundara, D.,Sullivan, M.,Gammie, F.,Sullivan, F. Cochrane Database Syst Rev Volume 7 , 2016 BACKGROUND: Inflammation and oedema of the facial nerve are implicated in causing (...) different corticosteroids against each other, rather than placebo, to find the best options in terms of timing, drug and dose. Share your views on the research. Why was this study needed? Bell’s palsy affects about 12,000 people in the UK each year. It is most common in people aged 15 to 60 years. Bell’s palsy is caused by inflammation or compression of the facial nerve, which controls the facial muscles. The cause is unknown, but it has been associated with viral infections such as the herpes virus

2018 NIHR Dissemination Centre

149. Management of Nasopharyngeal Carcinoma

-2 The survival rate is higher in rT1 (49.1% to 73%) and rT2 (24.7% to 40%) compared with higher T staging. 42, level II-3; 44, level II-2 Transient complications of nasopharyngectomy such as palatal fistula and submandibular necrosis may resolve spontaneously or require further intervention. 42, level II-3; 44, level II-2 Uncommon complications are: • permanent morbidities due to nerve injury (paralysis causing dysphagia) and severe trismus 42, level II-3; 44, level II-2 • mortality caused (...) , facial numbness, diplopia, ptosis, trismus, dysphagia or hoarseness of voice. The most common cranial nerve involvement is 5 th followed by 6 th , 3 rd , 4 th and others. The images of these symptoms can be viewed in Appendix 3. Majority of NPC patients in Malaysia present with advanced stage (Stages III/IV) at the time of diagnosis (75 - 85%). This is due to lack of awareness of NPC symptoms and signs among patients and doctors. 4, level III; 6, level III; 8, level III 3.2 Referral

2016 Ministry of Health, Malaysia

150. Safety and effectiveness of the herpes zoster vaccine to prevent postherpetic neuralgia: 2014 update and consensus statement from the Canadian Pain Society

is approximately $68 million. However, with an aging population, the incidence of HZ and the related costs are expected to increase. Shingles typically begins as a painful skin rash, usually on one side of the body. Pain may also be present without a rash. Repeat episodes are rare. Complications can include nerve damage, facial paralysis, serious eye infections and other secondary infections. However, the most common and serious complication of HZ is PHN, defined as pain lasting >3 months after the onset (...) management and research (listed below). The aim was to review the National Advisory Committee on Immunization guidelines and to prepare a CPS position statement concerning the use of the zoster vaccine in Canada. POSITION 1 The Canadian Pain Society strongly encourages health care practitioners to discuss herpes zoster vaccination with immunocompetent patients ≥60 years of age Rationale: Before 1996, when a vaccine was introduced, almost all Canadian children (>90%) developed chickenpox, caused

2015 CPG Infobase

151. Management of Bell palsy: clinical practice guideline

Management of Bell palsy: clinical practice guideline B ell palsy is an idiopathic weakness or paralysis of the face of peripheral nerve origin, with acute onset. It affects 20–30 persons per 100 000 annually, and 1 in 60 indi- viduals will be affected over the course of their lifetime. 1,2 The major cause of Bell palsy is believed to be an infection of the facial nerve by the herpes simplex virus. 3 As a result of this viral infection, the facial nerve swells and is compressed in its canal (...) weakness. (Strong recommendation: very low confidence in estimates.) We identified no randomized or observational studies comparing outcomes for patients with Bell palsy who were and were not referred to a special- ist. Therefore, our confidence in the effect estimates was very low. For patients with no improvement in facial nerve function or progression of facial nerve paralysis, referral to an otolaryngologist may be reasonable to confirm the diagnosis and to exclude other conditions. Referral

2014 CPG Infobase

152. Salivary Gland Cancer Treatment (Adult) (PDQ®): Health Professional Version

in detail in the section of this summary. Clinical Presentation Most patients with benign tumors of the major or minor salivary glands present with painless swelling of the parotid, submandibular, or the sublingual glands. Neurological signs, such as numbness or weakness caused by nerve involvement, typically indicate a malignancy.[ ] Facial nerve weakness that is associated with a parotid or submandibular tumor is an ominous sign. Persistent facial pain is highly suggestive of malignancy; approximately (...) .[ ] This neoplasm typically develops as a slow growing swelling in the preauricular or submandibular region. Pain and facial paralysis develop frequently during the course of the disease and are likely related to the associated high incidence of nerve invasion.[ ] (Refer to the PDQ summary on for more information.) Regardless of histologic grade, adenoid cystic carcinomas, with their unusually slow biologic growth, tend to have a protracted course and ultimately a poor outcome, with a 10-year survival reported

2018 PDQ - NCI's Comprehensive Cancer Database

153. Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock

), Ricard Ferrer (Adjunctive therapies), Anand Kumar ( Infection ), Jonathan E. Sevransky (Ventilation), Charles L. Sprung (Metabolic) GRADE Methodology Group Waleed Alhazzani (chair), Mark E. Nunnally, Bram Rochwerg For additional information regarding this article, email | INTRODUCTION Sepsis is life-threatening organ dysfunction caused by a dysregulated host response to infection ( ). Sepsis and septic shock are major healthcare problems, affecting millions of people around the world each year (...) . Sepsis is now defined as life-threatening organ dysfunction caused by a dysregulated host response to infection . Septic shock is a subset of sepsis with circulatory and cellular/metabolic dysfunction associated with a higher risk of mortality ( ). The Sepsis -3 definition also proposed clinical criteria to operationalize the new definitions; however, in the studies used to establish the evidence for these guidelines , patient populations were primarily characterized by the previous definition

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2016 European Respiratory Society

154. Non-Small Cell Lung Cancer Treatment (PDQ®): Health Professional Version

structures, distant metastases, or paraneoplastic phenomena. The most common symptoms at presentation are worsening cough or chest pain. Other presenting symptoms include the following: Hemoptysis. Malaise. Weight loss. Dyspnea. Hoarseness. Symptoms may result from local invasion or compression of adjacent thoracic structures such as compression involving the esophagus causing dysphagia, compression involving the laryngeal nerves causing hoarseness, or compression involving the superior vena cava causing (...) and Mortality Estimated new cases and deaths from lung cancer (NSCLC and SCLC combined) in the United States in 2019:[ ] New cases: 228,150. Deaths: 142,670. Lung cancer is the leading cause of cancer-related mortality in the United States.[ ] The 5-year relative survival rate from 1995 to 2001 for patients with lung cancer was 15.7%. The 5-year relative survival rate for patients with local-stage (49%), regional-stage (16%), and distant-stage (2%) disease varies markedly, depending on the stage

2018 PDQ - NCI's Comprehensive Cancer Database

155. 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

156. Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death

year. 24 3.1.1 Causes of sudden cardiac death in different age groups Cardiac diseases associated with SCD differ in young vs. older individuals. In the young there is a predominance of channelopathies and cardiomyopathies ( Web Table 2 ), 21,25–48 myocarditis and substance abuse, 49 while in older populations, chronic degenerative diseases predominate (CAD, valvular heart diseases and HF). Several challenges undermine identification of the cause of SCD in both age groups: older victims (...) , for instance, may suffer from multiple chronic cardiovascular conditions so that it becomes difficult to determine which contributed most to SCD. In younger persons, the cause of SCD may be elusive even after autopsy, because conditions such as inherited channelopathies or drug-induced arrhythmias that are devoid of structural abnormalities are epidemiologically relevant in this age group. Table 2 Levels of evidence Table 2 Levels of evidence 3.2 Autopsy and molecular autopsy in sudden death victims

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2015 European Society of Cardiology

157. 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

158. Acute pain management: scientific evidence (3rd Edition)

7.3.1 Drugs used for intrathecal analgesia 194 7.3.2 Combined spinal-epidural versus epidural analgesia in labour 196 7.4 Regional analgesia and concurrent anticoagulant medications 197 7.4.1 Neuraxial blockade 197 7.4.2 Plexus and other peripheral regional blockade 199 7.5 Other regional and local analgesic techniques 199 7.5.1 Continuous peripheral nerve blockade 199 7.5.2 Intra-articular analgesia 203 7.5.3 Wound infiltration including wound catheters 204 7.5.4 Topical application of local (...) anaesthetics 204 7.5.5 Safety 205 References 208 8. NON-PHARMACOLOGICAL TECHNIQUES 225 8.1 Psychological interventions 225 8.1.1 Provision of information 225 8.1.2 Stress and tension reduction 226 8.1.3 Attentional techniques 227 8.1.4 Cognitiv e-behavioural interventions 228 8.2 Transcutaneous electrical nerve stimulation 230 8.3 Acupuncture 231 8.4 Other physical therapies 232 8.4.1 Manual and massage therapies 232 8.4.2 Heat and cold 232 8.4.3 Other therapies 232 References 233 Acute Pain Management

2015 National Health and Medical Research Council

159. Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio as Prognostic Hematologic Markers of Bell's Palsy: A Meta-analysis. (PubMed)

Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio as Prognostic Hematologic Markers of Bell's Palsy: A Meta-analysis. Bell's palsy (BP) is the most common cause of unilateral peripheral facial paralysis, and inflammation has been proposed as the main pathological cause. The study aim was to investigate the relationship between hematologic inflammatory markers, including the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR), and BP.The following key words (...) were used to search PubMed and Scopus for English language articles: Bell's palsy, facial palsy, facial paresis or facial paralysis, neutrophil, lymphocyte, and platelet.Articles related to BP with NLR or PLR data.The data included patient profiles, House-Brackmann score, treatment modality, NLR, and PLR.Seven articles were selected. A random effect model was used to analyze the aggregated data. Six of these articles that included the NLR and two that included the PLR of BP and control patients

2019 Otology and Neurotology

160. Compare the efficacy of acupuncture with drugs in the treatment of Bell's palsy: A systematic review and meta-analysis of RCTs. (PubMed)

Compare the efficacy of acupuncture with drugs in the treatment of Bell's palsy: A systematic review and meta-analysis of RCTs. Bell's palsy or idiopathic facial paralysis is an acute facial paralysis caused by the inflammation of facial nerve. Several previous studies showed that acupuncture was beneficial in the treatment of facial paralysis. However, its effectiveness is still controversial compared with drug therapy. Therefore, this systematic review and meta-analysis was performed (...) to assess the efficacy of acupuncture for Bell's palsy.This is a systematic review and meta-analysis of clinical studies among patients with Bell's palsy. We did a systematic literature search in PubMed, Embase, and the Cochrane Register of Controlled Trials to identify studies comparing the efficacy of acupuncture and drug treatment in treating facial paralysis. The search was last updated on July 2018.The study included 11 randomized controlled trials with an overall sample of 1258 individuals

2019 Medicine

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