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Facial Nerve Paralysis Causes


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161. 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

162. Shingles

shingles affects the ophthalmic division of the trigeminal nerve) including keratitis, corneal ulceration, conjunctivitis, optic neuritis, and retinitis. If the shingles rash is visible on the tip of the nose, this indicates nasociliary branch involvement and an increased likelihood of eye inflammation [ ; ]. Ramsay Hunt syndrome: lesions in the ear, facial paralysis, and associated hearing and vestibular symptoms [ ; ; ]. Peripheral motor neuropathy: occurs when a motor rather than a sensory nerve (...) ) is a viral infection of nerve cells [ ] that occurs when a latent infection with varicella-zoster virus reactivates because of a decrease in virus-specific cell-mediated immunity [ ]. This can be many years after the primary infection. It is characterized by pain in a dermatomal distribution and a localised vesicular rash [ ; ]. Shingles and chickenpox are both caused by the varicella-zoster virus, but chickenpox usually causes a widespread rash and follows initial infection [ ]. Prevalence How common

2017 NICE Clinical Knowledge Summaries

163. Palliative care - dyspnoea

dyspnoea: Pleural effusion Pericardial effusion Phrenic nerve paralysis Tumour microemboli Superior vena cava syndrome Cachexia Anaemia Aspiration Surgery (pneumonectomy or lobectomy) Radiation-induced fibrosis Chemotherapy-induced pneumonitis Fibrosis Cardiomyopathy Pulmonary embolism Respiratory muscle weakness Non-malignant causes of dyspnoea include: Pneumonia Chronic obstructive pulmonary disease Heart failure Pneumothorax Anxiety Obesity Fever [ ; ; ] Further information Malignant causes (...) , and persistent cough or haemoptysis with a normal chest radiograph [ ; ]. Superior vena cava (SVC) obstruction is usually due to metastases in the upper mediastinal lymph nodes that cause extrinsic pressure, but it can also be caused by intraluminal thrombosis, external compression by the tumour, or direct invasion of the vessel wall by the tumour. Around 80% of cases are caused by lung cancer: Half of people with SVC obstruction experience dyspnoea; other common symptoms include neck and facial swelling

2017 NICE Clinical Knowledge Summaries

164. Otitis externa

perforation. Malignant otitis. The complications of malignant otitis include: Facial nerve paralysis. Meningitis. [ ; ; ] Prognosis What is the prognosis for people with otitis externa? Acute diffuse otitis externa: Symptoms of acute otitis externa usually improve within 48–72 hours of initiation of treatment. Between 65–90% of patients with uncomplicated diffuse otitis externa have clinical resolution within 7 to 10 days, regardless of the topical medicine used. Localized otitis externa: Folliculitis may (...) loss, or there is mastoid tenderness or swelling. Malignant otitis . Neoplasm — if there is a swelling in the ear canal that bleeds easily on contact. Compared with localized otitis externa, there is less pain and the onset is slower. Referred pain — may originate from the sphenoidal sinus, teeth, neck, or throat. Ramsay Hunt syndrome — a form of herpes zoster affecting the facial nerve, associated with facial paralysis and loss of taste, which can also produce pain in the ear and other areas

2017 NICE Clinical Knowledge Summaries

165. No, torturing colicky infants by sticking them with acupuncture needles won’t calm them

. Deafness. Redness and swelling of the eyes. Blurred vision. Nosebleed. Congestion and runny nose. Aphtha. Tension on the lips. Amenorrhea. Promotes labour. Retention of dead fetus. Stiff neck. Cold. Flu. Rhinitis. Conjunctivitis. Stye. Sinusitis. Epistaxis. Trigeminal neuralgia. Facial paralysis. Anxiety. Well, that's clear. Group B received "individualized" acupuncture, which means that the acupuncturist could basically do whatever he wanted. The authors describe it as Following a manual (...) the crying. I can't help but wonder whether the investigators to some extent took advantage of that desperation to sign up patients. On to the study itself. First, infantile colic is not a minor problem. Basically, when a baby cries more than three hours a day for more than three days a week, it's considered colic, and colic is the cause of and usually . Its natural history is to get better, which makes it a perfect condition for quacks because almost anything they do to intervene will appear to cause

2017 Respectful Insolence

166. 2015 ACC/AHA/HRS Guideline for the Management of Adult Patients With Supraventricular Tachycardia

or primary causes such as hyperthyroidism or anemia. Atrial tachycardia (AT) • Focal AT An SVT arising from a localized atrial site, characterized by regular, organized atrial activity with discrete P waves and typically an isoelectric segment between P waves. At times, irregularity is seen, especially at onset (“warm-up”) and termination (“warm-down”). Atrial mapping reveals a focal point of origin. • Sinus node reentry tachycardia A specific type of focal AT that is due to microreentry arising from (...) and are discussed only briefly in this document (Section 7). • Manifest accessory pathways A pathway that conducts anterogradely to cause ventricular pre-excitation pattern on the ECG. • Concealed accessory pathway A pathway that conducts only retrogradely and does not affect the ECG pattern during sinus rhythm. • Pre-excitation pattern An ECG pattern reflecting the presence of a manifest accessory pathway connecting the atrium to the ventricle. Pre-excited ventricular activation over the accessory pathway

2015 American Heart Association

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

interventions) to low-risk peripheral nerve blocks ( ). The ASRA 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 to patient safety and improved outcomes. For example, SCS lead placement requires the use of large gauge needles with a long bevel and stiff styletted leads to enhance directional control. In many cases, the technique is simple with little tissue stress produced to the region; but in some (...) a multifactorial etiology, certain anatomic features may pose higher risks secondary to the anatomy and vascular supply of that specific spinal location. It is important for interventional pain physicians to apply knowledge of spinal and epidural anatomy during preprocedural planning. Contents of the epidural space include the epidural fat, dural sac, spinal nerves, extensive venous plexuses, lymphatics, and connective tissue (eg, plica mediana dorsalis and scar tissue after previous surgical intervention

2015 American Society of Regional Anesthesia and Pain Medicine

168. Acute Pain Management: Scientific Evidence

-injection peripheral nerve blocks 211 5.8.2 Periarticular and intra-articular analgesia 216 5.8.3 Wound infiltration including wound catheters 217 5.8.4 Topical application of local anaesthetics 217 5.8.5 Safety 218 5.9 Regional analgesia and concurrent anticoagulant medications 221 5.9.1 Neuraxial block and epidural haematoma 221 5.9.2 Plexus and other peripheral regional block and anticoagulants 223 References 223 6. PATIENT-CONTROLLED ANALGESIA 241 6.1 Efficacy of intravenous PCA 241 6.1.1 Analgesia (...) Cognitive-behavioural interventions 262xvii CONTENTS 7.2 Transcutaneous electrical nerve stimulation 265 7.3 Acupuncture and acupressure 265 7.3.1 Postoperative pain 265 7.3.2 Other acute pain states 267 7.4 Physical therapies 269 7.4.1 Manual and massage therapies 269 7.4.2 Warming and cooling intervention 270 7.4.3 Other therapies 271 References 271 8. SPECIFIC CLINICAL SITUATIONS 279 8.1 Postoperative pain 279 8.1.1 Multimodal postoperative pain management 279 8.1.2 Procedure-specific postoperative

2015 Clinical Practice Guidelines Portal

169. Bell’s palsy: facing up to uncertainty

causes this paralysis of the facial nerve and there are also uncertainties about how best to treat it. Corticosteroids may be prescribed, to reduce inflammation and limit nerve damage. A viral cause has been suggested so antiviral drugs may be used to treat it and there are other options too. Even without treatment, the paralysis is usually temporary, but recovery can take weeks or months and about one in five people are left with some permanent disfigurement or pain. There are several Cochrane (...) moderate and low quality evidence that: adding antivirals to corticosteroids was more effective than corticosteroids alone for treating Bell’s palsy of varying levels of severity and was associated with fewer long-term after-effects of Bell’s palsy for people with severe Bell’s palsy (with complete or almost complete facial paralysis) adding antivirals to corticosteroids was slightly more effective corticosteroids alone were more effective than antivirals alone corticosteroids plus antivirals were more

2015 Evidently Cochrane

170. Endoscope-Assisted Open Reduction And Internal Fixation of Mandibular Subcondylar Fractures Is a Reliable and Comparable Technique to an Extraoral Surgical Approach

, or deviation on opening at the 6-month follow-up. However, one patient treated with the extraoral approach had facial palsy or paralysis at the 6-month follow-up. #3) Haug/2004 13 EAORIF studies (126 patients); 58 extraoral surgical studies (2900 patients) Narrative Review Key results Traditional ORIF and EORIF showed similar results for functional measurements such as maximum interincisal opening, lateral/protrusive excursions, and deviation upon opening at follow-up. Facial nerve palsy was more likely (...) . Comparable functional results were noted in both transoral and extraoral groups without any statistical significant difference; however, an extraoral approach tended to have a greater number of facial nerve injuries. On the other hand, the extraoral approach had an average quicker operation time. Best Evidence (you may view more info by clicking on the PubMed ID link) PubMed ID Author / Year Patient Group Study type (level of evidence) #1) Schmelzeisen/2009 74 patients Randomized Controlled Trial Key

2015 UTHSCSA Dental School CAT Library

171. 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

172. Early Management of Head Injury in Adults

ecchymosis (“Battle’s sign”), cerebrospinal fluid leakage either from the nose [cerebral spinal fluid (CSF) rhinorhoea] or ear (CSF otorhoea), or seventh and eighth cranial nerves deficits causing facial paralysis and hearing loss respectively.5 Early Management of Head Injury in Adults 3. CLASSIFICATION OF SEVERITY The severity of head injury can be classified according the presenting Glasgow Coma Score (GCS): 9 level III • mild head injury (MHI): GCS 13 - 15 • moderate head injury: GCS 9 - 12 • severe (...) ) accounted for 75% of cases with motorcyclists being most commonly injured. The younger age group of 15 - 34 years old (56.6%) is at highest risk of major trauma. A high proportion of those with major trauma (85%) had injuries to the head and neck with Abbreviated Injury Scale (AIS) =3. 1, level III Injury was the fifth (7.86%) commonest cause of hospitalisation in Malaysian public hospitals in 2014 2, level III with RTA being the commonest cause of injury-related hospitalisation. Apart from that, head

2015 Ministry of Health, Malaysia

173. Clinical practice guideline for the management of patients with Parkinson´s disease

Annex 5. Disclosure of potential conflicts of interest 150 Bibliography 151 CliniCal praCtiCe guidelines in the sns 7 Introduction Documenting variability in clinical practice, analysing the causes thereof and adopting strategies Documenting the variability of clinical practices, analysing the causes, and adopting strategies aimed at eliminating it have been proven to be initiatives that encourage healthcare professionals to make effective, safe, and patient-centred decisions. One (...) subcutaneous infusions of apomorphine may be used to reduce off time and dyskinesia in persons with PD and severe motor complications. This should only be initiated in expert units with facilities to allow adequate supervision. Management of problems related to antiparkinson medications Drug-induced psychosis D All persons with PD and psychosis should receive a general medical evaluation, in order to exclude other treatable causes of psychosis. D Before considering the use of anti-psychotic medication

2015 GuiaSalud

174. Acute Otitis Externa

, or systemic antibiotics that cover S aureus , the most common causative agent. Viral infections of the external ear, caused by varicella, measles, or herpes virus, are rare but are important on the differential of AOE. Herpes zoster oticus (Ramsay Hunt syndrome) causes vesicles on the external ear canal and posterior surface of the auricle, severe otalgia, facial paralysis or paresis, loss of taste on the anterior two-thirds of the tongue, and decreased lacrimation on the involved side. Management (...) , but untreated disease develops into a skull base osteomyelitis that can invade soft tissue, the middle ear, inner ear, or brain. Facial nerve paralysis may be an early sign, with the glossopharyngeal and spinal accessory nerves less frequently involved. Granulation tissue is classically seen on the floor of the canal and at the bony-cartilaginous junction. A clinical diagnosis of necrotizing otitis externa can be confirmed with a raised erythrocyte sedimentation rate plus an abnormal computed tomography

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2014 American Academy of Otolaryngology - Head and Neck Surgery

176. 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)

177. 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

178. Sedation for Patients in ICU

Tranquilisers / antipsychotics 355 7.8.1 Haloperidol Dosing 36 7.9 Non-Opioid Analgesics 36 7.9.1 Paracetamol 36 7.9.2 Non-Steroidal Analgesics (NSAIDS) 37 7.9.3 Tramadol 37 7.9.4 Analgesia for neuropathic pain 37 7.10 Local anaesthetics / Regional Nerve Blocks 38 8 Non Pharmacological Measures 39 8.1.1 Use of Sedation Breaks 39 8.2 Correction of underlying pathophysiology 40 8.2.1 Treatment of the Underlying Cause (e.g., sepsis) 40 8.2.2 Treat alcohol/drug withdrawal 40 8.2.3 Treating uraemia 42 8.3 (...) of delirium 64 Table 1 - Key Concepts for Management of Sedation and Analgesia 12 Table 2: Causes of Respiratory Distress and Ventilator Dysynchrony 13 Table 3: Independent Risk factors for the Development of Agitation (15) 16 Table 4: Similarities and differences between normal sleep and sedation 19 Table 5 - Deliriogenic Drugs 61 9 4 Abbreviations ALF Acute Liver Failure BD Twice a day dB Decibel ETT Endotracheal Tube GABA Gamma-Amino Butyric Acid ICP Intra-cerebral pressure ICU Intensive Care Unit

2014 Intensive Care Society

179. Safety and Efficacy of Droxidopa for Fatigue in Patients With Parkinsonism

, have smaller and slower movements, develop a tremor (shaking of the arms or legs), have decreased facial expression, and a softer voice. Fatigue is a common symptom that causes suffering and stress in diseases that affect the brain. Over 50% of patients with Parkinsonism report fatigue as one of their top three symptoms that make their life more difficult. Currently, there are no evidence-based guidelines for treating fatigue in Parkinson's Disease, and no effective medications or therapeutic (...) Brain Diseases Central Nervous System Diseases Nervous System Diseases Movement Disorders Neurodegenerative Diseases Signs and Symptoms Pathological Conditions, Anatomical Ophthalmoplegia Ocular Motility Disorders Cranial Nerve Diseases Tauopathies Paralysis Neurologic Manifestations Eye Diseases Primary Dysautonomias Autonomic Nervous System Diseases Hypotension Vascular Diseases Cardiovascular Diseases Droxidopa Antiparkinson Agents Anti-Dyskinesia Agents

2018 Clinical Trials

180. Effect of Adjuvant Hyperbaric Oxygen Therapy on Bells Palsy Outcome

Paralysis Neurologic Manifestations Nervous System Diseases Signs and Symptoms Herpesviridae Infections DNA Virus Infections Virus Diseases Mouth Diseases Stomatognathic Diseases Facial Nerve Diseases Cranial Nerve Diseases Antiviral Agents Anti-Infective Agents (...) in the first 1 week after onset of paralysis. Outcome Measures Go to Primary Outcome Measures : Change in the percentage of subjects that return to baseline facial function 1 year following the onset of paralysis Standard of Care Group [ Time Frame: 3, 6 and 12 months ] Change in the percentage of subjects that return to baseline facial function 1 year following the onset of paralysis Standard of Care + Hyperbaric Oxygen Therapy on Bells Palsy (HBOT) Group [ Time Frame: 3, 6 and 12 months ] Secondary

2018 Clinical Trials

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