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Facial Nerve Paralysis Causes

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161. Tinnitus

, or facial weakness/paralysis should be seen non-urgently by an ear, nose, and throat specialist [ ]. Referring people with tinnitus causing distress despite primary care management reflects expert opinion from the British Tinnitus Association [ ], and expert opinion in a review article [ ]. Refer all people with tinnitus for audiological assessment The British Tinnitus Association notes that many clinicians believe that all people with tinnitus should receive an audiological assessment [ ]. This opinion (...) urgently to an ear, nose, and throat specialist (using clinical judgement): Tinnitus of uncertain cause. This includes people with tinnitus that is not associated with hearing loss, ear pain, drainage or malodour, vestibular symptoms or facial weakness and people with hearing loss that cannot clearly be distinguished as either sensorineural or conductive. Tinnitus that is causing distress despite primary care management. Refer all people with tinnitus for an audiological assessment, particularly

2017 NICE Clinical Knowledge Summaries

162. Zelboraf - vemurafenib

, 450 mg/kg/day (in 2% Klucel LF pH4) oral gavage GD 7-20 Sacrifice GD 29 F0: 450: bw gain ?, food cons. ? F1: none F0: 150 AUC (0-24h) : day 1: 194 µg*h/mL day 14: 577 µg*h/mL F1: 450 AUC (0-24h) : day 1: 342 µg*h/mL day 14: 674 µg*h/mL GD: gestation day; Bw: body weight; #: At 450 mg/kg, foetuses could not be evaluated due to maternal deaths caused by dosing errors on gestation days 9-11. Toxicokinetic data There were no toxicokinetic studies submitted by the applicant. Local Tolerance There were (...) % o.c. Sediment dwelling organism C. elegans ISO 10872:2010 NOEC =4762 mg/kg dw normalised to 10% o.c. 2.3.6. Discussion on non-clinical aspects Vemurafenib is a low molecular weight, orally available, inhibitor of BRAF serine-threonine kinase. Mutations in the BRAF gene which substitute the valine at amino acid position 600 result in constitutively activated BRAF proteins, which can cause cell proliferation in the absence of growth factors that would normally be required for proliferation. Zelboraf

2012 European Medicines Agency - EPARs

163. Signifor - pasireotide

by the patient. There are no dose adjustments recommended in the elderly or in renal impairment. The recommended initial dose for patients with moderate or severe hepatic impairment is 0.3 mg twice a day, with a maximum recommended dose of 0.6 mg twice a day. Cushing’s disease Cushing’s disease is a very rare, debilitating, and life-threatening disease that is caused by an adrenocorticotropic hormone (ACTH)-secreting pituitary adenoma most commonly affecting adult females. The tumours are usually (...) ; results have not yet been published. Mifepristone acts very quickly in decreasing some of the signs of hypercortisolism, specially the psychotic manifestations. Mifepristone causes ACTH levels to increase causing an exacerbation of hypercortisolism. Cabergoline is a dopamine receptor agonist used for the treatment of prolactinomas and (at high doses) Parkinson’s disease. The rationale for the use of cabergoline in Cushing’s disease is the expression of dopamine receptors in some corticotroph pituitary

2012 European Medicines Agency - EPARs

164. Mirabegron (Myrbetriq)

Low risk, may be done along with behavioral therapy Usually not effective as stand alone therapy Antimuscarinic Agents Daily dose of agents either by patch, topical gel application or oral dosing Mainstay of current OAB therapy. Modest efficacy. Chronic use A/Es: dry mouth, constipation, blurred vision: glaucoma contraindication: 27% of OAB patients fail on medication: drug costs: Urinary retention Neuromodulation Surgical implantation (sacral nerves) of an electrical stimulator Used in refractory (...) patients Surgical procedure, device and lead failure, decreased efficacy over time in some patients Peripheral Nerve Stimulation Regularly scheduled visits with placement of external electrode to stimulate either the posterior tibial or pudendal nerve by PTNS This is a secondary therapy. Can be considered prior to neuromodulation. Less invasive than neuromodulation. No systemic AEs. Local needle site AEs: discomfort, bleeding, and tingling in leg (posterior tibial site). No substantial evidence

2012 FDA - Drug Approval Package

165. Is there any evidence of any therapy to improve a residual facial weakness following Bell's palsy in a 45 yr old woman who was treated with steroids and aciclovir on presentation 6 months ago?

evidence of any therapy to improve a residual facial weakness following Bell's palsy in a 45 yr old woman who was treated with steroids and aciclovir on presentation 6 months ago? eMedicine an American online textbook contains a chapter that looks at the follow-up of patients with Bell’s palsy (1). This notes: “If the paralysis is not resolved or is progressing to complete paralysis, a thorough neurologic and HEENT examination should be performed to rule out neoplastic causes of seventh nerve palsy (...) . The patient should be monitored if the initial EMG shows the involved facial muscles to have less than 25% of the function of the normal side. If the residual paralysis is severe, the patient should be referred for counseling.” A patient information leaflet published by the NHS (2)contains a section on further treatment which states: “The majority of people who have Bell's palsy will make a full recovery within nine months. If you have not made a complete recovery by this time, you may have experienced

2009 TRIP Answers

166. 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

167. Intratympanic Steroid for Bell's Palsy

Inclusion Criteria: English as primary language Acute unilateral facial palsy without skin lesions which developed within a 72-hour period and is present for 21 days or less. Moderate to severe facial palsy [House-Brackmann grade IV or greater] Exclusion Criteria: Another cause of facial nerve paralysis that is not idiopathic Otologic disease including otitis media, temporal bone fracture, a previous history of facial nerve palsy in either side, history of otologic surgery, and suspected Ramsay Hunt (...) , University of Missouri-Columbia Study Details Study Description Go to Brief Summary: Facial nerve paralysis is due to inflammation around the facial nerve. Current treatment for facial nerve paralysis is a 10 day course of oral steroids (which will reduce the inflammation), with electrodiagnostic testing. There have been limited studies on the use of intratympanic steroid injection, in addition to oral steroid, in the recovery of facial nerve paralysis. There are indications that the use of intratympanic

2018 Clinical Trials

168. Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock Full Text available with Trip Pro

), 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

2016 European Respiratory Society

169. Vestibular Evaluation After Vestibular Schwannoma Treatment

, University Hospital, Grenoble Study Details Study Description Go to Brief Summary: Vestibular schwannoma is a benign tumor located on the vestibular nerve. Patient could present dizziness symptoms cause to the tumor, and at least after the treatment by gamaknife radiosurgery or microsurgery resection. Only few studies keep the interest about dizziness symptoms and treatment modality in vestibular schwannoma. In the study dizziness symptoms were compared before and after the treatment of vestibular (...) a standarised scale : - Dizziness Functionnal Scale (AAO), this is a scale quote from 1 (no symptoms of dizzyness) to 6 (major disability). The patient have to choise only one item that correspond to the condition. The scale is completed before and after the treatement. The investigator send the scale to the patient by mail way. Secondary Outcome Measures : Facial fonction [ Time Frame: From 4 years to 6 months ] House and Brackmann scale : This scale is a standarised assessment of facial fonction from

2018 Clinical Trials

170. Comparison of the application of artificial ossicles and autologous ossicles in the reconstruction of a damaged ossicular chain. (Abstract)

in 16 cases; the average air-bone gap was 33.4 ± 4.5 dB pre-operatively and 17.8 ± 7.8 dB post-operatively.Ossicular chain reconstruction is an effective way of improving hearing in patients with ossicular chain damage. The results suggest that repair with either the titanium partial ossicular reconstruction prosthesis or autologous ossicles can improve hearing following ossicular chain injury with facial nerve paralysis caused by a temporal bone fracture. (...) Comparison of the application of artificial ossicles and autologous ossicles in the reconstruction of a damaged ossicular chain. To evaluate the therapeutic effect that the titanium partial ossicular reconstruction prosthesis and autologous ossicles have on hearing loss after reconstruction of a damaged ossicular chain.Forty-two medical records of treatments carried out from 2013 to 2015 for ossicular chain damage with facial nerve paralysis due to temporal bone fractures were reviewed

2018 Journal of Laryngology & Otology

171. 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

172. Submental Study (Sequential Treatment Approach)

in the neck or chin area within 6 months before the first treatment session. Subject has a known history of cryoglobulinemia, cold urticaria, paroxysmal cold hemoglobinuria or cold agglutinin disease. Subject has a known history of Raynaud's disease, or any known condition with a response to cold exposure that limits blood flow to the skin. Subject has a history of facial nerve paresis or paralysis (such as Bell's palsy) Subject has a history or current symptoms of dysphagia. Subject has a history (...) Self Rating Scale (SSRS) as determined at Screening visit. History of stable body weight confirmed by the subject, for at least 6 months prior to the first treatment session. Subject agrees to maintain his/her weight (i.e., within 5%) by not making any major changes in their diet or exercise routine during the course of the study. Subject agrees to forgo any treatment or behavior (e.g., unshaven facial hair) during the subject's participation in the study that may affect the assessments

2018 Clinical Trials

173. Clinical Efficacy of Platelet-Rich Plasma in the Treatment of Neurotrophic Corneal Ulcer Full Text available with Trip Pro

of 25 patients with nonhealing corneal ulcers due to herpes simplex or herpes zoster infection and facial nerve or trigeminal nerve paralysis as a result of a neurosurgical operation caused by a tumour or stroke. The patients were given autologous platelet-rich plasma drops five times a day and additionally preservative-free artificial tears and a vitamin A ointment at night for maximum 3 months. The following were evaluated: best corrected visual acuity (BCVA), healing of corneal surface

2018 Journal of ophthalmology

174. 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

175. Screening and Characterization of Hearing Disorders in Diabetic Persons

frequently characterized by facial paralysis or motor eye nerves. The association between hearing disorders and diabetes has always aroused controversy on the part of contradictory literature data. Are hearing disorders an underestimated complication of diabetes? A recent meta-analysis of 2013, examined the scientific literature between 1950 and 2011 and of the 3158 citations, only 13 articles were selected (with more than 20 000 participants). This study found that hearing disorders in diabetic patients (...) See Sponsor: University Hospital, Clermont-Ferrand Information provided by (Responsible Party): University Hospital, Clermont-Ferrand Study Details Study Description Go to Brief Summary: Diabetes is now the most common chronic disease, affecting nearly 6% of the population in Western populations. Diabetic neuropathy is a priori the most common and the most common specific complications of diabetes. It can of course touch the lower limbs, the vegetative nervous system as well as the cranial nerves

2018 Clinical Trials

176. 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

177. 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

179. 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

180. 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)

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