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PloS One 2014C5 palsy is a serious but poorly understood complication after posterior cervical decompression that could lead to muscle weakness, brachialgia and numbness of the upper... (Review)
Review
BACKGROUND
C5 palsy is a serious but poorly understood complication after posterior cervical decompression that could lead to muscle weakness, brachialgia and numbness of the upper limbs. The incidence of C5 palsy varies greatly between studies. The risk factors are inconclusive and even conflicting.
OBJECT
To perform a systematic review on the incidence and risk factors of C5 palsy after posterior cervical decompression.
MATERIALS AND METHODS
Four databases, PubMed, Embase, Web of Science and Cochrane CENTRAL, were searched to identify eligible studies. Either a fixed- or a random-effects model was used to calculate the pooled odd ratio (RR) or standardized mean difference (SMD) with its 95% confidence interval (95%CI).
RESULTS
Of the 589 pre-recruited studies, 25 were included in this study for systematic review. The pooled incidence of C5 palsy after posterior decompression was 5.8% (95%CI: 4.4-7.2%). The incidence after open-door laminoplasty, double-door laminoplasty and laminectomy was 4.5%, 3.1% and 11.3%, respectively. The significant risk factors of C5 palsy were OPLL (OR, 2.188; 95%CI, 1.307-3.665), narrower intervertebral foramen (SMD, -0.972; 95%CI, -1.398 to -0.545), laminectomy (vs. open-door laminoplasty, OR, 2.988; 95%CI, 1.298-6.876), excessive spinal cord drift (SMD, 1.289, 95%CI, 0,197-2.381) and male gender (OR, 1.54; 95%CI, 1.036-2.301).
CONCLUSIONS
The results of this systematic review suggest that patients with excessive spinal cord drift, preexisting intervertebral foramenal stenosis, OPLL, laminectomy and male gender are at high risk for postoperative C5 palsy, and risk-reduction options should be considered for such patients.
Topics: Adult; Aged; Aged, 80 and over; Cervical Vertebrae; Decompression, Surgical; Female; Humans; Incidence; Laminectomy; Male; Middle Aged; Paralysis; Postoperative Complications; Risk Factors; Sex Factors; Spinal Nerve Roots
PubMed: 25162509
DOI: 10.1371/journal.pone.0101933 -
Revista Paulista de Pediatria : Orgao... 2023To systematically review the literature in search of the most suitable and effective nutritional interventions and indications for the nutritional treatment of children...
OBJECTIVE
To systematically review the literature in search of the most suitable and effective nutritional interventions and indications for the nutritional treatment of children and adolescents with cerebral palsy (CP).
DATA SOURCE
This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The articles were selected from seven databases (Cochrane, Literatura Latino-Americana e do Caribe em Ciências da Saúde - Lilacs, Embase, United States National Library of Medicine - PubMed, Scientific Electronic Library Online - SciELO, Scopus, and Web of Science). Studies from a pediatric group (0 to 18 years old) diagnosed with CP were included and the search strategy included the descriptors: "children" OR "childhood" AND "nutritional therapy" OR "nutritional intervention" OR "nutrition" OR "nutritional support" OR "diet" AND "cerebral palsy" OR "cerebral injury". Methodological quality was assessed using the checklist for cross-sectional analytical studies, the Newcastle-Ottawa scale or the Cochrane Collaboration tool for clinical trials.
DATA SYNTHESIS
Fifteen studies (n=658) published from 1990 to 2020 met the inclusion criteria. All of them had a low risk of bias. The data showed that children and adolescents with CP have worse nutritional status than those normally developed. Those who received hypercaloric and hyperprotein nutritional supplementation benefited from its use. Studies indicate that enteral nutrition should be considered when nutritional needs are not met by the oral diet, especially in cases where oral motor functions are impaired. In addition, there was a direct relationship between the consistency of food, the level of motor function and nutritional status.
CONCLUSIONS
Children and adolescents with CP have a greater risk of malnutrition. The use of nutritional supplementation may help with weight gain. In addition, enteral nutrition and modification of food texture have been used to improve the nutritional status of this group.
Topics: United States; Child; Humans; Adolescent; Infant, Newborn; Infant; Child, Preschool; Cross-Sectional Studies; Nutritional Support; Enteral Nutrition; Dietary Supplements; Paralysis
PubMed: 37436239
DOI: 10.1590/1984-0462/2024/42/2022107 -
Child: Care, Health and Development Mar 2016Cerebral palsy (CP) is one of the most common causes of physical disability in childhood, and many children with CP access rehabilitation services throughout their... (Review)
Review
BACKGROUND
Cerebral palsy (CP) is one of the most common causes of physical disability in childhood, and many children with CP access rehabilitation services throughout their lives. The aim of this qualitative systematic review was to synthesize the experiences and perspectives of youth living with CP to inform the development of rehabilitation and social programmes.
METHODS
A thematic qualitative synthesis integrating qualitative evidence was undertaken where six electronic databases (MEDLINE, Embase, Healthstar, Cumulative Index to Nursing and Allied Health Literature, Proquest and PsychInfo) were searched from 1980 to September 2014.
RESULTS
Thirty-three articles involving 390 youth, aged from 2 to 25 years, across six countries were included. Themes were classified according to the International Classification of Functioning Child and Youth Version framework. Youth's accounts focused on social inclusion and the physical environment (i.e. services and supports, transportation, accessibility, accommodations, safety and weather), the role of family and peers and participation (i.e. leisure and recreation, school and civic engagement). Youth described how body structure and function (i.e. pain and physical functioning, mental health, fatigue and unpredictability of body function) affected them - often disrupting their biographies. Some youth described personal factors such as independence, coping and body image that affected their ability to cope with their condition. There was much less focus on youth's experiences of mobility, activities of daily living and assistive devices.
CONCLUSIONS
Youth with CP experience pain, fatigue and impairments to body function, along with social exclusion, which can affect their biographies. However, youth had strategies to revise their biographies to maintain personal and social normalcy.
Topics: Activities of Daily Living; Adaptation, Psychological; Adolescent; Cerebral Palsy; Child; Child, Preschool; Disabled Children; Female; Humans; International Classification of Functioning, Disability and Health; Male; Qualitative Research; Recreation; Social Participation; Young Adult
PubMed: 26754030
DOI: 10.1111/cch.12309 -
Clinical Neurology and Neurosurgery Feb 2023This study aims to describe the clinical characteristics of patients with isolated oculomotor nerve palsy from COVID-19 infection, and provide guidance on their...
AIM
This study aims to describe the clinical characteristics of patients with isolated oculomotor nerve palsy from COVID-19 infection, and provide guidance on their treatment and management.
METHODS
We performed a systematic review and retrospective analysis on the clinical features and outcomes of patients with isolated oculomotor nerve palsy from COVID-19 reported in literature over the past three years.
RESULTS
We analyzed a total of 11 cases; 9 identified in literature from January 2020 to September 2022, together with our two patients. Their median age was 46 years (range 2-65), and three were children. More than half (6/11, 55 %) were without medical history. Oculomotor nerve palsies tended to occur early (longest interval of 16 days), but they can also occur concurrently (2/11, 18 %) or before the appearance of COVID-19 symptoms (1/11, 9 %). COVID-19 symptoms tended to be mild (8/11, 73 %). Oculomotor nerve palsies, however, displayed neither a clear gender predilection, nor consistent clinical features in terms of the severity of extraocular weakness and the involvement of pupillary light responses. Nearly two-thirds (7/11, 64 %) received no pharmacological treatment. Regardless, recovery was complete in nearly all (9/10, 90 %), with most occurring within a month (8/9, 89 %) CONCLUSION: Isolated oculomotor nerve palsies are early but uncommon complications of COVID-19. They affect patients with mild infections, and can be the first symptom. Prognosis is excellent, with recovery being often complete and early. Early discharge and outpatient clinical review, with or without short courses of oral steroids, are reasonable treatment measures.
Topics: Child; Humans; Child, Preschool; Adolescent; Young Adult; Adult; Middle Aged; Aged; Retrospective Studies; COVID-19; Oculomotor Nerve Diseases; Prognosis; Oculomotor Nerve
PubMed: 36696848
DOI: 10.1016/j.clineuro.2023.107601 -
International Journal of Surgery... Mar 2017Intraoperative neuromonitoring (IONM) has been a commonly used technology during thyroid surgery aimed at reducing the incidence of recurrent laryngeal nerve palsy... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
Intraoperative neuromonitoring (IONM) has been a commonly used technology during thyroid surgery aimed at reducing the incidence of recurrent laryngeal nerve palsy (RLNP), which is a severe complication and leads to significant impacts on a patient's life. In order to give a comprehensive assessment for potential benefits and disadvantage of IONM, this meta-analysis and systematic review discusses RLNP rate, predictive power, continuous intraoperative neuromonitoring (CIONM), and emphasises application during thyroid cancer surgeries.
METHODS
A literature search was performed in the following electronic databases: PubMed, Embase, and the Cochrane library from January 1, 2004 to July 30, 2016. After applying inclusion and exclusion criteria, 24 studies, including four prospective randomised trials, were selected. Heterogeneity of studies was checked by the Cochran Q test. Publication bias was assessed by funnel plots with Egger's linear regression test of asymmetry. Odds ratio (OR) was calculated by random effects model.
RESULTS
Overall, 9203 patients and 17,203 nerves at risk (NAR) were included. Incidence of overall, transient, and persistent RLNP in IONM group were, respectively, 3.15%, 1.82%, and 0.67%, whereas for the ID group, they were 4.37%, 2.58%, and 1.07%. The summary OR of overall, transient, and persistent RLNP compared using IONM and ID were, respectively, 0.81 (95%CI 0.66-0.99), 0.76 (95%CI 0.61-0.94), and 0.78 (95%CI 0.55-1.09).
CONCLUSIONS
The presented data showed benefits of reducing RLNP rate by using IONM, but without statistical significance for persistent RLNP rate. For patients with thyroid cancer who undergo total thyroidectomy, using IONM may improve the outcome by reducing amount of residual thyroid tissue. However, no benefits were found for thyroid reoperation; visual identification and careful dissection remain standard for this challenging procedure. In addition, the relative low positive predictive power indicated intermittent intraoperative neuromonitoring (IIONM) may not be reliable; but CIONM was showed to be a more promising method, with prudent approach.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Female; Humans; Incidence; Male; Middle Aged; Monitoring, Intraoperative; Postoperative Complications; Prospective Studies; Randomized Controlled Trials as Topic; Thyroid Neoplasms; Thyroidectomy; Vocal Cord Paralysis; Young Adult
PubMed: 28130189
DOI: 10.1016/j.ijsu.2017.01.086 -
International Journal of Surgery... Feb 2017Use of intra-operative neuro-monitoring (IONM) during high-risk thyroidectomy has been suggested to decrease the rate of recurrent laryngeal nerve (RLN) palsy. However,... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
Use of intra-operative neuro-monitoring (IONM) during high-risk thyroidectomy has been suggested to decrease the rate of recurrent laryngeal nerve (RLN) palsy. However, current evidences were mixed and there was no large-scale study concluding its benefit. We evaluated the role of IONM in reducing RLN palsy during high-risk thyroidectomy and identified which high-risk subgroup would be most benefited.
METHODS
A systemic review was performed to identify studies comparing the use of IONM and visual identification of RLN alone (VA) during high-risk thyroidectomy, namely re-operation, thyroidectomy for malignancy, thyrotoxicosis or retrosternal goitre. Rate of RLN palsy was presented in terms of number of nerve-at-risk (NAR). Meta-analysis on overall high-risk thyroidectomy and subgroups were performed using fixed or random-effects model.
RESULTS
Ten articles were eligible for final analysis. There were 4460 NARs in VA group and 6155 NARs in IONM group. Comparing to VA, IONM had lower rate of overall [4.5% vs. 2.5%, Odd ratio (OR): 1.40, 95% confidence interval (CI): 1.12-1.79, p = 0.003] and temporary [3.9% vs. 2.4%; OR: 1.47, 95% CI: 1.07-2.00, p = 0.016] RLN palsy in overall high-risk thyroidectomies. On subgroup analysis, although numbers of NARs were less than minimal numbers required for a statistical powered study (2.1%-72.7%), use of IONM decreased the rate of overall RLN palsy during re-operation (7.6% vs. 4.5%, OR: 1.32, p = 0.021) and temporary RLN palsy during thyroidectomy for malignancy (3.1% vs. 1.6%, OR: 1.90, p = 0.026). Use of IONM tended to have a lower rate of overall RLN palsy during thyroidectomy for malignancy than VA alone. (3.5% vs. 2.1%, p = 0.050).
CONCLUSIONS
Selective use of IONM during high-risk thyroidectomy decreased the rate of overall RLN palsy. IONM should be applied during re-operative thyroidectomy and thyroidectomy for malignancy.
Topics: Female; Humans; Intraoperative Neurophysiological Monitoring; Male; Middle Aged; Recurrent Laryngeal Nerve Injuries; Reoperation; Risk; Thyroidectomy; Vocal Cord Paralysis
PubMed: 28034775
DOI: 10.1016/j.ijsu.2016.12.039 -
Surgery For Obesity and Related... May 2023Gastroparesis is a gastric motility disorder characterized by delayed gastric emptying. It is a rare disease and difficult to treat effectively; management is a dilemma... (Review)
Review
Gastroparesis is a gastric motility disorder characterized by delayed gastric emptying. It is a rare disease and difficult to treat effectively; management is a dilemma for gastroenterologists and surgeons alike. We conducted a systematic review of the literature to evaluate current diagnostic tools as well as treatment options. We describe key elements in the pathophysiology of the disease, in addition to current evidence on treatment alternatives, including nutritional considerations, medical and surgical options, and related outcomes.
Topics: Humans; Gastroparesis; Surgeons; Gastric Emptying
PubMed: 37080885
DOI: 10.1016/j.soard.2023.02.018 -
Neurological Sciences : Official... Jun 2023To provide new and comprehensive evidence for diagnosis and management of FOSMN syndrome. (Review)
Review
OBJECTIVE
To provide new and comprehensive evidence for diagnosis and management of FOSMN syndrome.
METHODS
We reviewed our database to identify patients with FOSMN syndrome. Online database including PubMed, EMBASE, and OVID were also searched for relevant cases.
RESULTS
We identified a total of 71 cases, including 4 cases from our database and 67 ones from online searching. A predominance of male was observed [44 (62.0%)] with median onset age of 53 (range: 7-75) years old. The median (range) disease duration was 60 (3-552) months at the time of the visit. The initial symptoms could be sensory deficits in face (80.3%) or oral cavity (4.2%), bulbar paralysis (7.0%), dysosmia (1.4%), dysgeusia (4.2%), weakness or numbness of upper limbs (5.6%), or lower limbs (1.4%). Abnormal blink reflex was presented in 64 (90.1%) patients. CSF tests showed elevated protein level in 5 (7.0%) patients. Six (8.5%) patients had MND-related gene mutation. Five (7.0%) patients showed transient responsiveness to immunosuppressive therapy, then deteriorated relentlessly. Fourteen (19.7%) patients died, with an average survival time of around 4 years. Among them, five patients died of respiratory insufficiency.
CONCLUSION
The age of onset, progress of disease course, and prognosis of FOSMN syndrome could be varied significantly. The prerequisites of diagnosis were progressive and asymmetric lower motor neuron dysfunction, with sensory dysfunction which usually showed in face at the onset. Immunosuppressive therapy could be tried in some patients with suspected inflammatory clues. In general, FOSMN syndrome tended to be motor neuron disease with sensory involvement.
Topics: Adolescent; Adult; Aged; Child; Female; Humans; Male; Middle Aged; Young Adult; Blinking; Bulbar Palsy, Progressive; Motor Neuron Disease; Mutation; Neurodegenerative Diseases
PubMed: 36864244
DOI: 10.1007/s10072-023-06703-1 -
Dental and Medical Problems 2022Many complications can occur after the injection of local intraoral anesthetics (ILIA) before dental intervention. Facial paralysis (FP) is one of these complications.... (Review)
Review
Many complications can occur after the injection of local intraoral anesthetics (ILIA) before dental intervention. Facial paralysis (FP) is one of these complications. The purpose of this study was to systematically analyze the association between ILIA and FP. A systematic review was carried out taking into account the methodology of the Cochrane Handbook for Systematic Reviews of Interventions and the PRISMA statement. The search strategy used "Palsy AND Facial" and "Paralysis AND Facial" as search terms. The ScienceDirect, PubMed and Scopus databases were searched using the "dentistry journal" filter. The inclusion criteria included studies describing FP after or during ILIA that were published in dental journals. The CAse REports (CARE) checklist was applied in evaluating the methodological quality of case reports. A total of 2,462 articles (algorithm) were identified. After reviewing titles and abstracts, 18 articles were deemed relevant taking into account the objectives of this study. Only 13 of them, after reading the full text, met the inclusion criteria and were analyzed. Case reports on 18 cases of FP were analyzed, 12 of which described the early development of FP (onset within 24 h) and 6 the late development (onset after 24 h). Acceptable compliance with CARE guidelines was observed in the included studies . Early FP CRs presented the effect of the administered anesthetic on the facial nerve, and the vascular effect of the vasoconstrictor included in the anesthetic formula, while more recent FP CRs focused on the reactivation of herpes simplex virus type 1 (HSV-1), human herpesvirus 6 (HHV-6) or varicella-zoster virus (VZV).
Topics: Humans; Facial Paralysis; Herpesvirus 1, Human; Herpesvirus 3, Human; Face; Anesthetics
PubMed: 36583841
DOI: 10.17219/dmp/138910 -
European Journal of Neurology Dec 2023Evidence-based recommendations for treatment of Lyme neuroborreliosis (LNB) should rely on the available literature. As new data emerges, close review and evaluation of... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Evidence-based recommendations for treatment of Lyme neuroborreliosis (LNB) should rely on the available literature. As new data emerges, close review and evaluation of the recent literature is needed to build evidence-based recommendations to inform clinical practice and management of LNB. We performed an update of a previous systematic review on treatment of LNB.
METHODS
A systematic literature search of Medline and CENTRAL was performed for published studies from 2015 to 2023 to update a previous systematic review. Randomized controlled trials (RCTs) and non-randomized studies (NRS) were evaluated. Risk of bias was assessed using the Cochrane risk of bias tools for RCTs; NRS were assessed using the ROBINS-I-tool. Quality of the evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Data were integrated into an existing meta-analysis of the available literature.
RESULTS
After screening 1530 records, two RCTs and five NRS with new and relevant data were additionally identified. Meta-analysis showed no statistically significant difference between doxycycline and beta-lactam antibiotics regarding residual neurological symptoms after 12 months. Meta-analysis showed no benefit of extended antibiotic treatment of LNB. Three NRS show no benefit for additional steroid use in LNB with facial palsy.
DISCUSSION
Additional incorporated recent research corroborates existing guideline recommendations for treatment of LNB. New RCTs add to the certainty of previous analysis showing similar efficacy for doxycycline and beta-lactam antibiotics in LNB. Available evidence shows no benefit for extended antibiotic treatment in LNB. NRS do not suggest a role for steroids in facial palsy due to LNB.
Topics: Humans; Lyme Neuroborreliosis; Doxycycline; Facial Paralysis; Anti-Bacterial Agents; Monobactams
PubMed: 37565386
DOI: 10.1111/ene.16034