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Ideggyogyaszati Szemle Jul 2022The incidence of brachial plexus palsy (BPP) has decreased recently, but the indivi-d-ual's quality of life is endangered. To provide better chan-ces to BPP neonates and... (Review)
Review
BACKGROUND AND PURPOSE
The incidence of brachial plexus palsy (BPP) has decreased recently, but the indivi-d-ual's quality of life is endangered. To provide better chan-ces to BPP neonates and infants, the Department of Developmental Neurology worked out, introduced, and applied a complex early therapy, including nerve point stimulation.
METHODS
After diagnosing the severity of BPP, early intensive and complex therapy should be started. Appro-x-imately after a week or ten days following birth, the slightest form (neurapraxia) normalizes without any intervention, and signs of recovery can be detected around this period. The therapy includes the unipolar nerve point electro-stimulation and the regular application of those elemen-tary sensorimotor patterns, which activate both extremities simultaneously.
RESULTS
With the guideline worked out and applied in the Department of Developmental Neurology, full recovery can be achieved in 50% of the patients, and even in the most severe cases (nerve root lesion), functional upper limb usage can be detected with typically developing body-scheme.
CONCLUSION
Immediately starting complex treatment based on early diagnosis alters the outcome of BPP, providing recovery in the majority of cases and enhancing the everyday arm function of those who only partially benefit from the early treatment.
Topics: Brachial Plexus; Brachial Plexus Neuropathies; Early Diagnosis; Humans; Infant; Infant, Newborn; Neonatal Brachial Plexus Palsy; Paralysis; Quality of Life
PubMed: 35916611
DOI: 10.18071/isz.75.0247 -
The Journal of Bone and Joint Surgery.... Dec 2005The management of radial nerve palsy associated with fractures of the shaft of the humerus has been disputed for several decades. This study has systematically reviewed... (Meta-Analysis)
Meta-Analysis Review
The management of radial nerve palsy associated with fractures of the shaft of the humerus has been disputed for several decades. This study has systematically reviewed the published evidence and developed an algorithm to guide management. We searched web-based databases for studies published in the past 40 years and identified further pages through manual searches of the bibliography in papers identified electronically. Of 391 papers identified initially, encompassing a total of 1045 patients with radial nerve palsy, 35 papers met all our criteria for eligibility. Meticulous extraction of the data was carried out according to a preset protocol. The overall prevalence of radial nerve palsy after fracture of the shaft of the humerus in 21 papers was 11.8% (532 palsies in 4517 fractures). Fractures of the middle and middle-distal parts of the shaft had a significantly higher association with radial nerve palsy than those in other parts. Transverse and spiral fractures were more likely to be associated with radial nerve palsy than oblique and comminuted patterns of fracture (p < 0.001). The overall rate of recovery was 88.1% (921 of 1045), with spontaneous recovery reaching 70.7% (411 of 581) in patients treated conservatively. There was no significant difference in the final results when comparing groups which were initially managed expectantly with those explored early, suggesting that the initial expectant treatment did not affect the extent of nerve recovery adversely and would avoid many unnecessary operations. A treatment algorithm for the management of radial nerve palsy associated with fracture of the shaft of the humerus is recommended by the authors.
Topics: Algorithms; Humans; Humeral Fractures; Paralysis; Practice Guidelines as Topic; Prognosis; Radial Nerve; Radial Neuropathy; Recovery of Function; Treatment Outcome
PubMed: 16326879
DOI: 10.1302/0301-620X.87B12.16132 -
Revue Medicale de Bruxelles Sep 2013Facial palsy is a daily challenge for the clinicians. Determining whether facial nerve palsy is peripheral or central is a key step in the diagnosis. Central nervous... (Review)
Review
Facial palsy is a daily challenge for the clinicians. Determining whether facial nerve palsy is peripheral or central is a key step in the diagnosis. Central nervous lesions can give facial palsy which may be easily differentiated from peripheral palsy. The next question is the peripheral facial paralysis idiopathic or symptomatic. A good knowledge of anatomy of facial nerve is helpful. A structure approach is given to identify additional features that distinguish symptomatic facial palsy from idiopathic one. The main cause of peripheral facial palsies is idiopathic one, or Bell's palsy, which remains a diagnosis of exclusion. The most common cause of symptomatic peripheral facial palsy is Ramsay-Hunt syndrome. Early identification of symptomatic facial palsy is important because of often worst outcome and different management. The prognosis of Bell's palsy is on the whole favorable and is improved with a prompt tapering course of prednisone. In Ramsay-Hunt syndrome, an antiviral therapy is added along with prednisone. We also discussed of current treatment recommendations. We will review short and long term complications of peripheral facial palsy.
Topics: Bell Palsy; Disease Progression; Facial Paralysis; Herpes Zoster Oticus; Humans; Neoplasms
PubMed: 24195231
DOI: No ID Found -
The American Journal of the Medical... Sep 2022The primary target of SARS-CoV-2 is the respiratory tract; nevertheless, the virus can invade extrapulmonary organs, such as the nervous system. Peripheral facial nerve... (Review)
Review
The primary target of SARS-CoV-2 is the respiratory tract; nevertheless, the virus can invade extrapulmonary organs, such as the nervous system. Peripheral facial nerve palsy has been reported in COVID-19 cases as isolated, unilateral, or bilateral in the context of Guillain-Barré syndrome (GBS). In the present study, online databases, including PubMed and Google Scholar, were searched. Studies without focusing on isolated peripheral facial nerve palsy and SARS-CoV-2 were excluded. Finally, 36 patients with facial nerve palsy were included in our study using reverse transcriptase-polymerase chain reaction (RT-PCR) or antibody SARS-CoV-2 positive test. Interestingly, 23 (63.8%) of these patients had no typical history of COVID-19, and facial nerve palsy was their first clinical manifestation. The present study concludes that there is enough evidence to suggest that SARS-CoV-2 infection may present with facial nerve palsy as the initial clinical manifestation.
Topics: COVID-19; Facial Nerve; Facial Paralysis; Guillain-Barre Syndrome; Humans; Paralysis; SARS-CoV-2
PubMed: 35429449
DOI: 10.1016/j.amjms.2022.04.010 -
The International Journal of... Mar 1982Progressive supranuclear palsy has been recognized as a distinct nosological entity for about three decades now. Typically, this progressive neurological disease... (Review)
Review
Progressive supranuclear palsy has been recognized as a distinct nosological entity for about three decades now. Typically, this progressive neurological disease manifests itself late in the sixth decade with a terminal course of approximately four to six years. Well over one hundred cases have been described in the literature and the heterogeneous nature of progressive supranuclear palsy includes the characteristic vertical ophthalmoplegia, frequent falling and a profound nuchal rigidity. Other features are similar in many respects to those found in Parkinson's disease. The present article reviews the literature on progressive supranuclear palsy with particular reference to its clinical manifestations including the ophthalmoplegia, characteristic sleep disturbances and unique dementia. Also addressed, are neuropathological and epidemiological findings. Finally, conclusions and recommendations for further investigation are offered especially with regard to the neuropsychological nature of this neurological disorder.
Topics: Brain; Brain Diseases; Dementia; Humans; Ophthalmoplegia; Paralysis; Sleep Wake Disorders; Syndrome
PubMed: 6762362
DOI: 10.3109/00207458209147609 -
American Journal of Ophthalmology Oct 2022We evaluated patients with hypertropia compatible with a diagnosis of superior oblique (SO) palsy to ascertain whether the 3-step test (3ST) can distinguish SO atrophy...
PURPOSE
We evaluated patients with hypertropia compatible with a diagnosis of superior oblique (SO) palsy to ascertain whether the 3-step test (3ST) can distinguish SO atrophy characteristic of trochlear nerve pathology from masquerading conditions.
DESIGN
Prospective cross-sectional study.
METHODS
In an academic practice, we performed quasi-coronal plane, surface coil magnetic resonance imaging in 83 patients clinically diagnosed with SO palsy. We evaluated alignment, SO cross-sectional area, SO contractility, and rectus muscle pulley positions.
RESULTS
A total of 57 patients with mean age 39 years (SD = 21 years) had unilateral SO palsy manifested by SO atrophy (22 congenital and 35 acquired). There was normal SO size in 26 patients with an average age of 39 years (SD =16 years) considered masquerades (8 congenital and 18 acquired). Maximum palsied SO cross-section averaged 9.5 ± 3.8 mm, less than 18.4 ± 3.9 mm contralaterally (P < 10). In masquerades, maximum hypertropic SO cross-section was 20.7 ± 3.1 mm, which was not different from the hypotropic SO or the contralesional muscle in SO palsy. Head tilt testing in masquerades was indistinguishable from SO palsy. In SO palsy, central hypertropia averaged 13.2 ± 9.4Δ, increasing to 21.1 ± 14.0Δ in ipsilateral tilt, and decreasing to 4.3 ± 5.3Δ in contralateral tilt. In masquerades, central hypertropia averaged 13.1 ± 8.7Δ, and was 17.7 ± 11.1Δ in ipsilateral and decreasing to 4.9 ± 5.1Δ in contralateral tilt. Upright hypertropia was larger at 17.7 ± 9.9Δ in congenital than 12.0 ± 8.4Δ in acquired SO palsy (P = 0025) but was indistinguishable from congenital masquerades. Contractile change in SO cross-section was bilaterally similar in masquerades. Relevant coordinates of rectus pulleys were similar bilaterally in masquerades.
CONCLUSIONS
The 3ST pattern characteristic of unilateral SO palsy may be mimicked in all respects by masquerades.
Topics: Adult; Atrophy; Cross-Sectional Studies; Humans; Oculomotor Muscles; Paralysis; Prospective Studies; Strabismus; Trochlear Nerve Diseases
PubMed: 35618024
DOI: 10.1016/j.ajo.2022.05.017 -
European Neurology 2007
Topics: Brain; Humans; Paralysis
PubMed: 17218773
DOI: 10.1159/000098476 -
The Journal of Hand Surgery Oct 2017The posterior interosseous nerve (PIN) is susceptible to a number of traumatic and atraumatic pathologies. In this article, we aim to review our current understanding of... (Review)
Review
The posterior interosseous nerve (PIN) is susceptible to a number of traumatic and atraumatic pathologies. In this article, we aim to review our current understanding of the etiology, pathology, diagnosis, treatment options, and published outcomes of atraumatic PIN palsy. In general, the etiology of atraumatic PIN palsy can be divided into mechanical, which is caused by an extrinsic compressive force on the nerve, and nonmechanical, which is caused by an intrinsic inflammatory reaction within the nerve. As per this discussion, there are 3 causes for atraumatic PIN palsy. These are entrapment neuropathy, Parsonage-Turner syndrome, and spontaneous "hourglass" constriction. The typical presentation of atraumatic PIN palsy is a patient with spontaneous onset of weakness of fingers/thumb metacarpophalangeal joints extension. However, the wrist extension is preserved with radial deviation due to preservation of extensor carpi radialis longus/brevis function. Magnetic resonance imaging is the imaging of choice and neurophysiology is indicated in all patients. If there is an obvious structural cause of the nerve palsy, prompt decompression and removal of the causative lesion are recommended to avoid irreversible damage to the nerve/muscles. Otherwise, in general, we would recommend consideration for exploration should there be no sign of recovery after 6 weeks of observation.
Topics: Hand; Humans; Nerve Compression Syndromes; Paralysis
PubMed: 28969808
DOI: 10.1016/j.jhsa.2017.07.026 -
The Journal of Hand Surgery Jan 2015
Review
Topics: Anesthesia Recovery Period; Birth Injuries; Brachial Plexus Neuropathies; Diagnosis, Differential; Humans; Paralysis; Radial Neuropathy
PubMed: 25443163
DOI: 10.1016/j.jhsa.2014.08.040 -
Revue Medicale Suisse Jul 2023Peripheral facial palsy is a common, often idiopathic and self-limiting mononeuropathy. However, secondary facial palsies require specific management: they are most...
Peripheral facial palsy is a common, often idiopathic and self-limiting mononeuropathy. However, secondary facial palsies require specific management: they are most often of infectious, vascular or dysimmune causes. The presence of red flags in the history, clinical examination or medical follow-up should alert clinicians. Because of the high incidence of Lyme disease in our region, this etiology deserves special attention. The management is based on general measures (eye protection, rehabilitation) and corticosteroid therapy; antivirals may provide additional benefit.
Topics: Humans; Facial Paralysis; Bell Palsy; Lyme Disease; Physical Examination; Incidence
PubMed: 37493118
DOI: 10.53738/REVMED.2023.19.836.1413