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BMJ Case Reports May 2017Traumatic injuries to the brachial plexus are typically high impact and can be debilitating, life-changing injuries. Backpack palsy is a rare but well-established cause...
Traumatic injuries to the brachial plexus are typically high impact and can be debilitating, life-changing injuries. Backpack palsy is a rare but well-established cause of brachial plexus injury, arising as a result of heavy backpack use. We present an unusual case of backpack palsy with Horner's syndrome.
Topics: Adult; Brachial Plexus; Brachial Plexus Neuropathies; Horner Syndrome; Humans; Male; Military Personnel; Paralysis; Weight-Bearing
PubMed: 28536218
DOI: 10.1136/bcr-2017-219402 -
European Journal of Physical and... Aug 2019Neuralgic amyotrophy (NA) is a relatively uncommon syndrome causing brachial nerves dysfunction. However, it can also affect other nerves including phrenic nerve, which...
BACKGROUND
Neuralgic amyotrophy (NA) is a relatively uncommon syndrome causing brachial nerves dysfunction. However, it can also affect other nerves including phrenic nerve, which is often misdiagnosed.
CASE REPORT
To determine the incidence and characteristics of phrenic nerve palsy in patients with NA in our population, we analyzed the records of all patients with phrenic nerve palsy and/or NA at the University Hospital and the county hospital within the last 10 years. We found that totally, seven patients were confirmed to have NA and phrenic nerve palsy. All of them are male of average age 51.9 years old (51.9±7.4) and had shortness of breath following shoulder and/or neck pain. All of them had elevated diaphragm found in SNIFF test and/or on chest X-ray. Pulmonary function test done in 6 patients demonstrated restrictive lung disease. Six patients needed long-term bi-level positive airway pressure (BiPAP) treatment but mechanic ventilation was not needed.
CLINICAL REHABILITATION IMPACT
Our cohort represents one of the largest case series yet reported for phrenic nerve involvement in NA. Most of these patients have had significant pulmonary compromise in the early stage of onset of shoulder/neck pain requiring ongoing BiPAP and specialist monitoring. Recognition of this subset of patients may further require nerve conduction studies/electromyography and respiratory testing.
Topics: Adult; Brachial Plexus Neuritis; Cohort Studies; Humans; Male; Middle Aged; Paralysis; Peripheral Nervous System Diseases; Phrenic Nerve
PubMed: 31058474
DOI: 10.23736/S1973-9087.19.05294-8 -
Neurology India 2016A single clear binocular vision is made possible by the nature through the oculomotor system along with inputs from the cortical areas as well their descending pathways...
A single clear binocular vision is made possible by the nature through the oculomotor system along with inputs from the cortical areas as well their descending pathways to the brainstem. Six systems of supranuclear control mechanisms play a crucial role in this regard. These are the saccadic system, the smooth pursuit system, the vestibular system, the optokinetic system, the fixation system, and the vergence system. In gaze disorders, lesions at different levels of the brain spare some of the eye movement systems while affecting others. The resulting pattern of eye movements helps clinicians to localize lesions accurately in the central nervous system. Common lesions causing gaze palsies include cerebral infarcts, demyelinating lesions, multiple sclerosis, tumors, Wernicke's encephalopathy, metabolic disorders, and neurodegenerative disorders such as progressive supranuclear palsy. Evaluation of the different gaze disorders is a bane of most budding neurologists and neurosurgeons. However, a simple and systematic clinical approach to this problem can make their early diagnosis rather easy.
Topics: Eye Diseases; Eye Movements; Humans; Multiple Sclerosis; Supranuclear Palsy, Progressive
PubMed: 26755003
DOI: 10.4103/0028-3886.173627 -
Journal of the Chinese Medical... Jul 2013
Topics: Cervical Vertebrae; Decompression, Surgical; Female; Humans; Male; Paralysis; Postoperative Complications; Quality of Life; Spinal Cord Compression
PubMed: 23664733
DOI: 10.1016/j.jcma.2013.03.009 -
Acta Orthopaedica Et Traumatologica... 2011The aim of this study was to evaluate the long-term outcome of shoulder arthrodesis with plate fixation and primary autogenous grafting in terms of pain, functional...
OBJECTIVE
The aim of this study was to evaluate the long-term outcome of shoulder arthrodesis with plate fixation and primary autogenous grafting in terms of pain, functional status and arthrodesis position.
METHODS
The study included 8 patients (7 males and 1 female; mean age: 39.3 years; range: 22 to 68 years) who underwent arthrodesis with plate fixation and primary autogenous grafting. Mean follow-up period was 66.6 (range: 47 to 96) months. Five cases had traumatic brachial plexus palsy, 2 polio sequela and 1 sequela of an operated proximal humerus fracture due to a falling injury. One of the traumatic palsy cases was accompanied with a humerus shaft fracture. Arthrodesis was performed in all cases according to AO principles with plate fixation and primary autogenous grafting. Five of the paralytic patients also underwent Steindler flexorplasty. Follow-up assessments included monthly radiologic control for union, the visual analog scale (VAS) for pain and the Oxford shoulder score (OSS) for functional status.
RESULTS
Radiological fusion was seen in all cases in an average of 16 (range: 12 to 18) weeks, and arthrodesis was stable at physical examination. The accompanying humerus shaft fracture was also fixed with plate. One patient with traumatic palsy experienced a humerus fracture distal to the arthrodesis plate at the 8th postoperative month. An additional traumatic palsy case had flexion deformity at the wrist in the second year of follow-up and a wrist arthrodesis with dorsal plate was performed. One patient (12.5%) had a donor site infection on the tenth day after surgery. The target positions of 30° of abduction, 30° of forward flexion, and 30° of internal rotation were achieved with an average deviation of 7°. Mean active abduction was 68.1° (range: 55° to 90°), flexion was 67.5° (range: 60° to 85°), and internal rotation was at the level of trochanter major. The mean OSS was 35.9 (range: 32 to 40), and the mean VAS score was 2.9 (range: 1 to 7).
CONCLUSION
Our findings show that AO reconstruction plate and primary autogenous bone grafting is a safe and effective arthrodesis method that can also be used as a salvage procedure.
Topics: Activities of Daily Living; Adult; Aged; Arthrodesis; Bone Plates; Bone Transplantation; Brachial Plexus; Female; Humans; Male; Middle Aged; Paralysis; Poliomyelitis; Radiography; Shoulder Injuries; Shoulder Joint; Transplantation, Autologous; Young Adult
PubMed: 22245817
DOI: 10.3944/AOTT.2011.2487 -
British Medical Journal Nov 1956
Topics: Facial Paralysis; Humans
PubMed: 13364414
DOI: 10.1136/bmj.2.5003.1197 -
British Medical Journal (Clinical... Feb 1981
Topics: Facial Paralysis; Humans; Nerve Degeneration; Prognosis
PubMed: 6780121
DOI: 10.1136/bmj.282.6263.545 -
European Archives of... Sep 2021There is a lack of data on patients' and diagnostic factors for prognostication of complete recovery in patients with non-idiopathic peripheral facial palsy (FP).
OBJECTIVES
There is a lack of data on patients' and diagnostic factors for prognostication of complete recovery in patients with non-idiopathic peripheral facial palsy (FP).
METHODS
Cohort register-based study of 264 patients with non-idiopathic peripheral FP and uniform diagnostics and standardized treatment in a university hospital from 2007 to 2017 (47% female, median age: 57 years). Clinical data, facial grading, electrodiagnostics, motor function tests, non-motor function tests, and onset of prednisolone therapy were assessed for their impact on the probability of complete recovery using univariable and multivariable statistics.
RESULTS
The most frequent reason for a non-idiopathic peripheral FP was a reactivation of Varicella Zoster Virus (VZV; 36.4%). Traumatic origin had a higher proportion of complete FP (52.9%). Furthermore, in traumatic FP, the mean interval between onset and start of prednisolone therapy was longer than in other cases (5.6 ± 6.2 days). Patients with reactivation of VZV, Lyme disease or otogenic FP had a significant higher recovery rate (p = 0.002, p < 0.0001, p = 0.018, respectively), whereas patients with post-surgery FP and other reasons had a significant lower recovery rate (p < 0.0001). After multivariate analyses voluntary activity in first EMG, Lyme disease and post-surgery cause were identified as independent diagnostic and prognostic factors on the probability of complete recovery (all p < 0.05).
CONCLUSION
Infectious causes for non-idiopathic FP like VZV reactivation and Lyme disease had best probability for complete recovery. Post-surgery FP had a worse prognosis.
LEVEL OF EVIDENCE
2.
Topics: Bell Palsy; Cohort Studies; Facial Paralysis; Female; Humans; Male; Middle Aged; Prognosis
PubMed: 33025045
DOI: 10.1007/s00405-020-06398-6 -
BMC Health Services Research Oct 2021This cross-sectional, retrospective, observational study analyzed the demographics of patients with peripheral facial palsy in South Korea and their use of healthcare... (Observational Study)
Observational Study
Analysis of medical services provided to patients with peripheral facial palsy in Korea: a descriptive, cross-sectional study of the health insurance review and assessment service national patient sample database.
BACKGROUND
This cross-sectional, retrospective, observational study analyzed the demographics of patients with peripheral facial palsy in South Korea and their use of healthcare services.
METHODS
The 2016 Korean Health Insurance Review and Assessment National Patient Sample dataset was used; a total of 4790 patients, diagnosed with facial palsy, who had used healthcare services at least once between January 2016 and December 2016 were included, and data on the use of medical services, hospitalizations, sociodemographic factors, treatments, and medications were analyzed.
RESULTS
Overall, 326 patients per 100,000 individuals used healthcare services at least once because of peripheral facial palsy in 2016, with higher numbers for women and those aged 50-59 years. The percentage of patients who used Korean traditional medicine (KM), Western medicine (WM), and both KM and WM was 54.4, 23.3, and 22.3%, respectively. Users of both WM and KM had higher per capita medical costs, more visits, and longer treatment durations. Physiotherapy was the most frequent WM treatment (44.4%), and "examinations" was the costliest (24.7%) category. "Procedures" was both the most frequent and costliest KM category (99.9 and 57.3%, respectively). "Continuous intravenous injections" (8.6%) and "superficial heat therapy" (8.3%) were the most frequent WM treatments, while acupuncture accounted for 98% of all KM treatments.
CONCLUSIONS
This study analyzed the demographic characteristics and medical service use of patients with peripheral facial palsy in detail. These results can be used as basic information to improve clinical and policy strategies for the management and treatment of peripheral facial palsy.
Topics: Cross-Sectional Studies; Facial Paralysis; Female; Humans; Insurance, Health; Republic of Korea; Retrospective Studies
PubMed: 34715858
DOI: 10.1186/s12913-021-07078-9 -
Acta Otorrinolaringologica Espanola 2004We report a 34 year old female patient with six episodes of idiopathic right facial palsy, all of wich had total recovery. Idiopathic recurrent facial palsy is a rare... (Review)
Review
We report a 34 year old female patient with six episodes of idiopathic right facial palsy, all of wich had total recovery. Idiopathic recurrent facial palsy is a rare entity, with a few cases in the literature. Recurrent facial palsy is usually in the setting of a family history and have both autosomal dominant and recessive inheritance or in the setting of hypertension and diabetes. A review of the literature does not report a previous case with six episodes.
Topics: Adult; Facial Paralysis; Female; Humans; Recurrence
PubMed: 15554591
DOI: 10.1016/s0001-6519(04)78534-9