Approach to Facial Weakness

Semin Neurol 2021; 41: 673-685 DOI: 10.1055/s-0041-1726358Facial palsy is a common neurologic concern and is the most common cranial neuropathy. The facial nerve contains motor, parasympathetic, and special sensory functions. The most common form of facial palsy is idiopathic (Bell's palsy). A classic presentation requires no further diagnostic measures, and generally improves with a course of corticosteroid and antiviral therapy. If the presentation is atypical, or concerning features are present, additional studies such as brain imaging and cerebrospinal fluid analysis may be indicated. Many conditions may present with facial weakness, either in isolation or with other neurologic signs (e.g., multiple cranial neuropathies). The most important ones to recognize include infections (Ramsay-Hunt syndrome associated with herpes zoster oticus, Lyme neuroborreliosis, and complications of otitis media and mastoiditis), inflammatory (demyelination, sarcoidosis, Miller–Fisher variant of Guillain–Barré syndrome), and neoplastic. No matter the cause, individuals may be at risk for corneal injury, and, if so, should have appropriate eye protection. Synkinesis may be a bothersome residual phenomenon in some individuals, but it has a variety of treatment options including neuromuscular re-education and rehabilitation, botulinum toxin chemodenervation, and surgical intervention. [...] Thieme Medical Publishers, Inc. 333 Seventh Avenue, 18th Floor, New York, NY 10001, USA...
Source: Seminars in Neurology - Category: Neurology Authors: Tags: Review Article Source Type: research

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AbstractTraumatic optic neuropathy (TON) is a serious complication of craniofacial trauma that directly or indirectly damages the optic nerve and can cause severe vision loss. The incidence of TON has been gradually increasing in recent years. Research on the protection and regeneration of the optic nerve after the onset of TON is still at the level of laboratory studies and which is insufficient to support clinical treatment of TON. And, due to without clear guidelines, there is much ambiguity regarding its diagnosis and management. Clinical interventions for TON include observation only, treatment with corticosteroids al...
Source: Neurosurgical Review - Category: Neurosurgery Source Type: research
CONCLUSION: With 73.2% recurrence, corticosteroid injections do not appear to be effective in treating dorsal ganglion cysts of the wrist. They lead to an improvement in the functional score of the wrist, but not significantly compared to treatment abstinence.LEVEL OF EVIDENCE: IV.PMID:35031514 | DOI:10.1016/j.otsr.2022.103198
Source: Hand Surgery - Category: Surgery Authors: Source Type: research
CONCLUSIONS: Both PRP and triamcinolone 40mg/mL injections provided cost-effective treatments from healthcare and societal perspectives. Overall, PRP injections were the dominant treatment with the greatest NMB for recalcitrant lateral epicondylitis over the time horizon of five years.PMID:35031496 | DOI:10.1016/j.jse.2021.12.010
Source: Hand Surgery - Category: Surgery Authors: Source Type: research
This study aimed to determine the prevalence and clinical characteristics of anti-HMGCR antibodies in idiopathic inflammatory myositis (IIM) at a tertiary care centre in northern India. Data (adult and children) were retrieved from the MyoCite dataset, identifying patients with polymyositis, dermatomyositis, and antibody-negative IIM whilst fulfilling the ACR/EULAR criteria. SLE, sarcoidosis, and systemic sclerosis were included for comparison as disease controls. The baseline clinical profile, laboratory tests, and muscle biopsies were retrieved and analysed. Descriptive statistics and non-parametric statistics were used ...
Source: Cancer Control - Category: Cancer & Oncology Authors: Source Type: research
Vet Parasitol. 2021 Dec 28;302:109644. doi: 10.1016/j.vetpar.2021.109644. Online ahead of print.ABSTRACTPolymerase spiral reaction (PSR) opens new avenues for specific diagnosis of pathogens known for cryptic infection at field level and its application is still unexplored in the field of parasitology. The present study aimed to explore and optimize colorimetric based PSR technique for the detection of Trypanosoma evansi in the blood of the host by targeting the 196bp Invariable Surface Glycoprotein (ISG) gene of Trypanosoma evansi. The specificity of the test was determined against Theileria equi, Theileria annulata, Babe...
Source: Herpes - Category: Infectious Diseases Authors: Source Type: research
J Pediatr Adolesc Gynecol. 2022 Jan 11:S1083-3188(22)00021-3. doi: 10.1016/j.jpag.2021.12.019. Online ahead of print.ABSTRACTThe Centers for Disease Control and Prevention's Sexually Transmitted Infections Treatment Guidelines, 2021 contain new recommendations for the treatment of gonococcal, chlamydial, and trichomonas infections, as well as pelvic inflammatory disease. Providers are encouraged to broaden their screening practices by considering incorporating rectal and pharyngeal testing when indicated, as well as opt-out testing for adolescent females. The discussion of testing and counseling for genital herpes infectio...
Source: Herpes - Category: Infectious Diseases Authors: Source Type: research
CONCLUSION: With 73.2% recurrence, corticosteroid injections do not appear to be effective in treating dorsal ganglion cysts of the wrist. They lead to an improvement in the functional score of the wrist, but not significantly compared to treatment abstinence.LEVEL OF EVIDENCE: IV.PMID:35031514 | DOI:10.1016/j.otsr.2022.103198
Source: Hand Surgery - Category: Surgery Authors: Source Type: research
CONCLUSIONS: Both PRP and triamcinolone 40mg/mL injections provided cost-effective treatments from healthcare and societal perspectives. Overall, PRP injections were the dominant treatment with the greatest NMB for recalcitrant lateral epicondylitis over the time horizon of five years.PMID:35031496 | DOI:10.1016/j.jse.2021.12.010
Source: Hand Surgery - Category: Surgery Authors: Source Type: research
ConclusionsShort-term and long-term post HT outcomes among patients with sarcoid cardiomyopathy are similar to those with common types of non-ischaemic cardiomyopathy.
Source: ESC Heart Failure - Category: Cardiology Authors: Tags: Original Article Source Type: research
ConclusionsThese findings may help in assessing the pretest probability of tumor recurrence in patients with mediastinal lymphadenopathy, thus aiding in the clinical decision-making in such scenarios.
Source: Thoracic Cancer - Category: Cancer & Oncology Authors: Tags: ORIGINAL ARTICLE Source Type: research
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