Cases reported "Facial Paralysis"

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1/13. 80 cases of peripheral facial paralysis treated by acupuncture with vibrating shallow insertion.

    Eighty cases of peripheral facial paralysis were treated by acupuncture with vibrating shallow insertion. The total effective rate was 98.75% and cure rate 88.75%. There was no significant difference in therapeutic effect as compared with the conventional electroacupuncture method (P > 0.5), suggesting that shallow puncture by vibratings can also yield satisfactory therapeutic results.
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2/13. A giant internal carotid-posterior communicating artery aneurysm presenting with atypical trigeminal neuralgia and facial nerve palsy in a patient with autosomal dominant polycystic kidney disease: a case report.

    BACKGROUND: In cases of internal carotid-posterior communicating artery (IC-PC) aneurysm, involvement of the trigeminal nerve at its root is rare, and facial nerve palsy is even more unusual. CASE REPORT: A large, unruptured IC-PC aneurysm was detected in a 56-year-old man with autosomal dominant polycystic kidney disease (ADPKD), but surgery was not performed because of mild renal dysfunction. Two months later, a sudden, severe headache suggested a subarachnoid hemorrhage, which was ruled out by computed tomography and lumbar puncture. Neurological examination revealed complete oculomotor palsy, atypical trigeminal neuralgia, and facial palsy with gustatory disturbance. Magnetic resonance (MR) imaging revealed a partially thrombosed giant aneurysm that directly compressed the trigeminal nerve root, reached the internal auditory canal, and was adjacent to the facial nerve. The neck of the aneurysm was successfully clipped via a subtemporal transtentorial approach. The postoperative course was uneventful, and all neurological symptoms had resolved within 3 months. CONCLUSIONS: We believe that the prosopalgia in this case was atypical trigeminal neuralgia due to direct compression of the trigeminal nerve root by the aneurysmal sac. A contributory cause was stretching of the oculomotor nerve, which contains sensory afferent inhibitory fibers derived from the ophthalmic branch of the trigeminal nerve. The facial palsy was of peripheral type and was accompanied by gustatory disturbance. This is the first reported case of facial palsy caused by an IC-PC aneurysm and also a very rare case of an IC-PC aneurysm clipped by a subtemporal transtentorial approach.
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3/13. Facial diplegia as the presenting manifestation of acute lymphoblastic leukemia.

    A 36-year-old man with recent onset of unilateral peripheral 7th nerve paresis presented ten days later with involvement of the other side of his face. physical examination was otherwise normal, and since blood tests and imaging were also normal, he was considered to have bilateral Bell's palsy. However, unexpected headaches and worsening of the paresis led to a gallium-67 scan which revealed uptake in the mediastinum. A repeat lumbar puncture revealed cells which were identified as lymphoblasts. T-cell acute lymphoblastic leukemia (T-ALL) was diagnosed, although the peripheral blood smear was normal. The differential diagnosis of bilateral 7th nerve palsy and of mononuclear cerebrospinal fluid pleocytosis is discussed, as well as this rare central nervous system presentation of acute leukemia.
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4/13. Bilateral simultaneous facial paralysis--differential diagnosis and treatment options. A case report and review of literature.

    Bilateral facial paralysis or paresis of peripheral origin is a rare condition and therefore represents a diagnostic challenge. We here present a case of a previously healthy woman who was hospitalized for symptoms of meningitis. On the second day of her hospital stay, she developed bilateral facial paresis. Later, the patient developed also tachycardia and dysrhythmias. A thorough diagnostic procedure including lumbar puncture, routine blood investigation with serological tests, MRI of the brain, Holter monitoring and transoesophageal echocardiographia, revealed meningitis with radiculitis, facial paresis and myocarditis. The clinical triad of meningitis, radiculitis and facial palsy is known as the Bannwarth Syndrome (lyme disease). The patient was treated with ceftriaxone and recovered well. Despite repeatedly taken serological tests, borrelia burgdorferi immunoglobulins were not detected. Acquired bilateral facial paralysis can occur in several diseases of infectious, neurological, idiopathic, iatrogenic, toxic, neoplastic or traumatic origin. In this article, we review the differential diagnoses and treatment options of bilateral facial paresis and present a scheme that is helpful in the diagnostic evaluation of this condition.
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5/13. Mind-refreshing acupuncture therapy for facial spasm, trigeminal neuralgia and stubborn facial paralysis.

    It has been proved by clinical experiment that needling at Fengchi (GB 20), Wangu (GB 12) and Tianzhu (BL 10) can markedly improve the blood supply to the vertebral basilar artery, increase the cerebral blood flow, and relax the spasm of the vascular smooth muscles. The combined use of Shangxing (GV 23) and Yintang (EX-HN3) can give the effects of resuscitating and tranquilizing the mind, dispelling wind, dredging the channels, and relieving spasm and pain. In short, the above therapy may turn the pathological state into a normal physiological state, and bring a quicker recovery for patients with facial spasm, trigeminal neuralgia and stubborn facial paralysis.
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6/13. Clinical observations on acupuncture treatment of peripheral facial paralysis aided by infra-red thermography--a preliminary report.

    We have carried out clinical observations on 34 patients with peripheral facial paralysis treated by acupuncture therapy prescribed according to selection of treatment regimen on the basis of facial thermogram and temperature. A comparison was made with a control group of 97 patients who received conventional acupuncture therapy only. It was found that 1) The cure rate in the group of selecting acupoints by thermogram (hereinafter referred to as the thermography--aided treatment group) was 67.65%, with a marked improvement rate of 26.40%; while the cure rate of the conventional acupuncture treatment group (hereinafter called the conventional treatment group) was 46.39%, the marked improvement rate being 29.90%, indicating a significant difference in therapeutic efficacy between the two groups (P less than 0.02). 2) The average duration of acupuncture therapy for the thermography aided treatment group was 6.02 weeks, whereas that for the conventional treatment group, 24 weeks. There was also a significant difference between the two groups (P less than 0.01). And 3) During the entire therapeutic course, 25.2 sessions of treatment were given on the average in the thermography--aided treatment group, and 78.8 sessions in the conventional treatment group, showing a very significant difference (P less than 0.001). The present thermography--aided method exhibits advantages over the conventional one in enhancing the cure rate and shortening the duration of treatment, which is worthy to be popularized in clinical practice. And it is also of certain significance in standardization and scientification of acupuncture therapy.
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7/13. Bilateral facial nerve paresis in eosinophilic meningitis.

    A 29-year-old man presented with headache, nuchal rigidity and bilateral facial paralysis. Lumbar puncture revealed eosinophilic CSF pleocytosis. Facial diplegia was improved by supportive treatment. Thus, eosinophilic meningitis is one of the etiologies of bilateral facial nerve paresis.
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8/13. Facial palsy as the initial symptom of a lymphoreticular malignancy. Case report.

    In this case report an adult patient is described who initially manifested a peripheral facial palsy mimicking 'Bell's palsy', which later on appeared to be the first manifestation of a lymphoreticular malignancy. Cranial nerve involvement appears to be very rare as a first symptom of malignant systemic disease. The importance of additional investigations including lumbar puncture and CSF cytology in cases of facial nerve palsy is stressed.
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9/13. Facial palsy in lymphocytic meningoradiculitis (Bannwarth's syndrome).

    Four patients had unilateral or bilateral facial palsy associated with lymphocytic meningoradiculitis (Bannwarth's syndrome). diagnosis depends on a lumbar puncture, and if the characteristic CSF changes, ie, pleocytosis and elevated protein level, are found, more comprehensive investigations can be restricted in view of the favorable prognosis.
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10/13. role of magnetic resonance imaging in the diagnosis of bilateral facial paralysis.

    Bilateral facial paralysis (BFP) is a rare clinical finding that may be caused by guillain-barre syndrome, a medical emergency. The differential diagnosis of BFP is lengthy but can be narrowed to a limited group of disorders by the patient's history and physical examination. The most important diagnostic tests to obtain initially are the lumbar puncture and magnetic resonance imaging (MRI) scan with gadolinium contrast enhancement. Based on the MRI and lumbar puncture findings, additional tests may be appropriately ordered. The diagnosis of bilateral Bell's palsy is made by exclusion of other disorders. This report presents five cases of BFP (guillain-barre syndrome, herpes simplex polyneuritis, meningeal lymphoma, and two cases of bilateral Bell's palsy) in which MRI imaging helped in the diagnosis and subsequent management of the patient. The appropriate sequence of diagnostic studies for patients with BFP is discussed.
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