Cases reported "Trismus"

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1/12. Hemimasticatory spasm associated with localized scleroderma and facial hemiatrophy.

    OBJECTIVES: To report a case and discuss the mechanism of hemimasticatory spasm. DESIGN: Case report. PATIENT: A 37-year-old woman had a 3-year history of involuntary spasms of the right masseter muscle in association with localized scleroderma and facial hemiatrophy. Electrophysiological studies revealed a normal blink reflex. However, the masseter reflex and silent period were absent on the affected side. Distal latency and compound muscle action potential of the masseter nerve were normal. Needle electromyography demonstrated irregular bursts of motor unit potentials similar to those described in hemifacial spasm. A magnetic resonance imaging scan of the head showed mild hypertrophy of the masseter muscle and atrophy of subcutaneous fatty tissues on the affected side. Local injection of botulinum toxin A into the masseter muscle resolved the patient's symptoms. CONCLUSION: On the basis of clinical and electrophysiological findings, focal demyelination of motor branches of the trigeminal nerve owing to deep tissue changes is suggested as the cause of abnormal excitatory electrical activities resulting in involuntary masticatory movement.
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2/12. Cephalic tetanus as a result of rooster pecking: an unusual case.

    In this paper, a case of cephalic tetanus caused by rooster pecking to the face is presented. Cephalic tetanus is a rare type of tetanus defined by trismus and paralysis of 1 or more cranial nerves. On admission to hospital the patient had facial palsy and trismus. With proper medical management she recovered without any relapse.
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3/12. mandibular nerve block treatment for trismus associated with hypoxic-ischemic encephalopathy.

    BACKGROUND AND OBJECTIVES: We describe the use of mandibular nerve block for the management of bilateral trismus associated with hypoxic-ischemic encephalopathy. CASE REPORT: The patient was a 65-year-old man with bilateral trismus due to hypoxic-ischemic encephalopathy. Despite his impaired consciousness, we performed fluoroscopically guided bilateral mandibular nerve block. The bilateral symptoms were sufficiently improved, without obvious side effects, by injecting a local anesthetic near the right mandibular nerve and a neurolytic near the left mandibular nerve. CONCLUSIONS: mandibular nerve block may be an effective treatment for patients with bilateral trismus due to ischemic-encephalopathy, even when consciousness is impaired.
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ranking = 2475.6867166418
keywords = nerve block, nerve
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4/12. trismus in a 6 year old child: a manifestation of leukemia?

    trismus is a firm closing of the jaw due to tonic spasm of the muscles of mastication from disease or the motor branch of the trigeminal nerve. trismus may be produced by a variety of reasons such as dental abscess, trauma, following mandibular block with local anesthesia, as a result of radiation to the facial muscles, and patients after chemotherapy. A case of a referral of a six-year-old boy to a dentist from an ENT due to severe limitation in jaw opening is presented. Intraoral examination and panoramic radiograph demonstrated no signs of infection and/or other pathology. After a diagnosis of trismus was made, due to his icteric appearance, the general fatigue and loss of appetite in the last few days, palpated and sensitive lymph nodes in the submandibular and cervical regions, the child was referred for a complete blood count and sedimentation rate. The laboratory and clinical findings resulted in the diagnosis of acute lymphoblastic leukemia (ALL). Dental and oral manifestations of ALL are discussed, and the trismus may be explained by an intensive infiltration of leukemic cells into the deep portion of the contracting muscles of the face. This case emphasizes the importance of physical examination and independent judgement made by dentists, even when patients are referred to them by other members of the medical communities.
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keywords = nerve
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5/12. Facial and trigeminal neuropathies in cavernous sinus fistulas.

    Three patients with carotid-cavernous fistulas had prominent ipsilateral facial nerve neuropathy. One patient also had ipsilateral third division trigeminal neuropathy, manifesting as painful trismus and lower facial numbness. Rarely reported in carotid-cavernous fistula, these neuropathies may occur when there is substantial drainage of the fistula into a dilated inferior petrosal sinus. Closure of the fistula in two cases resulted in full recovery of the neuropathies within weeks to months. The neuropathies may be caused by ischemia from an unfavorable arteriovenous flow gradient, venous compression, or secondary inflammation.
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6/12. Removal of a deeply impacted mandibular third molar through a sagittal split ramus osteotomy approach.

    We describe the case of a 48-year-old man who, after a 5-year history of recurrent infection and intermittent trismus associated with a deeply impacted lower right third molar tooth, presented to the accident and emergency department with severely limited mouth opening, extensive facial swelling and pyrexia. The lower right third molar was later removed successfully through a sagittal split ramus osteotomy approach. This case shows that the sagittal split osteotomy continues to have a valuable role in the removal of deeply impacted lower third molars, particularly when they are in close proximity to the inferior alveolar nerve.
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7/12. mandibular nerve blocks for the removal of dentures during trismus caused by tetanus.

    We report a case of trismus caused by tetanus in an 80-yr-old woman who developed severe and painful masseter spasms during which she violently bit the tip of her tongue with her dentures. Bilateral mandibular blocks were performed to remove the dentures. The patient fully recovered. We suggest that mandibular blocks are a useful tool in the management of oral events during trismus in conscious patients.
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ranking = 1414.1066952239
keywords = nerve block, nerve
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8/12. Lateral pharyngeal space abscess as a consequence of regional anesthesia.

    trismus may be a complication from local anesthesia. patients with trismus of unknown cause after dental treatment should be evaluated thoroughly. The dentist should perform a complete examination and establish a differential diagnosis to avoid missing a serious or life-threatening infection. A right lateral pharyngeal space infection developed after a general restorative procedure that involved an inferior alveolar nerve injection on the same side. The patient's severe trismus required awake intubation, incision and drainage while the patient was under general anesthesia, treatment with antibiotics and ten days of hospitalization.
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keywords = nerve
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9/12. Postinjection trismus due to formation of fibrous band.

    A persistent form of trismus which sometimes follows inferior alveolar nerve block is described. Clinical data from sixteen cases indicate that in most cases the condition responds to conservative therapy.
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ranking = 353.52667380598
keywords = nerve block, nerve
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10/12. Lockjaw secondary to skull base osteochondroma: CT findings.

    Osteochondromas arising from the long bones, pelvis, or scapulae are common. However, osteochondromas originating from the base of the skull are extremely unusual. Although these tumors are histologically benign, intracranial extension and their close proximity to the cranial nerves may require complex surgery. We present a case in which CT clearly delineated an osteochondroma arising from the base of the skull. The tumor had created a fusion with the ipsilateral coronoid process of the mandible, thus causing lockjaw.
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keywords = nerve
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