• 제목/요약/키워드: Peripheral Nerve Paralysis

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Facial palsy reconstruction

  • Soo Hyun Woo;Young Chul Kim;Tae Suk Oh
    • 대한두개안면성형외과학회지
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    • 제25권1호
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    • pp.1-10
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    • 2024
  • The facial nerve stimulates the muscles of facial expression and the parasympathetic nerves of the face. Consequently, facial nerve paralysis can lead to facial asymmetry, deformation, and functional impairment. Facial nerve palsy is most commonly idiopathic, as with Bell palsy, but it can also result from a tumor or trauma. In this article, we discuss traumatic facial nerve injury. To identify the cause of the injury, it is important to first determine its location. The location and extent of the damage inform the treatment method, with options including primary repair, nerve graft, cross-face nerve graft, nerve crossover, and muscle transfer. Intracranial proximal facial nerve injuries present a challenge to surgical approaches due to the complexity of the temporal bone. Surgical intervention in these cases requires a collaborative approach between neurosurgery and otolaryngology, and nerve repair or grafting is difficult. This article describes the treatment of peripheral facial nerve injury. Primary repair generally offers the best prognosis. If primary repair is not feasible within 6 months of injury, nerve grafting should be attempted, and if more than 12 months have elapsed, functional muscle transfer should be performed. If the affected nerve cannot be utilized at that time, the contralateral facial nerve, ipsilateral masseter nerve, or hypoglossal nerve can serve as the donor nerve. Other accompanying symptoms, such as lagophthalmos or midface ptosis, must also be considered for the successful treatment of facial nerve injury.

말초성 안면신경마비에 대한 임상적 고찰 (A Clinical Study on Peripheral Paralysis of the Facial Nerve)

  • 김호봉;김경범;배윤한
    • 대한물리치료과학회지
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    • 제4권2호
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    • pp.433-438
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    • 1997
  • This study has done to show the analysis and ressult of their recovery in 35 cases of peripheral paralysis of the facial nerve. The research was from Jan. 1, 1994 to Dec. 31, 1996 at Ulsan Dong Kang Hospital. The results were as follows ; 1. There were 19 males(54.3%) and 16 females(45.7%). Age distribution of patients showed above 20 years old in 31 patients(88.6%). 2. 18 cases(51.4%) were on the right and 17 cases(48.6%) on the left side. 3. Unknown of etiology was 23 cases(65.7%). 4. Grade of injury was zero in 21 cases(60.0%), trace in 8 cases(22.9%). 5. The period of treatment was $2{\sim}3$ weeks in 23 cases(65.7%), $1{\sim}2$ months in 3 cases(8.6%). 6. On electromyography facial nerve action potential amplitude was above 1.0 mv in 22 patients(62.9 %) after treatment. Facial nerve conduction latency using orbicularis oris was below 6.0 msec in 23 patients(65.7%) after treatment. 7. Recovery of patient was normal in 25 cases(71.5%) and fair in 10 cases(28.5%).

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동안신경마비 사시환자 1례 증례보고 (A Clinical Case Report of Oculomotor Nerve Palsy)

  • 엄유식;심성용;남혜정;김경준
    • 한방안이비인후피부과학회지
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    • 제17권3호
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    • pp.126-130
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    • 2004
  • Oculomotor nerve palsy presents itself with sudden onset unilateral ptosis and inability to turn the eye upward, downward, or inward, which causes visual disturbances. Strabismus caused oculomotor nerve palsy refers to muscle imbalance that results in improper alignment of the visual axes of the two eyes It may be divided into paralytic and non paralytic strabismus. paralytic strabismus is primarily a neurologic problem. Characteristic clinical disturbances result from lesions of the third, fourth, and sixth cranial nerves. Lesions of the third nerve result in a paralysis of lateral or outward movement and a crossing of the visual axes. Objective: This study was designed to evaluate the effects of oriental medicine therapy on a peripheral oculomotor nerve palsy. Methods & Result: The clinical data was analyzed on a patient with oculomotor nerve palsy whose main symptoms were right side ptosis and inability to turn the eye inward. The patient was treated by the electroacupucture(4Hz frequency, intensity was adjusted so that localized muscle contractions could be seen). As the result, symptoms are improved remarkably. Conclusion: The patient showed right eye ptosis and unilateral deviation of the right eye ball in neutral position. After acupuncture treatment and electroacupuncture treatment, the ptosis and deviation of the patient's right eye was recovered six weeks after the onset. The study suggests that oriental medicine therapy is significantly effective on the treatment of peripheral oculomotor nerve palsy.

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Treatment of chemotherapy-related peripheral neuropathy with traditional Chinese medicine from the perspective of blood-arthralgia Zheng

  • Cao, Peng;Yang, Jie;Cai, Xueting;Wang, Xiaoning;Huo, Jiege
    • 셀메드
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    • 제2권4호
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    • pp.30.1-30.4
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    • 2012
  • Traditional Chinese medicine classifies peripheral nerve impairment as paralysis and arthromyodynia, and considers that it is the result of defects of meridians and vessels, QI and blood, bones and muscles. Huangqi (Astragalus) Guizhi (Cassia Twig) Wuwu Tang, as a Qi invigorating formula, is usually used to improve peripheral nerve impairment. In recent years, some scholars have conducted research into Chemotherapy-induced peripheral neuropathy (CIPN) treatment with Huangqi Guizhi Wuwu Tang and certain values of this treatment approach have been identified. CIPN is a type of blood-arthralgia Zheng in traditional Chinese medicine theory. In this review, we will discuss the treatment of CIPN with Huangqi Guizhi Wuwu Tang according to blood-arthtalgia Zheng.

말초성 안면신경마비의 한양방 협진치료에 관한 임상적 연구 (A Clinical Study of Oriental-Western Medicine Treatment on Facial Nerve Paralysis)

  • 김지훈;송재준;홍승욱
    • 한방안이비인후피부과학회지
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    • 제22권1호
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    • pp.148-156
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    • 2009
  • Objectives : Facial palsy is not uncommon disease and most patients with facial palsy are peripheral type, as in Bell' s palsy. In western medicine, oral steroid is the mainstay of the treatment. Recently, oriental-western treatment became one of the alternative modality for the treatment of the facial palsy. However, the treatment result and the degree of patient' s satisfaction were not evaluated. In this study, we tried to characterize the clinical characteristics, short-term recovery rate and degree of patient' s satisfaction after oriental-western medicine treatment on facial palsy of peripheral type. Methods : Between May 2008 and December 2008, we examined 16 patients who presented with facial palsy of peripheral type in Dongguk University Medical Center. Clinical characteristics and recovery rate was analyzed by retrospective chart review. The degree of patient' s satisfaction was measured by 5 point scale. Results : The causes of facial palsy were Bell' s palsy (87.5%) and the Ramsay-Hunt syndrome (12.5%). The highest age groups of facial palsy were 6th and 7th decades. Most frequent accompanying symptom was postauricular pain. After oriental-western medicine treatment, 10 patients (62.5%) showed recovery of facial palsy better than House-Brackmann grade 2. 11 patients (68.8%) were satisfied with the oriental-western medicine treatment. Conclusions : Considering the degree of patient' s satisfaction and treatment result, we believe that oriental-western treatment could be safe and reliable protocol for the treatment of facial nerve palsy of peripheral type.

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Ramsay Hunt 증후군 -2예 보고- (Ramsay Hunt Syndrome -Case report on two cases-)

  • 이상곤;여상임;고준석;민병우
    • The Korean Journal of Pain
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    • 제5권2호
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    • pp.263-268
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    • 1992
  • Ramsay Hunt 증후군으로 확진된 환자 2예를 경험하였다. 첫 예인 경우 안면신경마비가 발생하던 날 바로 방문하여 대상포진에 대한 치료와 환측 성상신경절 차단 15회, TENS, 안면운동 훈련 반복 등으로 발병 후 3주만에 완전 치유 되었으며, 두번째 환자는 발병 후 7주일 후에 방문하여 대상포진에 대한 치료는 생략하고 안면신경마비에 대한 치료라고 사료되는 환측 성상신경절 차단 50회, TENS 수백회, 안면운동 훈련 반복시행하였으나 부분적인 회복을 하였을 뿐이다. 그러므로 Ramsay Hunt 증후군의 치료도 다른 여러 질환과 마찬가지로 조기에 치료하면 회복이 빠르고 거의 완전하며, 늦어질수록 예후가 좋지 않다는 것을 경험하였다. 두 예 모두에서 대상포진 후 신경통으로의 이행은 없었다.

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손발저림의 원인(原因)에 대(對)한 동서의학적(東西醫學的) 고찰(考察) (Consideration of the Son-Bal Jeorim in oriental and western medicine)

  • 박치영;임낙철;김영일;홍권의
    • 혜화의학회지
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    • 제13권1호
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    • pp.47-59
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    • 2004
  • Objectives & Methods: We investigated 28 books to study etiology and pathology of Son-Bal Jeorim. Result and Conclusion 1. The eiology of Son-Bal Jeorim is same as it of Bee Jeung(痺症). 2. Generally speaking, the cause of Bee Jeung was distributed Wind(風), Coldness(寒), Wetness (濕) of meridian. Bee Jeung can be devided into SilBi(實痺) and HeoBi(虛痺). In SilBi(實痺) there are PungHanSeupBi(風寒濕痺) and YeolBi(熱痺). In HeoBi(虛痺), there are GiHyeolHeoBi(氣血虛痺), EumheoBi(陰虛痺) and YangHeoBi(陽虛痺). 3. Son-Bal Jeorim belong to peripheral neuropathy in western medicine. 4. Syndrome of acute motor paralysis with variable disturbance of sensory and autonomic function, subacute sensorymotor paralysis, syndrome of chronic sensorimotor polyneuropathy, neuropathy with mitochondrial disease, syndrome of mononeuropathy or nerve plexusopathy. 5. Peripheral neuropathy is caused by carpal tunnel syndrome, diabetic neuropathy, uremic neuropathy, hepatic neuropathy, hypothyroid neuropathy, hyperthyroid neuropathy, neuropathy due to malnutrition, neuropathy due to toxic material, neuropathy due to drug, paraneoplastic neuropathy, hereditary neuropathy, etc. 6. Cerebral apoplexy, myelopathy, peripheral circulatory disturbance, anxiety syndrome cause symptoms of peripheral neuropathy

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급성 벨마비에서 Acyclovir의 효과 (The Effect of Acyclovir in Acute Stage of Bell's Palsy)

  • 김태일;서상일;이동국
    • Annals of Clinical Neurophysiology
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    • 제3권2호
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    • pp.122-127
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    • 2001
  • Background : Bell's palsy(BP) is defined as an idiopathic peripheral facial paralysis of sudden onset and account more than 50% of facial paralysis. It's etiology is unclear, but herpes simplex virus type-1(HSV-1) has been the most suspicious causative agent of BP that ever been studied. We evaluated the effect of add-on acyclovir in acute stage of BP. Methods : Subject consisted of 35 patients who developed acute idiopathic unilateral facial nerve palsy(16 men and 19 women with age 9-78 years old). The treatments were started within 10 days after onset of BP. Facial nerve function was assessed by the House-Brackman facial nerve grading scale and facial nerve conduction study including blink reflex. Follow-up evaluation were made 2 month after onset. Twenty of 35 patients were treated with combined therapy of acyclovir and prednisone. As a control group, 15 patients were treated with prednisone only. We compared the improvement of neurologic defects at recovery phase. Results : Compared with two groups, difference in grading scale at recovery phase is statistically significant(p<0.01). So, acyclovir-prednisone group showed a significant improvement in grading scale at recovery phase compared with prednisone group. Conclusion : We identified the benefits of add-on acyclovir in the acute stage of BP.

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Reconstruction of a long defect of the median nerve with a free nerve conduit flap

  • Campodonico, Andrea;Pangrazi, Pier Paolo;De Francesco, Francesco;Riccio, Michele
    • Archives of Plastic Surgery
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    • 제47권2호
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    • pp.187-193
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    • 2020
  • Upper limb nerve damage is a common condition, and evidence suggests that functional recovery may be limited following peripheral nerve repair in cases of delayed reconstruction or reconstruction of long nerve defects. A 26-year-old man presented with traumatic injury from a wide, blunt wound of the right forearm caused by broken glass, with soft tissue loss, complete transection of the radial and ulnar arteries, and a large median nerve gap. The patient underwent debridement and subsequent surgery with a microsurgical free radial fasciocutaneous flap to provide a direct blood supply to the hand; the cephalic vein within the flap was employed as a venous vascularized chamber to wrap the sural nerve graft and to repair the wide gap (14 cm) in the median nerve. During the postoperative period, the patient followed an intensive rehabilitation program and was monitored for functional performance over 5 years of follow-up. Our assessment demonstrated skin tropism and sufficient muscle power to act against strong resistance (M5) in the muscles previously affected by paralysis, as well as a good localization of stimuli in the median nerve region and an imperfect recovery of two-point discrimination (S3+). We propose a novel and efficient procedure to repair >10-cm peripheral nerve gap injuries related to upper limb trauma.

Lumbar burner and stinger syndrome in an elderly athlete

  • Wegener, Veronika;Stabler, Axel;Jansson, Volkmar;Birkenmaier, Christof;Wegener, Bernd
    • The Korean Journal of Pain
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    • 제31권1호
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    • pp.54-57
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    • 2018
  • Burner or stinger syndrome is a rare sports injury caused by direct or indirect trauma during high-speed or contact sports mainly in young athletes. It affects peripheral nerves, plexus trunks or spinal nerve roots, causing paralysis, paresthesia and pain. We report the case of a 57-year-old male athlete suffering from burner syndrome related to a lumbar nerve root. He presented with prolonged pain and partial paralysis of the right leg after a skewed landing during the long jump. He was initially misdiagnosed since the first magnet resonance imaging was normal whereas electromyography showed denervation. The insurance company refused to pay damage claims. Partial recovery was achieved by pain medication and physiotherapy. Burner syndrome is an injury of physically active individuals of any age and may appear in the cervical and lumbar area. MRI may be normal due to the lack of complete nerve transection, but electromyography typically shows pathologic results.