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1

Laryngeal Paralysis: Distinguishing Xth Nerve from Recurrent Nerve Paralysis Through Videoendoscopic Swallowing Study (VESS)  

Microsoft Academic Search

Distinction between unilateral recurrent laryngeal nerve paralysis and Xth nerve paralysis is a rarely addressed issue in the literature. However, it may be crucial to examine the cause of the paralysis and to perform the appropriate investigation. The videoendoscopic swallowing study has been demonstrated to be a useful tool in assessing pharyngeal function. Since in unilateral Xth nerve paralysis the

Sophie Perie ´; Bernard Roubeau; Jean Lacau St. Guily

2003-01-01

2

[Bilateral recurrent laryngeal nerve paralysis in a child following a neurosurgical operation].  

PubMed

We experienced a case of 7-year-old boy who developed bilateral recurrent laryngeal nerve paralysis following an elective neurosurgical operation under oxygen-nitrous oxide-isoflurane anesthesia. He underwent a removal of brain tumor in the supratentorial region on supine position. After the removal of the endotracheal tube in the intensive care unit, he developed marked respiratory effort and inspiratory stridor. A diagnosis of bilateral recurrent laryngeal nerve paralysis was made by a direct diagnostic laryngoscopy. The patient needed continuous care for his airway patency with tracheotomy tube in place, and his normal vocal cord mobility recovered on the 23 rd postoperative day. Common cause of recurrent nerve injury following general anesthesia is either the procedure of endotracheal intubation itself or trauma due to surgical manipulation. In the present case, an endotracheal tube, a transesophageal stethoscope and a nasogastric tube inserted into the narrow laryngeal space might have been a cause of this complication. Moreover, accidental extreme flexion of his neck which occurred during the surgery might also be an additional cause. This case suggests that recurrent laryngeal nerve paralysis due to anesthetic instruments around the larynx is a possible cause of complications during general anesthesia in pediatric patients. PMID:15966392

Hattori, Shinichi; Ohata, Hiroto; Dohi, Shuji

2005-06-01

3

Laryngeal nerve monitoring.  

PubMed

Intraoperative neurophysiological monitoring of the vagus and recurrent laryngeal nerves is increasingly used during thyroidectomy, parathyroidectomy, skull base surgery, and cervical discectomy with fusion. Monitoring can assist in nerve localization and in reducing the incidence of neural trauma. To be effective, however, monitoring must be correctly implemented and the results interpreted based on an in-depth understanding of technique and the surgical structures at risk. Because "poor monitoring is worse than no monitoring" all members of the surgical monitoring team must have training specific to laryngeal recording to maximize its benefit and minimize pitfalls. This publication will review pertinent anatomy and neurophysiology as well as technical and interpretative factors. PMID:25351033

Kartush, Jack M; Naumann, Ilka

2014-09-01

4

A spatiotemporal prospective study of speech in patients with or without recurrent laryngeal nerve paralysis after thyroid  

E-print Network

pathology of the thyroid gland. Consequently, it is possible to carry out systematic analyses of the diverse studies on a large number of speakers. Let us recall that the thyroid gland, located at the base paralysis after thyroid surgery Camille Fauth1 Béatrice Vaxelaire1 , Jean-François Rodier2 , Pierre

Paris-Sud XI, Université de

5

Effects of Asymmetric Superior Laryngeal Nerve Stimulation on Glottic Posture, Acoustics, Vibration  

PubMed Central

Objectives Evaluate the effects of asymmetric superior laryngeal nerve stimulation on the vibratory phase, laryngeal posture, and acoustics. Study Design Basic science study using an in vivo canine model. Methods The superior laryngeal nerves were symmetrically and asymmetrically stimulated over eight activation levels to mimic laryngeal asymmetries representing various levels of superior laryngeal nerve paresis and paralysis conditions. Glottal posture change, vocal fold speed, and vibration of these 64 distinct laryngeal activation conditions were evaluated by high speed video and concurrent acoustic and aerodynamic recordings. Assessments were made at phonation onset. Results Vibratory phase was symmetric in all symmetric activation conditions but consistent phase asymmetry towards the vocal fold with higher superior laryngeal nerve activation was observed. Superior laryngeal nerve paresis and paralysis conditions had reduced vocal fold strain and fundamental frequency. Superior laryngeal nerve activation increased vocal fold closure speed, but this effect was more pronounced for the ipsilateral vocal fold. Increasing asymmetry led to aperiodic and chaotic vibration. Conclusions This study directly links vocal fold tension asymmetry with vibratory phase asymmetry; in particular the side with greater tension leads in the opening phase. The clinical observations of vocal fold lag, reduced vocal range, and aperiodic voice in superior laryngeal paresis and paralysis is also supported. PMID:23712542

Chhetri, Dinesh K.; Neubauer, Juergen; Bergeron, Jennifer L.; Sofer, Elazar; Peng, Kevin A.; Jamal, Nausheen

2013-01-01

6

A Case of Associated Laryngeal Paralysis Caused by Varicella Zoster Virus without Eruption  

PubMed Central

We report a patient with significant weakness of the left soft palate, paralysis of the left vocal cord, and left facial nerve palsy. Although the patient showed no herpetic eruption in the pharyngolaryngeal mucosa and auricle skin, reactivation of varicella zoster virus (VZV) was confirmed by serological examination. She was diagnosed with zoster sine herpete. After treatment with antiviral drugs and corticosteroids, her neurological disorder improved completely. When we encounter a patient with associated laryngeal paralysis, we should consider the possibility of reactivation of VZV even when no typical herpetic eruption is observed. PMID:24715925

Fujiwara, Keishi; Furuta, Yasushi; Fukuda, Satoshi

2014-01-01

7

A Case of Associated Laryngeal Paralysis Caused by Varicella Zoster Virus without Eruption.  

PubMed

We report a patient with significant weakness of the left soft palate, paralysis of the left vocal cord, and left facial nerve palsy. Although the patient showed no herpetic eruption in the pharyngolaryngeal mucosa and auricle skin, reactivation of varicella zoster virus (VZV) was confirmed by serological examination. She was diagnosed with zoster sine herpete. After treatment with antiviral drugs and corticosteroids, her neurological disorder improved completely. When we encounter a patient with associated laryngeal paralysis, we should consider the possibility of reactivation of VZV even when no typical herpetic eruption is observed. PMID:24715925

Fujiwara, Keishi; Furuta, Yasushi; Fukuda, Satoshi

2014-01-01

8

Ethmoidal Mucocele Presenting as Oculomotor Nerve Paralysis  

PubMed Central

A 56-year-old male was admitted with an acute headache and sudden ptosis on the right side. No ophthalmological or neurological etiologies were apparent. A mucocele of the right posterior ethmoid sinus was observed with radiology. After the marsupialization of the mucocele via a transnasal endoscopic approach, the patient's symptoms (oculomotor nerve paralysis and headache) resolved in 4 weeks. Oculomotor paralysis is a rare symptom of an ethmoidal mucocele. In this article, we report this rare case along with a literature review. PMID:23799169

Kim, Dae Woo; Sohn, Hee-Young; Jeon, Sea-Yuong; Kim, Jin-Pyeong; Ahn, Seong-Ki; Park, Jung Je; Woo, Seung Hoon

2013-01-01

9

Autonomic neuropathy resulting in recurrent laryngeal nerve palsy in an HIV patient with Hodgkin lymphoma receiving vinblastine and antiretroviral therapy.  

PubMed

Hoarseness of voice due to vocal cord paresis as a result of recurrent laryngeal nerve palsy has been well recognised. Recurrent laryngeal nerve palsy is commonly caused by compression due to tumour or lymph nodes or by surgical damage. Vinca alkaloids are well known to cause peripheral neuropathy. However, vinca alkaloids causing recurrent laryngeal nerve palsy has been reported rarely in children. We report a case of an adult patient with HIV who developed hoarseness of voice due to vocal cord paralysis during vinblastine treatment for Hodgkin lymphoma. Mediastinal and hilar lymph node enlargement in such patients may distract clinicians from considering alternative causes of recurrent laryngeal nerve palsy, with potential ensuing severe or even life-threatening stridor. PMID:24828552

Cherif, S; Danino, S; Yoganathan, K

2015-03-01

10

Paralysis  

MedlinePLUS

... is due to strokes or injuries such as spinal cord injury or a broken neck. Other causes of paralysis include Nerve diseases such as amyotrophic lateral sclerosis Autoimmune diseases ... used to be a cause of paralysis, but polio no longer occurs in the U.S.

11

Influence of Asymmetric Recurrent Laryngeal Nerve Stimulation on Vibration, Acoustics, and Aerodynamics  

PubMed Central

Objectives/Hypothesis Evaluate the influence of asymmetric recurrent laryngeal nerve (RLN) stimulation on the vibratory phase, acoustics and aerodynamics of phonation. Study Design Basic science study using an in vivo canine model. Methods The RLNs were symmetrically and asymmetrically stimulated over eight graded levels to test a range of vocal fold activation conditions from subtle paresis to paralysis. Vibratory phase, fundamental frequency (F0), subglottal pressure, and airflow were noted at phonation onset. The evaluations were repeated for three levels of symmetric superior laryngeal nerve (SLN) stimulation. Results Asymmetric laryngeal adductor activation from asymmetric left-right RLN stimulation led to a consistent pattern of vibratory phase asymmetry, with the more activated vocal fold leading in the opening phase of the glottal cycle and in mucosal wave amplitude. Vibratory amplitude asymmetry was also observed, with more lateral excursion of the glottis of the less activated side. Onset fundamental frequency was higher with asymmetric activation because the two RLNs were synergistic in decreasing F0, glottal width, and strain. Phonation onset pressure increased and airflow decreased with symmetric RLN activation. Conclusion Asymmetric laryngeal activation from RLN paresis and paralysis has consistent effects on vocal fold vibration, acoustics, and aerodynamics. This information may be useful in diagnosis and management of vocal fold paresis. PMID:24913182

Chhetri, Dinesh K.; Neubauer, Juergen; Sofer, Elazar

2015-01-01

12

Recovery of laryngeal function after intraoperative injury to the recurrent laryngeal nerve  

PubMed Central

Loss of function in the recurrent laryngeal nerve (RLN) during thyroid/parathyroid surgery, despite a macroscopically intact nerve, is a challenge which highlights the sensitivity and complexity of laryngeal innervation. Furthermore, the uncertain prognosis stresses a lack of capability to diagnose the reason behind the impaired function. There is a great deal of literature considering risk factors, surgical technique and mechanisms outside the nerve affecting the incidence of RLN paresis during surgery. To be able to prognosticate recovery in cases of laryngeal dysfunction and voice changes after thyroid surgery, the surgeon would first need to define the presence, location, and type of laryngeal nerve injury. There is little data describing the events within the nerve and the neurobiological reasons for the impaired function related to potential recovery and prognosis. In addition, very little data has been presented in order to clarify any differences between the transient and permanent injury of the RLN. This review aims, from an anatomical and neurobiological perspective, to provide an update on the current understandings of surgically-induced injury to the laryngeal nerves. PMID:25713777

Hydman, Jonas; Svensson, Mikael

2015-01-01

13

Recovery of laryngeal function after intraoperative injury to the recurrent laryngeal nerve.  

PubMed

Loss of function in the recurrent laryngeal nerve (RLN) during thyroid/parathyroid surgery, despite a macroscopically intact nerve, is a challenge which highlights the sensitivity and complexity of laryngeal innervation. Furthermore, the uncertain prognosis stresses a lack of capability to diagnose the reason behind the impaired function. There is a great deal of literature considering risk factors, surgical technique and mechanisms outside the nerve affecting the incidence of RLN paresis during surgery. To be able to prognosticate recovery in cases of laryngeal dysfunction and voice changes after thyroid surgery, the surgeon would first need to define the presence, location, and type of laryngeal nerve injury. There is little data describing the events within the nerve and the neurobiological reasons for the impaired function related to potential recovery and prognosis. In addition, very little data has been presented in order to clarify any differences between the transient and permanent injury of the RLN. This review aims, from an anatomical and neurobiological perspective, to provide an update on the current understandings of surgically-induced injury to the laryngeal nerves. PMID:25713777

Mattsson, Per; Hydman, Jonas; Svensson, Mikael

2015-02-01

14

Laryngeal elevation by selective stimulation of the hypoglossal nerve  

NASA Astrophysics Data System (ADS)

Objective. Laryngeal elevation protects the airway and assists opening of the esophagus during swallowing. The GH, thyrohyoid, and MH muscles provide a majority of this elevatory motion. This study applied functional electrical stimulation to the XII/C1 nerve complex using a nerve cuff electrode to determine the capabilities of neural stimulation to induce laryngeal elevation. Approach. Multi-contact FINE electrodes were implanted onto the XII/C1 nerve complex at locations proximal and distal to the thyrohyoid branching point in five anesthetized canines. Motion of the thyroid cartilage and the hyoid bone was recorded during stimulation of nerve cuffs and intramuscular electrodes. Main Results. Nerve stimulation induced 260% more laryngeal elevation than intramuscular stimulation (18.8 mm versus 5.2 mm, p ? 0.01), and 228% higher velocity (143.8 versus 43.9 mm s-1, p ? 0.01). While stimulation at all cuff and electrode locations elevated the larynx, only the proximal XII/C1 nerve cuff significantly elicited both thyroid-hyoid approximation and hyoid elevation. In all proximal XII/C1 nerve cuffs (n = 7), stimulation was able to obtain selectivity of greater than 75% of at least one elevatory muscle. Significance. These results support the hypothesis that an implanted neural interface system can produce increased laryngeal elevation, a significant protective mechanism of deglutition.

Hadley, Aaron J.; Kolb, Ilya; Tyler, Dustin J.

2013-08-01

15

Hypoglossal nerve paralysis in a burn patient following mechanical ventilation  

PubMed Central

Summary Traumatic injury resulting in isolated dysfunction of the hypoglossal nerve is relatively rare and described in few case reports. We present a patient with isolated unilateral palsy of the twelfth cranial nerve (CN XII) resulting from recurrent airway intervention following extensive burn injuries. The differential diagnosis for paralysis of the CN XII is also discussed herein. This case illustrates the significance of comprehensive diagnostic evaluation and the need for refined airway manipulation in patients that require multiple endotracheal intubations PMID:24133402

Weissman, O.; Weissman, O.; Farber, N.; Berger, E.; Grabov Nardini, G.; Zilinsky, I.; Winkler, E.; Haik, J.

2013-01-01

16

Superior laryngeal nerve monitoring using laryngeal surface electrodes and intraoperative neurophysiological monitoring during thyroidectomy.  

PubMed

The objective of this study is to establish normative waveform data for the external branch of the superior laryngeal nerve (SLN) utilizing laryngeal surface electrodes and intraoperative neurophysiological monitoring (IONM) in conjunction with a clinical neurophysiologist. A retrospective chart review of 91 consecutive at-risk SLN were identified in 51 patients in whom IONM using laryngeal surface electrodes was performed by a clinical neurophysiologist using Dragonfly (Neurovision Medical Products, Ventura, CA) recording electrodes and a Protektor (Natus Medical Inc., San Carlos, CA)16 channel- intraoperative nerve monitoring system. Inclusion criteria were met for 30 SLN. Data collected included preoperative diagnosis, surgical procedure, rates of nerve identification and stimulation, and waveform characteristics. Waveform analysis for 30 SLN yielded a peak latency of 4.0?±?0.2 ms, onset latency 2.3?±?0.1 ms, peak-to-peak amplitude of 220.4?±?31.1 µV, onset-to-peak amplitude of 186.0?±?25.0 µV, and stimulation current threshold of 0.55?±?0.03 mA (data?=?mean?±?SEM). Two patients had abnormal SLN function documented clinically on postoperative laryngoscopic examination. Laryngeal surface electrodes were successfully utilized to identify and monitor SLN function intraoperatively. IONM using laryngeal surface electrodes enables analysis of waveform morphology and latency in addition to threshold and amplitude data obtained with the traditional NIM system, potentially improving the performance of nerve monitoring during thyroid surgery. Clin. Anat. 28:460-466, 2015. © 2014 Wiley Periodicals, Inc. PMID:25425500

Hodnett, Benjamin L; Schmitt, Nicole C; Clayburgh, Daniel R; Burkowsky, Alex; Balzer, Jeffrey; Thirumala, Parthasarathy D; Duvvuri, Umamaheswar

2015-05-01

17

Oral lichen planus: an unusual cause of facial and abducens nerve paralysis associated with conjunctival and oesophageal involvement.  

PubMed

Lichen planus (LP) is a T-cell-mediated disorder that may involve the skin, nails and mucosal surfaces. Conjunctival, laryngeal and oesophageal involvement were reported to be extremely rare manifestations of the disease. In this report, we present an oral LP case who complained of severe burning pain on his tongue and oral mucosa caused by ulcerative lesions and associated with conjunctival, laryngeal and oesophageal involvement. In addition, neurological examination revealed facial and abducens nerve palsy. To the best of our knowledge, we are presenting the first case of erosive oral LP associated with facial and abducens nerve paralysis. Although this association may be coincidental, according to an immunological concept proposed to explain the pathogenesis of Bell's palsy, degranulation of mast cells activated by complement or specific allergens with the release of histamine and other substances were to be presented responsible from nerve oedema, ischaemia and paralysis. As mast cell mediators are likely to be involved in the immunopathogenesis of OLP, we think that the cause of facial and bilateral abducens nerve palsy could be explained by the same mechanism. This case is a good example of the need for team work in lichen planus patients undergoing interdisciplinary consultations. PMID:15324414

Tunca, A; Calikoglu, E; Akta?, D; Safak, N; Ustün, H

2004-09-01

18

Superior laryngeal nerve injury: effects, clinical findings, prognosis, and management options  

PubMed Central

Purpose of review The superior laryngeal nerve (SLN) provides motor innervation to the cricothyroid muscle. However, the functions of this muscle and the anatomic variations of the nerve that supplies it are not fully understood. SLN paresis and paralysis (SLNp) is difficult to diagnose because of a lack of consistent laryngeal findings, and its effects on the voice likely goes beyond simple pitch elevation control. Recent findings Although SLNp has traditionally been thought to lead to voice pitch limitation, recent research findings reveal multiple roles for this nerve in voice and speech. Cricothyroid muscles are the primary controls of fundamental frequency of voice. SLNp can lead to significant contraction of pitch range, vocal fold vibratory phase asymmetry, and acoustic aperiodicity, thus leading to an overall poor vocal quality. In addition, cricothyroid muscles may also play a role in pitch lowering and shifting from voiced to unvoiced sounds during speech. Summary Subtle signs, symptoms, and diagnostic findings associated with SLNp make this disorder difficult to characterize clinically. Lack of treatment methodologies to restore the dynamic action of the cricothyroid muscles poses difficulties in treating patients with this condition. A more thorough understanding of the effects of SLNp will improve diagnosis and treatment. PMID:25136863

Orestes, Michael I.; Chhetri, Dinesh K.

2015-01-01

19

Outcome of 45 dogs with laryngeal paralysis treated by unilateral arytenoid lateralization or bilateral ventriculocordectomy.  

PubMed

The purpose of this retrospective study was to assess risk factors and complications affecting postoperative outcome of dogs with laryngeal paralysis treated by either unilateral arytenoid lateralization (UAL) or bilateral ventriculocordectomy (VCC). Medical records of all dogs having either UAL or VCC between 2000 and 2011 were analyzed. Twenty-five dogs had VCC and 20 dogs had UAL. The overall postoperative complications rates for VCC and UAL were similar (52% and 60%, respectively; P = .0887). Dogs that had UAL were more likely to have acute postoperative respiratory distress and aspiration pneumonia (P = .0526). Dogs with VCC were more likely to have chronic postoperative respiratory distress and aspiration pneumonia (P = .0079). Revision surgery was required in 6 dogs (24%) following VCC and 2 dogs (10%) following UAL. Sex, breed, presenting complaint, type of service provided, and concurrent diseases were not significantly associated with higher risk of either death or decreased survival time postoperatively with either procedure. Overall postoperative complication rates, required revision surgeries, and episodes of aspiration pneumonia were similar in dogs undergoing UAL and VCC surgeries. Dogs that had VCC appeared to have an increased risk of lifelong complications postoperatively compared with UAL; therefore, VCC may not be the optimal choice for treatment of laryngeal paralysis. PMID:24855094

Bahr, Katherine L; Howe, Lisa; Jessen, Carl; Goodrich, Zachary

2014-01-01

20

Laryngeal zoster with multiple cranial nerve palsies  

Microsoft Academic Search

A young immunocompetent patient is presented with a very rare presentation of a common viral illness: herpes zoster of the\\u000a left hemilarynx with sensorial and motoric neuropathy of three ipsilateral lower cranial nerves: IX, X and XI. The mucosal\\u000a lesions were discovered during upper gastrointestinal endoscopy. PCR of erosional exsudate confirmed the clinical diagnosis.\\u000a Antiviral therapy and corticosteroids possibly contributed

Paul Van Den Bossche; Karolien Van Den Bossche; Hilde Vanpoucke

2008-01-01

21

Laryngeal and tracheal afferent nerve stimulation evokes swallowing in anaesthetized guinea pigs  

PubMed Central

We describe swallowing reflexes evoked by laryngeal and tracheal vagal afferent nerve stimulation in anaesthetized guinea pigs. The swallowing reflexes evoked by laryngeal citric acid challenges were abolished by recurrent laryngeal nerve (RLN) transection and mimicked by electrical stimulation of the central cut ends of an RLN. By contrast, the number of swallows evoked by upper airway/pharyngeal distensions was not significantly reduced by RLN transection but they were virtually abolished by superior laryngeal nerve transection. Laryngeal citric acid-evoked swallowing was mimicked by laryngeal capsaicin challenges, implicating transient receptor potential vanilloid 1 (TRPV1)-expressing laryngeal afferent nerves arising from the jugular ganglia. The swallowing evoked by citric acid and capsaicin and evoked by electrical stimulation of either the tracheal or the laryngeal mucosa occurred at stimulation intensities that were typically subthreshold for evoking cough in these animals. Swallowing evoked by airway afferent nerve stimulation also desensitized at a much slower rate than cough. We speculate that swallowing is an essential component of airway protection from aspiration associated with laryngeal and tracheal afferent nerve activation. PMID:23858010

Tsujimura, Takanori; Udemgba, Chioma; Inoue, Makoto; Canning, Brendan J

2013-01-01

22

Aerodynamic and Nonlinear Dynamic Acoustic Analysis of Tension Asymmetry in Excised Canine Larynges  

ERIC Educational Resources Information Center

Purpose: To model tension asymmetry caused by superior laryngeal nerve paralysis (SLNP) in excised larynges and apply perturbation, nonlinear dynamic, and aerodynamic analyses. Method: SLNP was modeled in 8 excised larynges using sutures and weights to mimic cricothyroid (CT) muscle function. Weights were removed from one side to create tension…

Devine, Erin E.; Bulleit, Erin E.; Hoffman, Matthew R.; McCulloch, Timothy M.; Jiang, Jack J.

2012-01-01

23

Overview of pediatric peripheral facial nerve paralysis: analysis of 40 patients.  

PubMed

Peripheral facial nerve paralysis in children might be an alarming sign of serious disease such as malignancy, systemic disease, congenital anomalies, trauma, infection, middle ear surgery, and hypertension. The cases of 40 consecutive children and adolescents who were diagnosed with peripheral facial nerve paralysis at Baskent University Adana Hospital Pediatrics and Pediatric Neurology Unit between January 2010 and January 2013 were retrospectively evaluated. We determined that the most common cause was Bell palsy, followed by infection, tumor lesion, and suspected chemotherapy toxicity. We noted that younger patients had generally poorer outcome than older patients regardless of disease etiology. Peripheral facial nerve paralysis has been reported in many countries in America and Europe; however, knowledge about its clinical features, microbiology, neuroimaging, and treatment in Turkey is incomplete. The present study demonstrated that Bell palsy and infection were the most common etiologies of peripheral facial nerve paralysis. PMID:24810082

Özkale, Yasemin; Erol, ?lknur; Sayg?, Semra; Y?lmaz, ?smail

2015-02-01

24

Latencies longer than 3.5 ms after vagus nerve stimulation does not exclude a nonrecurrent inferior laryngeal nerve  

PubMed Central

Background It has recently been reported that a signal latency shorter than 3.5 ms after electrical stimulation of the vagus nerve signify a nonrecurrent course of the inferior laryngeal nerve. We present a patient with an ascending nonrecurrent inferior laryngeal nerve. In this patient, the stimulation latency was longer than 3.5 ms. Case presentation A 74-years old female underwent redo surgery due to a right-sided recurrent nodular goitre. The signal latency on electrical stimulation of the vagus nerve at the level of the carotid artery bifurcation was 3.75 ms. Further dissection revealed a nonrecurrent but ascending course of the inferior laryngeal nerve. Caused by the recurrent goitre, the nerve was elongated to about 10 cm resulting in this long latency. Conclusion This case demonstrates that the formerly proposed “3.5 ms rule” for identifying a nonrecurrent course of the inferior laryngeal nerve has exceptions. A longer latency does not necessarily exclude a nonrecurrent laryngeal nerve. PMID:25168966

2014-01-01

25

Mesenchymal stem cells in iatrogenic facial nerve paralysis: a possible role in the future  

Microsoft Academic Search

Iatrogenic facial nerve paralysis is one of the major and drastic complications of ear surgery. We report a case of a 20-year-old female patient with simple chronic otitis media who underwent mastoidectomy and tympanoplasty. During the mastoidectomy process the facial nerve was unintentionally destroyed, leaving a gap of 8–10 mm in the third segment of the intratemporal facial nerve. The nerve

Refik Caylan; Devrim Bektas; Tamer Dikmen; Ozlen Bektas; Serdar B. Omay; Ercument Ovali

2006-01-01

26

A Novel Technique for Clinical Assessment of Laryngeal Nerve Conduction: Normal and Abnormal Results  

PubMed Central

Objectives/Hypothesis To describe a novel conduction study of the laryngeal nerves, including normal values and abnormal findings. Study Design Prospective nonrandomized. Methods Seventeen healthy adult volunteers, as well as three patients with clinically identified laryngeal neuropathy, underwent low-level brief electrical stimulation of the laryngeal mucosa by means of a wire inserted via a transnasal flexible laryngoscope. Bilateral hookwire electrodes recorded the result in the laryngeal adductor muscles. Results This study yields an early response ipsilateral to the side of stimulation (LR1), which is uniform and consistent (right 5 13.2 6 0.80 msec; left 5 15.2 6 1.20 msec), and late bilateral responses (ipsilateral LR2 [LR2i] and contralateral LR2 [LR2c]), which exhibit greater variation in latency and morphology (right LR2i 5 50.5 6 3.38 msec; left LR2i 5 52.2 msec; right LR2c 5 50.7 6 4.26; left LR2c 5 50.6 6 4.07). Findings in abnormal patients differ significantly from normal, consistent with the distribution of neuropathy. Conclusions We describe a novel, clinically applicable conduction study of laryngeal nerves. Normative electrodiagnostic values and variations of the reflex responses of the laryngeal adductor muscles in response to irritative stimulation of the laryngeal mucosa (Laryngeal Closure Reflex) are proposed. By enabling the determination of electrophysiological parameters of the superior laryngeal and recurrent laryngeal branches of cranial nerve X (CN X), this procedure, which is used as an adjunct to laryngeal electromyography, may provide earlier and more accurate information regarding the extent and grade of nerve injury. Because injury grade relates directly to prognosis, the information derived from this test may have clinical relevance in determining optimal treatment. Level of Evidence 4. PMID:23835889

Sulica, Lucian; Carey, Bridget; Branski, Ryan C.

2014-01-01

27

Quantitative PCR Analysis of Laryngeal Muscle Fiber Types  

ERIC Educational Resources Information Center

Voice and swallowing dysfunction as a result of recurrent laryngeal nerve paralysis can be improved with vocal fold injections or laryngeal framework surgery. However, denervation atrophy can cause late-term clinical failure. A major determinant of skeletal muscle physiology is myosin heavy chain (MyHC) expression, and previous protein analyses…

Van Daele, Douglas J.

2010-01-01

28

Relationship of vocal cord paralysis to the coil diameter of vagus nerve stimulator leads.  

PubMed

OBJECT This investigation was done to examine, following implantation of vagus nerve stimulators, the relationship of vocal cord paralysis to the inner diameter of the coils used to attach the stimulator lead to the nerve. Methods All data in this investigation were collected, as mandated by the FDA, by the manufacturer of vagus nerve stimulators and were made available without restrictions for analysis by the authors. The data reflect all initial device implantations in the United States for the period from 1997 through 2012. Results Vocal cord paralysis was reported in 193 of 51,882 implantations. In patients aged 18 years and older, the incidence of paralysis was 0.26% when the stimulator leads had coil diameters of 3 mm and 0.51% when the leads had 2-mm-diameter coils (p < 0.05). Across all age groups, the incidence of vocal cord paralysis increased with age at implantation for leads having 2-mm-diameter coils. Conclusions In patients aged 18 years and older, vocal cord paralysis occurred at almost twice the rate with the implantation of vagus nerve stimulator leads having 2-mm-diameter coils than with leads having 3-mm-diameter coils. The incidence of vocal cord paralysis increases with patient age at implantation. PMID:25526267

Robinson, Leslie C; Winston, Ken R

2015-03-01

29

Reorganization of laryngeal motoneurons after crush injury in the recurrent laryngeal nerve of the rat  

PubMed Central

Motoneurons innervating laryngeal muscles are located in the nucleus ambiguus (Amb), but there is no general agreement on the somatotopic representation and even less is known on how an injury in the recurrent laryngeal nerve (RLN) affects this pattern. This study analyzes the normal somatotopy of those motoneurons and describes its changes over time after a crush injury to the RLN. In the control group (control group 1, n = 9 rats), the posterior cricoarytenoid (PCA) and thyroarytenoid (TA) muscles were injected with cholera toxin-B. In the experimental groups the left RLN of each animal was crushed with a fine tip forceps and, after several survival periods (1, 2, 4, 8, 12 weeks; minimum six rats per time), the PCA and TA muscles were injected as described above. After each surgery, the motility of the vocal folds was evaluated. Additional control experiments were performed; the second control experiment (control group 2, n = 6 rats) was performed labeling the TA and PCA immediately prior to the section of the superior laryngeal nerve (SLN), in order to eliminate the possibility of accidental labeling of the cricothyroid (CT) muscle by spread from the injection site. The third control group (control group 3, n = 5 rats) was included to determine if there is some sprouting from the SLN into the territories of the RLN after a crush of this last nerve. One week after the crush injury of the RLN, the PCA and TA muscles were injected immediately before the section of the SLN. The results show that a single population of neurons represents each muscle with the PCA in the most rostral position followed caudalwards by the TA. One week post-RLN injury, both the somatotopy and the number of labeled motoneurons changed, where the labeled neurons were distributed randomly; in addition, an area of topographical overlap of the two populations was observed and vocal fold mobility was lost. In the rest of the survival periods, the overlapping area is larger, but the movement of the vocal folds tends to recover. After 12 weeks of survival, the disorganization within the Amb is the largest, but the number of motoneurons is similar to control, and all animals recovered the movement of the left vocal fold. Our additional controls indicate that no tracer spread to the CT muscle occurred, and that many of the labeled motoneurons from the PCA after 1 week post-RLN injury correspond to motoneurons whose axons travel in the SLN. Therefore, it seems that after RLN injury there is a collateral sprouting and collateral innervation. Although the somatotopic organization of the Amb is lost after a crush injury of the RLN and does not recover in the times studied here, the movement of the vocal folds as well as the number of neurons that supply the TA and the PCA muscles recovered within 8 weeks, indicating that the central nervous system of the rat has a great capacity of plasticity. PMID:23444899

Hernández-Morato, Ignacio; Valderrama-Canales, Francisco J; Berdugo, Gabriel; Arias, Gonzalo; McHanwell, Stephen; Sañudo, José; Vázquez, Teresa; Pascual-Font, Arán

2013-01-01

30

Losing Your Voice: Etiologies and Imaging Features of Vocal Fold Paralysis  

PubMed Central

Neurogenic compromise of vocal fold function exists along a continuum encompassing vocal cord hypomobility (paresis) to vocal fold immobility (paralysis) with varying degrees and patterns of reinnervation. Vocal fold paralysis (VFP) may result from injury to the vagus or the recurrent laryngeal nerves anywhere along their course from the brainstem to the larynx. In this article, we review the anatomy of the vagus and recurrent laryngeal nerves and examine the various etiologies of VFP. Selected cases are presented with discussion of key imaging features of VFP including radiologic findings specific to central vagal neuropathy and peripheral recurrent nerve paralysis. PMID:23814687

Vachha, Behroze; Cunnane, Mary Beth; Mallur, Pavan; Moonis, Gul

2013-01-01

31

Post-traumatic facial nerve paralysis: three cases of delayed temporal bone exploration with recovery.  

PubMed

No consensus exists today on the management of immediate-onset post-traumatic facial nerve paralysis. Controversy surrounds the timing of surgical intervention and the role of electrophysiologic testing. Three patients are presented who sustained immediate, complete facial paralysis following closed head trauma. They did not have prompt facial nerve decompression. In each case, electroneurography and electromyography showed complete nerve degeneration and denervated muscle. Despite the results of the electrophysiologic tests, all patients underwent late surgical decompression of the nerve: one at 2 1/2 months, one at 3 months, and one as late as 14 months after injury. They all had good recovery of facial function within 6 months of surgery. Early surgical intervention has been advocated in post-traumatic facial nerve paralysis if any benefit is to be gained. It is thought that late surgical intervention is unlikely to yield further improvement in the facial nerve function. Experience with these cases suggests that surgical exploration of the facial nerve is indicated at anytime, as it may be beneficial even in very old injuries. The prognostic value of electroneurography and electromyography in determining facial nerve recovery and in deciding upon facial nerve surgery is questioned. PMID:6645756

Brodsky, L; Eviatar, A; Daniller, A

1983-12-01

32

Ectopic thyroid tissue surrounding the right laryngeal nerve: a case report.  

PubMed

Ectopic thyroid tissue (ETT) is a rare developmental anomaly of the thyroid tissue which is defined as the presence of thyroid tissue in locations other than the pretracheal area. However, ectopic thyroid tissue in the lateral neck surrounding the recurrent laryngeal nerve is unusually found. Here we describe a case of a 64-year-old woman who was found bilateral thyroid goiter by the ultrasound examination. The total thyroidectomy plus a modified radical neck dissection was performed. Surprisingly we also found a nodule surrounding the right recurrent laryngeal nerve at the same time. Nevertheless the diagnosis of the nodule was confirmed by pathology and Histologic examination demonstrating that it was ectopic thyroid tissue. Ectopic thyroid tissue surrounding recurrent laryngeal nerve is a rare finding, with hardly any cases reported. For it is generally thought that any thyroid tissue found in the lateral aspect of the neck may indicate metastatic deposits from well-differentiated thyroid carcinoma. Although pathogenesis of ectopic thyroid tissue surrounding recurrent laryngeal nerve without any symptoms remains unknown, our case could suggest ectopic thyroid tissue should not be excluded in the differential diagnosis of lateral neck masses especially when the recurrent laryngeal nerves were surrounded by the nodules. PMID:25197416

He, Bin; Li, Peng; Yang, Kai; Shan, Yunfeng

2014-01-01

33

Nicolaus A. Friedreich's description of peripheral facial nerve paralysis in 1798.  

PubMed Central

In 1798, Nicolaus A. Friedreich of Wurzburg published a detailed clinical account of three patients with idopathic peripheral facial nerve paralysis. His astute observations of onset, physical findings, natural course, treatment, and recovery preceded those of Charles Bell by 23 years. PMID:368292

Bird, T D

1979-01-01

34

Management of traumatic facial nerve paralysis with carotid artery cavernous sinus fistula  

Microsoft Academic Search

Massive skull base injuries require detailed preoperative neurological and neurovascular assessment prior to undertaking surgical repair of isolated cranial nerve deficits. We present the management of a patient with traumatic facial paralysis, cerebrospinal fluid leak, and carotid artery cavernous sinus fistula as the result of a gunshot wound to the skull base. The carotid artery cavernous sinus fistula was ultimately

J. T. Roland Jr; P. E. Hammerschlag; W. S. Lewis; I. Choi; A. Berenstein

1994-01-01

35

Functional Regeneration of Recurrent Laryngeal Nerve Injury During Thyroid Surgery Using an Asymmetrically Porous Nerve Guide Conduit in an Animal Model  

PubMed Central

Background: Vocal cord paralysis (VCP) caused by recurrent laryngeal nerve (RLN) damage during thyroidectomy commonly results in serious medico-legal problems. The purpose of this study was to evaluate the usefulness of an asymmetrically porous polycaprolactone (PCL)/Pluronic F127 nerve guide conduit (NGC) for functional regeneration in a RLN injury animal model. Methods: A biodegradable, asymmetrically porous PCL/F127 NGC with selective permeability was fabricated for use in this study. A 10-mm segment of left RLN was resected in 28 New Zealand white rabbits, and then an asymmetrically porous NGC or a nonporous silicone tube was interposed between both stumps and securely fixed. Vocal cord mobility was endoscopically evaluated at one, four, and eight weeks postoperatively. Nerve growth through NGCs was assessed by toluidine blue staining, and thyroarytenoid (TA) muscle atrophy was evaluated by hematoxylin and eosin staining. Immunohistochemical stainings for acetylcholinesterase (AchE), anti-neurofilament (NF), and anti-S100 protein were also conducted, and transmission electron microscopy (TEM) was used to evaluate functional nerve regeneration. Results: At eight weeks postoperatively, endoscopic evaluations showed significantly better recovery from VCP in the asymmetrically porous PCL/F127 NGC group (6 of 10 rabbits) than in the silicone tube group (1 of 10 rabbits). Continued nerve growth on the damaged nerve endings was observed with time in the asymmetrically porous PCL/F127 NGC-interposed RLNs. TA muscle dimensions and AchE expressions in TA muscle were significantly greater in the asymmetrically porous PCL/F127 NGC group than in the silicone tube group. Furthermore, immunohistochemical staining revealed the expression of NF and S100 protein in the regenerated nerves in the asymmetrically porous PCL/F127 NGC group at eight weeks postoperatively, and at this time, TEM imaging showed myelinated axons in the regenerated RLNs. Conclusion: The study shows that asymmetrically porous PCL/F127 NGC provides a favorable environment for RLN regeneration and that it has therapeutic potential for the regeneration of RLN damage. PMID:24015805

Choi, Jeong-Seok; Oh, Se Heang; An, Hye-Young; Kim, Young-Mo; Lee, Jin Ho

2014-01-01

36

Quantitative analysis of the anatomy of the epineurium of the canine recurrent laryngeal nerve  

PubMed Central

The purpose of this investigation was to determine the amount of epineurium surrounding the recurrent laryngeal nerve (RLN) compared with a limb nerve, that to flexor hallicus longus (NFHL). Nerve samples were obtained from 10 adult dogs and studied using scanning electron microscopy and light microscopy to measure the relative proportion of epineurium and the relative proportions of adipose and collagenous tissue comprising the epineurium in both nerves. Significantly greater relative epineurial cross-sectional areas and adipose content were found in the RLN than in the NFHL. Based on observations on noncranial peripheral nerves, the findings indicate that the RLN is better protected against deformational forces associated with compression than stretching forces. The RLN may not be structured well for successful reinnervation after injury. The patterns observed for adipose tissue in RLN epineurial tissue appeared unique compared with those previously reported in peripheral nerves. The primary role associated with adipose tissue is to ‘package’ the nerve for protection. The RLN is considered to be a vital nerve in the body, as are other cranial nerves. The large proportions of adipose tissue in the epineurium may relate to the importance of protecting this nerve from injury. PMID:10697291

BARKMEIER, JULIE M.; LUSCHEI, ERICH S.

2000-01-01

37

Identification alone versus intraoperative neuromonitoring of the recurrent laryngeal nerve during thyroid surgery: experience of 2034 consecutive patients  

PubMed Central

Background The aim of this study was to evaluate the ability of intraoperative neuromonitoring in reducing the postoperative recurrent laryngeal nerve palsy rate by a comparison between patients submitted to thyroidectomy with intraoperative neuromonitoring and with routine identification alone. Methods Between June 2007 and December 2012, 2034 consecutive patients underwent thyroidectomy by a single surgical team. We compared patients who have had neuromonitoring and patients who have undergone surgery with nerve visualization alone. Patients in which neuromonitoring was not utilized (Group A) were 993, patients in which was utilized (group B) were 1041. Results In group A 28 recurrent laryngeal nerve injuries were observed (2.82%), 21 (2.11%) transient and 7 (0.7%) permanent. In group B 23 recurrent laryngeal nerve injuries were observed (2.21%), in 17 cases (1.63%) transient and in 6 (0.58%) permanent. Differences were not statistically significative. Conclusions Visual nerve identification remains the gold standard of recurrent laryngeal nerve management in thyroid surgery. Neuromonitoring helps to identify the nerve, in particular in difficult cases, but it did not decrease nerve injuries compared with visualization alone. Future studies are warranted to evaluate the benefit of intraoperative neuromonitoring in thyroidectomy, especially in conditions in which the recurrent nerve is at high risk of injury. PMID:24942225

2014-01-01

38

Phrenic Nerve Paralysis as the Initial Presentation in Pleural Sarcomatoid Mesothelioma  

PubMed Central

A 74-year-old man was referred to our hospital because of persistent cough. A chest radiograph revealed an elevation of the right diaphragm. Computed tomography (CT) images revealed a small nodule localized on the right mediastinum. Five months later, the nodule had grown and was diagnosed as malignant pleural mesothelioma (MPM) by a CT-guided needle biopsy. The patient underwent combined chemotherapy, but the disease progressed rapidly and he passed away. On autopsy, microscopic findings and immunohistological examinations supported the diagnosis of sarcomatoid mesothelioma. Therefore, we diagnosed this rare case as localized sarcomatoid MPM showing phrenic nerve paralysis as an initial presentation. PMID:25076889

Makimoto, Go; Fujiwara, Keiichi; Fujimoto, Nobukazu; Yamadori, Ichiro; Sato, Toshio; Kishimoto, Takumi

2014-01-01

39

Phrenic nerve paralysis as the initial presentation in pleural sarcomatoid mesothelioma.  

PubMed

A 74-year-old man was referred to our hospital because of persistent cough. A chest radiograph revealed an elevation of the right diaphragm. Computed tomography (CT) images revealed a small nodule localized on the right mediastinum. Five months later, the nodule had grown and was diagnosed as malignant pleural mesothelioma (MPM) by a CT-guided needle biopsy. The patient underwent combined chemotherapy, but the disease progressed rapidly and he passed away. On autopsy, microscopic findings and immunohistological examinations supported the diagnosis of sarcomatoid mesothelioma. Therefore, we diagnosed this rare case as localized sarcomatoid MPM showing phrenic nerve paralysis as an initial presentation. PMID:25076889

Makimoto, Go; Fujiwara, Keiichi; Fujimoto, Nobukazu; Yamadori, Ichiro; Sato, Toshio; Kishimoto, Takumi

2014-05-01

40

Vocal cord paralysis caused by stingray.  

PubMed

Foreign bodies in the oral cavity and pharynx are commonly encountered in the emergency room and outpatient departments, and the most frequently observed of these foreign bodies are fish bones. Among the possible complications resulting from a pharyngeal foreign body, vocal cord fixation is extremely rare, with only three cases previously reported in the English literature. The mechanisms of vocal cord fixation can be classified into mechanical articular fixation, direct injury of the recurrent laryngeal nerve, or recurrent laryngeal nerve paralysis secondary to inflammation. The case discussed here is different from previous cases. We report a rare case of vocal cord paralysis caused by the venom of a stingray tail in the hypopharynx. PMID:24077868

Kwon, Oh Jin; Park, Jung Je; Kim, Jin Pyeong; Woo, Seung Hoon

2013-11-01

41

Clinical significance of recurrent laryngeal nerve exposure during esophagogastric anastomosis of the neck  

Microsoft Academic Search

Objective  To investigate the clinical value in a comparison between intraoperative exposure and non-exposure of the recurrent laryngeal\\u000a nerve (RLN) of the neck during left neck esophagogastric anastomosis following resection of carcinomas of the middle and inferior-segment\\u000a esophagus.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  From January 2003 to April 2009, 237 patients were selected to undergo resection of esophageal squamous carcinoma via posteroexternal\\u000a incision of the left

Chun-hong Yang; Xiang-yang Wei

2010-01-01

42

Closed-loop eyelid reanimation system with real-time blink detection and electrochemical stimulation for facial nerve paralysis  

Microsoft Academic Search

Electrical stimulation in eyelid reanimation has been verified in previous studies as a potential treatment for facial nerve paralysis. Design challenges, including physical pain during stimulation, reducing the latency between the natural blink and the artificial blink, and patient-to-patient differences, make it difficult to build this system. In this paper, the design challenges are analyzed in detail, based on which

Kuanfu Chen; Tung-Chien Chen; Kimberly Cockerham; Wentai Liu

2009-01-01

43

Cricotracheal separation: a review and a case with bilateral recovery of recurrent laryngeal nerve function.  

PubMed

Cricotracheal separation (CTS) is an uncommon injury, with a high index of suspicion required to establish the diagnosis. Computerized tomography (CT) plays a role in diagnosis but cannot necessarily be relied upon. Bilateral recurrent laryngeal nerve (RLN) palsies are usually associated with this type of injury. We recently treated a patient with CTS in whom one RLN was intact from the time of the injury and the other nerve recovered within three months. Computed tomography was inconclusive. Early open repair of the injury and frequent follow-up examinations led to successful decannulation after six weeks and excellent short-term voice and airway outcomes. A detailed discussion of this unusual case is followed by a review of the current literature on CTS, with particular emphasis on significant management dilemmas and controversies. Clinical suspicion remains more sensitive than investigations in diagnosing CTS. Permanent bilateral RLN palsies are not inevitable following these injuries. PMID:16606523

McCrystal, D J; Bond, C

2006-06-01

44

Preoperative diagnosis and intraoperative protection of nonrecurrent laryngeal nerve: A review of 5 cases  

PubMed Central

Background Nonrecurrent laryngeal nerve (NRLN) is a risk factor for nerve injury during thyroidectomy or parathyroidectomy. It is usually associated with abnormal vasculature that can be identified by several imaging methods. The aim of this study was to retrospectively analyze the preoperative diagnosis and intraoperative protection of NRLN. Material/Methods Of the 7169 patients who underwent thyroid surgery at our hospital between August 2008 and January 2013, 5 patients with NRLN were identified. Preoperative chest X-rays, neck ultrasonography (US), and computed tomography (CT) findings were reviewed. NRLNs were carefully and systematically searched for in surgery. Results Preoperative CT predicted NRLN in all 5 cases (100% accuracy). The detection rate of NRLN by CT was 0.4% (5/1170). NRLNs were confirmed in surgery. All of them were right-sided NRLN with type IIA variant. The CT scans clearly revealed the vascular anomalies. The review of US images suggested that vascular anomalies could be identified on the images in 1 patient. No postoperative complications occurred in any patient. Conclusions The preoperative CT scan was a reliable and effective method for identifying abnormal vasculature to indirectly predict NRLN. Combining the CT and US findings with adequate surgical technique may help to reduce the risk of nerve damage, in addition to preventing nerve palsy. PMID:24518037

Wang, Zhihong; Zhang, Hao; Zhang, Ping; He, Liang; Dong, Wenwu

2014-01-01

45

Traction injury of the recurrent laryngeal nerve: Results of continuous intraoperative neuromonitoring in a swine model.  

PubMed

Background Recurrent laryngeal nerve(RLN) palsy is the most serious complication after thyroidectomy. However, little is known about the degree of traction injury that causes loss of signal(LOS). This study aimed to evaluate traction injuries in the swine RLN using continuous intraoperative neuromonitoring(IONM) and determine the traction power that results in LOS. Methods Thirteen pigs underwent traction injury to the RLNs with continuous IONM, and stress-strain curves were determined for eight nerves using the universal material testing machine in an ex vivo model. Results Traction injury at a mean power of 2.83 megapascal(MPa) caused LOS. The mean physiologic limit strain and tensile strength of the swine RLNs were found to be 15.0% and 4.9 MPa, respectively. Histological analysis showed no abnormal structural findings. Conclusion Traction injury of swine RLNs causes LOS at a power of 2.83 MPa. However, all injuered nerves recovered within 7days with no observed structural damage. This article is protected by copyright. All rights reserved. PMID:25488415

Lee, Hye Yoon; Cho, Young Geon; You, Ji Young; Choi, Byoung Ho; Kim, Joon Yub; Wu, Che-Wei; Chiang, Feng-Yu; Kim, Hoon Yub

2014-12-01

46

Paralysis: Rehabilitation and Recovery  

MedlinePLUS

... through your mind after you've acquired a spinal cord injury or developed paralysis. You'll find your answers ... to activate nerves affected by paralysis resulting from spinal cord injury (SCI), stroke or other neurological disorders. FES can ...

47

Phrenic nerve paralysis following pediatric cardiac surgery. Role of diaphragmatic plication.  

PubMed

Eighteen children sustained unilateral phrenic nerve paralysis (PNP) after cardiac surgical procedures. Ten (Group I), under 7 months (mean: 2.9 +/- 2.2), required long-term ventilatory assistance (mean: 23.9 +/- 13.0 days); they failed to be weaned from the ventilator. All underwent diaphragmatic plication (DP). DP was performed late in 7 cases (Group Ia) with a mean time of 30.8 days between surgery and DP, and early in 3 others (Group Ib) with a mean time of 10.2 days. Eight children (Group II), older than 1 year, tolerated PNP better and could be extubated early without diaphragmatic plication. In Group Ia severe lung infections were recorded in 5 before or/and after DP, and two died at 3 and 30 days after plication. Five children from Group Ia and all 3 from Group Ib were late survivors. They could be weaned from ventilatory support in a mean time of 3 days after DP, although those with severe lung infection (Group Ia) took the longest time. All from Group II were late survivors. We conclude: PNP is well tolerated without plication in children older than 1 year. However early DP offers excellent and immediate results in infants with PNP. Early DP in these children avoids or reduces severe lung infections and death. PMID:3182930

Affatato, A; Villagra, F; De Leon, J P; Gomez, R; Checa, S L; Vellibre, D; Sanchez, P; Diez Balda, J I; Brito, J M

1988-01-01

48

Rhizotomy targeting the intermediate nerve, the glossopharyngeal nerve and the upper 1st to 2nd rootlets of the vagus nerve for the treatment of laryngeal neuralgia combined with intermediate nerve neuralgia-a case report  

PubMed Central

Background In neurosurgery, the most common type of facial and pharyngeal pain is trigeminal neuralgia. In contrast, glossopharyngeal neuralgia is relatively rare, and laryngeal neuralgia is the most rarely observed. Case presentation A case of laryngeal neuralgia combined with intermediate nerve neuralgia that was admitted to our hospital in May 2012 was reported here. The patient was a 58-year-old middle-aged female, who experienced 2 years of paroxysmal burning and stabbing pain near the thyroid perichodrium, in the skin covering the right front side of the neck, and deep in inner ear. Conclusion The surgical treatment plan similar to that for glossopharyngeal neuralgia could be applied if laryngeal neuralgia is associated with glossopharyngeal neuralgia and intermediate neuralgia or if no obvious improvement is achieved with the above mentioned treatment approaches. PMID:25168864

2014-01-01

49

Intraoperative neuromonitoring of the recurrent laryngeal nerve in robotic thyroid surgery.  

PubMed

This study evaluated the technical feasibility and efficacy of intraoperative neuromonitoring (IONM) of the recurrent laryngeal nerve (RLN) to aid its identification and preservation during robotic thyroidectomy (RoT). IONM of the RLN was evaluated in 30 consecutive patients undergoing RoT. All patients underwent an indirect laryngoscope examination to objectively assess vocal cord function. Their Voice Handicap Index-10 (VHI-10) was measured to subjectively assess vocal cord function preoperatively and at postoperative months 1 and 3. Of the 56 RLNs at risk in 30 patients undergoing RoT, all were visualized and identified by IONM. The IONM sensitivity for postoperative permanent RLN palsy was 100%, with a positive predictive value of 100%. The mean VHI-10 scores preoperatively and at postoperative months 1 and 3 were 0.20±0.66, 3.47±5.04, and 1.53±2.47, respectively (P<0.001). IONM of the RLN during RoT is technically feasible and effective for identifying this nerve. PMID:25238177

Bae, Dong Sik; Kim, Su-Jin

2015-02-01

50

Safe distance between electrotome and recurrent laryngeal nerve: an experimental canine model  

PubMed Central

Background: Various energy based surgical devices (ESD) like electrotome have been widely applied in thyroid surgery. This is the first canine model to determine the safety margin of using the electrotome near the recurrent laryngeal nerve (RLN) to prevent injury to this nerve during thyroid surgery. Methods: Eighteen healthy male dogs were divided equally into three groups according to the distance between electrotome application and the RLN: Group A (5 mm), Group B (3 mm), Group C (1 mm). The parameters of evoked electromyography (EEMG) of vocal muscles between right normal RLNs and left RLNs after electrotome application at a power of 30 W for 1 second in each group were recorded and compared. The acute microstructural morphological changes of the RLNs were observed immediately after the operation under electron microscope. Results: In Group B and Group C, after using the electrotome at a vertical distance of 3 mm or 1 mm from the left RLNs, the stimulating thresholds of left RLNs had a significant increase (P = 0.005; P = 0.002) compared with right normal RLNs, and there occurred obvious acute microstructural morphological changes under electron microscope for left RLNs. While there was no significant functional or histological changes for left RLNs after using the electrotome at a vertical distance of 5 mm from the RLN (P = 0.187) in Group A. Conclusions: When using the electrotome near the RLN at a power of 30W in thyroid surgery, a safety margin of more than 3 mm should be recommended. PMID:25785056

Jiang, Kewei; Zhu, Yi; Zhou, Gang; Ye, Yingjiang; Xie, Qiwei; Yang, Xiaodong; Wang, Shan

2015-01-01

51

[Monitoring of recurrent laryngeal nerve injury using an electromyographic endotracheal tube in thyroid and parathyroid surgery. Anesthetic aspects].  

PubMed

Recurrent laryngeal nerve injury remains one of the main complications in thyroid and parathyroid surgery. When this injury is bilateral, an acute upper airway obstruction may occur, leading to a potentially life-threatening situation for the patient. The visual identification of the nerve during surgery is the best way to preserve its integrity. However identification of the nerves by means of electromyographic stimuli through electrodes attached to endotracheal tubes could help in decreasing nerve injury. In these cases the experience and role of the anesthetist is essential to correctly place the electromyographic endotracheal tube and ensure that the electrodes are in touch with the vocal cords during the surgery. Moreover, the results of the electromyography can be affected by the neuromuscular blocking agents. Therefore, the choice and dose must be adapted, in order to ensure a suitable anesthetic depth, and adequate response. PMID:23886448

Martín Jaramago, J; Tamarit Conejeros, M; Escudero Torrella, M; Solaz Roldán, C

2013-12-01

52

Prevention and treatment of recurrent laryngeal nerve injury in thyroid surgery  

PubMed Central

Aim: To summary the experience for prevention and treatment of recurrent laryngeal nerve (RLN) injury in thyroid surgery. Methods: Clinical features of 623 patients who received thyroid surgery from January 2010 to December 2012 were analyzed retrospectively, and the features of RLN injury and intraoperative as well as postoperative treatments were reviewed. Results: RLN injury occurred in 31 patients (4.98%), in which, unilateral RLN injury occurred in 27 patients and bilateral RLN injuries occurred in 4 patients (temporary injury in 28 patients and permanent injury in 3 patients). 6 patients underwent RLN anastomosis during surgery and exhibited transient hoarseness after surgery. RLN exploration and decompression was given in 1 patient and the patient got normal vocal cord motion 2 months after surgery. 1 patient with bilateral injuries received tracheotomy and CO2 laser resection of arytenoid cartilage and achieved recovery 1 year later. Conclusions: In order to prevent RLN injury, the anatomic variations of RLN should be mastered. Routine exposure of RLN can effectively prevent the injury in patients receiving the second or multiple surgeries. Early interventions for RLN injury include mainly early discovery, early exploration and early anastomosis, and the function of RLN in some patients can recover completely. Subsequent treatments mainly focus on the improvement of the voice, expansion of glottis and melioration of dyspnea. PMID:24482694

Jiang, Yan; Gao, Bo; Zhang, Xiaohua; Zhao, Jianjie; Chen, Jinping; Zhang, Shu; Luo, Donglin

2014-01-01

53

Facial nerve paralysis and partial brachial plexopathy after epidural blood patch: a case report and review of the literature  

PubMed Central

We report a complication related to epidural analgesia for delivery in a 24- year-old woman who was admitted with mild pre-eclampsia and for induction of labor. At the first postpartum day she developed a postdural puncture headache, which was unresponsive to conservative measures. On the fifth day an epidural blood patch was done, and her headache subsided. Sixteen hours later she developed paralysis of the right facial nerve, which was treated with prednisone. Seven days later she complained of pain in the left arm and the posterior region of the shoulder. She was later admitted and diagnosed with partial brachial plexopathy. PMID:21386953

Shahien, Radi; Bowirrat, Abdalla

2011-01-01

54

Cannabinoids Facilitate the Swallowing Reflex Elicited by the Superior Laryngeal Nerve Stimulation in Rats  

PubMed Central

Cannabinoids have been reported to be involved in affecting various biological functions through binding with cannabinoid receptors type 1 (CB1) and 2 (CB2). The present study was designed to investigate whether swallowing, an essential component of feeding behavior, is modulated after the administration of cannabinoid. The swallowing reflex evoked by the repetitive electrical stimulation of the superior laryngeal nerve in rats was recorded before and after the administration of the cannabinoid receptor agonist, WIN 55-212-2 (WIN), with or without CB1 or CB2 antagonist. The onset latency of the first swallow and the time intervals between swallows were analyzed. The onset latency and the intervals between swallows were shorter after the intravenous administration of WIN, and the strength of effect of WIN was dose-dependent. Although the intravenous administration of CB1 antagonist prior to intravenous administration of WIN blocked the effect of WIN, the administration of CB2 antagonist did not block the effect of WIN. The microinjection of the CB1 receptor antagonist directly into the nucleus tractus solitarius (NTS) prior to intravenous administration of WIN also blocked the effect of WIN. Immunofluorescence histochemistry was conducted to assess the co-localization of CB1 receptor immunoreactivity to glutamic acid decarboxylase 67 (GAD67) or glutamate in the NTS. CB1 receptor was co-localized more with GAD67 than glutamate in the NTS. These findings suggest that cannabinoids facilitate the swallowing reflex via CB1 receptors. Cannabinoids may attenuate the tonic inhibitory effect of GABA (gamma-aminobuteric acid) neurons in the central pattern generator for swallowing. PMID:23209814

Takatsuji, Hanako; Yamada, Yoshiaki; Yamamura, Kensuke; Kitagawa, Junichi

2012-01-01

55

Cannabinoids facilitate the swallowing reflex elicited by the superior laryngeal nerve stimulation in rats.  

PubMed

Cannabinoids have been reported to be involved in affecting various biological functions through binding with cannabinoid receptors type 1 (CB1) and 2 (CB2). The present study was designed to investigate whether swallowing, an essential component of feeding behavior, is modulated after the administration of cannabinoid. The swallowing reflex evoked by the repetitive electrical stimulation of the superior laryngeal nerve in rats was recorded before and after the administration of the cannabinoid receptor agonist, WIN 55-212-2 (WIN), with or without CB1 or CB2 antagonist. The onset latency of the first swallow and the time intervals between swallows were analyzed. The onset latency and the intervals between swallows were shorter after the intravenous administration of WIN, and the strength of effect of WIN was dose-dependent. Although the intravenous administration of CB1 antagonist prior to intravenous administration of WIN blocked the effect of WIN, the administration of CB2 antagonist did not block the effect of WIN. The microinjection of the CB1 receptor antagonist directly into the nucleus tractus solitarius (NTS) prior to intravenous administration of WIN also blocked the effect of WIN. Immunofluorescence histochemistry was conducted to assess the co-localization of CB1 receptor immunoreactivity to glutamic acid decarboxylase 67 (GAD67) or glutamate in the NTS. CB1 receptor was co-localized more with GAD67 than glutamate in the NTS. These findings suggest that cannabinoids facilitate the swallowing reflex via CB1 receptors. Cannabinoids may attenuate the tonic inhibitory effect of GABA (gamma-aminobuteric acid) neurons in the central pattern generator for swallowing. PMID:23209814

Mostafeezur, Rahman Md; Zakir, Hossain Md; Takatsuji, Hanako; Yamada, Yoshiaki; Yamamura, Kensuke; Kitagawa, Junichi

2012-01-01

56

A comparison between succinylcholine and rocuronium on the recovery profile of the laryngeal muscles during intraoperative neuromonitoring of the recurrent laryngeal nerve: a prospective porcine model.  

PubMed

The use of succinylcholine and rocuronium are reportedly feasible during intraoperative neuromonitoring (IONM) of the recurrent laryngeal nerve (RLN) in thyroid surgery. This study aimed to investigate and compare the recovery profiles of succinylcholine and rocuronium on the laryngeal muscle during IONM of the RLN in a porcine model. Nine male Duroc-Landrace piglets were anesthetized with thiamylal and underwent tracheal intubation without neuromuscular blocking agents (NMBAs). Needle electrodes were inserted into the vocalis muscles through the cricothyroid ligament. The RLN was exposed and stimulated. Electromyographic (EMG) signals were obtained before and after the intravenous administration of a NMBA. The EMG amplitudes were measured before and after (at 1-minute intervals) the administration of the study drug until complete recovery. The study NMBA regimen included succinylcholine (1 mg/kg), low-dose rocuronium (0.3 mg/kg), and standard dose rocuronium (0.6 mg/kg). The maximal neuromuscular blockade and 80% recovery (i.e., duration) of the control responses were recorded and analyzed. The 80% recovery of the control response for succinylcholine (1 mg/kg) was 19.7 ± 1.5 minutes; low-dose rocuronium (0.3 mg/kg), 16.3 ± 2.5 minutes; and standard dose rocuronium (0.6 mg/kg), 29.3 ± 5.7 minutes. Succinylcholine (1 mg/kg) and low-dose rocuronium (0.3 mg/kg) had significantly shorter durations than standard dose rocuronium (0.6 mg/kg). The EMG signal recovery returned to baseline within 30 minutes in the succinylcholine and low-dose rocuronium groups, but it did not return to baseline until 1 hour after surgery in the rocuronium (0.6 mg/kg) group. In this study, succinylcholine (1 mg/kg) and low-dose rocuronium (0.3 mg/kg) had favorable recovery profiles on the laryngeal muscle. It is recommended that low-dose rocuronium may replace succinylcholine for the induction of general anesthesia during IONM of the RLN in thyroid surgery. PMID:24018151

Lu, I-Cheng; Chang, Pi-Ying; Hsu, Hung-Te; Tseng, Kuang-Yi; Wu, Che-Wei; Lee, Ka-Wo; Ho, Kuen-Yao; Chiang, Feng-Yu

2013-09-01

57

Facial nerve paralysis: A case report of rare complication in uncontrolled diabetic patient with mucormycosis  

PubMed Central

Mucormycosis is a rare opportunistic aggressive and fatal infection caused by mucor fungus. Seven types of mucormycosis are identified based on the extension and involvement of the lesion, of which the rhino orbital mucormycosis is most common in the head and neck region. Although it is widely spread in nature, clinical cases are rare and observed only in immunocompromised patients and patients with uncontrolled diabetes mellitus. Early symptoms include fever, nasal ulceration or necrosis, periorbital edema or facial swelling, paresthesia and reduced vision. Involvement of cranial nerves although not common, facial nerve palsy is a rare finding. The infection may spread through cribriform plate to the brain resulting in extensive cerebellar infarctions. Timely diagnosis and early recognition of the signs and symptoms, correction of underlying medical disorders, and aggressive medical and surgical intervention are necessary for successful therapeutic outcome.

Shekar, Vandana; Sikander, Jeelani; Rangdhol, Vishwanath; Naidu, Madhulika

2015-01-01

58

Use of steroids for facial nerve paralysis after parotidectomy: A systematic review  

PubMed Central

AIM: To systematically review the literature to assess the efficacy of corticosteroids in treating post-parotidectomy facial nerve palsy (FNP). METHODS: We searched the Cochrane library, EMBASE and MEDLINE (from inception to 2014) for studies assessing the use of corticosteroids in post-parotidectomy FNP. Studies were assessed for inclusion and quality. Data was extracted from included studies. RESULTS: Two randomised controlled trials met the inclusion criteria. One study assessed the use of dexamethasone and the other prednisolone. None of the studies demonstrated a significant difference in the outcome of FNP post-parotidectomy with the use of corticosteroids vs no therapy. The majority of FNP post-parotidectomy is transient. Preoperative factors (size of tumour and malignancy), intraoperative factors (extent of parotidectomy and integrity of facial nerve at the end of the operation) are important in determining prognosis of FNP if it does occur. CONCLUSION: Corticosteroids do not appear to improve FNP prognosis post-parotidectomy. Further studies assessing patients by cohort and with long term follow-up are required to increase scientific evidence. PMID:25685765

Varadharajan, Kiran; Beegun, Issa; Daly, Niall

2015-01-01

59

Vesalius on the anatomy and function of the recurrent laryngeal nerves: medical illustration and reintroduction of a physiological demonstration from Galen.  

PubMed

The purpose of this article is to review the anatomical illustrations and physiological demonstrations of sixteenth-century Flemish-born anatomist and physician Andreas Vesalius concerning the recurrent laryngeal nerves. Although Vesalius was primarily an anatomist, he also used vivisection as a pedagogical device to help his students understand the function of structures within the fabric of the body that they had previously studied in anatomical detail. Vesalius's masterwork, De humani corporis fabrica or simply the Fabrica (1543, 1555), was ostensibly an anatomy text, but Vesalius included textual and figural references to his use of vivisection to explicate the function of specific structures. Even as he began to criticize the errors in Galen's anatomical works, Vesalius nevertheless adopted some of Galen's classic physiological demonstrations, in particular the ligation (and subsequent release) of the recurrent laryngeal nerves of a pig to demonstrate their role in generating the pig's squeal. Vesalius's illustrations concerning the recurrent laryngeal nerve in the Fabrica were of two types: elegant anatomical woodcut plates-unsurpassed for their clarity, accuracy, and detail - and the distinctly inelegant historiated initial Q, depicting a throng of putti busily engaged in vivisecting a pig. Vesalius' anatomical plates were heavily plagiarized while the historiated initials, showing the rough work of an anatomist or surgeon, were largely ignored and remain little recognized today. While Vesalius' anatomical illustrations of the recurrent laryngeal nerves contained some errors, they were a dramatic departure from prior meager efforts at medical illustration and indeed far surpassed all contemporary published illustrations by others. Vesalius was also influential in reviving Galen's approach to vivisection, at least for pedagogical purposes, if not really then yet as a full-fledged investigative technique. PMID:24870272

Lanska, Douglas J

2014-01-01

60

Safety Profile of Bone Marrow Mononuclear Stem Cells in the Rehabilitation of Patients with Posttraumatic Facial Nerve Paralysis—A Novel Modality (Phase One Trial)  

PubMed Central

Objectives?The objectives of this study were to study the safety profile and role of mononuclear stem cells in the rehabilitation of posttraumatic facial nerve paralysis not improving with conventional treatment. Study Design?This is a prospective nonrandomized controlled trial. Study Setting?This study is conducted at Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh between July, 2007 and December, 2008. Patients?We included eight patients of either sex aged between 18 and 60 years of posttraumatic facial nerve paralysis not improving with conventional treatment presented to PGIMER, Chandigarh between July 2007 and December 2008. Methods?All patients underwent preoperative electroneuronography (ENoG), clinical photography, and high-resolution computed tomography (HRCT) temporal bone. All patients then underwent facial nerve decompression and stem cell implantation. Stem cells processing was done in well-equipped bone marrow laboratory. Postoperatively, all patients underwent repeat ENoG and clinical photography at 3 and 6 months to assess for objective and clinical improvement. Clinical improvement was graded according to modified House–Brackmann grading system. Intervention Done?All patients of posttraumatic facial nerve paralysis who were not improving with conventional surgical treatment were subjected to facial nerve decompression and stem cell implantation. Main Outcome Measures?All patients who were subjected to stem cell implantation were followed up for 6 months to assess for any adverse effects of stem cell therapy on human beings; no adverse effects were seen in any of our patients after more than 6 months of follow-up. Results?Majority of the patients were male, with motor vehicle accidents as the most common cause of injury in our series. Majority had longitudinal fractures on HRCT temporal bone. The significant improvement in ENoG amplitude was seen between preoperative and postoperative amplitudes on involved side which was statistically significant (0.041). Clinical improvement seen was statistically significant both for eye closure (p?nerve paralysis not improving with conventional surgical treatment but few more clinical series are required for validation. PMID:23905000

Aggarwal, Sushil Kumar; Gupta, Ashok Kumar; Modi, Manish; Gupta, Rijuneeta; Marwaha, Neelam

2012-01-01

61

Residual Chemoresponsiveness to Acids in the Superior Laryngeal Nerve in “Taste-Blind” (P2X2/P2X3 Double-KO) Mice  

PubMed Central

Mice lacking both the P2X2 and the P2X3 purinergic receptors (P2X-dblKO) exhibit loss of responses to all taste qualities in the taste nerves innervating the tongue. Similarly, these mice exhibit a near total loss of taste-related behaviors in brief access tests except for a near-normal avoidance of acidic stimuli. This persistent avoidance of acids despite the loss of gustatory neural responses to sour was postulated to be due to continued responsiveness of the superior laryngeal (SL) nerve. However, chemoresponses of the larynx are attributable both to taste buds and to free nerve endings. In order to test whether the SL nerve of P2X-dblKO mice remains responsive to acids but not to other tastants, we recorded responses from the SL nerve in wild-type (WT) and P2X-dblKO mice. WT mice showed substantial SL responses to monosodium glutamate, sucrose, urea, and denatonium—all of which were essentially absent in P2X-dblKO animals. In contrast, the SL nerve of P2X-dblKO mice exhibited near-normal responses to citric acid (50 mM) although responsiveness of both the chorda tympani and the glossopharyngeal nerves to this stimulus were absent or greatly reduced. These results are consistent with the hypothesis that the residual avoidance of acidic solutions by P2X-dblKO mice may be attributable to the direct chemosensitivity of nerve fibers innervating the laryngeal epithelium and not to taste. PMID:22362867

Ohkuri, Tadahiro; Horio, Nao; Stratford, Jennifer M.; Finger, Thomas E.; Ninomiya, Yuzo

2012-01-01

62

Generating Sexually Differentiated Vocal Patterns: Laryngeal Nerve and EMG Recordings from Vocalizing Male and Female African  

E-print Network

by asynchronous activity of motoneurons, a pattern shared with vocal production in females. We suggest that these distinct neuronal activity patterns in males may be subserved by two populations of motor units in males in assigning sex-specific acoustic features to brain nuclei or motor nerves has been achieved in songbirds

Kelley, Darcy B.

63

Unilateral Superior Laryngeal Nerve Lesion in an Animal Model of Dysphagia and Its Effect on Sucking and Swallowing  

PubMed Central

We tested two hypotheses relating to the sensory deficit that follows a unilateral superior laryngeal nerve (SLN) lesion in an infant animal model. We hypothesized that it would result in (1) a higher incidence of aspiration and (2) temporal changes in sucking and swallowing. We ligated the right-side SLN in six 2–3-week-old female pigs. Using videofluoroscopy, we recorded swallows in the same pre- and post-lesion infant pigs. We analyzed the incidence of aspiration and the duration and latency of suck and swallow cycles. After unilateral SLN lesioning, the incidence of silent aspiration during swallowing increased from 0.7 to 41.5 %. The durations of the suck containing the swallow, the suck immediately following the swallow, and the swallow itself were significantly longer in the post-lesion swallows, although the suck prior to the swallow was not different. The interval between the start of the suck containing a swallow and the subsequent epiglottal movement was longer in the post-lesion swallows. The number of sucks between swallows was significantly greater in post-lesion swallows compared to pre-lesion swallows. Unilateral SLN lesion increased the incidence of aspiration and changed the temporal relationships between sucking and swallowing. The longer transit time and the temporal coordinative dysfunction between suck and swallow cycles may contribute to aspiration. These results suggest that swallow dysfunction and silent aspiration are common and potentially overlooked sequelae of unilateral SLN injury. This validated animal model of aspiration has the potential for further dysphagia studies. PMID:23417250

Campbell-Malone, Regina; Holman, Shaina D.; Lukasik, Stacey L.; Fukuhara, Takako; Gierbolini-Norat, Estela M.; Thexton, Allan J.; German, Rebecca Z.

2013-01-01

64

Central orexin inhibits reflex swallowing elicited by the superior laryngeal nerve via caudal brainstem in the rat.  

PubMed

We examined the effects of orexins on the reflex swallowing using anesthetized rats. Orexins were administered into the fourth ventricle. Swallowing was induced by repeated electrical stimulation of the central cut end of the superior laryngeal nerve (SLN) and was identified by the electromyogram lead penetrated the mylohyoid muscle through bipolar electrodes. The frequency of swallowing during the electrical stimulation of the SLN decreased after the administration of orexin-A in a dose-dependent manner. The latency of the first swallowing tended to be extended after the administration of orexin-A. The administration of orexin-B did not affect swallowing frequency. Pre-administration of SB334867, an orexin-1 receptor antagonist, attenuated the degree of inhibition of swallowing frequency induced by the administration of orexin-A. To identify the effective site of orexin-A, the effect of a microinjection of orexin-A into the dorsal vagal complex (DVC) was evaluated. Orexin-A was injected into one of the lateral DVC, the intermediate DVC, or the medial DVC. Microinjection of orexin-A into the medial DVC but not the other two sites decreased swallowing frequency. Pre-injection of SB334867 into the medial DVC disrupted the inhibitory response induced by fourth ventricular administration of orexin-A. The electrical lesion of the commissural part of the NTS, but not ablation of the AP, abolished the inhibition of reflex swallowing induced by fourth ventricular administration of orexin-A. These results suggest that orexin-A inhibits reflex swallowing via orexin-1 receptors situated in the commissural part of the NTS and/or its vicinity. PMID:24637063

Kobashi, Motoi; Mizutani, Satoshi; Fujita, Masako; Mitoh, Yoshihiro; Shimatani, Yuichi; Matsuo, Ryuji

2014-05-10

65

Laryngeal Paraganglioma: A Case Report  

PubMed Central

Paragangliomas in the head and neck are found typically in the region of the carotid body, jugular body, and along the 9th and 10th cranial nerves. They can occur in multicenteric forms, but generally, laryngeal paragangliomas are not found in these patients. Only two cases of laryngeal paraganglioma have been reported with a synchronous lesion elsewhere. We report an additional case of a 34-year-old female with multiple paragangliomas beginning with laryngeal involvement.

Sharifkashany, Shervin; Yazdani, Nasrin; Ghazavi, Hossein; Tajdini, Ardavan

2014-01-01

66

Facial paralysis  

MedlinePLUS

Paralysis of the face. ... from the brain to the muscles of the face Damage to the area of the brain that sends signals to the muscles of the face In people who are otherwise healthy, facial paralysis ...

67

Hypokalaemic paralysis  

Microsoft Academic Search

Hypokalaemic paralysis is a relatively uncommon but potentially life-threatening clinical syndrome. If recognised and treated appropriately, patients recover without any clinical sequellae. The syndrome of hypokalaemic paralysis represents a heterogenous group of disorders characterised clinically by hypokalaemia and acute systemic weakness. Most cases are due to familial or primary hypokalaemic periodic paralysis; sporadic cases are associated with numerous other conditions

Sushil K Ahlawat; Anita Sachdev

1999-01-01

68

Laryngeal reinnervation in the horse.  

PubMed

Left laryngeal hemiplegia is a frustrating condition for the equine athlete and equine veterinarian. Treatment for the past 30 years has centered on the prosthetic laryngoplasty ("tie-back") with or without ventriculectomy. Laryngeal reinnervation has been used successfully in people and has been shown experimentally to benefit affected horses. This article reviews equine laryngeal reinnervation using the nerve muscle pedicle graft and describes the surgical technique, its complications, and the follow-up in 146 cases treated over the past 10 years. Also discussed is ongoing research into stimulation studies to improve the success of equine laryngeal reinnervation. PMID:12747668

Fulton, Ian C; Stick, John A; Derksen, Fredrik J

2003-04-01

69

Phonatory Effects of Type I Thyroplasty Implant Shape and Depth of Medialization in Unilateral Vocal Fold Paralysis  

PubMed Central

Objectives/Hypothesis Medialization thyroplasty (MT) is commonly used to treat glottic insufficiency. In this study, we investigated the phonatory effects of MT implant medialization depth and medial surface shape. Methods Recurrent laryngeal nerve (RLN) and vagal paralysis were simulated in an in vivo canine. A type 1 MT was performed using a silicone elastomer implant with variable medialization depths and medial surface shapes: rectangular, V-shaped, divergent, and convergent. The effects on phonation onset flow/pressure relationships and acoustics were measured. Results Increasing depth of medialization led to improvements in fundamental frequency (F0) range and normalization of the slope of pressure/flow relationship toward baseline activation conditions. The effects of implant medial shape also depended on depth of medialization. Outcome measures were similar among the implants at smaller medialization depths. With large medialization depths and vagal paralysis conditions, the divergent implant maintained pressure/flow relationship closer to baseline. The vagal paralysis conditions also demonstrated decreased fundamental frequency range and worse flow/pressure relationship compared to RLN paralysis. Conclusions The depth and medial shape of a medialization laryngoplasty (ML) implant significantly affect both the F0 range and aerodynamic power required for phonation. These effects become more notable with increasing depth of medialization. The study also illustrates that ML is less effective in vagal paralysis compared to RLN paralysis. PMID:25046146

Orestes, Michael I.; Neubauer, Juergen; Sofer, Elazar; Salinas, Jonathon; Chhetri, Dinesh K.

2015-01-01

70

Hypokalaemic paralysis  

PubMed Central

Hypokalaemic paralysis is a relatively uncommon but potentially life-threatening clinical syndrome. If recognised and treated appropriately, patients recover without any clinical sequellae. The syndrome of hypokalaemic paralysis represents a heterogenous group of disorders characterised clinically by hypokalaemia and acute systemic weakness. Most cases are due to familial or primary hypokalaemic periodic paralysis; sporadic cases are associated with numerous other conditions including barium poisoning, hyperthyroidism, renal disorders, certain endocrinopathies and gastrointestinal potassium losses. The age of onset, race, family history, medications, and underlying disease states can help in identifying the cause of hypokalaemic paralysis. Initial therapy of the patient with hypokalaemic paralysis includes potassium replacement and search for underlying aetiology. Further management depends on the aetiology of hypokalaemia, severity of symptoms, and duration of disease. This review presents the differential diagnosis for hypokalaemic paralysis and discusses management of the syndrome.???Keywords: hypokalaemia; periodic paralysis PMID:10715756

Ahlawat, S.; Sachdev, A.

1999-01-01

71

Histoplasmosis laryngeal  

PubMed Central

Laryngeal histoplasmosis is a fungal infection that is frequent in Colombia. Laryngeal histoplasmosis usually occurs in immunocompromised patients through the dissemination of the fungus from the lungs to other organs. Histoplasmosis isolated laryngeal (primary) is rare. If a patient presents with a history of immunosuppression by renal transplant, primary laryngeal histoplasmosis with supraglottic granulomatous inflammation that was treated with amphotericin B and Itraconazole, with complete resolution of laryngeal lesions.

Moriones Robayo, Carlos Alberto

2014-01-01

72

Facilitation at the sexually differentiated laryngeal synapse of Xenopus laevis  

Microsoft Academic Search

Under physiological conditions, the laryngeal synapse of male Xenopus laevis exhibits marked facilitation during repetitive nerve stimulation. The male laryngeal synapse is weak and requires facilitation\\u000a to produce muscle action potentials and ultimately sound. The female laryngeal synapse is strong: muscle contractions are\\u000a produced to single nerve stimuli. We sought to determine if laryngeal synapses of males and females also

T. D. Ruel; D. B. Kelley; M. L. Tobias

1997-01-01

73

Description of Laryngeal Pathologies in Children Evaluated by Otolaryngologists.  

ERIC Educational Resources Information Center

Data were collected on 731 patients (age birth to 18) at a children's hospital otolaryngology clinic. Most frequent laryngeal pathologies were subglottic stenosis, vocal nodules, laryngomalacia, and vocal fold paralysis. Laryngeal pathologies were more common to males than females, were most common in the youngest patients, and were distributed…

Dobres, Rachel; And Others

1990-01-01

74

Tick Paralysis  

MedlinePLUS

... Control How to Remove a Tick Deer Tick Ecology Tick species that cause Tick Paralysis: Deer tick, ... and livestock in the United States as well, human cases are rare and usually occur in children ...

75

Todd's Paralysis  

MedlinePLUS

... don't know what causes Todd's paralysis. Current theories propose biological processes in the brain that involve ... Fax: 301-577-2684 Prepared by: Office of Communications and Public Liaison National Institute of Neurological Disorders ...

76

Reconstructive procedures for impaired upper airway function: laryngeal respiration  

PubMed Central

The larynx is the "bottleneck" of the human airway. For this reason, the effects of stenosing laryngeal pathologies on the vital factor respiratory gas exchange are particularly critical. Internal stabilization is a prerequisite for recovery of the laryngeal respiratory function in severe forms of inspiratory collapse (laryngomalacia). Effective laser surgery techniques have been developed to this end in recent years. Glottis-dilating surgery in cases of bilateral vocal cord motion impairment is now moving in the direction of endoscopic laser cordotomy or cordectomy, whereas arytenoidectomy and open surgical procedures are now used only rarely due to higher secondary morbidity rates. In individual cases, in particular if functional recovery is expected, temporary laterofixation of a vocal cord using an endoscopic suturing technique can be a helpful approach. Extensive laryngeal defects can be covered by means of composite grafts with mucosal lining, a supporting skeleton and their own vascularization. Autologous transplantation of the larynx, with its complex surgical and immunological problems, has become a manageable procedure. The problems of post-transplantation reinnervation and risk assessment of immunosuppression-induced recurrence of the tumor are still under consideration. Reanimation of the bilaterally paralyzed larynx by means of neurorrhaphy (neurosuture), neural grafting and, more recently, functional electrostimulation (pacemaker) represents a challenge for the coming years. In most cases of paralysis of the recurrent laryngeal nerve, a part of the muscles is maintained by synkinetic reinnervation when therapy is carried out, which however also prevents effective vocal cord movement due to simultaneous activity of agonists and antagonists. Modulation of reinnervation by means of electrostimulation and modern genetic therapy approaches justify hopes of better outcomes in the future. PMID:22073057

Müller, Andreas

2005-01-01

77

Delayed onset neuropathy along with recurrent laryngeal nerve palsy due to organophosphate poisoning and the role of physiotherapy rehabilitation  

PubMed Central

Organophosphorus poisoning is a major global cause of health problems and the leading cause of mortality and morbidity in the developing countries. In this, the inhibition of acetyl-choline esterase and neurotoxic esterase along with nicotinic receptor involvement produces three well-identified and documented clinical phases: The initial cholinergic phase, which is a medical emergency often requiring management in an intensive care unit; the intermediate syndrome, during which prolonged ventilator care is necessary; and finally delayed neurotoxicity. Vocal cord paralysis is rare and leads to aphonia. Role of physiotherapy rehabilitation is substantial in all three stages and aims at early weaning off from mechanical ventilator until the functional independence and community integration of the patient. PMID:24678153

Shetye, Jaimala Vijay; Surkar, Swati M.; Karnik, Niteen D.; Mehta, Amita A.

2014-01-01

78

Does recurrent laryngeal nerve lymph node metastasis really affect the prognosis in node-positive patients with squamous cell carcinoma of the middle thoracic esophagus?  

PubMed Central

Background Recurrent laryngeal nerve (RLN) lymph node metastasis used to be shown a predictor for poor prognosis in esophageal squamous cell carcinoma. The purpose of this study was to evaluate the prognostic impact of RLN node metastasis and the number of metastatic lymph nodes in node-positive patients with squamous cell carcinoma of middle thoracic esophagus. Methods A cohort of 235 patients who underwent curative surgery for squamous cell carcinoma of middle thoracic esophagus was investigated. The prognostic impact was evaluated by univariate and multivariate analyses. Results Lymph node metastasis was found in 133 patients. Among them, 81 had metastatic RLN nodes, and 52 had at least one positive node but no RLN nodal involvement. The most significant difference in survival was detected between patients with metastatic lymph nodes below and above a cutoff value of six (P?

2014-01-01

79

The Effect of Bilateral Superior Laryngeal Nerve Lesion on Swallowing – A Novel Method to Quantitate Aspirated Volume and Pharyngeal Threshold in Videofluoroscopy  

PubMed Central

Purpose To determine the effect of bilateral superior laryngeal nerve (SLN) lesion on swallowing threshold volume and the occurrence of aspiration, using a novel measurement technique for videofluorscopic swallowing studies (VFSS). Methods and Materials We used a novel radiographic phantom to assess volume of the milk containing barium from fluoroscopy. The custom made phantom was firstly calibrated by comparing image intensity of the phantom with known cylinder depths. Secondly, known volume pouches of milk in a pig cadaver were compared to volumes calculated with the phantom. Using these standards, we calculated the volume of milk in the valleculae, esophagus and larynx, for 205 feeding sequences from four infant pigs feeding before and after had bilateral SLN lesions. Swallow safety was assessed using the IMPAS scale. Results The log-linear correlation between image intensity values from the phantom filled with barium milk and the known phantom cylinder depths was strong (R2>0.95), as was the calculated volumes of the barium milk pouches. The threshold volume of bolus in the valleculae during feeding was significantly larger after bilateral SLN lesion than in control swallows (p<0.001). The IMPAS score increased in the lesioned swallows relative to the controls (p<0.001). Conclusion Bilateral SLN lesion dramatically increased the aspiration incidence and the threshold volume of bolus in valleculae. The use of this phantom permits quantification of the aspirated volume of fluid. The custom made phantom and calibration allow for more accurate 3D volume estimation from 2D x-ray in VFSS. PMID:25270532

DING, Peng; FUNG, George Shiu-Kai; LIN, Ming De; HOLMAN, Shaina D.; GERMAN, Rebecca Z.

2015-01-01

80

Prototype Nerve-Specific Near-Infrared Fluorophores  

PubMed Central

Nerve preservation is an important issue during most surgery because accidental transection or injury results in significant morbidity, including numbness, pain, weakness, or paralysis. Currently, nerves are still identified only by gross appearance and anatomical location during surgery, without intraoperative image guidance. Near-infrared (NIR) fluorescent light, in the wavelength range of 650-900 nm, has the potential to provide high-resolution, high-sensitivity, and real-time avoidance of nerve damage, but only if nerve-specific NIR fluorophores can be developed. In this study, we evaluated a series of Oxazine derivatives to highlight various peripheral nerve structures in small and large animals. Among the targeted fluorophores, Oxazine 4 has peak emission near into the NIR, which provided nerve-targeted signal in the brachial plexus and sciatic nerve for up to 12 h after a single intravenous injection. In addition, recurrent laryngeal nerves were successfully identified and highlighted in real time in swine, which could be preserved during the course of thyroid resection. Although optical properties of these agents are not yet optimal, chemical structure analysis provides a basis for improving these prototype nerve-specific NIR fluorophores even further. PMID:24955143

Park, Min Ho; Hyun, Hoon; Ashitate, Yoshitomo; Wada, Hideyuki; Park, GwangLi; Lee, Jeong Heon; Njiojob, Costyl; Henary, Maged; Frangioni, John V.; Choi, Hak Soo

2014-01-01

81

Laryngeal (Voice Box) Cancer  

MedlinePLUS

... laryngeal cancer can be severe with respect to voice, breathing, or swallowing. It is fundamentally a preventable disease though, since the primary risk factors for laryngeal cancer are associated with modifiable behaviors. Risk Factors Associated With Laryngeal Cancer Development of ...

82

Using Laryngeal Electromyography to Differentiate Presbylarynges from Paresis  

ERIC Educational Resources Information Center

Purpose: Differential diagnosis of patients over 64 years of age reporting hoarseness is challenging. Laryngeal electromyography (LEMG) was used to determine the status of the recurrent and superior laryngeal nerves. The authors hypothesized that individuals with hoarseness but normal LEMG would have measures similar to those of patients from…

Stager, Sheila V.; Bielamowicz, Steven A.

2010-01-01

83

Modified thyroplasty for unilateral vocal fold paralysis using an adjustable titanium implant.  

PubMed

This study aimed to describe a new titanium thyroplasty implant that can be adjusted with a screw. Six Beagle dogs were randomly divided into experimental and control groups (n = 3). The titanium screw was implanted in the experimental group after the left recurrent laryngeal nerve was cut off under general anaesthesia. This procedure caused arytenoid cartilage internal shift, allowing the vocal cord to locate at the median and the glottis to close during phonation. No other operation was conducted in the control group. Each group, respectively, underwent video laryngoscopy, CT scan and histopathology before and after operation. After 4 months of follow-up, the video laryngoscopy results showed that the left arytenoid cartilage in the experimental group underwent internal adduct and shift, whereas the left vocal cords in the control group located at the paramedian position and exhibited fissure during phonation. CT scan results showed that the adjustable titanium screw was in proper position. Postoperative pathological examination showed that, in addition to early local inflammation, the laryngeal muscle may atrophy. The adjustable titanium screw requires a simple operation and can be significantly adjusted. The effect of the operation can be immediately observed without rejection. Therefore, this method is an efficient treatment for unilateral vocal cord paralysis. PMID:24728279

Wen, Wu; Sun, Guangbin; Sun, Bifeng; Liu, Chang; Zhang, Mingxing

2015-03-01

84

Neurophysiology and Clinical Implications of the Laryngeal Adductor Reflex  

PubMed Central

The laryngeal adductor reflex (LAR) is an involuntary protective response to stimuli in the larynx. The superior laryngeal nerve (SLN) acts as the afferent limb and the recurrent laryngeal nerve (RLN) as the efferent limb of this reflex, which is modulated by the central nervous system. Perhaps the most clinically significant application of the LAR is its use in laryngopharyngeal (LP) sensory discrimination testing. Importantly, aberrations in the LAR may predict dysphagia or portend clinical phenotypes of chronic cough, vocal cord dysfunction or pediatric apneas. LP sensation is a potential target for interventions addressing the aforementioned conditions though currently remains an area of active investigation. PMID:25254155

Domer, Amanda S.; Kuhn, Maggie A.

2014-01-01

85

Reversible electrophysiological abnormalities in hypokalemic paralysis: Case report of two cases.  

PubMed

Compound muscle action potential (CMAP) amplitude declines during a paralytic attack in patients with hypokalemic periodic paralysis (HPP). However, serial motor nerve conduction studies in hypokalemic paralysis have not been commonly reported. We report two cases with hypokalemic paralysis, who had severely reduced CMAPs in all motor nerves at presentation during the episode of quadriparesis. However, the amplitude of CMAPs increased and reached normal levels, as the serum potassium concentration and motor power returned to normal state. PMID:24753672

Sharma, C M; Nath, Kunal; Parekh, Jigar

2014-01-01

86

Paralysis Episodes in Carbonic Anhydrase II Deficiency.  

PubMed

Carbonic anhydrase II (CAII) deficiency is an autosomal recessive disorder manifest by osteopetrosis, renal tubular acidosis, and cerebral calcification. Other features include growth failure and mental retardation. Complications of the osteopetrosis include frequent bone fractures, cranial nerve compression, and dental mal-occlusion. A hyper-chloremic metabolic acidosis, sometimes with hypokalemia, occurs due to renal tubular acidosis that may be proximal, distal, or more commonly, the combined type. Such patients may present with global hypotonia, muscle weakness or paralysis. We report a case of CA II deficiency with recurrent attacks of acute paralysis which was misdiagnosed initially as Guillian-Barre syndrome. PMID:17657093

Al-Ibrahim, Alia; Al-Harbi, Mosa; Al-Musallam, Sulaiman

2003-01-01

87

Palsies of Cranial Nerves That Control Eye Movement  

MedlinePLUS

... Disorders 4 Palsies of Cranial Nerves That Control Eye Movement These disorders involve paralysis of one of the cranial nerves that control eye movement (the 3rd, 4th, or 6th nerve), impairing the ...

88

Isolated sleep paralysis  

PubMed Central

Sleep paralysis (SP) is a cardinal symptom of narcolepsy. However, little is available in the literature about isolated sleep paralysis. This report discusses the case of a patient with isolated sleep paralysis who progressed from mild to severe SP over 8 years. He also restarted drinking alcohol to be able to fall asleep and allay his anxiety symptoms. The patient was taught relaxation techniques and he showed complete remission of the symptoms of SP on follow up after 8 months. PMID:20711316

Sawant, Neena S.; Parkar, Shubhangi R.; Tambe, Ravindra

2005-01-01

89

Current therapeutic prospectives in the functional rehabilitation of vocal fold paralysis after thyroidectomy: CO2 laser aritenoidectomy.  

PubMed

A frequent complication of thyroid surgery is laryngeal nerve palsy with transitory or permanent deficiency of cordal motility. Peripheral mono-or bilateral palsy in these cases may either occur, in adduction or abduction, and be complete or not complete. Bilateral vocal cords paralysis cause a persistent dyspnoic symptomatology with worsening during physical exercise or flogistic episodes of the upper airway: true vocal cords adduction, in median or paramedian position reduce the glottic space and increases respiratory resistances. Several surgical procedures have been proposed for the treatment of respiratory distress secondary to bilateral cord palsy. The aim of this study is to value the role of CO2 laser aritenoidectomy in 93 patients affected by bilateral paralysis in adduction of true vocal cords. Pre and postoperative evaluations included clinical results, spirometry, aerodynamics studies and evaluation of foniatric performance (MPT, H/N Ratio, Jitter and Shimmer) with a mean follow-up of 12 years. CO2 laser aritenoidectomy induces a complete resolution of respiratory failure, maintaining a good vocal quality, minimum surgical stress with low percentage of complications and a short hospitalization. PMID:24909138

Testa, Domenico; Guerra, Germano; Landolfo, Pasquale Gianluca; Nunziata, Michele; Conzo, Giovanni; Mesolella, Massimo; Motta, Gaetano

2014-01-01

90

Sleep paralysis: Psychodynamics  

Microsoft Academic Search

Summary A patient with sleep paralysis is discussed in view of the paucity of such reports in current American literature. It is believed, however, that this disability is more common than realized and reported heretofore. This case is of additional interest in view of the still less frequent presentation of patients with sleep paralysis in the absence of narcolepsy or

Jerome M. Schneck

1948-01-01

91

Idiopathic Diaphragmatic Paralysis: Bell’s Palsy of the Diaphragm?  

Microsoft Academic Search

Study Objectives Idiopathic diaphragm paralysis is probably more common and responsible for more morbidity than generally appreciated. Bell’s\\u000a palsy, or idiopathic paralysis of the seventh cranial nerve, may be seen as an analogous condition. The roles of zoster sine\\u000a herpete and herpes simplex have increasingly been recognized in Bell’s palsy, and there are some data to suggest that antiviral\\u000a therapy

Robert S. Crausman; Eleanor M. Summerhill; F. Dennis McCool

2009-01-01

92

Diaphragmatic weakness and paralysis  

Microsoft Academic Search

Diaphragmatic weakness implies a decrease in the strength of the diaphragm. Diaphragmatic paralysis is an extreme form of\\u000a diaphragmatic weakness. Diaphragmatic paralysis is an uncommon clinical problem while diaphragmatic weakness, although uncommon,\\u000a is probably frequently unrecognized because appropriate tests to detect its presence are not performed. Weakness of the diaphragm\\u000a can result from abnormalities at any site along its neuromuscular

Pearce G. Wilcox; Richard L. Pardy

1989-01-01

93

[Vocal cord paralysis - analysis of a cohort of 400 patients].  

PubMed

Vocal cord paralysis has diverse etiologies. In the present study, vocal chord paralysis caused by surgery/trauma was present in more than two thirds of the cases, followed by primary malignancy-associated paralysis. Thyroidectomy was the most common cause in bilateral paresis, especially if performed in recurrent or malignant disease. Voice therapy was promising in pa-tients with unilateral paresis and hoarseness as main symptom. Persistent dysphonia due to insufficiency of the glottic closure led to an operative glottis restricting procedure in only 6% of cases. In almost half the patients with dyspnea as the main symp-tom of bilateral vocal cord paresis, temporary tracheotomy or surgical glottis widening procedures had to be performed. The group of idiopathic and traumatic paresis patients showed the best spontaneous recovery within the first 12 months in comparison to primary malignancy-associated paralysis, which showed no recovery of the recurrens nerve. PMID:24676872

Reiter, R; Pickhard, A; Smith, E; Hansch, K; Weber, T; Hoffmann, T K; Brosch, S

2015-02-01

94

Treating sleep paralysis with hypnosis  

Microsoft Academic Search

The use of hypnosis in the management of sleep paralysis is described and discussed. 2 cases are presented in which autohypnosis was used to desensitize the patients to the anxiety that accompanied their sleep paralysis. The autohypnosis also provided a means of terminating the attacks. Follow-up data suggests that this approach may serve to decrease the frequency of sleep paralysis

Thomas J. Nardi

1981-01-01

95

Sleep Paralysis Among Medical Students  

Microsoft Academic Search

Sleep paralysis is a sensation of an inability to speak or move other muscles when falling asleep or awakening. Sleep paralysis by itself has been reported as occurring infrequently and many clinicians are uncertain of its significance. In contrast, sleep paralysis in conjunction with sleep attacks has been reported as a concomitant of narcolepsy. To further examine the incidence of

Nolan E. Penn; Daniel F. Kripke; Janice Scharff

1981-01-01

96

Chronic cough as a sign of laryngeal sensory neuropathy: diagnosis and treatment.  

PubMed

Chronic cough is often attributed to reflux, postnasal drip, or asthma. We present 28 patients who had chronic cough or throat-clearing as a manifestation of sensory neuropathy involving the superior or recurrent laryngeal nerve. They had been identified as having sudden-onset cough, laryngospasm, or throat-clearing after viral illness, surgery, or an unknown trigger. Cough and laryngospasm were the most common complaints. Seventy-one percent of the patients had concomitant superior laryngeal nerve or recurrent laryngeal nerve motor neuropathy documented by laryngeal electromyography or videostroboscopy. After a negative workup for reflux, asthma, or postnasal drip, these patients were treated with gabapentin at 100 to 900 mg/d. Symptomatic relief was achieved in 68% of the patients. Sensory neuropathy of the recurrent laryngeal nerve or superior laryngeal nerve should be considered in the workup for chronic cough or larynx irritability. Symptomatic management of patients with cough and laryngospasm due to a suspected sensory neuropathy may include the use of antiseizure medications such as gabapentin. PMID:15895778

Lee, Bryant; Woo, Peak

2005-04-01

97

Imaging of laryngeal trauma.  

PubMed

External laryngeal trauma is a rare but potentially life-threatening situation in the acutely injured patient. Trauma mechanism and magnitude, maximum focus of the applied force, and patient related factors, such as age and ossification of the laryngeal cartilages influence the spectrum of observed injuries. Their correct diagnosis and prompt management are paramount in order to avoid patient death or long-term impairment of breathing, swallowing and speaking. The current review provides a comprehensive approach to the radiologic interpretation of imaging studies performed in patients with suspected laryngeal injury. It describes the key anatomic structures that are relevant in laryngeal trauma and discusses the clinical role of multidetector computed tomography (MDCT) and magnetic resonance imaging (MRI) in the acute emergency situation. The added value of two-dimensional multiplanar reconstructions (2D MPR), three-dimensional volume rendering (3D VR) and virtual endoscopy (VE) for the non-invasive evaluation of laryngeal injuries and for treatment planning is discussed. The clinical presentation, biomechanics of injury, diagnostic pitfalls and pearls, common and uncommon findings are reviewed with emphasis of fracture patterns, involvement of laryngeal joints, intra- and extralaryngeal soft tissue injuries, and complications seen in the acute emergency situation. The radiologic appearance of common and less common long-term sequelae, as well as treatment options are equally addressed. PMID:24238937

Becker, Minerva; Leuchter, Igor; Platon, Alexandra; Becker, Christoph D; Dulguerov, Pavel; Varoquaux, Arthur

2014-01-01

98

Ascending paralysis associated with HIV infection  

PubMed Central

We present two patients with a high viral load of HIV-1 who developed symptoms of ascending paralysis leading to respiratory failure and autonomic instability. One patient had symptom improvement with highly active antiretroviral therapy (HAART) and a subsequent decrease in viral load. The other patient improved with intravenous immunoglobulin therapy and did not show much improvement on HAART alone. There are several proposed mechanisms for peripheral neuropathies seen in HIV-infected patients, including a direct action of HIV on the nerve by neurotropic strains or formation of autoantibodies against nerve elements. The comparison of the response to different therapies in these two cases highlights the importance of understanding different pathophysiologies, as the treatment modality may differ. PMID:25552790

Afzal, Aasim; Benjamin, Mina; Gummelt, Kyle L.; Afzal, Sadaf; Tribble, Marc

2015-01-01

99

[Familial hypokalemic periodic paralysis].  

PubMed

Recent genetic studies have identified mutations in the genes causative for familial hypokalemic periodic paralysis (F-HypoPP) . The major locus for F-HypoPP is the skeletal muscle calcium channel alpha(1S) subunit (CACNA1S), and two predominant missense mutations were found in the same gene. A small part of other F-HypoPP families has been identified to result from the missense mutations found in the skeletal muscle sodium channel alpha subunit (SCN4A) gene. We analyzed Japanese hypokalemic periodic paralysis patients (familial, sporadic and thyrotoxic), and detected the Arg 528His mutation in two F-HypoPP families. Thus F-HypoPP is related to the functional deficiency of the skeletal muscle ion-channels. PMID:15775665

Ikeda, Y; Okamoto, K

2001-11-01

100

Effects of unilateral vocal cord paralysis on objective voice measures obtained by Praat  

Microsoft Academic Search

Unilateral vocal cord paralysis (VCP) affects the objective properties of voice by diminished neurologic control and degenerative\\u000a changes in laryngeal tissue. The goal of this study was to compare the acoustic parameters of VCP patients with control volunteers\\u000a using the software Praat. Acoustic analysis results of 18 unilateral VCP patients were compared with age and sex matched 72\\u000a normal adult

Haldun Oguz; Munir Demirci; Mustafa A. Safak; Necmi Arslan; Ahmet Islam; Selda Kargin

2007-01-01

101

Visual Experiences during Paralysis  

PubMed Central

Rationale: Paralyzed human volunteers (n?=?6) participated in several studies the primary one of which required full neuromuscular paralysis while awake. After the primary experiment, while still paralyzed and awake, subjects undertook studies of humor and of attempted eye-movement. The attempted eye-movements tested a central, intentional component to one’s internal visual model and are the subject of this report. Methods: Subjects reclined in a supportive chair and were ventilated after paralysis (cisatracurium, 20?mg intravenously). In illumination, subjects were requested to focus alternately on the faces of investigators standing on the left and the right within peripheral vision. In darkness, subjects were instructed to look away from a point source of light. Subjects were to report their experiences after reversal of paralysis. Results: During attempted eye-movement in illumination, one subject had an illusion of environmental movement but four subjects perceived faces as clearly as if they were in central vision. In darkness, four subjects reported movement of the target light in the direction of attempted eye-movements and three could control the movement of the light at will. Conclusion: The hypothesis that internal visual models receive intended ocular-movement-information directly from oculomotor centers is strengthened by this evidence. PMID:22162967

Whitham, Emma M.; Fitzgibbon, Sean P.; Lewis, Trent W.; Pope, Kenneth J.; DeLosAngeles, Dylan; Clark, C. Richard; Lillie, Peter; Hardy, Andrew; Gandevia, Simon C.; Willoughby, John O.

2011-01-01

102

Hypnagogic Hallucinations and Sleep Paralysis  

Microsoft Academic Search

\\u000a Hypnagogic hallucinations and sleep paralysis are two associated features of narcolepsy that can also be found as isolated\\u000a phenomena or within the context of other clinical conditions. Hypnagogic hallucinations are abnormal sensory perceptions experienced\\u000a in the transition between wakefulness and sleep, whereas analogous hallucinations that occur upon awakening are called hypnopompic.\\u000a Sleep paralysis is a transient paralysis of skeletal muscles

Armando D’Agostino; Ivan Limosani

103

Genetics Home Reference: Hypokalemic periodic paralysis  

MedlinePLUS

... Recent literature OMIM Genetic disorder catalog Conditions > Hypokalemic periodic paralysis On this page: Description Genetic changes Inheritance ... Glossary definitions Reviewed April 2007 What is hypokalemic periodic paralysis? Hypokalemic periodic paralysis is a condition that ...

104

A case of hypokalemic paralysis in a patient with neurogenic diabetes insipidus.  

PubMed

Acute hypokalemic paralysis is characterized by muscle weakness or paralysis secondary to low serum potassium levels. Neurogenic diabetes insipidus (DI) is a condition where the patient excretes large volume of dilute urine due to low levels of antidiuretic hormone. Here, we describe a patient with neurogenic DI who developed hypokalemic paralysis without a prior history of periodic paralysis. A 30-year-old right-handed Hispanic male was admitted for refractory seizures and acute DI after developing a dental abscess. He had a history of pituitary adenoma resection at the age of 13 with subsequent pan-hypopituitarism and was noncompliant with hormonal supplementation. On hospital day 3, he developed sudden onset of quadriplegia with motor strength of 0 of 5 in the upper extremities bilaterally and 1 of 5 in both lower extremities with absent deep tendon reflexes. His routine laboratory studies revealed severe hypokalemia of 1.6 mEq/dL. Nerve Conduction Study (NCS) revealed absent compound motor action potentials (CMAPs) with normal sensory potentials. Electromyography (EMG) did not reveal any abnormal insertional or spontaneous activity. He regained full strength within 36 hours following aggressive correction of the hypokalemia. Repeat NCS showed return of CMAPs in all nerves tested and EMG revealed normal motor units and normal recruitment without myotonic discharges. In patients with central DI with polyuria, hypokalemia can result in sudden paralysis. Hypokalemic paralysis remains an important differential in an acute case of paralysis and early recognition and appropriate management is key. PMID:24707338

Nguyen, Frederic N; Kar, Jitesh K; Verduzco-Gutierrez, Monica; Zakaria, Asma

2014-04-01

105

A Case of Hypokalemic Paralysis in a Patient With Neurogenic Diabetes Insipidus  

PubMed Central

Acute hypokalemic paralysis is characterized by muscle weakness or paralysis secondary to low serum potassium levels. Neurogenic diabetes insipidus (DI) is a condition where the patient excretes large volume of dilute urine due to low levels of antidiuretic hormone. Here, we describe a patient with neurogenic DI who developed hypokalemic paralysis without a prior history of periodic paralysis. A 30-year-old right-handed Hispanic male was admitted for refractory seizures and acute DI after developing a dental abscess. He had a history of pituitary adenoma resection at the age of 13 with subsequent pan-hypopituitarism and was noncompliant with hormonal supplementation. On hospital day 3, he developed sudden onset of quadriplegia with motor strength of 0 of 5 in the upper extremities bilaterally and 1 of 5 in both lower extremities with absent deep tendon reflexes. His routine laboratory studies revealed severe hypokalemia of 1.6 mEq/dL. Nerve Conduction Study (NCS) revealed absent compound motor action potentials (CMAPs) with normal sensory potentials. Electromyography (EMG) did not reveal any abnormal insertional or spontaneous activity. He regained full strength within 36 hours following aggressive correction of the hypokalemia. Repeat NCS showed return of CMAPs in all nerves tested and EMG revealed normal motor units and normal recruitment without myotonic discharges. In patients with central DI with polyuria, hypokalemia can result in sudden paralysis. Hypokalemic paralysis remains an important differential in an acute case of paralysis and early recognition and appropriate management is key. PMID:24707338

Nguyen, Frederic N.; Kar, Jitesh K.; Verduzco-Gutierrez, Monica; Zakaria, Asma

2014-01-01

106

A computational study of the role of the aortic arch in idiopathic unilateral vocal-fold paralysis.  

PubMed

Unilateral vocal-fold paralysis (UVP) occurs when one of the vocal folds becomes paralyzed due to damage to the recurrent laryngeal nerve (RLN). Individuals with UVP experience problems with speaking, swallowing, and breathing. Nearly two-thirds of all cases of UVP is associated with impaired function of the left RLN, which branches from the vagus nerve within the thoracic cavity and loops around the aorta before ascending to the larynx within the neck. We hypothesize that this path predisposes the left RLN to a supraphysiological, biomechanical environment, contributing to onset of UVP. Specifically, this research focuses on the identification of the contribution of the aorta to onset of left-sided UVP. Important to this goal is determining the relative influence of the material properties of the RLN and the aorta in controlling the biomechanical environment of the RLN. Finite element analysis was used to estimate the stress and strain imposed on the left RLN as a function of the material properties and loading conditions. The peak stress and strain in the RLN were quantified as a function of RLN and aortic material properties and aortic blood pressure using Spearman rank correlation coefficients. The material properties of the aortic arch showed the strongest correlation with peak stress [? = -0.63, 95% confidence interval (CI), -1.00 to -0.25] and strain (? = -0.62, 95% CI, -0.99 to -0.24) in the RLN. Our results suggest an important role for the aorta in controlling the biomechanical environment of the RLN and potentially in the onset of left-sided UVP that is idiopathic. PMID:25477351

Williams, Megan J; Ayylasomayajula, Avinash; Behkam, Reza; Bierhals, Andrew J; Jacobs, M Eileen; Edgar, Julia D; Paniello, Randal C; Barkmeier-Kraemer, Julie M; Vande Geest, Jonathan P

2015-02-15

107

Observations on laryngeal disease, laryngeal behavior and voice.  

PubMed

This discussion accepted the hypothesis that every laryngeal sound is produced by its unique type of vocal cord vibration. The production of vocal sound is not capricious, it follows certain laws many of which are not known. Research into the behavior of the larynx has produced some interesting and perhaps, useful findings. It was the intention of this paper to describe some of the features of laryngeal behavior as they relate to both phonation and laryngeal disorders in the belief that such knowledge lends itself to the more efficient management of certain vocal and laryngeal problems. The central theme has been that it is laryngeal behavior and not laryngeal disease itself that determines vocal deviation. PMID:791049

Moore, G P

1976-01-01

108

Retrospective study of the functional recovery of men compared with that of women with long-term facial paralysis.  

PubMed

Sex is likely to play an important part in reanimation of the face after paralysis, with women being superior in terms of resistance to neural injury and regeneration. Our aim was to evaluate the influence of the sex of the patient on the recovery of facial paralysis after surgical reanimation by comparing the degree of restored movement between men and women with long-standing paralysis that was reanimated by transfer of the hypoglossal nerve or cross-face nerve grafting. Between 1999 and 2010 we operated on 174 patients with facial paralysis. Of these we studied 26 cases (19 women and 7 men) with complete long-standing paralysis reanimated with either cross-face nerve grafting (n=14) or transfer of the hemihypoglossal nerve (n=12). The degree of movement restored was recorded in each case. Statistical analysis showed that in cases with long-standing paralysis women had significantly more movement restored than men for both cross-face nerve grafting (p=0.02) and hypoglossal transposition (p=0.04). We conclude that, after a neural injury, women tend to maintain the viability of the facial musculature longer than men, which suggests that they are more resistant to both denervation and the development of muscular atrophy. Whether this phenomenon can be explained by neural or muscular processes, or both, warrants further studies. PMID:23684625

Hontanilla, Bernardo; Marre, Diego

2013-12-01

109

Speech rehabilitation in total paralysis of the tongue.  

PubMed

A 31-year-old woman attempted suicide by cutting her throat. In doing so, she severed the hypoglossal nerves bilaterally. The patient received full speech rehabilitation following nerve suture and logopedic training. The surgeon who is faced with deep wounds of the anterior part of the neck, especially cut wounds (due to accident, suicide, or murder), should be aware of the possibility of a severance of the hypoglossal nerve, and perform surgical exploration of the tongue later when a paralysis of the tongue has been diagnosed with the aim of doing a nerve suture. With modern technique, interfascicular suture under the microscope, not only tonus of the tongue is likely to be recovered, but also some degree of more differentiated motility that would shorten the period of convalescence and reduce the need for logopedic training. PMID:7150074

Siemssen, S J

1982-12-01

110

Artifacts produced during electrical stimulation of the vestibular nerve in cats. [autonomic nervous system components of motion sickness  

NASA Technical Reports Server (NTRS)

Evidence is presented to indicate that evoked potentials in the recurrent laryngeal, the cervical sympathetic, and the phrenic nerve, commonly reported as being elicited by vestibular nerve stimulation, may be due to stimulation of structures other than the vestibular nerve. Experiments carried out in decerebrated cats indicated that stimulation of the petrous bone and not that of the vestibular nerve is responsible for the genesis of evoked potentials in the recurrent laryngeal and the cervical sympathetic nerves. The phrenic response to electrical stimulation applied through bipolar straight electrodes appears to be the result of stimulation of the facial nerve in the facial canal by current spread along the petrous bone, since stimulation of the suspended facial nerve evoked potentials only in the phrenic nerve and not in the recurrent laryngeal nerve. These findings indicate that autonomic components of motion sickness represent the secondary reactions and not the primary responses to vestibular stimulation.

Tang, P. C.

1973-01-01

111

Egg binding and hind limb paralysis in an African Penguin – a case report  

Microsoft Academic Search

This case report assesses the role acupuncture played in the rehabilitation therapy of an African penguin with bilateral hind limb paresis and paralysis following egg binding and a caesarean section. Egg binding is the failure of the oviduct to pass the egg down into the cloaca. In avian species the sciatic nerve runs through the middle of the kidney. Swelling

Monique Anamarie Crouch

2009-01-01

112

Hyperkalemic paralysis in primary adrenal insufficiency  

PubMed Central

Hyperkalemic paralysis due to Addison's disease is rare, and potentially life-threatening entity presenting with flaccid motor weakness. This case under discussion highlights Hyperkalemic paralysis as initial symptomatic manifestation of primary adrenal insufficiency. PMID:25136192

Mishra, Ajay; Pandya, Himanshu V.; Dave, Nikhil; Sapre, Chinmaye M.; Chaudhary, Sneha

2014-01-01

113

Hyperkalemic paralysis in primary adrenal insufficiency.  

PubMed

Hyperkalemic paralysis due to Addison's disease is rare, and potentially life-threatening entity presenting with flaccid motor weakness. This case under discussion highlights Hyperkalemic paralysis as initial symptomatic manifestation of primary adrenal insufficiency. PMID:25136192

Mishra, Ajay; Pandya, Himanshu V; Dave, Nikhil; Sapre, Chinmaye M; Chaudhary, Sneha

2014-08-01

114

Transient paralysis after robotic prostatectomy.  

PubMed

Laparoscopic radical prostatectomy (LARP) has been accepted as first line therapy for clinically localized prostate cancer. Complications have been low and outcomes are comparable to that of open surgery with potential benefits including shorter hospital stay, less pain and quicker return to normal activity. Unexplained paralysis following LARP is a rare entity with no reported cases in the current literature. We report a case of complete motor paralysis following LARP. An extensive multidisciplinary evaluation did not definitively establish a diagnosis. Aggressive multimodality treatment led to a complete recovery. Our understanding of this phenomena with the possible etiology and treatment is discussed. PMID:25484986

Deem, Samuel; Davis, Cordell R; Tierney, James P

2008-01-01

115

Resection of an oculomotor nerve cavernous angioma  

PubMed Central

Background: Cavernous angiomas (CAs) of cranial nerves are rare, and their occurrence on the third cranial nerve is particularly rare. Surgical management of such CAs involving the third nerve is controversial. We describe a case of a symptomatic CA of the oculomotor nerve and review the literature in order to ascertain the relevance of surgical intervention. Case Description: A 71-year-old male patient presented with a 2-month history of progressive oculomotor nerve paralysis. CA of the oculomotor nerve was suspected on magnetic resonance imaging (MRI). The patient underwent complete resection of the CA through a subtemporal approach, preserving the integrity of the nerve. Histopathological analysis confirmed the diagnosis of CA. Despite optimal resection, the patient did not improve postoperatively. Conclusion: CAs of cranial nerves can cause rapid or progressive neurological deterioration. Whereas delayed treatment often leads to irreversible deficits, early nerve-sparing surgical excision of the CAs may potentially restore function. PMID:25184101

Obaid, Sami; Li, Shu; Denis, Daniel; Weil, Alexander G.; Bojanowski, Michel W.

2014-01-01

116

[Hypokalemic periodic paralysis. A case report].  

PubMed

Periodic paralysis is a rare disorder that causes episodes of severe muscle weakness that can be confused with other diseases, including epilepsy or myasthenia gravis. Hyperkalemic and hypokalemic paralysis are included within these diseases, the latter being divided into periodic paralysis (familial, thyrotoxic or sporadic) and non-periodic paralysis. In this regard, we present a case of familial hypokalemic periodic paralysis in an eighteen year-old female who was diagnosed with epilepsy in childhood, as well as a subclinical hypothyroidism (for which she received replacement therapy) months ago. The diagnosis was made by the anamnesis and the confirmation of hypokalemia. PMID:24360869

Areta-Higuera, J D; Algaba-Montes, M; Oviedo-García, A Á

2014-01-01

117

UNILATERAL PARALYSIS OF EYE MUSCLES ASSOCIATED WITH INTRACRANIAL SACCULAR ANEURYSMS  

PubMed Central

Unexplained unilateral paralysis of eye muscles with or without evidence of altered function of other cranial nerves, or of the presence of intracranial bruit, is strong positive diagnostic evidence of saccular aneurysm of the intracranial internal carotid or of the circle of Willis. If pulsating exophthalmos is present the lesion probably is an arteriovenous fistula. The presence of such clinical signs strongly indicates the desirability of cerebral angiography. Once demonstrated, the lesion can usually be treated successfully by ligation of the contributing vascular connections. PMID:18123524

Boldrey, Edwin; Miller, Earl R.

1949-01-01

118

Laryngeal fracture after coughing.  

PubMed

Nontraumatic laryngeal fractures are exceedingly rare disease entities. Only 3 prior instances have been described in the medical literature (Br Med J 1950;1:1052; Acta Otorrinolaringol Esp 2007;58:73-4; Otolaryngol Head Neck Surg 2012;147:801-2). We present a case of thyroid cartilage fracture and associated phlegmon formation after a vigorous coughing spell in a 47-year-old man. On presentation, the patient's symptoms included the triad of odynophagia, dysphagia, and dysphonia as well as diffuse swelling and tenderness over the thyroid cartilage. Computed tomography and magnetic resonance imaging revealed a mildly displaced anterior thyroid cartilage fracture as well as a phlegmon in the strap muscle compartment adjacent to the fracture (Figs. 1 and 2). Intravenous dexamethasone and antibiotics were initiated, and the patient was admitted to the medical intensive care unit. On fiberoptic examination with the flexible laryngoscope, the patient was found to have slightto-moderate watery edema of the right aryepiglottic fold and right greater than left arytenoid cartilages. After 48 hours, the patient's neck swelling and pain significantly improved. On hospital day 4, the patient was discharged with a course of oral antibiotics. One week later, the patient reported only mild odynophagia and persistent dysphonia. He otherwise felt well and was tolerating fluids and soft food without difficulty. A preexisting, congenital abnormality resulting in a focal weakness in the thyroid cartilage might predispose patients to nontraumatic fractures (Otolaryngol Head Neck Surg 2012;147:801-2). Patients in prior case reports of nontraumatic laryngeal fractures presented with similar symptoms (Table). The triad of odynophagia, dysphagia, and dysphonia after a severe coughing or sneezing episode should raise the clinician's suspicion of a thyroid cartilage fracture. PMID:23806730

Fenig, Mark; Strasberg, Stephen; Cohen, Justin C; Almadi, Rami; Gold, Menachem

2013-09-01

119

Bell's palsy before Bell: Evert Jan Thomassen à Thuessink and idiopathic peripheral facial paralysis.  

PubMed

Bell's palsy is the eponym for idiopathic peripheral facial paralysis. It is named after Sir Charles Bell (1774-1842), who, in the first half of the nineteenth century, discovered the function of the facial nerve and attracted the attention of the medical world to facial paralysis. Our knowledge of this condition before Bell's landmark publications is very limited and is based on just a few documents. In 1804 and 1805, Evert Jan Thomassen à Thuessink (1762-1832) published what appears to be the first known extensive study on idiopathic peripheral facial paralysis. His description of this condition was quite accurate. He located several other early descriptions and concluded from this literature that, previously, the condition had usually been confused with other afflictions (such as 'spasmus cynicus', central facial paralysis and trigeminal neuralgia). According to Thomassen à Thuessink, idiopathic peripheral facial paralysis and trigeminal neuralgia were related, being different expressions of the same condition. Thomassen à Thuessink believed that idiopathic peripheral facial paralysis was caused by 'rheumatism' or exposure to cold. Many aetiological theories have since been proposed. Despite this, the cold hypothesis persists even today. PMID:19607737

van de Graaf, R C; IJpma, F F A; Nicolai, J-P A; Werker, P M N

2009-11-01

120

Varying occurrence of vocal cord paralysis in a family with autosomal dominant hereditary motor and sensory neuropathy  

Microsoft Academic Search

A white British family with the axonal form of hereditary motor and sensory neuropathy (HMSN, type II) contained one member\\u000a who developed a recurrent laryngeal nerve palsy at the age of 41 years, in addition to 4 years of symptomatic polyneuropathy\\u000a and an abducens nerve palsy. Neither of the other family members (the mother and sister) with electrophysiologically confirmed\\u000a polyneuropathy

Michael Donaghy; Robin Kennett

1999-01-01

121

Bilateral diaphragmatic paralysis due to cervical chiropractic manipulation.  

PubMed

Neck pain from cervical spinal disease is a common problem with significant disability, and chiropractic manipulation has emerged as one of the leading forms of alternative treatment for such spinal symptoms. However, more experience with these forms of treatment has revealed associated complications that are far from benign. Complications range from mild symptoms, such as local neck tenderness or stiffness, to more severe injuries involving the spinal cord, peripheral nerve roots, and arteries within the neck. Phrenic nerve injury causing diaphragmatic palsy is a rare complication of cervical chiropractic manipulation. We report a case of bilateral diaphragmatic paralysis in a healthy gentleman who underwent cervical manipulation. Physicians must be aware of this complication and should be cautious when recommending spinal manipulation for the treatment of neck pain, especially in the presence of preexisting degenerative disease of the cervical spine. PMID:25692510

John, Seby; Tavee, Jinny

2015-02-01

122

Thyrotoxic Periodic Paralysis: Clinical Challenges  

PubMed Central

Thyrotoxic periodic paralysis (TPP), a disorder most commonly seen in Asian men, is characterized by abrupt onset of hypokalemia and paralysis. The condition primarily affects the lower extremities and is secondary to thyrotoxicosis. The underlying hyperthyroidism is often subtle causing difficulty in early diagnosis. Factors like high-carbohydrate meal exercise, steroid, and stress can precipitate an attack of TPP. Evidence is building up showing role of genetic mutations in Kir2.6 channel in the pathogenesis of TPP. Loss of function of Kir2.6 together with increased activity of Na+/K+ ATPase may trigger a positive feed-forward cycle of hypokalemia. Biochemical hyperthyroidism with normal urinary potassium excretion and ECG changes are characteristic of TPP. Treatment with low-dose potassium supplements and nonselective beta-blockers should be initiated upon diagnosis, and the serum potassium level should be frequently monitored to prevent rebound hyperkalemia. PMID:24695373

Vijayakumar, Abhishek; Ashwath, Giridhar; Thimmappa, Durganna

2014-01-01

123

Earwax and level of paralysis  

Microsoft Academic Search

Study design: Inception cohort.Objectives: The clinical impression that earwax is uncommonly frequent among spinal cord injury patients with high levels of paralysis was tested.Setting: Veterans Administration Hospital, USA.Methods: A cohort of 15 chronically paralyzed patients, motor complete, living as residents in a long-term care facility was offered monthly irrigations of the ears for removal of wax over a 6-month period.

J H Frisbie; E H Zahn

2003-01-01

124

Menthol suppresses laryngeal C-fiber hypersensitivity to cigarette smoke in a rat model of gastroesophageal reflux disease: the role of TRPM8.  

PubMed

Patients with gastroesophageal reflux disease (GERD) display enhanced laryngeal reflex reactivity to stimuli that may be due to sensitization of the laryngeal C-fibers by acid and pepsin. Menthol, a ligand of transient receptor potential melastatin-8 (TRPM8), relieves throat irritation. However, the possibility that GERD induces laryngeal C-fiber hypersensitivity to cigarette smoke (CS) and that menthol suppresses this event has not been investigated. We delivered CS into functionally isolated larynxes of 160 anesthetized rats. Laryngeal pH 5-pepsin treatment, but not pH 5-denatured pepsin, augmented the apneic response to CS, which was blocked by denervation or perineural capsaicin treatment (a procedure that blocks the conduction of C fibers) of the superior laryngeal nerves. This augmented apnea was partially attenuated by capsazepine [an transient receptor potential vanilloid 1 (TRPV1) antagonist], SB-366791 (a TRPV1 antagonist), and HC030031 [a transient receptor potential ankyrin 1 (TRPA1) antagonist] and was completely prevented by a combination of TRPV1 and TRPA1 antagonists. Local application of menthol significantly suppressed the augmented apnea and this effect was reversed by pretreatment with AMTB (a TRPM8 antagonist). Our electrophysiological studies consistently revealed that laryngeal pH 5-pepsin treatment increased the sensitivity of laryngeal C-fibers to CS. Likewise, menthol suppressed this laryngeal C-fiber hypersensitivity and its effect could be reversed by pretreatment with AMTB. Our results suggest that laryngeal pH 5-pepsin treatment increases sensitivity to CS of both TRPV1 and TRPA1, which are presumably located at the terminals of laryngeal C-fibers. This sensory sensitization leads to enhanced laryngeal reflex reactivity and augmentation of the laryngeal C-fiber responses to CS, which can be suppressed by menthol acting via TRPM8. PMID:25539933

Liu, Bi-Yu; Lin, Yu-Jung; Lee, Hung-Fu; Ho, Ching-Yin; Ruan, Ting; Kou, Yu Ru

2015-03-01

125

Laryngeal electromyographic findings in Charcot-Marie-Tooth disease type II.  

PubMed

Charcot-Marie-Tooth disease is a hereditary motor and sensory neuropathy that exhibits progressive muscular atrophy in the limbs, beginning with the lower extremities. It is now understood to be a heterogeneous group of disorders that can be differentiated both clinically and genetically. In Charcot-Marie-Tooth disease type II C, axonal neuropathy, diaphragm weakness, and vocal cord paralysis are described within kindreds. We used laryngeal electromyography to study a patient with this disorder. This technique has potential in the diagnosis of Charcot-Marie-Tooth disease type II. PMID:10404989

Dray, T G; Robinson, L R; Hillel, A D

1999-07-01

126

Varying occurrence of vocal cord paralysis in a family with autosomal dominant hereditary motor and sensory neuropathy.  

PubMed

A white British family with the axonal form of hereditary motor and sensory neuropathy (HMSN, type II) contained one member who developed a recurrent laryngeal nerve palsy at the age of 41 years, in addition to 4 years of symptomatic polyneuropathy and an abducens nerve palsy. Neither of the other family members (the mother and sister) with electrophysiologically confirmed polyneuropathy had any neuropathic symptoms in the limbs or laryngeal or respiratory muscle involvement. An autosomal dominant pattern of inheritance is likely. This is a second report of this rare form of HMSN (type IIC) in which there is associated laryngeal or respiratory muscle weakness. This family differs from the two previously reported pedigrees in which laryngeal or diaphragm weakness had commenced within the first two decades. The discovery of asymptomatic family members attests to the diagnostic value of clinical and electrophysiological study of first-degree relatives when laryngeal or bulbar symptoms develop in the context of chronic axonal polyneuropathy. HMSN type IIC should be distinguished from the more common forms of HMSN - type IIA, in which axonal polyneuropathy is restricted to the limbs, and type IIB, which is of early onset and associated with foot ulceration. PMID:10463355

Donaghy, M; Kennett, R

1999-07-01

127

Injury to the Superior Laryngeal Branch of the Vagus During Thyroidectomy: Lesson or Myth?  

PubMed Central

Objective To examine the historical evidence that the thyroidectomy performed on operatic soprano Amelita Galli-Curci was responsible for the abrupt termination of her career. Summary Background Data The superior laryngeal branch of the vagus nerve may be injured during thyroidectomy, producing vocal defects more subtle than those found after recurrent nerve injury. It is widely believed that Galli-Curci suffered superior laryngeal nerve injury during her thyroidectomy by Arnold Kegel, MD, in 1935, resulting in the termination of her career. Methods The authors examined contemporary press reviews after surgery, conducted interviews with colleagues and relatives of the surgeon, and compared the career of Galli-Curci with that of other singers. Results Evidence against the prevailing view is to be found in the fact that she continued to perform acceptably after surgery, her continued friendly relationship with the surgeon for years afterward, the absence of the typical effects of superior laryngeal nerve injury, and the presence of other explanations for the gradual decline in her vocal abilities (documentation of deterioration before surgery, physiologic changes in the larynx comparable to those found in most other famous sopranos who retire at about the same age or earlier, and the possible development of myxedema). Conclusions The story should no longer be perpetuated in surgical textbooks and papers. PMID:11303143

Crookes, Peter F.; Recabaren, James A.

2001-01-01

128

NUMERICAL SIMULATION OF LARYNGEAL FLOW  

EPA Science Inventory

In this study, we have investigated laryngeal air flows by numerically solving the corresponding Navier-Stokes equations expressed in a two-dimensional cylindrical coordinate system. The glottal aperture, defined by the geometry of the vocal folds was allowed to change with the v...

129

Evaluation of phrenic nerve and diaphragm function with peripheral nerve stimulation and M-mode ultrasonography in potential pediatric phrenic nerve or diaphragm pacing candidates.  

PubMed

Assessing phrenic nerve function in the setting of diaphragmatic paralysis in diaphragm pacing candidates can be challenging. Traditional imaging modalities and electrodiagnostic evaluations are technically difficult. Either modality alone is not a direct measure of the function of the phrenic nerve and diaphragm unit. In this article, the authors present their method for evaluating phrenic nerve function and the resulting diaphragm function. Stimulating the phrenic nerve with transcutaneous stimulation and directly observing the resulting movement of the hemidiaphragm with M-mode ultrasonography provides quantitative data for predicting the success of advancing technologies such as phrenic nerve pacing and diaphragm pacing. PMID:25479785

Skalsky, Andrew J; Lesser, Daniel J; McDonald, Craig M

2015-02-01

130

Dosimetric Predictors of Laryngeal Edema  

SciTech Connect

Purpose: To investigate dosimetric predictors of laryngeal edema after radiotherapy (RT). Methods and Materials: A total of 66 patients were selected who had squamous cell carcinoma of the head and neck with grossly uninvolved larynx at the time of RT, no prior major surgical operation except for neck dissection and tonsillectomy, treatment planning data available for analysis, and at least one fiberoptic examination of the larynx within 2 years from RT performed by a single observer. Both the biologically equivalent mean dose at 2 Gy per fraction and the cumulative biologic dose-volume histogram of the larynx were extracted for each patient. Laryngeal edema was prospectively scored after treatment. Time to endpoint, moderate or worse laryngeal edema (Radiation Therapy Oncology Group Grade 2+), was calculated with log rank test from the date of treatment end. Results: At a median follow-up of 17.1 months (range, 0.4- 50.0 months), the risk of Grade 2+ edema was 58.9% {+-} 7%. Mean dose to the larynx, V30, V40, V50, V60, and V70 were significantly correlated with Grade 2+ edema at univariate analysis. At multivariate analysis, mean laryngeal dose (continuum, hazard ratio, 1.11; 95% confidence interval, 1.06-1.15; p < 0.001), and positive neck stage at RT (N0-x vs. N +, hazard ratio, 3.66; 95% confidence interval, 1.40-9.58; p = 0.008) were the only independent predictors. Further stratification showed that, to minimize the risk of Grade 2+ edema, the mean dose to the larynx has to be kept {<=}43.5 Gy at 2 Gy per fraction. Conclusion: Laryngeal edema is strictly correlated with various dosimetric parameters; mean dose to the larynx should be kept {<=}43.5 Gy.

Sanguineti, Giuseppe [Department of Radiation Oncology, University of Texas Medical Branch, Galveston, TX (United States)]. E-mail: gisangui@utmb.edu; Adapala, Prashanth [Department of Radiation Oncology, University of Texas Medical Branch, Galveston, TX (United States); Endres, Eugene J. C [Department of Medical Physics, University of Texas Medical Branch, Galveston, TX (United States); Brack, Collin [Department of Medical Physics, University of Texas Medical Branch, Galveston, TX (United States); Fiorino, Claudio [Department of Physics, Ospedale San Raffaele, Milan (Italy); Sormani, Maria Pia [Biostatistics Unit, University of Genoa, Genoa (Italy); Parker, Brent [Department of Medical Physics, University of Texas Medical Branch, Galveston, TX (United States)

2007-07-01

131

Tick paralysis in a red wolf.  

PubMed

A free-ranging male red wolf (Canis rufus) in North Carolina (USA), exhibiting paresis, anorexia and heavy tick infection was diagnosed with tick paralysis. The wolf recovered completely following the removal of all ticks. This is the first record of tick paralysis in the red wolf. PMID:9391981

Beyer, A B; Grossman, M

1997-10-01

132

Cruciate paralysis secondary to traumatic atlantooccipital dislocation.  

PubMed

Cruciate paralysis is a clinical phenomenon thought to result from injury to decussating pyramidal tract fibers at the cervicomedullary junction, producing clinical findings of upper-extremity weakness out of proportion to the lower extremities. The authors present, to their knowledge, the first reported case of cruciate paralysis resulting from atlantooccipital dislocation. PMID:20043758

Sweet, Jennifer; Ammerman, Joshua; Deshmukh, Vivek; White, Joseph

2010-01-01

133

Novel etiopathophysiological aspects of thyrotoxic periodic paralysis  

Microsoft Academic Search

Thyrotoxicosis can lead to thyrotoxic periodic paralysis (TPP), an endocrine channelopathy, and is the most common cause of acquired periodic paralysis. Typically, paralytic attacks cease when hyperthyroidism is abolished, and recur if hyperthyroidism returns. TPP is often underdiagnosed, as it has diverse periodicity, duration and intensity. The age at which patients develop TPP closely follows the age at which thyrotoxicosis

Rui M. B. Maciel; Susan C. Lindsey; Magnus R. Dias da Silva

2011-01-01

134

Personality components in patients with sleep paralysis  

Microsoft Academic Search

Summary Sleep paralysis occurs more often than has been recognized heretofore. It is not necessarily accompanied by narcolepsy and cataplexy. Physiological and psychological explanations for it have been suggested, but they are not mutually exclusive. A personality conflict between passive and aggressive trends appears to be important in patients with these symptoms. Four patients with sleep paralysis are described in

Jerome M. Schneck

1969-01-01

135

Conditions That Can Cause Paralysis  

MedlinePLUS

... spine, or incomplete closure in the spinal column. Spinal Cord Injury Involves damage to the nerves within the spinal ... a result of an irritation or infection in spinal cord injuries at T6 or higher. Bladder Management Information on ...

136

Influence and interactions of laryngeal adductors and cricothyroid muscles on fundamental frequency and glottal posture control  

PubMed Central

The interactions of the intrinsic laryngeal muscles (ILMs) in controlling fundamental frequency (F0) and glottal posture remain unclear. In an in vivo canine model, three sets of intrinsic laryngeal muscles—the thyroarytenoid (TA), cricothyroid (CT), and lateral cricoarytenoid plus interarytenoid (LCA/IA) muscle complex—were independently and accurately stimulated in a graded manner using distal laryngeal nerve stimulation. Graded neuromuscular stimulation was used to independently activate these paired intrinsic laryngeal muscles over a range from threshold to maximal activation, to produce 320 distinct laryngeal phonatory postures. At phonation onset these activation conditions were evaluated in terms of their vocal fold strain, glottal width at the vocal processes, fundamental frequency (F0), subglottic pressure, and airflow. F0 ranged from 69 to 772?Hz and clustered into chest-like and falsetto-like groups. CT activation was always required to raise F0, but could also lower F0 at low TA and LCA/IA activation levels. Increasing TA activation first increased then decreased F0 in all CT and LCA/IA activation conditions. Increasing TA activation also facilitated production of high F0 at a lower onset pressure. Independent control of membranous (TA) and cartilaginous (LCA/IA) glottal closure enabled multiple pathways for F0 control via changes in glottal posture. PMID:25235003

Chhetri, Dinesh K.; Neubauer, Juergen; Sofer, Elazar; Berry, David A.

2014-01-01

137

Respiratory paralysis in a child: The severe axonal variant of childhood Guillain-Barré syndrome  

PubMed Central

Guillain–Barre syndrome (GBS) is a common cause of acute flaccid paralysis in children. Axonal variants of this disease are rare, and frequently life-threatening or debilitating. The course and outcome of a 17-month-old child with acute flaccid paralysis including severe respiratory involvement are presented. GBS was suspected. Nerve conduction studies demonstrated acute motor-sensory axonal neuropathy including both phrenic nerves. The difficulties with the diagnosis and management of this severe and life-threatening condition are discussed. Significant morbidity is also highlighted. Axonal variants of GBS although rare cause significant morbidity in children. Diagnosis relies solely on accurate neurophysiologic testing and is important because the available treatment options for GBS are frequently ineffective in these variants. PMID:25878751

Ravishankar, N.

2015-01-01

138

21 CFR 874.3730 - Laryngeal prosthesis (Taub design).  

Code of Federal Regulations, 2010 CFR

...ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Prosthetic Devices § 874.3730 Laryngeal prosthesis (Taub design). (a) Identification. A laryngeal...

2010-04-01

139

Unusual delayed presentation of head trauma complicating outcome of facial nerve decompression surgery.  

PubMed

Late presentation of head trauma is rare. A young boy presented with a traumatic facial paralysis after head trauma. A CT scan of the head showed temporal bone fracture without intracranial insult. Facial nerve decompression was performed and paralysis started improving. However, he presented with vertigo and sensorineural hearing loss after 2 months. Clinical examination also showed cerebellar sign. We suspected iatrogenic injury to the cochlea; however, brain MRI showed haemorrhage in the area of anterior inferior cerebellar artery. The patient was managed conservatively and the vertigo improved. This case stresses on unusual late presentation of head trauma and cerebellar artery injury that complicated the outcome of facial nerve paralysis. PMID:23964046

Thakur, J S; Shekar, Vidya; Saluja, Manika; Mohindroo, N K

2013-01-01

140

Laryngeal histoplasmosis: an occupational hazard.  

PubMed

Isolated laryngeal histoplasmosis is a very rare entity. It has variable clinical presentations that might mimic both benign and malignant lesions, and is usually associated with pulmonary and other disseminated forms of histoplasmosis. Herein, we report a case of primary laryngeal histoplasmosis without the involvement of other systems in a 70-year-old Chinese man, who previously worked as a miner. He presented with a history of hoarseness for two months, with no other associated symptoms. Direct laryngoscopy revealed irregularity of the posterior one-third of both vocal folds. Histopathological examination revealed the presence of Histoplasma capsulatumon periodic acidSchiff and Grocott's methenamine silver staining. The lesion resolved after one month of oral itraconazole treatment. However, the patient had to complete six months of antifungal treatment to prevent recurrence. PMID:24154590

Teoh, Jian Woei; Hassan, Faridah; Mohamad Yunus, Mohd Razif

2013-10-01

141

Night shift paralysis in air traffic control officers  

Microsoft Academic Search

In an earlier paper (Folkard et al. 1984) we reported on the incidence of a temporary but incapacitating paralysis known as ‘night shift paralysis’. This appeared to be a special form of sleep paralysis that occurs when night workers manage to maintain a state of wakefulness despite considerable pressures to sleep. The incidence of this paralysis might thus be assumed

SIMON FOLKARD; RUTH CONDON

1987-01-01

142

Multidisciplinary Management of Laryngeal Carcinoma  

SciTech Connect

The management of head and neck cancer has evolved into a multidisciplinary approach in which patients are evaluated before treatment and decisions depend on prospective multi-institutional trials, as well as retrospective outcome studies. The choice of one or more modalities to use in a given case varies with the tumor site and extent, as exemplified in the treatment of laryngeal squamous cell carcinomas. The goals of treatment include cure, laryngeal voice preservation, voice quality, optimal swallowing, and minimal xerostomia. Treatment options include transoral laser excision, radiotherapy (both definitive and postoperative), open partial laryngectomy, total laryngectomy, and neck dissection. The likelihood of local control and preservation of laryngeal function is related to tumor volume. Patients who have a relatively high risk of local recurrence undergo follow-up computed tomography scans every 3-4 months for the first 2 years after radiotherapy. Patients with suspicious findings on computed tomography might benefit from fluorodeoxyglucose positron emission tomography to differentiate post-radiotherapy changes from tumor.

Mendenhall, William M. [Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, FL (United States)], E-mail: mendewil@shands.ufl.edu; Mancuso, Anthony A. [Department of Diagnostic Radiology, University of Florida College of Medicine, Gainesville, FL (United States); Hinerman, Russell W.; Malyapa, Robert S. [Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, FL (United States); Werning, John W. [Department of Otolaryngology, University of Florida College of Medicine, Gainesville, FL (United States); Amdur, Robert J. [Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, FL (United States); Villaret, Douglas B. [Department of Otolaryngology, University of Florida College of Medicine, Gainesville, FL (United States)

2007-10-01

143

[Summery and recommendations for acupuncture for peripheral facial paralysis].  

PubMed

Articles on acupuncture for peripheral facial paralysis were picked up from CNKI database. The retrieved original studies were evaluated and summarized. The problems of acupuncture for peripheral facial paralysis were analyzed, and concrete solutions were proposed. Problems that differential diagnosis, prognosis, treatment of severe facial paralysis, and identification of sequelae and compliation were not embasized in clinical treatment of facial paralysis. Consequently, the effectiveness of acupuncture for peripheral facial paralysis will be improved by sloving above problems. PMID:22256658

Wang, Sheng-Qiang; Yu, Su; Wang, Jian-Ping

2011-12-01

144

Genetics Home Reference: Hyperkalemic periodic paralysis  

MedlinePLUS

... that can trigger attacks include rest after exercise, potassium-rich foods such as bananas and potatoes, stress, ... with hyperkalemic periodic paralysis have increased levels of potassium in their blood (hyperkalemia) during attacks. Hyperkalemia results ...

145

Caffeine-induced hypokalemic paralysis in pregnancy  

Microsoft Academic Search

Background: Excessive ingestion of caffeine can induce hypokalemia, which affects the neuromuscular system and can lead to paralysis.Case: A 24-year-old woman, gravida 3, para 2-0-0-2 at 33 weeks’ gestation presented with muscular paralysis and hypokalemia secondary to drinking 6 to 7 L of cola per day with little other oral intake. After potassium replacement and stopping caffeine ingestion, the symptoms

Carin C Appel; Thomas D Myles

2001-01-01

146

Literature study on clinical treatment of facial paralysis in the last 20 years using Web of Science  

PubMed Central

BACKGROUND: Facial paralysis is defined as severe or complete loss of facial muscle motor function. OBJECTIVE: The study was undertaken to explore a bibliometric approach to quantitatively assess the research on clinical treatment of facial paralysis using rehabilitation, physiotherapy and acupuncture using Web of Science from 1992 to 2011. DESIGN: Bibliometric approach. DATA RETRIEVAL: A bibliometric analysis based on the publications on Web of Science was performed using key words such as “facial paralysis”, “rehabilitation”, “physiotherapy” and “acupuncture”. INCLUSIVE CRITERIA: (1) Research articles on the clinical treatment of facial paralysis using acupuncture or physiotherapy (e.g. exercise, electro-stimulation) and other rehabilitation methods; (2) researches on human and animal fundamentals, clinical trials and case reports; (3) Article types: article, review, proceedings paper, note, letter, editorial material, discussion, book chapter. (4) Publication year: 1992–2011 inclusive. Exclusion criteria: (1) Articles on the causes and diagnosis on facial paralysis; (2) Type of articles: correction; (3) Articles from following databases: all databases related to social science and chemical databases in Web of Science. MAIN OUTCOME MEASURES: (1) Overall number of publications; (2) number of publications annually; (3) number of citations received annually; (4) top cited paper; (5) subject categories of publication; (6) the number of countries in which the article is published; (7) distribution of output in journals. RESULTS: Overall population stands at 3 543 research articles addressing the clinical treatment of facial paralysis in Web of Science during the study period. There is also a markedly increase in the number of publications on the subject “facial paralysis treatments using rehabilitation” during the first decade of the 21st century, except in 2004 and 2006 when there are perceptible drops in the number of articles published. The only other year during the study period saw such a drop is 1993. Specifically, there are 192 published articles on facial paralysis treated by rehabilitation in the past two decades, far more than the output of physiotherapy treatment. Physiotherapy treatment scored only 25 articles including acupuncture treatment, with over 80% of these written by Chinese researchers and clinicians. Ranked by regions, USA is by far the most productive country in terms of the number of publications on facial paralysis rehabilitation and physiotherapy research. Seeing from another angle, the journals that focus on otolaryngology published the most number of articles in rehabilitation and physiotherapy studies, whereas most acupuncture studies on facial paralysis were published in the alternative and complementary medicine journals. CONCLUSION: Study of facial paralysis remains an area of active investigation and innovation. Further clinical studies in humans addressing the use of growth factors or stem cells continue to successful facial nerve regeneration.

Zhang, Xiaoge; Feng, Ling; Du, Liang; Zhang, Anxiang; Tang, Tian

2012-01-01

147

A Case of Anterior Interosseous Nerve Syndrome After Peripherally Inserted Central Catheter (PICC) Line Insertion  

Microsoft Academic Search

Palsies involving the anterior interosseous nerve comprise less than 1% of all upper extremity nerve palsies. Patients often present initially with acute pain in the proximal forearm, lasting several hours to days. The pain subsides, to be followed by paresis or total paralysis of the pronator quadratus, flexor pollicis longus and the radial half of the flexor profundus, either individually

M E Puhaindran; H P Wong

148

Acute Flaccid paralysis in adults: Our experience  

PubMed Central

Acute flaccid paralysis (AFP) is a complex clinical syndrome with a broad array of potential etiologies that vary with age. We present our experience of acute onset lower motor neuron paralysis. Materials and Methods: One hundred and thirty-three consecutive adult patients presenting with weakness of duration less than four weeks over 12 months period were enrolled. Detailed history, clinical examination, and relevant investigations according to a pre-defined diagnostic algorithm were carried out. The patients were followed through their hospital stay till discharge or death. Results: The mean age was 33.27 (range 13-89) years with male preponderance (67.7%). The most common etiology was neuroparalytic snake envenomation (51.9%), followed by Guillain Barre syndrome (33.1%), constituting 85% of all patients. Hypokalemic paralysis (7.5%) and acute intermittent porphyria (4.5%) were the other important conditions. We did not encounter any case of acute polio mylitis in adults. In-hospital mortality due to respiratory paralysis was 9%. Conclusion: Neuroparalytic snakebite and Guillain Barre syndrome were the most common causes of acute flaccid paralysis in adults in our study. PMID:25114422

Kaushik, Rupesh; Kharbanda, Parampreet S.; Bhalla, Ashish; Rajan, Roopa; Prabhakar, Sudesh

2014-01-01

149

Hypokalemic paralysis in a professional bodybuilder.  

PubMed

Severe hypokalemia is a potentially life-threatening disorder and is associated with variable degrees of skeletal muscle weakness, even to the point of paralysis. On rare occasions, diaphragmatic paralysis from hypokalemia can lead to respiratory arrest. There may also be decreased motility of smooth muscle, manifesting with ileus or urinary retention. Rarely, severe hypokalemia may result in rhabdomyolysis. Other manifestations of severe hypokalemia include alteration of cardiac tissue excitability and conduction. Hypokalemia can produce electrocardiographic changes such as U waves, T-wave flattening, and arrhythmias, especially if the patient is taking digoxin. Common causes of hypokalemia include extrarenal potassium losses (vomiting and diarrhea) and renal potassium losses (eg, hyperaldosteronism, renal tubular acidosis, severe hyperglycemia, potassium-depleting diuretics) as well as hypokalemia due to potassium shifts (eg, insulin administration, catecholamine excess, familial periodic hypokalemic paralysis, thyrotoxic hypokalemic paralysis). Although the extent of diuretic misuse in professional bodybuilding is unknown, it may be regarded as substantial. Hence, diuretics must always be considered as a cause of hypokalemic paralysis in bodybuilders. PMID:21871759

Mayr, Florian B; Domanovits, Hans; Laggner, Anton N

2012-09-01

150

Use of the masseter motor nerve in facial animation with free muscle transfer.  

PubMed

Facial paralysis is either congenital or acquired, and of varying severity, which leads to an asymmetrical or absent facial expression. It is an important disability both from the aesthetic and functional points of view. Between 2003 and 2008, at the Department of Maxillofacial Surgery, University of Parma, Italy, 21 patients with facial paralysis had their faces reanimated with a gracilis transplant reinnervated by the masseter motor nerve. All free-muscle transplants survived the transfer, and no flap was lost. Facial symmetry at rest and while smiling was excellent or good in most cases, and we found an appreciable improvement in both speech and oral competence. We consider that the masseter motor nerve is a powerful and reliable donor nerve, which allows us to obtain movement of the commissure and upper lip similar to those of the normal site for degree and direction. There may be a role for the masseter motor nerve in innervation of patients with facial paralysis. PMID:21885172

Bianchi, Bernardo; Copelli, Chiara; Ferrari, Silvano; Ferri, Andrea; Sesenna, Enrico

2012-10-01

151

Facial diplegia, pharyngeal paralysis, and ophthalmoplegia after a timber rattlesnake envenomation.  

PubMed

The timber rattlesnake, also known as Crotalus horridus, is well known to cause significant injury from toxins stored within its venom. During envenomation, toxic systemic effects immediately begin to cause damage to many organ systems including cardiovascular, hematologic, musculoskeletal, respiratory, and neurologic. One defining characteristic of the timber rattlesnake is a specific neurotoxin called crotoxin, or the "canebrake toxin," which is a potent ?-neurotoxin affecting presynaptic nerves that can cause paralysis by inhibiting appropriate neuromuscular transmission. We present an unusual case of an 8-year-old boy bitten twice on his calf by a timber rattlesnake, who presented with a life-threatening envenomation and suffered multisystem organ failure as well as a prominent presynaptic neurotoxicity resulting in facial diplegia, pharyngeal paralysis, and ophthalmoplegia. PMID:24196093

Madey, Jason J; Price, Amanda B; Dobson, Joseph V; Stickler, David E; McSwain, S David

2013-11-01

152

Spinal Cord and Nerve Root Decompression  

Microsoft Academic Search

Tumors of the vertebral column include both primary and metastatic lesions. These tumors can cause significant morbidity consisting\\u000a of lesional pain and pain from deformity. Compression of the spinal cord and spinal nerve roots can also cause radicular pain\\u000a as well as neurologial deterioration including sensory deficits, weakness, paralysis, and\\/or sexual\\/bowel\\/ bladder dysfunction.\\u000a In cases of metastatic lesions, the spine

Keith R. Lodhia; Paul Park; Gregory P. Graziano

153

Ophthalmic Management of Facial Nerve Palsy: A Review  

Microsoft Academic Search

Facial nerve palsy affects individuals of all ages, races, and sexes. Psychological and functional implications of the paralysis present a devastating management problem to those afflicted, as well as the carriers. Since Sir Charles Bell's original description of facial palsy in 1821, our understanding and treatment options have expanded. It is essential that a multidisciplinary approach, encompassing ophthalmologists; Ear, Nose,

Imran Rahman; S. Ahmed Sadiq

2007-01-01

154

Mutation screening in Chinese hypokalemic periodic paralysis patients  

Microsoft Academic Search

Thyrotoxic periodic paralysis (TPP), familial periodic paralysis (FPP), and sporadic periodic paralysis (SPP) are the most common causes of hypokalemic periodic paralysis (hypoKPP). The patients present with similar clinical features characterized by episodic attacks of muscle weakness and a decrease in blood potassium. Mutations in the gene encoding the voltage-sensor coding regions of the skeletal muscle sodium channel gene (SCN4A)

Weiqing Wang; Lei Jiang; Lei Ye; Na Zhu; Tingwei Su; Liqing Guan; Xiaoying Li; Guang Ning

2006-01-01

155

[Hypoglossal nerve neuropraxia after shoulder hemiarthroplasty].  

PubMed

We report a case of hypoglossal nerve damage after shoulder hemiarthroplasty with the patient in "beach chair" position, performed with general anesthesia with orotracheal intubation, and without complications. An ultrasound-guided interscalene block was previously performed in an alert patient. After the intervention, the patient showed clinical symptomatology compatible with paralysis of the right hypoglossal nerve that completely disappeared after 4 weeks. Mechanisms such as hyperextension of the neck during intubation, endotracheal tube cuff pressure, excessive hyperextension, or head lateralization during surgery have been described as causes of this neurological damage. We discuss the causes, the associated factors and suggest preventive measures. PMID:23787368

Pariente, L; Camarena, P; Koo, M; Sabaté, A; Armengol, J

2014-05-01

156

Sleep paralysis and microsomatognosia with special reference to hypnotherapy  

Microsoft Academic Search

Sleep paralysis is described in connection with a patient whose episodes incorporated the experience of her entire body feeling extremely small. The psychological implications of the paralysis and her microsomatognosia are discussed. Comparisons are made with other perceptual distortions involving the sense of change in body size. The characteristics of sleep paralysis and associated personality patterns are delineated. This material

Jerome M. Schneck

1977-01-01

157

Detecting unilateral phrenic paralysis by acoustic respiratory analysis.  

PubMed

The consequences of phrenic nerve paralysis vary from a considerable reduction in respiratory function to an apparently normal state. Acoustic analysis of lung sound intensity (LSI) could be an indirect non-invasive measurement of respiratory muscle function, comparing activity on the two sides of the thoracic cage. Lung sounds and airflow were recorded in ten males with unilateral phrenic paralysis and ten healthy subjects (5 men/5 women), during progressive increasing airflow maneuvers. Subjects were in sitting position and two acoustic sensors were placed on their back, on the left and right sides. LSI was determined from 1.2 to 2.4 L/s between 70 and 2000 Hz. LSI was significantly greater on the normal (19.3±4.0 dB) than the affected (5.7±3.5 dB) side in all patients (p?=?0.0002), differences ranging from 9.9 to 21.3 dB (13.5±3.5 dB). In the healthy subjects, the LSI was similar on both left (15.1±6.3 dB) and right (17.4±5.7 dB) sides (p?=?0.2730), differences ranging from 0.4 to 4.6 dB (2.3±1.6 dB). There was a positive linear relationship between the LSI and the airflow, with clear differences between the slope of patients (about 5 dB/L/s) and healthy subjects (about 10 dB/L/s). Furthermore, the LSI from the affected side of patients was close to the background noise level, at low airflows. As the airflow increases, the LSI from the affected side did also increase, but never reached the levels seen in healthy subjects. Moreover, the difference in LSI between healthy and paralyzed sides was higher in patients with lower FEV1 (%). The acoustic analysis of LSI is a relevant non-invasive technique to assess respiratory function. This method could reinforce the reliability of the diagnosis of unilateral phrenic paralysis, as well as the monitoring of these patients. PMID:24718599

Fiz, José Antonio; Jané, Raimon; Lozano, Manuel; Gómez, Rosa; Ruiz, Juan

2014-01-01

158

Laryngitis  

MedlinePLUS

... Answer the question: "What's your favorite flavor of ice cream?" At the top of your windpipe — also called ... best flavor!" (or whatever your favorite flavor of ice cream happens to be). You can make different sounds ...

159

Laryngitis  

MedlinePLUS

... BH, Lund VJ et al. eds. Cummings Otolaryngology: Head & Neck Surgery. 5th ed. Philadelphia, PA: Elsevier Mosby; 2010; ... et al. Clinical practice guideline: hoarseness (dysphonia). Otolaryngol Head Neck Surg . 2009;141(3 Suppl 2):S1-S31.

160

Hypokalemic Periodic Paralysis in Primary Hyperaldosteronism  

Microsoft Academic Search

A case of a patient suffering from primary hyperaldosteronism is reported. In this case the disease is manifested clinically by periodic paralysis and hypopotasemia without permanent myopathy. The morphological study of the muscle demonstrates selective atrophy of the type 2A fibers as the most pronounced alteration. These findings suggest a chronic myopathic process.Copyright © 1979 S. Karger AG, Basel

J. Bautista; E. Gil-Neciga; A. Gil-Peralta

1979-01-01

161

[Thyrotoxic hypokalemic periodic paralysis. A case report].  

PubMed

Thyrotoxic hypokalemic periodic paralysis is an uncommon complication of thyrotoxicosis, characterized by attacks of generalized muscular weakness associated with hypokalemia in patients with hyperthyroidism, most frequently with Graves-Basedow disease. Treatment with antithyroid drugs and potassium supplements reversed the symptoms and the episodes of acute muscular weakness did not reappear. PMID:24315080

Villar Jiménez, J; Ruiz Serrato, A E; Bautista Galán, C; Guerrero León, M Á

2013-01-01

162

Focal epileptic seizures mimicking sleep paralysis  

Microsoft Academic Search

Sleep paralysis (SP) is a common parasomnia. The diagnostic criteria for SP, as reported in the International Classification of Sleep Disorders, are essentially clinical, as electroencephalography (EEG)–polysomnography (PSG) is not mandatory. We describe a subject whose sleep-related events fulfilled the diagnostic criteria for SP, even though her visual hallucinations were elementary, repetitive and stereotyped, thus differing from those usually reported

Carlo Andrea Galimberti; Maria Ossola; Silvia Colnaghi; Carla Arbasino

2009-01-01

163

Phonology Project Part II: Laryngeal Neutralization and Syllable Structure  

E-print Network

.3 Laryngeal Processes in Icelandic and Sanskrit . . . . . . . . . . . . . . . . . . . . 3 1.3.1 Icelandic Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 1.3.2 Sanskrit Overview.3 Sanskrit: Repair Strategies for the Laryngeal Constraint . . . . . . . . . . . . . . 9 2.3.1 Interaction

Ananian, C. Scott

164

What's New in Laryngeal and Hypopharyngeal Cancer Research and Treatment?  

MedlinePLUS

... Additional resources for laryngeal and hypopharyngeal cancers What’s new in laryngeal and hypopharyngeal cancers research and treatment? ... to better tests for early detection and to new targeted treatments. Chemoprevention Chemoprevention is the use of ...

165

What Are the Key Statistics about Laryngeal and Hypopharyngeal Cancers?  

MedlinePLUS

... laryngeal and hypopharyngeal cancers? What are the key statistics about laryngeal and hypopharyngeal cancers? The American Cancer ... 725 in men and 675 in women). Survival statistics for these cancers are discussed in the section “ ...

166

Nerve and Nerve Root Biomechanics  

Microsoft Academic Search

\\u000a Together, the relationship between the mechanical response of neural tissues and the related mechanisms of injury provide\\u000a a foundation for defining relevant thresholds for injury. The nerves and nerve roots are biologic structures with specific\\u000a and important functions, and whose response to mechanical loading can have immediate, long-lasting and widespread consequences.\\u000a In particular, when nerves or nerve roots are mechanically

Kristen J. Nicholson; Beth A. Winkelstein

167

Facial Pain Followed by Unilateral Facial Nerve Palsy: A Case Report with Literature Review  

PubMed Central

Peripheral facial nerve palsy is the commonest cranial nerve motor neuropathy. The causes range from cerebrovascular accident to iatrogenic damage, but there are few reports of facial nerve paralysis attributable to odontogenic infections. In majority of the cases, recovery of facial muscle function begins within first three weeks after onset. This article reports a unique case of 32-year-old male patient who developed facial pain followed by unilateral facial nerve paralysis due to odontogenic infection. The treatment included extraction of the associated tooth followed by endodontic treatment of the neighboring tooth which resulted in recovery of facial nerve plasy. A thorough medical history and physical examination are the first steps in making any diagnosis. It is essential to rule out other causes of facial paralysis before making the definitive diagnosis, which implies the intervention. The authors hereby, report a case of 32-year-old male patient who developed unilateral facial nerve paralysis due to odontogenic infection with a good prognosis after appropriate treatment. PMID:25302280

GV, Sowmya; Goel, Saurabh; Singh, Mohit Pal; Astekar, Madhusudan

2014-01-01

168

Hypoglycaemia causes degeneration of large myelinated nerve fibres in the vagus nerve of insulin-treated diabetic BB\\/Wor rats  

Microsoft Academic Search

The aim of this study was to find out whether dysglycaemia causes neuropathy in the vagus nerve of insulin-treated diabetic BB\\/Wor rats. Specimens were collected from the left vagus nerve proximal and distal to the level of recurrent laryngeal branch and from the recurrent branch itself in control rats and diabetic BB\\/Wor rats subjected to hyper- or hypoglycaemia. Myelinated and

Reza Jamali; Simin Mohseni

2005-01-01

169

Goiter and Laryngeal Sensory Neuropathy  

PubMed Central

Objective. Examining the prevalence of laryngeal sensory neuropathy (LSN) in goiter patients versus a control group. Study Design. Cross-sectional study. Methods. 33 Goiter patients were enrolled versus 25 age-matched controls. TSH levels, size of thyroid gland, and presence or absence of thyroid nodules were reported. Subjects were asked about the presence or absence of any of the following symptoms: cough, globus pharyngeus, and/or throat clearing that persistented for more than 6 weeks. The presence of one or more of these symptoms for at least six weeks in the absence of LPRD, allergy, asthma, ACE inhibitor intake, and psychogenic disorder was defined as LSN. Results. For goitrous patients mean age (years) was (41.73 ± 9.47) versus (37.44 ± 10.89) for controls. 82% goitrous patients had known nodules and 27% carried a simultaneous diagnosis of hypothyroidism. Among those with documented size (61%), mean total thyroid volume was 26.996 ± 14.852?cm3, with a range from 9.430 to 67.022?cm3. The overall prevalence of LSN among goitrous patients was 42% versus 12% among controls (P = 0.0187). There was no correlation between LSN, size of thyroid gland, and TSH level. Conclusion. The prevalence of LSN in goitrous patients is significantly higher than that in a nongoitrous population. PMID:23818901

Hamdan, Abdul Latif; Jabour, Jad; Azar, Sami T.

2013-01-01

170

Goiter and laryngeal sensory neuropathy.  

PubMed

Objective. Examining the prevalence of laryngeal sensory neuropathy (LSN) in goiter patients versus a control group. Study Design. Cross-sectional study. Methods. 33 Goiter patients were enrolled versus 25 age-matched controls. TSH levels, size of thyroid gland, and presence or absence of thyroid nodules were reported. Subjects were asked about the presence or absence of any of the following symptoms: cough, globus pharyngeus, and/or throat clearing that persistented for more than 6 weeks. The presence of one or more of these symptoms for at least six weeks in the absence of LPRD, allergy, asthma, ACE inhibitor intake, and psychogenic disorder was defined as LSN. Results. For goitrous patients mean age (years) was (41.73 ± 9.47) versus (37.44 ± 10.89) for controls. 82% goitrous patients had known nodules and 27% carried a simultaneous diagnosis of hypothyroidism. Among those with documented size (61%), mean total thyroid volume was 26.996 ± 14.852?cm(3), with a range from 9.430 to 67.022?cm(3). The overall prevalence of LSN among goitrous patients was 42% versus 12% among controls (P = 0.0187). There was no correlation between LSN, size of thyroid gland, and TSH level. Conclusion. The prevalence of LSN in goitrous patients is significantly higher than that in a nongoitrous population. PMID:23818901

Hamdan, Abdul Latif; Jabour, Jad; Azar, Sami T

2013-01-01

171

Flaccid Leg Paralysis Caused by a Thoracic Epidural Catheterization: A Case Report  

PubMed Central

We report a case of a 44-year-old patient with paralysis of the left leg who had a thoracic epidural catheterization after general anesthesia for abdominal surgery. Sensory losses below T10 and motor weakness of the left leg occurred after the surgery. Magnetic resonance image study demonstrated a well-defined intramedullary linear high signal intensity lesion on T2-weighted image and low-signal intensity on T1-weighted image in the spinal cord between T9 and L1 vertebral level, and enhancements of the spinal cord below T8 vertebra and in the cauda equina. Electrodiagnostic examination revealed lumbosacral polyradiculopathy affecting nerve roots below L4 level on left side. We suggest that the intrinsic spinal cord lesion and nerve root lesion can be caused by an epidural catheterization with subsequent local anesthetic injection. PMID:23869348

Jeon, Byoung Hyun; Bang, Heui Je; Lee, Gyung Moo; Kwon, Oh Pum

2013-01-01

172

[From gene to diseases; hypokalemic periodic paralysis].  

PubMed

Hypokalaemic periodic paralysis is an autosomal, dominantly inherited disorder, characterised by attacks of partial or total muscle weakness and serum hypokalaemia. the mutations responsible are located in the CACNA1S gene (type 1) and in the SCN4A gene (type 2), and are all missense mutations where arginine is mostly replaced by histidine or sometimes glycine. The mutation has been localised in the voltage sensor of the transmembrane segment of calcium channel (type 1) and sodium channel (type 2) respectively. How muscle weakness develops is not known. Oral or intravenous administration of potassium is helpful in treating partial or complete attacks. Acetazolamide can reduce the frequency of attacks in type-1 hypokalaemic periodic paralysis. PMID:15185439

Links, T P; Ginjaar, H B; van der Hoeven, J H

2004-05-22

173

Dihydropyridine receptor mutations cause hypokalemic periodic paralysis  

Microsoft Academic Search

Hypokalemic periodic paralysis (hypoKPP) is an autosomal dominant skeletal muscle disorder manifested by episodic weakness associated with low serum potassium. Genetic linkage analysis has localized the hypoKPP gene to chromosome 1q31-q32 near a dihydropyridine receptor (DHP) gene. This receptor functions as a voltage-gated calcium channel and is also critical for excitation-contraction coupling in a voltage-sensitive and calcium-independent manner. We have

L. J. Ptacek; M. F. Leppert; R. Tawil

1994-01-01

174

Facial paralysis rehabilitation: retraining selective muscle control.  

PubMed

Traumatic facial paralysis can be improved with surgical techniques but alone will not restore full function. EMG sensory (bio) feedback can, however, facilitate rehabilitation. Four cases are described using a combined treatment technique of EMG, behavioural modification and specific action exercises. Retraining of eyelid control was also accomplished. Standardized evaluation methods are described. All four patients showed improvement, despite the failure of traditional retraining methods. PMID:7174215

Balliet, R; Shinn, J B; Bach-y-Rita, P

1982-01-01

175

[About two cases of hypokaliemic periodic paralysis].  

PubMed

We report on two cases of hypokaliemic periodic paralysis due to a potassium shift from the extracellular to the intracellular compartment of skeletal muscle cells. The first case occurred in a 15-year-old boy who experienced rapid onset flaccid tetraplegia without neurological abnormalities. Physical exam revealed facial dysmorphy, and EKG a long QT. Biology evidenced shift hypokalemia that was quickly reversible after administration of intravenous potassium. After exclusion of Andersen-Tawil syndrom, hypokalemic familial paralysis (Westphall disease) was diagnosed by molecular genetic testing (disease-causing mutation in CACNA1S) in the proband and in three other family members. The second case occurred in a 24-year-old male who experienced rapid onset flaccid tetraplegia due to intracellular potassium shift that was quickly reversible after administration of intravenous potassium. Biology revealed thyrotoxicosis due to Grave's disease. To the best of our knowledge, this is the first case described in a people from pacific origin. The clinical, biological, and electromyographic findings of the most frequent causes of periodic paralysis are underlined as well as the molecular genetic diagnosis in familial forms. PMID:17081960

Burtey, Stéphane; Vacher-Coponat, Henri; Berland, Yvon; Dussol, Bertrand

2006-11-01

176

Energy, macronutrients and laryngeal cancer risk  

Microsoft Academic Search

(95% CI 1.12-1.21) for alcohol energy, and 1.02 (95% CI 1.01-1.04) for non-alcohol energy. A significantly increased risk of laryngeal cancer was observed for animal protein (continuous OR = 1.21, 95% CI 1.03-1.41), polyunsaturated fats other than linoleic and linolenic fatty acids (OR = 1.43, 95% CI 1.19-1.70), and cholesterol intake (OR = 1.43, 95% CI 1.19-1.71). Laryngeal cancer risk

C. Bosetti; C. La Vecchia; R. Talamini; E. Negri; F. Levi; J. Fryzek; J. K. McLaughlin; W. Garavello; S. Franceschi

2003-01-01

177

[Diagnosis and therapy of laryngitis gastrica].  

PubMed

We treated 64 patients with the diagnosis of laryngitis gastrica with Antra (Omeprazol) in doses of 10, 20, and 40 mg. To determine the success of the therapy, pH monitoring of the esophagus and hypopharynx, the voice status and measurement of vocal penetrating capacity were used. The results prove that a 20-mg dose of Antra is suitable for the therapy of laryngitis gastrica with a high rate of success. Problems which arose during the investigation, consequent changes of the original concept of the project as well as new aspects and questions which resulted from this are discussed with respect to further investigation. PMID:10955230

Pahn, J; Schlottmann, A; Witt, G; Wilke, W

2000-07-01

178

[Tissue reactions of the laryngeal mucous membrane and its regulatory structures in experimental chronic laryngitis].  

PubMed

Experimental chronic laryngitis (ECL) was induced in 34 adult male rabbits by placement of fosta nylon thread into their trachea. Changes in the laryngeal mucous membrane in ECL were studied at days 30-90 using histological, histochemical and morphometric methods. ECL resulted in the thickening of both the epithelium and lamina propria of the laryngeal mucous membrane. In the ECL dynamics, the thickness of stratified squamous epithelium was increased insignificantly, however, it demonstrated the stimulation of the focal hyperplastic processes. Lamina propria, underlying this epithelium, was found to become thicker throughout the whole experiment (days 30-90). At the same time, progressive growth of the thickness of both pseudostratified ciliated epithelium and the lamina propria beneath was observed. This was accompanied by the hyperplasia of laryngeal endocrine cells and the increase of their secretory activity. PMID:21500431

Khamidova, F M; Blinova, S A

2010-01-01

179

Monolimb Paralysis after Laparoscopic Appendectomy Due to Conversion Disorder  

PubMed Central

Limb paralysis can develop for various reasons. We found a 13-year-old patient who became paralyzed in her lower extremities after laparoscopic appendectomy. Some tests, including electrodiagnostic studies and magnetic resonance imaging, were performed to evaluate the cause of lower limb paralysis. None of the tests yielded definite abnormal findings. We subsequently decided to explore the possibility of psychological problems. The patient was treated with simultaneous rehabilitation and psychological counseling. Paralysis of the patient's lower extremity improved gradually and the patient returned to normal life. Our findings indicate that psychological problems can be related to limb paralysis without organ damage in patients who have undergone laparoscopic surgical procedures. PMID:25426280

Song, Sung Hyuk; Lee, Kyeong Hwan

2014-01-01

180

Lifetime Prevalence Rates of Sleep Paralysis: A Systematic Review  

PubMed Central

Objective To determine lifetime prevalence rates of sleep paralysis. Data Sources Keyword term searches using “sleep paralysis”, “isolated sleep paralysis”, or “parasomnia not otherwise specified” were conducted using MEDLINE (1950-present) and PsychINFO (1872-present). English and Spanish language abstracts were reviewed, as were reference lists of identified articles. Study Selection Thirty five studies that reported lifetime sleep paralysis rates and described both the assessment procedures and sample utilized were selected. Data Extraction Weighted percentages were calculated for each study and, when possible, for each reported subsample. Data Synthesis Aggregating across studies (total N = 36533), 7.6% of the general population, 28.3% of students, and 31.9% of psychiatric patients experienced at least one episode of sleep paralysis. Of the psychiatric patients with panic disorder, 34.6% reported lifetime sleep paralysis. Results also suggested that minorities experience lifetime sleep paralysis at higher rates than Caucasians. Conclusions Sleep paralysis is relatively common in the general population and more frequent in students and psychiatric patients. Given these prevalence rates, sleep paralysis should be assessed more regularly and uniformly in order to determine its impact on individual functioning and better articulate its relation to psychiatric and other medical conditions. PMID:21571556

Barber, Jacques P.

2011-01-01

181

Tick paralysis in Australia caused by Ixodes holocyclus Neumann  

PubMed Central

Ticks are obligate haematophagous ectoparasites of various animals, including humans, and are abundant in temperate and tropical zones around the world. They are the most important vectors for the pathogens causing disease in livestock and second only to mosquitoes as vectors of pathogens causing human disease. Ticks are formidable arachnids, capable of not only transmitting the pathogens involved in some infectious diseases but also of inducing allergies and causing toxicoses and paralysis, with possible fatal outcomes for the host. This review focuses on tick paralysis, the role of the Australian paralysis tick Ixodes holocyclus, and the role of toxin molecules from this species in causing paralysis in the host. PMID:21396246

Hall-Mendelin, S; Craig, S B; Hall, R A; O’Donoghue, P; Atwell, R B; Tulsiani, S M; Graham, G C

2011-01-01

182

[Manifestations of progressive paralysis. Not a theme of the past].  

PubMed

Investigations carried out on 293 cases of progressive paralysis showed that the widely held view of a "classical form" of progressive paralysis is not applicable. Thus megalomania was found in only 13% of the patients and a manic type state in less than half. Disturbances in affectivity, drive and intellectual functions in progressive paralysis are, in general, uncharacteristic and can appear in any psychotic syndrome. Moreover, neurological symptoms taken as characteristic for progressive paralysis such as the Argyll-Robertson phenomenon or the "mimic quivering" are more the exception than the rule. PMID:4017887

Risse, A; Rohde, A; Marneros, A

1985-08-01

183

Ventricular pressures in phonating excised larynges  

PubMed Central

Pressure in the laryngeal ventricle was measured with a beveled needle connected to a pressure transducer in excised canine larynges. Air pressures within the ventricle were obtained for different adduction levels of the true vocal folds (TVFs), false vocal folds (FVFs), and subglottal pressures (Ps). Results indicated that the air pressures in the ventricle appear to be strongly related to the motion of the FVFs rather than to the effects of TVF vibration. Both dc and ac pressures depend on FVF adduction, amplitude of motion of the FVFs, and whether the FVFs touch each other during the vibratory cycle. Mean and peak-to-peak pressures in the ventricle were as high as 65% of the mean and peak-to-peak Ps, respectively, when the FVFs vibrated with large amplitude and contact each cycle. If the glottis was not closed, a medial movement of the FVFs appeared to create a positive pressure pulse on the Ps signal due to an increase in the laryngeal flow resistance. The electroglottograph signal showed evidence of tissue contact for both the TVFs and the FVFs. The study suggests that the laryngeal ventricle acts as a relatively independent aero-acoustic chamber that depends primarily upon the motion of the FVFs. PMID:22894222

Alipour, Fariborz; Scherer, Ronald C.

2012-01-01

184

Ventricular pressures in phonating excised larynges.  

PubMed

Pressure in the laryngeal ventricle was measured with a beveled needle connected to a pressure transducer in excised canine larynges. Air pressures within the ventricle were obtained for different adduction levels of the true vocal folds (TVFs), false vocal folds (FVFs), and subglottal pressures (Ps). Results indicated that the air pressures in the ventricle appear to be strongly related to the motion of the FVFs rather than to the effects of TVF vibration. Both dc and ac pressures depend on FVF adduction, amplitude of motion of the FVFs, and whether the FVFs touch each other during the vibratory cycle. Mean and peak-to-peak pressures in the ventricle were as high as 65% of the mean and peak-to-peak Ps, respectively, when the FVFs vibrated with large amplitude and contact each cycle. If the glottis was not closed, a medial movement of the FVFs appeared to create a positive pressure pulse on the Ps signal due to an increase in the laryngeal flow resistance. The electroglottograph signal showed evidence of tissue contact for both the TVFs and the FVFs. The study suggests that the laryngeal ventricle acts as a relatively independent aero-acoustic chamber that depends primarily upon the motion of the FVFs. PMID:22894222

Alipour, Fariborz; Scherer, Ronald C

2012-08-01

185

Current role of stroboscopy in laryngeal imaging  

PubMed Central

Purpose of review This paper summarizes recent technological advancements and insight into the role of stroboscopy in laryngeal imaging. Recent findings Videostroboscopic technology Although stroboscopy has not undergone major technological improvements, recent clarifications have been made to the application of stroboscopic principles to video-based laryngeal imaging. Also recent advances in coupling stroboscopy with high-definition video cameras provide higher spatial resolution of phonatory function. Visual stroboscopic assessment Studies indicate that interrater reliability of visual stroboscopic assessment varies depending on the laryngeal feature being rated and that only a subset of features may be needed to represent an entire assessment. High-speed videoendoscopy (HSV) judgments have been shown to be more sensitive than stroboscopy for evaluating vocal fold phase asymmetry, pointing to the potential of complementing stroboscopy with alternative imaging modalities in hybrid systems. Clinical role Stroboscopic imaging continues to play a central role in voice clinics. Although HSV may provide more detailed information about phonatory function, its eventual clinical adoption depends on how remaining practical, technical, and methodological challenges will be met. Summary Laryngeal videostroboscopy continues to be the modality of choice for imaging vocal fold vibration, but technological advancements and HSV research findings are driving increased interest in the clinical adoption of HSV to complement videostroboscopic assessment. PMID:22931908

Mehta, Daryush D.; Hillman, Robert E.

2013-01-01

186

Atraumatic laser treatment for laryngeal papillomatosis  

NASA Astrophysics Data System (ADS)

Ten to fifteen thousand new cases of recurrent respiratory papillomatosis (RRP) are diagnosed each year in the United States. RRP is caused by the human papillomavirus (HPV) and is characterized by recurrent, non-malignant, proliferative lesions of the larynx. Patients with RRP undergo numerous microsurgical procedures to remove laryngeal papilloma threatening airway patency and interfering with phonation. The standard surgical technique involves CO2 laser vaporization of laryngeal epithelium affected by the lesions, and requires general anesthesia. The pulsed dye laser operating at 585 nm has previously been demonstrated to be effective in clearing HPV lesions of the skin (verrucae). For treatment of RRP, the fiber- compatible pulsed dye laser radiation may be delivered under local anesthesia using a flexible intranasal laryngoscope. Potential advantages of the pulsed dye laser treatment over CO2 laser surgery include (1) reduced morbidity, especially a lower risk of laryngeal scarring; (2) lower cost; (3) reduced technical difficulty; and (4) reduced risk of viral dissemination or transmission. In vivo studies are underway to determine the effect of pulsed dye laser radiation on normal canine laryngeal tissue.

McMillan, Kathleen; Pankratov, Michail M.; Wang, Zhi; Bottrill, Ian; Rebeiz, Elie E.; Shapshay, Stanley M.

1994-09-01

187

Laryngeal descent is not uniquely mammalian  

Microsoft Academic Search

The hyo-laryngeal complex moves caudally during speech in humans (1) as well as during non-verbal vocalization in non- human mammals (2). Little is known about this structure or its role in avian vocalization. Using anatomical data from dissected birds, Homberger (3, 4, 5) predicted the movements of the hyoid skeleton. White (6) showed cineradiographically that the larynx of the rooster

Tobias Riede; Rod Suthers

188

Applications of Robotics for Laryngeal Surgery  

E-print Network

Applications of Robotics for Laryngeal Surgery Alexander T. Hillel, MDa , Ankur Kapoor, Ph and Neck Surgery, Johns Hopkins University School of Medicine, 601 N. Caroline Street, 6th Floor, JHOC 6163. Open surgery of the larynx allows for increased expo- sure of the surgical field and dexterity

Simaan, Nabil

189

Facial nerve trauma: evaluation and considerations in management.  

PubMed

The management of facial paralysis continues to evolve. Understanding the facial nerve anatomy and the different methods of evaluating the degree of facial nerve injury are crucial for successful management. When the facial nerve is transected, direct coaptation leads to the best outcome, followed by interpositional nerve grafting. In cases where motor end plates are still intact but a primary repair or graft is not feasible, a nerve transfer should be employed. When complete muscle atrophy has occurred, regional muscle transfer or free flap reconstruction is an option. When dynamic reanimation cannot be undertaken, static procedures offer some benefit. Adjunctive tools such as botulinum toxin injection and biofeedback can be helpful. Several new treatment modalities lie on the horizon which hold potential to alter the current treatment algorithm. PMID:25709748

Gordin, Eli; Lee, Thomas S; Ducic, Yadranko; Arnaoutakis, Demetri

2015-03-01

190

Development and validation of the Newcastle laryngeal hypersensitivity questionnaire  

PubMed Central

Background Laryngeal hypersensitivity may be an important component of the common disorders of laryngeal motor dysfunction including chronic refractory cough, pdoxical vocal fold movement (vocal cord dysfunction), muscle tension dysphonia, and globus pharyngeus. Patients with these conditions frequently report sensory disturbances, and an emerging concept of the ‘irritable larynx’ suggests common features of a sensory neuropathic dysfunction as a part of these disorders. The aim of this study was to develop a Laryngeal Hypersensitivity Questionnaire for patients with laryngeal dysfunction syndromes in order to measure the laryngeal sensory disturbance occurring in these conditions. Methods The 97 participants included 82 patients referred to speech pathology for behavioural management of laryngeal dysfunction and 15 healthy controls. The participants completed a 21 item self administered questionnaire regarding symptoms of abnormal laryngeal sensation. Factor analysis was conducted to examine correlations between items. Discriminant analysis and responsiveness to change were evaluated. Results The final questionnaire comprised 14 items across three domains: obstruction, pain/thermal, and irritation. The questionnaire demonstrated significant discriminant validity with a mean difference between the patients with laryngeal disorders and healthy controls of 5.5. The clinical groups with laryngeal hypersensitivity had similar abnormal scores. Furthermore the Newcastle Laryngeal Hypersensitivity Questionnaire (LHQ) showed improvement following behavioural speech pathology intervention with a mean reduction in LHQ score of 2.3. Conclusion The Newcastle Laryngeal Hypersensitivity Questionnaire is a simple, non-invasive tool to measure laryngeal pesthesia in patients with laryngeal conditions such as chronic cough, pdoxical vocal fold movement (vocal cord dysfunction), muscle tension dysphonia, and globus pharyngeus. It can successfully differentiate patients from healthy controls and measure change following intervention. It is a promising tool for use in clinical research and practice. PMID:24552215

2014-01-01

191

9 CFR 310.15 - Disposition of thyroid glands and laryngeal muscle tissue.  

Code of Federal Regulations, 2013 CFR

...Disposition of thyroid glands and laryngeal muscle tissue. 310.15 Section 310.15...Disposition of thyroid glands and laryngeal muscle tissue. (a) Livestock thyroid glands and laryngeal muscle tissue shall not be used for human...

2013-01-01

192

9 CFR 310.15 - Disposition of thyroid glands and laryngeal muscle tissue.  

Code of Federal Regulations, 2010 CFR

...Disposition of thyroid glands and laryngeal muscle tissue. 310.15 Section 310.15...Disposition of thyroid glands and laryngeal muscle tissue. (a) Livestock thyroid glands and laryngeal muscle tissue shall not be used for human...

2010-01-01

193

9 CFR 310.15 - Disposition of thyroid glands and laryngeal muscle tissue.  

Code of Federal Regulations, 2014 CFR

...Disposition of thyroid glands and laryngeal muscle tissue. 310.15 Section 310.15...Disposition of thyroid glands and laryngeal muscle tissue. (a) Livestock thyroid glands and laryngeal muscle tissue shall not be used for human...

2014-01-01

194

9 CFR 310.15 - Disposition of thyroid glands and laryngeal muscle tissue.  

Code of Federal Regulations, 2012 CFR

...Disposition of thyroid glands and laryngeal muscle tissue. 310.15 Section 310.15...Disposition of thyroid glands and laryngeal muscle tissue. (a) Livestock thyroid glands and laryngeal muscle tissue shall not be used for human...

2012-01-01

195

9 CFR 310.15 - Disposition of thyroid glands and laryngeal muscle tissue.  

Code of Federal Regulations, 2011 CFR

...Disposition of thyroid glands and laryngeal muscle tissue. 310.15 Section 310.15...Disposition of thyroid glands and laryngeal muscle tissue. (a) Livestock thyroid glands and laryngeal muscle tissue shall not be used for human...

2011-01-01

196

Thyrotoxic periodic paralysis in a pediatric patient.  

PubMed

Thyrotoxic periodic paralysis is a reversible metabolic disorder that is characterized by acute muscle weakness and hypokalemia. It predominantly affects males of Asian descent. We describe the youngest such patient yet reported, a 13-year-old Asian male with a history of transient attacks of weakness who presented to our emergency department with weakness in his extremities and mild tachycardia. Laboratory test results initially revealed marked hypokalemia and later confirmed associated hyperthyroidism. Correction of the hypokalemia reversed the patient's weakness in the emergency department. PMID:24378858

Jones, Peter; Papadimitropoulos, Laura; Tessaro, Mark O

2014-01-01

197

Laryngeal Preservation in Managing Advanced Tracheal Adenoid Cystic Carcinoma  

PubMed Central

A 37-year-old male athlete was diagnosed with primary tracheal adenoid cystic carcinoma following investigation for dyspnea, wheeze, and eventual stridor. Preoperative bronchoscopy revealed a highly vascular tumor 4?cm distal to the cricoid with no gross disease extending to the carina. Imaging revealed circumferential tracheal irregularity immediately inferior to the cricoid, with no definite cricoid invasion. Locoregional extension of disease was noted invading the thyroid and abutment of the carotid approximately 180°. Intraoperative findings identified tracheal mucosal disease extending distal to the carina and proximally at the cricothyroid joints where bilateral functional recurrent nerves were preserved. A decision made to preserve the larynx given the inability to fully resect distal tracheal disease. A 5?cm sleeve resection of the trachea was made with a cricotracheal anastomosis following suprahyoidal muscle release and laryngeal drop-down. The patient was treated with adjuvant radiotherapy including platinum based chemotherapy in an effort to maximise local control. PET scanning three months after therapy revealed no FDG uptake locally or distally. PMID:25878915

Subramaniam, Thavakumar; Lennon, Paul; Kinsella, John; O'Neill, James Paul

2015-01-01

198

A simple and rapid approach to hypokalemic paralysis  

Microsoft Academic Search

Hypokalemia with paralysis (HP) is a potentially reversible medical emergency. It is primarily the result of either hypokalemic periodic paralysis (HPP) caused by an enhanced shift of potassium (K+) into cells or non-HPP resulting from excessive K+ loss. Failure to make a distinction between HPP and non-HPP could lead to improper management. The use of spot urine for K+ excretion

Shih-Hua Lin; Jainn-Shiun Chiu; Chin-Wang Hsu; Tom Chau

2003-01-01

199

Thyrotoxic periodic paralysis triggered by ?2-adrenergic bronchodilators.  

PubMed

ABSTRACTHypokalemic periodic paralysis is the most common form of periodic paralysis and is characterized by attacks of muscle paralysis associated with a low serum potassium (K+) level due to an acute intracellular shifting. Thyrotoxic periodic paralysis (TPP), characterized by the triad of muscle paralysis, acute hypokalemia, and hyperthyroidism, is one cause of hypokalemic periodic paralysis. The triggering of an attack of undiagnosed TPP by ?2-adrenergic bronchodilators has, to our knowledge, not been reported previously. We describe two young men who presented to the emergency department with the sudden onset of muscle paralysis after administration of inhaled ?2-adrenergic bronchodilators for asthma. In both cases, the physical examination revealed an enlarged thyroid gland and symmetrical flaccid paralysis with areflexia of lower extremities. Hypokalemia with low urine K+ excretion and normal blood acid-base status was found on laboratory testing, suggestive of an intracellular shift of K+, and the patients' muscle strength recovered at serum K+ concentrations of 3.0 and 3.3 mmol/L. One patient developed hyperkalemia after a total potassium chloride supplementation of 110 mmol. Thyroid function testing was diagnostic of primary hyperthyroidism due to Graves disease in both cases. These cases illustrate that ?2-adrenergic bronchodilators should be considered a potential precipitant of TPP. PMID:24852589

Yeh, Fu-Chiang; Chiang, Wen-Fang; Wang, Chih-Chiang; Lin, Shih-Hua

2014-05-01

200

Retal tubular acidosis complicated with hypokalemic periodic paralysis  

Microsoft Academic Search

Three Chinese girls with hypokalemic periodic paralysis secondary to different types of renal tubular acidosis are presented. One girl has primary distal renal tubular acidosis complicated with nephrocalcinosis. Another has primary Sjögren syndrome with distal renal tubular acidosis, which occurs rarely with hypokalemic periodic paralysis in children. The third has an isolated proximal renal tubular acidosis complicated with multiple organ

Ying-Chao Chang; Chao-Chang Huang; Yuan-Yow Chiou; Chin-Yin Yu

1995-01-01

201

Delayed hypokalemic paralysis following a convulsion due to alcohol abstinence  

Microsoft Academic Search

We encountered three patients with hypokalemic paralysis following a convulsion in the early stages of alcohol abstinence. The transtubular potassium gradient was less than 2.0, suggesting intracellular potassium shift. Hypokalaemic paralysis may result from retention of intracellular cationic potassium bound by anionic phosphorylated compounds, precipitated by an acceleration of the Na+–K+ pump in alcohol withdrawal and convulsions. These findings warn

Wei-Hsi Chen; Hsin-Ling Yin; Hung-Sheng Lin; Shun-Sheng Chen; Jia-Shou Liu

2006-01-01

202

Selective Activation of the Human Tibial and Common Peroneal Nerves with a Flat Interface Nerve Electrode  

PubMed Central

Problem Addressed Electrical stimulation has been shown effective in restoring basic lower extremity motor function in individuals with paralysis. We tested the hypothesis that a Flat Interface Nerve Electrode (FINE) placed around the human tibial or common peroneal nerve above the knee can selectively activate each of the most important muscles these nerves innervate for use in a neuroprosthesis to control ankle motion. Methodology During intraoperative trials involving three subjects, an 8-contact FINE was placed around the tibial and/or common peroneal nerve, proximal to the popliteal fossa. The FINE’s ability to selectively recruit muscles innervated by these nerves was assessed. Data were used to estimate the potential to restore active plantarflexion or dorsiflexion while balancing inversion and eversion using a biomechanical simulation. Results, Significance, and Potential Impact With minimal spillover to non-targets, at least three of the four targets in the tibial nerve, including two of the three muscles constituting the triceps surae were independently and selectively recruited in all subjects. As acceptable levels of spillover increased, recruitment of the target muscles increased. Selective activation of muscles innervated by the peroneal nerve was more challenging. Estimated joint moments suggests that plantarflexion sufficient for propulsion during stance phase of gait and dorsiflexion sufficient to prevent foot drop during swing can be achieved, accompanied by a small but tolerable inversion or eversion moment. PMID:23918148

Schiefer, M A; Freeberg, M; Pinault, G J C; Anderson, J; Hoyen, H; Tyler, D J; Triolo, R J

2013-01-01

203

Nerve Blocks  

MedlinePLUS

... doctor. By performing a nerve block and then monitoring how the patient responds to the injection, the ... and/or imaging guidance. He or she will clean the area with antiseptic solution, and then the ...

204

Feasibility of the laryngeal tube airway for artificial ventilation in pigs and comparison with the laryngeal mask airway.  

PubMed

Airway management in anesthetized pigs is known to be technically demanding, and the 'gold standard' technique of endotracheal intubation is particularly difficult to master. The authors investigated the feasibility of the laryngeal tube as an alternative technique for airway management in German Landrace pigs (n = 5). They compared this method with the laryngeal mask, which is considered to be an effective yet relatively straightforward tool for porcine airway management. One after the other, investigators attempted to establish an airway in each anesthetized, artificially ventilated pig using each device. The laryngeal tube was too short to intubate the largest pig (weighing 45 kg), and it took investigators slightly longer to insert this device compared with the laryngeal mask. With the laryngeal mask, there were several incidents of gastric insufflation. Despite these complications, all investigators were able to establish a secure airway and maintain oxygenation with the laryngeal tube, and all subjectively rated both devices as easy to use. PMID:18650825

Birkholz, Torsten; Irouschek, Andrea; Kessler, Peter; Blunk, James Allen; Labahn, Dirk; Schmidt, Joachim

2008-08-01

205

Lodged oesophageal button battery masquerading as a coin: an unusual cause of bilateral vocal cord paralysis  

PubMed Central

An 11?month?old girl with an oesophageal foreign bodywas presented: from the radiographic appearance it was presumed to be a coin. Microlaryngoscopy 5?h after ingestion revealed a button battery impacted in the hypopharynx with severe damage to the oesophageal mucosa. The patient was intubated for 6?days in the intensive care unit because of stridor and respiratory distress. Repeat microlaryngoscopy demonstrated bilateral vocal cord palsy, which was presumed to be secondary to the involvement of the recurrent laryngeal nerves in the injury. We recommend that in the absence of a history of observed ingestion, it should be assumed that coin?like foreign bodies are button batteries until proven otherwise. PMID:17351209

Bernstein, Jonathan Michael; Burrows, Stuart A; Saunders, Michael W

2007-01-01

206

Organ preservation surgery for laryngeal cancer  

PubMed Central

The principles of management of the laryngeal cancer have evolved over the recent past with emphasis on organ preservation. These developments have paralleled technological advancements as well as refinement in the surgical technique. The surgeons are able to maintain physiological functions of larynx namely speech, respiration and swallowing without compromising the loco-regional control of cancer in comparison to the more radical treatment modalities. A large number of organ preservation surgeries are available to the surgeon; however, careful assessment of the stage of the cancer and selection of the patient is paramount to a successful outcome. A comprehensive review of various organ preservation techniques in vogue for the management of laryngeal cancer is presented. PMID:19442314

Chawla, Sharad; Carney, Andrew Simon

2009-01-01

207

Contact laser surgery in laryngeal tumor management  

NASA Astrophysics Data System (ADS)

The data is presented referring to the details of contact YAG-Nd laser surgery technique under experimental and clinical conditions. Essentially, the contact method is compared with the effect of the scalpel in the surgeon's hands and biologically there is no tangible difference between the carbon dioxide laser and the YAG-Nd laser when the latter is applied in the contact manner. Laryngeal application of the laser contact technique proved to be very beneficial clinically. Tracheal puncture approach with jet ventilation of the lungs ensured absolute safety of the endoscopic laser operative procedure. On the basis of almost 300 operations it has been concluded that the laryngeal neoplasms (benign and T1 - T2 cancer) can be successfully treated in this manner.

Plouzhnikov, Marius S.; Konoplev, Oleg; Basiladze, Levan

1994-02-01

208

Avoidance of Laryngeal Injuries during Gastric Intubation  

PubMed Central

Gastric intubation is a common and simple procedure that is often performed on patients who are sedated or anaesthetised. If the gastric tube (GT) is inserted blindly while the patient is unconscious, this procedure may result in easily preventable complications such as laryngeal trauma. We present an interesting case where the blind placement of a orogastric tube (OGT) in an anesthetised 52-year-old female patient at Sultan Qaboos University Hospital in Oman resulted in significant arytenoid trauma. This led to delayed tracheal extubation. The movement of the GT from the oropharyngeal area to the upper oesophageal sphincter can be visualised and controlled with the use of Magill forceps and a laryngoscope. Therefore, this report highlights the need for GT insertion procedures to be performed under direct vision in patients who are unconscious (due to sedation, anaesthesia or an inherent condition) in order to prevent trauma to the laryngeal structures. PMID:25097780

Burad, Jyoti; Deoskar, Sonali; Bhakta, Pradipta; Date, Rohit; Sharma, Pradeep

2014-01-01

209

Applications of robotics for laryngeal surgery  

PubMed Central

Synopsis The author presents the clinical application of robotics to laryngeal surgery in terms of enhancement of surgical precision and performance of other minimally invasive procedures not feasible with current instrumentation. Presented in this article are comparisons of human arm with robotic arm in terms of degrees of freedom and discussion of surgeries and outcomes with use of the robotic arm. Robotic equipment for laryngeal surgery has the potential to overcome many of the limitations of endolaryngeal procedures by improving optics, increasing instrument degrees of freedom, and modulating tremor. Outside of laryngology, a multi-armed robotic system would have utility in microvascular procedures at the base of the skull, sinus surgery, and single port gastrointestinal and thoracic access surgery. PMID:18570959

Hillel, Alexander T.; Kapoor, Ankur; Simaan, Nabil; Taylor, Russell H.; Flint, Paul

2014-01-01

210

Capnometry and the paediatric laryngeal mask airway  

Microsoft Academic Search

The laryngeal mask airway (LMA), an alternative to tracheal intubation in certain situations, has gained popularity in recent\\u000a years. Initially designed for use in adults it has now become available in suitable sizes for paediatric anaesthesia. The\\u000a objectives of this study were to identify the preferred site of sampling the end-tidal carbon dioxide (PetCO2 with the LMA and to determine

I. A. Spahr-Schopfer; B. Bissonnette; E. J. Hartley

1993-01-01

211

Laryngeal-level amplitude modulation in vibrato.  

PubMed

The goal of this investigation was to test a new methodology for measuring amplitude modulation (AM) at the level of the vocal folds during vibrato in trained singers, because previous research has suggested that AM arises in large part as an acoustic epiphenomenon through an interaction of the harmonics in the laryngeal source with the resonances of the vocal tract as the fundamental frequency oscillates. A within-subjects model was used to compare vocal activity across three pitch and three loudness conditions. Seventeen female singers with a range of training and experience were recorded with a microphone and an electroglottograph (EGG). Fluctuations in the ratio of closing to opening peaks in the first derivative of the EGG signal were used as an index of laryngeal-level AM. Evidence of laryngeal AM was found to a greater or lesser extent in all the singers, and its extent was not related to the degree of training. Across singers and pitch conditions, it was more prominent at lower intensities. The differentiated EGG signal lends itself to the measurement of AM at the level of the larynx, and the extent of the modulation appears more related to the level of vocal effort than to individual singer characteristics. PMID:17658720

Dromey, Christopher; Reese, Lorie; Hopkin, J Arden

2009-03-01

212

Obstructive laryngeal schwannoma in a young female.  

PubMed

Laryngeal schwannomas are rare, benign neurogenic tumors. They normally present as a slow-growing, encapsulated, submucosal mass in the supraglottic region. We describe a 20-year-old female presenting with a 2-year history of hoarseness and progressive worsening dyspnea. Fiberoptic laryngoscopy and computed tomography revealed a round, low-density submucosal mass at right false cord and arytenoepiglottic regions with glottic extension. Microlaryngoscopic biopsy and debulking for this solid tumor were performed without tracheostomy. Schwannoma was confirmed by histopathological study. However, rapidly worsening stridor occurred 2 weeks after the surgery. Fiberoptic laryngoscopy showed an exophytic tumor occupying the right hemilarynx with airway compromise. Definite complete excision of the tumor was performed by right vertical hemilaryngectomy. At 5-month follow-up, the laryngeal wound was clear without signs of recurrence. Rapid occurrence of airway obstruction after debulking and biopsy was demonstrated in this case. Vertical hemilaryngectomy was inevitable to cure this potentially life-threatening laryngeal schwannoma in this young female with postoperative serviceable voice. PMID:25778013

Chiu, Chang-Chieh; Chou, Shah-Hwa; Wu, Chun-Chieh; Liang, Peir-In; Lee, Ka-Wo

2015-12-01

213

Isolated sleep paralysis and fearful isolated sleep paralysis in outpatients with panic attacks.  

PubMed

Isolated sleep paralysis (ISP) has received scant attention in clinical populations, and there has been little empirical consideration of the role of fear in ISP episodes. To facilitate research and clinical work in this area, the authors developed a reliable semistructured interview (the Fearful Isolated Sleep Paralysis Interview) to assess ISP and their proposed fearful ISP (FISP) episode criteria in 133 patients presenting for panic disorder treatment. Of these, 29.3% met lifetime ISP episode criteria, 20.3% met the authors' lifetime FISP episode criteria, and 12.8% met their recurrent FISP criteria. Both ISP and FISP were associated with minority status and comorbidity. However, only FISP was significantly associated with posttraumatic stress disorder, body mass, anxiety sensitivity, and mood and anxiety disorder symptomatology. PMID:20715166

Sharpless, Brian A; McCarthy, Kevin S; Chambless, Dianne L; Milrod, Barbara L; Khalsa, Shabad-Ratan; Barber, Jacques P

2010-12-01

214

Isolated Sleep Paralysis and Fearful Isolated Sleep Paralysis in Outpatients With Panic Attacks  

PubMed Central

Isolated sleep paralysis (ISP) has received scant attention in clinical populations, and there has been little empirical consideration of the role of fear in ISP episodes. To facilitate research and clinical work in this area, the authors developed a reliable semistructured interview (the Fearful Isolated Sleep Paralysis Interview) to assess ISP and their proposed fearful ISP (FISP) episode criteria in 133 patients presenting for panic disorder treatment. Of these, 29.3% met lifetime ISP episode criteria, 20.3% met the authors’ lifetime FISP episode criteria, and 12.8% met their recurrent FISP criteria. Both ISP and FISP were associated with minority status and comorbidity. However, only FISP was significantly associated with posttraumatic stress disorder, body mass, anxiety sensitivity, and mood and anxiety disorder symptomatology. PMID:20715166

Sharpless, Brian A.; McCarthy, Kevin S.; Chambless, Dianne L.; Milrod, Barbara L.; Khalsa, Shabad-Ratan; Barber, Jacques P.

2013-01-01

215

Comparative study of thyrotoxic periodic paralysis from idiopathic hypokalemic periodic paralysis: An experience from India  

PubMed Central

Objective: There is paucity of reports on thyrotoxic periodic paralysis (TPP) from India. We report the patients with TPP and compare them with idiopathic hypokalemic periodic paralysis (IHPP). Materials and Methods: Patients with hypokalemic periodic paralysis (HPP) treated during the past 11 years were evaluated retrospectively. Their demographic parameters, family history, clinical features, precipitating factors, severity of weakness, laboratory parameters and rapidity of recovery were recorded. The demographic, clinical and laboratory parameters of TPP and IHPP were compared. Results: During the study period, we managed 52 patients with HPP; nine (17.3%) of whom had TPP and 27 (52%) had IHPP. The demographic, precipitating factors, number of attacks and severity of limb weakness were similar between the TPP and IHPP groups, except in the IHPP group, bulbar weakness was present in four and respiratory paralysis in six, needing artificial ventilation in two patients. Serum potassium was significantly lower in TPP (2.21 ± 0.49) compared with IHPP (2.67 ± 0.59, P = 0.04). Four patients with TPP had subclinical thyrotoxicosis and two had subclinical hyperthyroidism. Rebound hyperkalemia occurred in both TPP and IHPP (three versus eight patients). The recovery was faster in IHPP (26.7 ± 15.4 h) compared with TPP (34.0 ± 14.0 h), but was statistically insignificant. Conclusion: TPP constitutes 17.3% of HPP, and absence of clinical features of thyrotoxicosis and subclinical hyperthyroidism in TPP is not uncommon. Clinical features, demographic profile and rebound hyperkalemia are similar in both TPP and IHPP. The serum potassium level is significantly low in the TPP compared with the IHPP group. PMID:22919190

Kalita, J.; Goyal, G.; Bhoi, S. K.; Chandra, S.; Misra, U. K.

2012-01-01

216

Isolated Sleep Paralysis: Fear, Prevention, and Disruption.  

PubMed

Objectives: Relatively little is known about isolated sleep paralysis (ISP), and no empirically supported treatments are available. This study aims to determine: the clinical impact of ISP, the techniques used to prevent or disrupt ISP, and the effectiveness of these techniques. Method: 156 undergraduates were assessed with lifetime ISP using a clinical interview. Results: 75.64% experienced fear during ISP, and 15.38% experienced clinically significant distress/interference, while 19.23% attempted to prevent ISP, and 79.31% of these believed their methods were successful. Regarding disruption, 69.29% made attempts, but only 54.12% reported them effective. Conclusions: Disruption was more common than prevention, but several techniques were useful. Encouraging individuals to utilize these techniques and better monitor their symptoms may be an effective way to manage problematic ISP. PMID:25315810

Sharpless, Brian Andrew; Grom, Jessica Lynn

2014-10-14

217

Paralysis recovery in humans and model systems  

NASA Technical Reports Server (NTRS)

Considerable evidence now demonstrates that extensive functional and anatomical reorganization following spinal cord injury occurs in centers of the brain that have some input into spinal motor pools. This is very encouraging, given the accumulating evidence that new connections formed across spinal lesions may not be initially functionally useful. The second area of advancement in the field of paralysis recovery is in the development of effective interventions to counter axonal growth inhibition. A third area of significant progress is the development of robotic devices to quantify the performance level of motor tasks following spinal cord injury and to 'teach' the spinal cord to step and stand. Advances are being made with robotic devices for mice, rats and humans.

Edgerton, V. Reggie; Roy, Roland R.

2002-01-01

218

Parkinson Disease Affects Peripheral Sensory Nerves in the Pharynx  

PubMed Central

Dysphagia is very common in patients with Parkinson’s disease (PD) and often leads to aspiration pneumonia, the most common cause of death in PD. Unfortunately, current therapies are largely ineffective for dysphagia. As pharyngeal sensation normally triggers the swallowing reflex, we examined pharyngeal sensory nerves in PD for Lewy pathology. Sensory nerves supplying the pharynx were excised from autopsied pharynges obtained from patients with clinically diagnosed and neuropathologically confirmed PD (n = 10) and healthy age-matched controls (n = 4). We examined: the glossopharyngeal nerve (IX); the pharyngeal sensory branch of the vagus nerve (PSB-X); and the internal superior laryngeal nerve (ISLN) innervating the laryngopharynx. Immunohistochemistry for phosphorylated ?-synuclein was used to detect potential Lewy pathology. Axonal ?-synuclein aggregates in the pharyngeal sensory nerves were identified in all of the PD subjects but not in the controls. The density of ?-synuclein-positive lesions was significantly greater in PD subjects with documented dysphagia compared to those without dysphagia. In addition, ?-synuclein-immunoreactive nerve fibers in the ISLN were much more abundant than those in the IX and PSBX. These findings suggest that pharyngeal sensory nerves are directly affected by the pathologic process of PD. This anatomic pathology may decrease pharyngeal sensation impairing swallowing and airway protective reflexes, thereby contributing to dysphagia and aspiration. PMID:23771215

Mu, Liancai; Sobotka, Stanislaw; Chen, Jingming; Su, Hungxi; Sanders, Ira; Nyirenda, Themba; Adler, Charles H.; Shill, Holly A.; Caviness, John N.; Samanta, Johan E.; Sue, Lucia I.; Beach, Thomas G.

2013-01-01

219

Botox induced muscle paralysis rapidly degrades bone  

PubMed Central

The means by which muscle function modulates bone homeostasis is poorly understood. To begin to address this issue, we have developed a novel murine model of unilateral transient hindlimb muscle paralysis using botulinum toxin A (Botox). Female C57BL/6 mice (16 weeks) received IM injections of either saline or Botox (n = 10 each) in both the quadriceps and calf muscles of the right hindleg. Gait dysfunction was assessed by multi-observer inventory, muscle alterations were determined by wet mass, and bone alterations were assessed by micro-CT imaging at the distal femur, proximal tibia, and tibia mid-diaphysis. Profound degradation of both muscle and bone was observed within 21 days despite significant restoration of weight bearing function by 14 days. The muscle mass of the injected quadriceps and calf muscles was diminished ?47.3% and ?59.7%, respectively, vs. saline mice (both P < 0.001). The ratio of bone volume to tissue volume (BV/TV) within the distal femoral epiphysis and proximal tibial metaphysis of Botox injected limbs was reduced ?43.2% and ?54.3%, respectively, while tibia cortical bone volume was reduced ?14.6% (all P < 0.001). Comparison of the contralateral non-injected limbs indicated the presence of moderate systemic effects in the model that were most probably associated with diminished activity following muscle paralysis. Taken as a whole, the micro-CT data implied that trabecular and cortical bone loss was primarily achieved by bone resorption. These data confirm the decisive role of neuromuscular function in mediating bone homeostasis and establish a model with unique potential to explore the mechanisms underlying this relation. Given the rapidly expanding use of neuromuscular inhibitors for indications such as pain reduction, these data also raise the critical need to monitor bone loss in these patients. PMID:16185943

Warner, Sarah E.; Sanford, David A.; Becker, Blair A.; Bain, Steven D.; Srinivasan, Sundar; Gross, Ted S.

2006-01-01

220

Arnold’s nerve cough reflex: evidence for chronic cough as a sensory vagal neuropathy  

PubMed Central

Arnold’s nerve ear-cough reflex is recognised to occur uncommonly in patients with chronic cough. In these patients, mechanical stimulation of the external auditory meatus can activate the auricular branch of the vagus nerve (Arnold’s nerve) and evoke reflex cough. This is an example of hypersensitivity of vagal afferent nerves, and there is now an increasing recognition that many cases of refractory or idiopathic cough may be due to a sensory neuropathy of the vagus nerve. We present two cases where the cause of refractory chronic cough was due to sensory neuropathy associated with ear-cough reflex hypersensitivity. In both cases, the cough as well as the Arnold’s nerve reflex hypersensitivity were successfully treated with gabapentin, a treatment that has previously been shown to be effective in the treatment of cough due to sensory laryngeal neuropathy (SLN). PMID:25383210

Gibson, Peter G.; Birring, Surinder S.

2014-01-01

221

Arnold's nerve cough reflex: evidence for chronic cough as a sensory vagal neuropathy.  

PubMed

Arnold's nerve ear-cough reflex is recognised to occur uncommonly in patients with chronic cough. In these patients, mechanical stimulation of the external auditory meatus can activate the auricular branch of the vagus nerve (Arnold's nerve) and evoke reflex cough. This is an example of hypersensitivity of vagal afferent nerves, and there is now an increasing recognition that many cases of refractory or idiopathic cough may be due to a sensory neuropathy of the vagus nerve. We present two cases where the cause of refractory chronic cough was due to sensory neuropathy associated with ear-cough reflex hypersensitivity. In both cases, the cough as well as the Arnold's nerve reflex hypersensitivity were successfully treated with gabapentin, a treatment that has previously been shown to be effective in the treatment of cough due to sensory laryngeal neuropathy (SLN). PMID:25383210

Ryan, Nicole M; Gibson, Peter G; Birring, Surinder S

2014-10-01

222

Thyrotoxic Periodic Paralysis: A Case Report and Literature Review  

PubMed Central

We describe a 37-year-old man with a 4-month history of episodic muscular weakness, involving mainly lower-limbs. Hypokalemia was documented in one episode and managed with intravenous potassium chloride. Hyperthyroidism was diagnosed 4 months after onset of attacks because of mild symptoms. The patient was subsequently diagnosed as having thyrotoxic periodic paralysis associated with Graves’ disease. Treatment with propranolol and methimazol was initiated and one year later he remains euthyroid and symptom free. Thyrotoxic periodic paralysis is a rare disorder, especially among Caucasians, but it should always be considered in patients with acute paralysis and hypokalemia, and thyroid function should be evaluated. PMID:19625499

Barahona, M. J.; Vinagre, I.; Sojo, L.; Cubero, J. M.; Pérez, Antonio

2009-01-01

223

Bilateral Facial Nerve Palsy: A Diagnostic Dilemma  

PubMed Central

Introduction. Bilateral facial nerve palsy (FNP) is a rare condition, representing less than 2% of all cases of FNP. Majority of these patients have underlying medical conditions, ranging from neurologic, infectious, neoplastic, traumatic, or metabolic disorders. Objective. The differential diagnosis of its causes is extensive and hence can present as a diagnostic challenge. Emergency physicians should be aware of these various diagnostic possibilities, some of which are potentially fatal. Case Report. We report a case of a 43-year-old female who presented to the emergency department with sequential bilateral facial nerve paralysis which could not be attributed to any particular etiology and, hence, presented a diagnostic dilemma. Conclusion. We reinforce the importance of considering the range of differential diagnosis in all cases presenting with bilateral FNP. These patients warrant admission and prompt laboratory and radiological investigation for evaluation of the underlying cause and specific further management as relevant. PMID:23326715

Pothiawala, Sohil; Lateef, Fatimah

2012-01-01

224

[The use of eurespal for the treatment of chronic laryngitis].  

PubMed

The author provides a rationale for the use of eurespal for the treatment of chronic laryngitis based on the pathogenetic concept of pathological condition. The results of a clinical study designed to evaluate the efficiency and safety of eurespal therapy in patients with chronic laryngitis are presented. PMID:21378745

Riabova, M A

2011-01-01

225

Aspiration Rate following Nonsurgical Therapy for Laryngeal Cancer  

Microsoft Academic Search

The aim of this study was to evaluate the aspiration rate following nonsurgical therapy, i.e. chemoradiation or radiation alone for laryngeal cancer. Modified barium swallow was performed in 43 patients who complained of dysphagia following chemoradiation (n = 22) or radiation alone (n = 21) for laryngeal cancer. Patients were selected if they were cancer free at the time of

Nam P. Nguyen; Candace C. Moltz; Cheryl Frank; Paul Vos; Carrie Millar; Herbert J. Smith; Howard Lee; Ulf Karlsson; Phuc D. Nguyen; Tomas Martinez; Ly M. Nguyen; Sabah Sallah

2007-01-01

226

Peripheral Nerve Disorders  

MedlinePLUS

... spinal cord. Like static on a telephone line, peripheral nerve disorders distort or interrupt the messages between the brain ... body. There are more than 100 kinds of peripheral nerve disorders. They can affect one nerve or many nerves. ...

227

[Professor HE Tianyou's clinical experience of acupuncture and medicine on intractable facial paralysis].  

PubMed

Professor HE Tianyou's unique understanding and treatment characteristics for intractahle facial paralysis are introduced. In clinical practice professor HE highly values acupoint selection and manipulation application, and integrates Chinese and western medicine to flexibly choose acupoints and formulate prescriptions according to syndrome differentiation and location differentiation, besides, he creates several specialized manipulation methods including "tug-of war opposite acupuncture method" and "tractive flash cupping". Based on strengthening body and dredging collaterals. more attention is given on stimulation to local paralyzed facial nerves; meanwhile acupuncture and medication are combined to improve clinical efficacy. During the treatment, the important role of psychological counseling on patient's anxiety is emphasized, and comprehensive treatment is given physically and psychologically in order to achieve the purpose of total rehabilitation. PMID:25854027

Yan, Fenghua; Yao, Xuhong; Yan, Xingke; Zhang, Yongkui; Jing, Xiaohui; He, Tianyou

2015-02-01

228

Scorpion toxins for the reversal of BoNT-induced paralysis.  

PubMed

The botulinum neurotoxins, characterized by their neuromuscular paralytic effects, are the most toxic proteins known to man. Due to their extreme potency, ease of production, and duration of activity, the BoNT proteins have been classified by the Centers for Disease Control as high threat agents for bioterrorism. In an attempt to discover effective BoNT therapeutics, we have pursued a strategy in which we leverage the blockade of K(+) channels that ultimately results in the reversal of neuromuscular paralysis. Towards this end, we utilized peptides derived from scorpion venom that are highly potent K(+) channel blockers. Herein, we report the synthesis of charybdotoxin, a 37 amino acid peptide, and detail its activity, along with iberiotoxin and margatoxin, in a mouse phrenic nerve hemidiaphragm assay in the absence and the presence of BoNT/A. PMID:24252544

Lowery, Colin A; Adler, Michael; Borrell, Andrew; Janda, Kim D

2013-12-15

229

High-resolution measurement of electrically-evoked vagus nerve activity in the anesthetized dog  

NASA Astrophysics Data System (ADS)

Objective. Not fully understanding the type of axons activated during vagus nerve stimulation (VNS) is one of several factors that limit the clinical efficacy of VNS therapies. The main goal of this study was to characterize the electrical recruitment of both myelinated and unmyelinated fibers within the cervical vagus nerve. Approach. In anesthetized dogs, recording nerve cuff electrodes were implanted on the vagus nerve following surgical excision of the epineurium. Both the vagal electroneurogram (ENG) and laryngeal muscle activity were recorded in response to stimulation of the right vagus nerve. Main results. Desheathing the nerve significantly increased the signal-to-noise ratio of the ENG by 1.2 to 9.9 dB, depending on the nerve fiber type. Repeated VNS following nerve transection or neuromuscular block (1) enabled the characterization of A-fibers, two sub-types of B-fibers, and unmyelinated C-fibers, (2) confirmed the absence of stimulation-evoked reflex compound nerve action potentials in both the ipsilateral and contralateral vagus nerves, and (3) provided evidence of stimulus spillover into muscle tissue surrounding the stimulating electrode. Significance. Given the anatomical similarities between the canine and human vagus nerves, the results of this study provide a template for better understanding the nerve fiber recruitment patterns associated with VNS therapies.

Yoo, Paul B.; Lubock, Nathan B.; Hincapie, Juan G.; Ruble, Stephen B.; Hamann, Jason J.; Grill, Warren M.

2013-04-01

230

Does primary brachial plexus surgery alter palliative tendon transfer surgery outcomes in children with obstetric paralysis?  

PubMed Central

Background The surgical management of obstetrical brachial plexus palsy can generally be divided into two groups; early reconstructions in which the plexus or affected nerves are addressed and late or palliative reconstructions in which the residual deformities are addressed. Tendon transfers are the mainstay of palliative surgery. Occasionally, surgeons are required to utilise already denervated and subsequently reinnervated muscles as motors. This study aimed to compare the outcomes of tendon transfers for residual shoulder dysfunction in patients who had undergone early nerve surgery to the outcomes in patients who had not. Methods A total of 91 patients with obstetric paralysis-related shoulder abduction and external rotation deficits who underwent a modified Hoffer transfer of the latissimus dorsi/teres major to the greater tubercle of the humerus tendon between 2002 and 2009 were retrospectively analysed. The patients who had undergone neural surgery during infancy were compared to those who had not in terms of their preoperative and postoperative shoulder abduction and external rotation active ranges of motion. Results In the early surgery groups, only the postoperative external rotation angles showed statistically significant differences (25 degrees and 75 degrees for total and upper type palsies, respectively). Within the palliative surgery-only groups, there were no significant differences between the preoperative and postoperative abduction and external rotation angles. The significant differences between the early surgery groups and the palliative surgery groups with total palsy during the preoperative period diminished postoperatively (p < 0.05 and p > 0.05, respectively) for abduction but not for external rotation. Within the upper type palsy groups, there were no significant differences between the preoperative and postoperative abduction and external rotation angles. Conclusions In this study, it was found that in patients with total paralysis, satisfactory shoulder abduction values can be achieved with tendon transfers regardless of a previous history of neural surgery even if the preoperative values differ. PMID:21489264

2011-01-01

231

Feasibility of the laryngeal tube airway for artificial ventilation in pigs and comparison with the laryngeal mask airway  

Microsoft Academic Search

Airway management in anesthetized pigs is known to be technically demanding, and the 'gold standard' technique of endotracheal intubation is particularly difficult to master. The authors investigated the feasibility of the laryngeal tube as an alternative technique for airway management in German Landrace pigs (n = 5). They compared this method with the laryngeal mask, which is considered to be

Andrea Irouschek; Peter Kessler; James Allen Blunk; Dirk Labahn; Joachim Schmidt; Torsten Birkholz

2008-01-01

232

An fMRI investigation of racial paralysis  

PubMed Central

We explore the existence and underlying neural mechanism of a new norm endorsed by both black and white Americans for managing interracial interactions: “racial paralysis’, the tendency to opt out of decisions involving members of different races. We show that people are more willing to make choices—such as who is more intelligent, or who is more polite—between two white individuals (same-race decisions) than between a white and a black individual (cross-race decisions), a tendency which was evident more when judgments involved traits related to black stereotypes. We use functional magnetic resonance imaging to examine the mechanisms underlying racial paralysis, to examine the mechanisms underlying racial paralysis, revealing greater recruitment of brain regions implicated in socially appropriate behavior (ventromedial prefrontal cortex), conflict detection (anterior cingulate cortex), deliberative processing (dorsolateral prefrontal cortex), and inhibition (ventrolateral prefrontal cortex). We also discuss the impact of racial paralysis on the quality of interracial relations. PMID:22267521

Mason, Malia F.; Vandello, Joseph A.; Biga, Andrew; Dyer, Rebecca

2013-01-01

233

Nerve Racking  

NSDL National Science Digital Library

This lesson describes the function and components of the human nervous system. It helps students understand the purpose of our brain, spinal cord, nerves and the five senses. How the nervous system is affected during spaceflight is also discussed in this lesson.

Integrated Teaching and Learning Program,

234

Three cases of thyrotoxic periodic paralysis due to painless thyroiditis  

PubMed Central

We present three cases of thyrotoxic periodic paralysis (TPP) due to painless thyroiditis presenting as acute quadriparesis. All responded to potassium supplementation and propranolol. TPP may be due to thyrotoxicosis of any etiology, commonly Grave's disease. The absence of clinical signs of thyrotoxicosis can delay diagnosis and treatment. Thyroid function tests should be a routine evaluation in all cases of hypokalemic periodic paralysis. PMID:24251144

Sanyal, Debmalya; Raychaudhuri, Moutusi; Bhattacharjee, Shakya

2013-01-01

235

Sleep Paralysis and the Structure of Waking-Nightmare Hallucinations  

Microsoft Academic Search

Sleep paralysis (SP) entails a period of paralysis upon waking or falling asleep and is often accompanied by terrifying hallucinations. These hallucinations constitute a waking nightmare (w-nightmare) REM experience and are the original referents of the term “nightmare.” W-nightmare hallucinations are described by a three-factor structure involving experiences consistent with 1) threatening intruders, 2) physical assaults, and 3) vestibular-motor (V-M)

J. A. Cheyne

2003-01-01

236

Relevance of Sleep Paralysis and Hypnic Hallucinations to Psychiatry  

Microsoft Academic Search

Objective: To describe a patient who presented with psychopathology in the wake of sleep paralysis and hypnopompic hallucinations, and to discuss the importance of these phenomena to psychiatric diagnoses.Methods: Case report.Results: A 25-year-old black South African woman developed paranoid beliefs and a sad and anxious mood in the wake of her first experience of sleep paralysis and hypnic hallucinations. She

Prakash Gangdev

2004-01-01

237

Three cases of thyrotoxic periodic paralysis due to painless thyroiditis.  

PubMed

We present three cases of thyrotoxic periodic paralysis (TPP) due to painless thyroiditis presenting as acute quadriparesis. All responded to potassium supplementation and propranolol. TPP may be due to thyrotoxicosis of any etiology, commonly Grave's disease. The absence of clinical signs of thyrotoxicosis can delay diagnosis and treatment. Thyroid function tests should be a routine evaluation in all cases of hypokalemic periodic paralysis. PMID:24251144

Sanyal, Debmalya; Raychaudhuri, Moutusi; Bhattacharjee, Shakya

2013-10-01

238

Hypoglycaemia causes degeneration of large myelinated nerve fibres in the vagus nerve of insulin-treated diabetic BB/Wor rats.  

PubMed

The aim of this study was to find out whether dysglycaemia causes neuropathy in the vagus nerve of insulin-treated diabetic BB/Wor rats. Specimens were collected from the left vagus nerve proximal and distal to the level of recurrent laryngeal branch and from the recurrent branch itself in control rats and diabetic BB/Wor rats subjected to hyper- or hypoglycaemia. Myelinated and unmyelinated axons were counted and myelinated axon diameters were measured by electron microscopy. In controls, the vagus nerve proximal to the recurrent branch exhibited three regions in terms of fibre composition: part A was mainly composed of large myelinated axons, part B contained small myelinated and unmyelinated axons, and part C contained mainly unmyelinated axons. The distal level resembled part C at the proximal level and the recurrent branch resembled parts A and B. In hyperglycaemic rats, a normal picture was found at the proximal and distal levels of the vagus nerve and in the recurrent branch. In hypoglycaemic rats, signs of past and ongoing degeneration and regeneration of large myelinated axons were found at the proximal and distal levels and in the recurrent branch. We conclude that hypoglycaemia elicits degenerative alterations in large myelinated axons in the vagus and recurrent laryngeal nerves in diabetic BB/Wor rats. The absence of signs of neuropathy in unmyelinated and small myelinated axons suggests that the sensory and autonomic components of the nerve are less affected. In contrast, the hyperglycaemic rats examined here did not show obvious degenerative alterations. PMID:15549329

Jamali, Reza; Mohseni, Simin

2005-02-01

239

Hypokalemic periodic paralysis as first sign of thyrotoxicosis  

PubMed Central

Background: periodic paralysis related to hypokalemia is seldom reported in thyrotoxicosis, and it usually occurs in Asian males. Patients and methods: Two Romanian (Caucasian) young patients presented with hypokalemic paralysis. TSH, FT4, TT3 was measured by immunochemiluminescence. Case report 1. Patient O.R, aged 19, presented marked asthenia and lower limbs paralysis, following high carbohydrate meal. He declared 10 kg weight loss on hypocaloric diet and mild sweating. Biochemical data revealed moderate hypokalemia (K+=2.6 mmol/L) and thyrotoxicosis (TSH<0.03 mIU/L, FT4=30 pmol/L, TT3=315 ng/dL). Case report 2. Patient T.A., aged 18, presented 2 episodes of weakness and flaccid paralysis, with hypokalemia, precipitated by effort, without any sign of thyrotoxicosis. Biochemical data revealed severe hypokalemia (K+=1.8 mmol/L) and thyrotoxicosis (TSH<0.03 mIU/L, FT4=24 pmol/L, TT3=190 ng/dL). Treatment with intravenous potassium, thereafter methimazole and propranolol were administered in both cases, with the maintenance of normal kalemia and thyrotoxicosis’ control. Conclusion: these 2 cases of hypokalemic periodic paralysis occurring in young Caucasian teenagers with mild thyrotoxicosis underlined the importance of thyroid screening in patients with symptomatic hypokalemia, even in the absence of symptoms and signs of thyrotoxicosis. Abbreviations: THPP=Thyrotoxic periodic paralysis, BMI=body mass index, TRAb=TSH receptor antibody, ECG=electrocardiogram. PMID:23599824

Trifanescu, RA; Danciulescu Miulescu, R; Carsote, M; Poiana, C

2013-01-01

240

Changes in laryngeal sensation evaluated with a new method before and after radiotherapy  

Microsoft Academic Search

Radiotherapy of the laryngopharynx sometimes leads to functional disabilities including swallowing dysfunction. One of the\\u000a reasons for these disabilities is a deterioration of laryngeal sensation. Laryngeal sensation is an important factor in swallowing,\\u000a but quantitative evaluation of laryngeal sensation has been difficult. In this study, we evaluated changes in laryngeal sensation\\u000a before and after radiotherapy for laryngeal and hypopharyngeal cancer,

Kikuko Ozawa; Yasushi Fujimoto; Tsutomu Nakashima

2010-01-01

241

Non-accidental caustic ear injury: two cases of profound cochleo-vestibular loss and facial nerve injury.  

PubMed

Non-accidental caustic injury is a rare form of child abuse usually secondary to forced ingestion. Caustic injury to the ear most commonly arises from battery lodgement in the external canal. This case series represents the first report of non-accidental caustic injury to previously normal ears resulting in profound sensorineural hearing loss, vertigo with horizontal canal hypofunction and in one patient a severe facial nerve paralysis. Both patients required blind-end sac closure of the injured ear and one required sural nerve interposition combined with transfer of the masseteric branch of the trigeminal nerve to the ipsilateral facial nerve. PMID:22018928

Wolter, Nikolaus E; Cushing, Sharon L; Das-Purkayastha, Prodip K; Papsin, Blake C

2012-01-01

242

Mini-temporalis transposition: a less invasive procedure of smile restoration for long-standing incomplete facial paralysis.  

PubMed

Facial paralysis is a common craniofacial deformity that is responsible for significant psychological and functional impairment. Free muscle transfer in 2 stages and latissimus dorsi transfer in one stage may be the most effective surgical procedure for achieving a symmetrical spontaneous smile for a patient with complete facial paralysis. However, these 2 procedures are unsuitable for many incomplete patients. The authors introduce a less invasive procedure, termed mini-temporalis transposition that is able to achieve a symmetrical spontaneous smile in incomplete patients. Through a zigzag incision into the temporal region, the middle third of the temporalis is transferred and elongated with the palmaris longus tendon or combined with the deep temporal fascia. The strips are anchored to key points at the modiolus and the middle of the ipsilateral orbicularis oris muscle through a small intraoral incision and subcutaneous tunnel. The key points are marked during preoperative smile analysis. This procedure was applied to 15 patients with long-standing incomplete facial paralysis. All patients obtained improvements in smile symmetry after the operation, and patients' satisfaction was high. In addition, no damage to residual facial nerve functions or development of procedure-induced complications (such as a facial contour defect, lip eversion or puckering, or skin tethering) was observed in any of the patients. Nevertheless, slight temporal hollowing was observed in 4 patients, and mild bulkiness over the zygomatic arch was a common observation. In summary, the mini-temporalis transfer technique is a safe and effective method of smile restoration for long-standing incomplete facial paralysis. PMID:25759922

Chen, Gang; Yang, Xianxian; Wang, Wei; Li, Qingfeng

2015-03-01

243

Studies on hyperkalemic periodic paralysis. Evidence of changes in plasma Na and Cl and induction of paralysis by adrenal glucocorticoids  

PubMed Central

In a 19 yr old male with familial hyperkalemic periodic paralysis, paralysis was consistently induced by the administration of potassium chloride, corticotropin-gel, and a variety of glucocorticoids (dexamethasone, 6-methylprednisolone, triamcinolone) but not by mineralocorticoids (D-aldosterone, deoxycorticosterone) or by adrenocorticotropin (ACTH)-gel plus metyrapone. Induced attacks were virtually identical with spontaneous attacks, being associated, after a latent period of a few hours, with a rise in plasma K+ and HCO3- and a simultaneous fall in plasma Na+ and Cl- concentrations to an extent implying exchange of 1 K+ with 2 Na+ and 2 Cl- between extracellular and intracellular fluid. ACTH-induced paralysis was preceded by rising serum inorganic P, and associated with increased plasma glucose, blood lactate, and serum creatine phosphokinase concentrations. In normal subjects ACTH, cortisol, and triamcinolone administration failed to change plasma electrolytes or strength, while ingestion of KCl produced no weakness and smaller changes in plasma K and Na than in the patient. Since the patient and normal subjects showed the same changes in renal excretion of K after the administration of cortisol and KCl, it seems likely that paralysis in the patient resulted from abnormally slow uptake (and/or excessive loss) of K by the muscle cells, possibly caused by an abnormal “ion-exchange pump.” Normal adrenocortical function and absence of a peak in plasma 11-hydroxycorticoid (11-OHCS) concentration preceding spontaneous paralysis, indicated that spontaneous paralysis did not result from changes in cortisol secretion. Similar hyperkalemic paralysis was precipitated by ACTH-gel in a brother and first cousin of the propositus. Administration of acetazolamide and fludrocortisone reduced the rise in plasma K concentration and prevented the weakness which otherwise invariably followed KCl administration to the patient. He and two close relatives have been completely protected from severe attacks of paralysis in the past 14 months by treatment with these two medications. PMID:4322666

Streeten, David H. P.; Dalakos, Theodore G.; Fellerman, Herbert

1971-01-01

244

Phrenic nerve palsy: A rare cause of respiratory distress in newborn  

PubMed Central

Birth injury is defined as an impairment of a newborn's body function or structure due to adverse influences that occurred at birth. Phrenic nerve palsy may result from birth trauma during a traumatic neonatal delivery from a stretch injury due to lateral hyperextension of the neck at birth. This could be a rare cause of respiratory distress in the newborn period with irregular respiration. Respiratory distress due to phrenic nerve damage leading to paralysis of the ipsilateral diaphragm may require continuous positive airway pressure or mechanical ventilation and if unresponsive, surgical plication of diaphragm. Herein, we report a case of phrenic nerve palsy in a newborn presenting with respiratory distress. PMID:23560016

Murty, V. S. S. Yerramilli; Ram, K. Dinedra

2012-01-01

245

Abnormal pupillary function in third nerve regeneration (the pseudo-Argyll robertson pupil). A case report.  

PubMed

A case of congenital oculomotor paralysis demonstrating retraction of the upper lid and constriction of the pupil in response to eye movements is described. The pupil was found to be unresponsive to light, but to contract promptly on attempted ocular movements which involved motor neurons of the third nerve. As demonstrated by infrared pupillography, the duration of the constriction phase was found to be remarkably long. Also, very little hippus was noted during constriction. The findings are explained on basis of the 'misdirection' hypothesis according to which regenerating nerve fibres find a wrong path in the peripheral part of the damaged nerve. PMID:6720273

Olsen, T; Jakobsen, J

1984-02-01

246

Dihydropyridine receptor mutations cause hypokalemic periodic paralysis  

SciTech Connect

Hypokalemic periodic paralysis (hypoKPP) is an autosomal dominant skeletal muscle disorder manifested by episodic weakness associated with low serum potassium. Genetic linkage analysis has localized the hypoKPP gene to chromosome 1q31-q32 near a dihydropyridine receptor (DHP) gene. This receptor functions as a voltage-gated calcium channel and is also critical for excitation-contraction coupling in a voltage-sensitive and calcium-independent manner. We have characterized patient-specific DHP receptor mutations in 11 probands of 33 independent hypoKPP kindreds that occur at one of two adjacent nucleotides within the same codon and predict substitution of a highly conserved arginine in the S4 segment of domain 4 with either histidine or glycine. In one kindred, the mutation arose de novo. Taken together, these data establish the DHP receptor as the hypoKPP gene. We are unaware of any other human diseases presently known to result from DHP receptor mutations.

Ptacek, L.J.; Leppert, M.F. [Univ. of Utah, Salt Lake City, UT (United States); Tawil, R. [Univ. of Rochester, MN (United States)] [and others

1994-09-01

247

Expression of DNA topoisomerase II-?: Clinical significance in laryngeal carcinoma  

PubMed Central

DNA topoisomerase II-? (Topo II-?) is essential for numerous cell processes, including DNA replication, transcription, recombination, and chromosome separation and condensation. Altered Topo II-? expression may lead to carcinogenesis and cancer progression. The aim of the present study was to investigate the association between Topo II-? expression levels and clinicopathological data from laryngeal cancer patients. Immunohistochemistry was used to analyze Topo II-? expression in laryngeal squamous cell carcinoma and distant healthy tissues obtained from 70 patients. In addition, fluorescence in situ hybridization was used to detect Topo II-? amplification and chromosome 17 ploidy using a laryngeal cancer tissue microarray. The expression of Topo II-? protein was detected in 71.43% (50/70) of laryngeal carcinoma tissues, in contrast to 9% of healthy tissues (2/22). Furthermore, the expression of Topo II-? protein was found to be associated with tumor de-differentiation and advanced tumor T stage. However, the expression of Topo II-? protein was not identified to be associated with Topo II-? amplification in laryngeal carcinoma, although was found to positively correlate with chromosome 17 aneuploidy (P<0.05). A higher aneuploidy rate contributed to increased expression levels of Topo II-? protein. Aberrant Topo II-? expression and chromosome 17 aneuploidy contributed to the development and progression of laryngeal cancer, indicating that targeting Topo II-? may provide a treatment strategy for patients with laryngeal cancer. PMID:25202370

FENG, YAN; ZHANG, HAILI; GAO, WEI; WEN, SHUXIN; HUANGFU, HUI; SUN, RUIFANG; BAI, WEI; WANG, BINQUAN

2014-01-01

248

Diet, cigarettes and alcohol in laryngeal cancer  

SciTech Connect

Diet and other risk factors for cancer of the larynx were examined in a case-control study among white males in Western New York, conducted in 1975-1985. Incident, pathologically-confirmed cases and age- and neighborhood-matched controls were interviewed to determine usual diet, and lifetime use of tobacco and alcohol. Because response rates were low for both cases and controls, this cannot be considered a population-based study. A strong association of risk with cigarette but not pipe and cigar smoking was found. Beer and hard liquor but not wine were associated with increased risk. After control for cigarettes, alcohol and education, the upper quartile odds ratio for fat was 2.40, while the odds ratio for high intake of carotenoids was 0.51. There was effect modification by smoking. Carotenoids were most negatively associated with risk among lighter smokers; dietary fat was most positively associated with risk among heavier smokers. Total calories, protein, and retinol were associated with increased risk; there was no relationship between laryngeal cancer and vitamins C and E or carbohydrate. This study again demonstrates the strong association between tobacco and alcohol and laryngeal cancer and also suggests that diets low in carotenoids and high fat may increase risk.

Freudenheim, J.L.; Graham, S.; Byers, T.E.; Marshall, J.R.; Haughey, B.P.; Swanson, M.K.; Wilkinson, G. (State Univ. of New York, Buffalo (United States))

1991-03-11

249

Changes of laryngeal parameters during intrauterine life  

PubMed Central

Objective Increased care of fetal and neonatal airways has led to advances in neonatal medicine. The early diagnosis and treatment of respiratory diseases require a detailed knowledge of fetal airway anatomy and development. The aim of this study was to determine the anatomical development of the thyroid and cricoid cartilages and their structural variability during fetal life. Materials and methods The study was performed on the thyroid and cricoid cartilages of 55 human fetal larynges of both sexes, between the ages of 13 and 27 weeks of intrauterine life. Numerous measurements of the thyroid and cricoid cartilages were performed. Results Correlations between the obtained results were calculated in relation to the crown-rump (C-R) length of human fetuses and to sex. The structural variability of the thyroid and cricoid cartilages of human male and female fetuses in subsequent weeks of intrauterine life was observed. In both genders a correlation between laryngeal size and fetal crown-rump length, regardless of sex, was found. The thyroid cartilage presents a sexual dimorphism. Conclusions The results of this study can be useful in the analysis of prenatal examinations, and in planning the treatment of airway emergencies. PMID:21147618

2010-01-01

250

Critical literature review on the management of intraparotid facial nerve schwannoma and proposed decision-making algorithm  

Microsoft Academic Search

Management of intraparotid facial nerve schwannomas (IFNS) is very challenging because the diagnosis is often made intra-operatively\\u000a and in most cases, resection could lead to severe facial nerve (FN) paralysis, with important aesthetic consequences. Articles\\u000a in the English language focused on the management of FN schwannoma have been selected and critically reviewed. A decision-making\\u000a algorithm is proposed. In the case

Matteo Alicandri-Ciufelli; Daniele Marchioni; Francesco Mattioli; Margherita Trani; Livio Presutti

2009-01-01

251

Transient Delayed Facial Nerve Palsy After Inferior Alveolar Nerve Block Anesthesia  

PubMed Central

Facial nerve palsy, as a complication of an inferior alveolar nerve block anesthesia, is a rarely reported incident. Based on the time elapsed, from the moment of the injection to the onset of the symptoms, the paralysis could be either immediate or delayed. The purpose of this article is to report a case of delayed facial palsy as a result of inferior alveolar nerve block, which occurred 24 hours after the anesthetic administration and subsided in about 8 weeks. The pathogenesis, treatment, and results of an 8-week follow-up for a 20-year-old patient referred to a private maxillofacial clinic are presented and discussed. The patient's previous medical history was unremarkable. On clinical examination the patient exhibited generalized weakness of the left side of her face with a flat and expressionless appearance, and she was unable to close her left eye. One day before the onset of the symptoms, the patient had visited her dentist for a routine restorative procedure on the lower left first molar and an inferior alveolar block anesthesia was administered. The patient's medical history, clinical appearance, and complete examinations led to the diagnosis of delayed facial nerve palsy. Although neurologic occurrences are rare, dentists should keep in mind that certain dental procedures, such as inferior alveolar block anesthesia, could initiate facial nerve palsy. Attention should be paid during the administration of the anesthetic solution. PMID:22428971

Tzermpos, Fotios H.; Cocos, Alina; Kleftogiannis, Matthaios; Zarakas, Marissa; Iatrou, Ioannis

2012-01-01

252

Laryngeal Chondrosarcoma as a Rare Cause of Subglottic Stenosis  

PubMed Central

Laryngeal chondrosarcoma (CS) is a very rare entity. It is usually seen in 50–80-year olds. It is developed from cricoid cartilage largely. Patients have laryngeal CS complaint of respiratuvar distress, dysphonia, and dysphagia generally. A submucous mass is usually seen in physical examination with an intact mucosa. Distant metastasis is rare in CSs. Main treatment is surgical excision. An 82-year-old patient who has respiratuvar distress is presented in this paper and laryngeal CS is reviewed in the light of the literature. PMID:25197601

Köko?lu, Kerem; Canöz, Özlem; Do?an, Serap; Gülmez, Emrah; Yüce, ?mdat; Ça?l?, Sedat

2014-01-01

253

A case of laryngeal angioleiomyoma and review of literature  

PubMed Central

Angioleiomyoma is a rare benign vascular smooth muscle tumor that arise from the tunica media of veins and arteries. Here a case of laryngeal angioleiomyoma in a 57-year-old Chinese man is reported. The patient presented with dysphagia for one and half-month and dyspnea during the previous one week, was hospitalized for treatment with a tracheotomy and laryngofissure with the unblock mass excision. Final pathological evaluation of the neoplasm confirmed a diagnosis of laryngeal angioleiomyoma. The patient had been followed up 4 years with no recurrence of disease. This study demonstrated the clinical feature, pathology, treatment and outcome of the rare disease of laryngeal angioleiomyoma.

Zhao, Xue; Yu, Dan; Zhao, Yin; Liu, Yan; Qi, Xinmeng; Jin, Chunshun

2015-01-01

254

Transglottic laryngeal paraganglioma: a rare location for this tumor.  

PubMed

Laryngeal paragangliomas are rare neoplasms that originate in the neural crest cells of the laryngeal paraganglia. Although the vast majority of these tumors are benign, they exhibit different types of biologic behavior that require different treatment modalities. Therefore, differentiation among these tumors is extremely important. We report a rare case of laryngeal paraganglioma that presented as a transglottic lesion in a 68-year-old man. The atypical location of the tumor led to difficulties in diagnosis and management. To the best of our knowledge, this is only the third such case to be reported in the English-language literature. PMID:24366713

Arslano?lu, Seçil; U?uz, M Zafer; Etit, Demet; Ermete, Murat

2013-12-01

255

Hypokalemic Periodic Paralysis: a case report and review of the literature  

PubMed Central

Hypokalemic Periodic Paralysis is one form of Periodic Paralysis, a rare group of disorders that can cause of sudden onset weakness. A case of a 29 year old male is presented here. The patient presented with sudden onset paralysis of his extremities. Laboratory evaluation revealed a markedly low potassium level. The patient's paralysis resolved upon repletion of his low potassium and he was discharged with no neurologic deficits. An association with thyroid disease is well established and further workup revealed Grave's disease in this patient. Although rare, Periodic Paralysis must differentiated from other causes of weakness and paralysis so that the proper treatment can be initiated quickly. PMID:18939979

Soule, Benjamin R; Simone, Nicole L

2008-01-01

256

Single session of brief electrical stimulation immediately following crush injury enhances functional recovery of rat facial nerve.  

PubMed

Peripheral nerve injuries lead to a variety of pathological conditions, including paresis or paralysis when the injury involves motor axons. We have been studying ways to enhance the regeneration of peripheral nerves using daily electrical stimulation (ES) following a facial nerve crush injury. In our previous studies, ES was not initiated until 24 h after injury. The current experiment tested whether ES administered immediately following the crush injury would further decrease the time for complete recovery from facial paralysis. Rats received a unilateral facial nerve crush injury and an electrode was positioned on the nerve proximal to the crush site. Animals received daily 30 min sessions of ES for 1 d (day of injury only), 2 d, 4 d, 7 d, or daily until complete functional recovery. Untreated animals received no ES. Animals were observed daily for the return of facial function. Our findings demonstrated that one session of ES was as effective as daily stimulation at enhancing the recovery of most functional parameters. Therefore, the use of a single 30 min session of ES as a possible treatment strategy should be studied in human patients with paralysis as a result of acute nerve injuries. PMID:22773203

Foecking, Eileen M; Fargo, Keith N; Coughlin, Lisa M; Kim, James T; Marzo, Sam J; Jones, Kathryn J

2012-01-01

257

External laryngeal manipulation done by the laryngoscopist makes the best laryngeal view for intubation  

PubMed Central

Purpose: External laryngeal manipulation (ELM) is used to get better laryngeal view during direct laryngoscopy. This study was designed to test the hypothesis that ELM done by the intubating anesthetist (laryngoscopist) offers the best laryngeal view for tracheal intubation. Materials and method: A total of 160 patients underwent different surgical procedures were included in this study. Percentage of glottic opening (POGO) score and Cormack and Lehane scale were used as outcome measures for comparison between different laryngoscopic views. Four views were described; basic laryngoscopic view and then views after ELM done by the assistant, by the laryngoscopist and finally by the assistant after the guidance from the laryngoscopist respectively. The last three views compared with the basic laryngoscopic view. Results: ELM done by the laryngoscopist or by the assistant after guidance from the laryngoscopist showed significant improvement of Cormack grades and POGO scores compared with basic laryngoscopic view. Number of patients with Cormack grade1 increased from 39 after direct laryngoscopy to 97 and 96 patients (P < 0.001 by Fisher's exact test), after ELM done by the laryngoscopist and that done by the assistant after guidance from the anesthetist respectively. Furthermore, the number of patients with POGO scores of 100% increased from 39 after direct laryngoscopy to 78 and 61 (P < 0.01) patients after ELM done by the laryngoscopist and that done by the assistant after guidance from the anesthetist respectively. Conclusion: It appeared from this study that ELM done by the anesthetist makes the best laryngeal view for tracheal intubation. PMID:25191185

Ali, Mohamed Shaaban; Bakri, Mohamed Hassan; Mohamed, Hesham Ali; Shehab, Hany; Al Taher, Waleed

2014-01-01

258

Loss of signal in recurrent nerve neuromonitoring: causes and management  

PubMed Central

During recurrent laryngeal nerve (RLN) neuromonitoring in thyroid surgery, laryngeal electromyography (EMG) amplitude may be correlated with the number of muscle fibers participating in the polarization and these might be correlated with the function of RLN. If RLN is severely injured during the operation, most nerve fibers do not transmit nerve impulse and substantial decrease of EMG amplitude or loss of signal (LOS) will occur. True LOS at the end of an operation often indicates a postoperative fixed vocal cord, and the surgeon should consider the optimal contralateral surgery timing in patients with planned bilateral thyroid operation to avoid the disaster of bilateral vocal cord palsy. However, LOS recovery and false LOS may occur and may lead to an unnecessary 2nd operation. Therefore, a reliable modality for intraoperative LOS evaluation and management would afford the surgeon real-time information that could help guide surgical procedure and planning. The updated causes, algorithm, and management of LOS during RLN neuromonitoring are reviewed and summarized. PMID:25713776

Wu, Che-Wei; Wang, Mei-Hui; Chen, Cheng-Chien; Chen, Hui-Chun; Chen, Hsiu-Ya; Yu, Jing-Yi; Chang, Pi-Ying; Lu, I-Cheng; Lin, Yi-Chu

2015-01-01

259

Comparison of hemihypoglossal- and accessory-facial neurorrhaphy for treating facial paralysis in rats.  

PubMed

The aim of this study was to determine the effectiveness of hypoglossal-facial nerve "side"-to-end (HemiHN-FN) and accessory-facial nerve end-to-end (AN-FN) neurorrhaphy using a predegenerated nerve graft (PNG) for reanimating facial paralysis in a rat FN injury model. A total of 25 rats with complete unilateral facial paralysis resulting from section of the right FN were divided into 5 groups (n=5 each) that were submitted to immediate, delayed (3 months after FN injury) or no (control) FN reconstruction procedures involving HemiHN-FN or AN-FN neurorrhaphy. Approximately 3 months after FN reconstruction, cholera toxin subunit B conjugate Alexa 555 (CTB-Alexa 555) was injected into the ipsilateral whisker pad muscle and CTB-Alexa 555-labeled neurons were observed in the hypoglossal or accessory nuclei of all the FN reconstruction rats, but none of these neurons were found in the controls. There were numerous myelinated and nonmyelinated axons in both PNG and repaired FN of the FN reconstruction rats. No differences were found for these numbers between the two neurorrhaphy methods for each of the treatment time points, indicating the equal effectiveness of axon regeneration. However, a significantly higher number of CTB-Alexa 555-labeled neurons was observed in the hypoglossal nucleus of the immediate HemiHN-FN neurorrhaphy-treated rats when compared to that in the accessory nucleus of the immediate AN-FN neurorrhaphy-treated rats, consistent with the surface values of the recorded MAPs at the whisker pad muscle while electro-stimulating the FN. These results suggest that HemiHN-FN neurorrhaphy produces more efficient innervation of the paralyzed facial muscles than AN-FN neurorrhaphy without sacrificing ipsilateral hypoglossal function. Taking into consideration the clinical relevance of these findings for postoperative complications and functional reanimation in relation to the central plasticity, we suggest that HemiHN-FN neurorrhaphy may be the preferable facial reanimation procedure after an FN injury. PMID:25454640

Li, Dezhi; Wan, Hong; Feng, Jie; Wang, Shiwei; Su, Diya; Hao, Shuyu; Schumacher, Michael; Liu, Song

2014-12-15

260

Mutation screening in Chinese hypokalemic periodic paralysis patients.  

PubMed

Thyrotoxic periodic paralysis (TPP), familial periodic paralysis (FPP), and sporadic periodic paralysis (SPP) are the most common causes of hypokalemic periodic paralysis (hypoKPP). The patients present with similar clinical features characterized by episodic attacks of muscle weakness and a decrease in blood potassium. Mutations in the gene encoding the voltage-sensor coding regions of the skeletal muscle sodium channel gene (SCN4A) and the alpha-1 subunit of the skeletal muscle calcium channel gene were analyzed in 23 Chinese hypoKPP patients, including 1 FPP pedigree, 14 TPP patients, and 8 SPP patients. In addition, R83H mutation of the potassium channel subunit gene which was originally published as periodic paralysis mutation was also analyzed. A heterozygous CGT-TGT mutation at codon 672 in SCN4A gene was identified to segregate with the disease in the FPP family. Mutations in these regions were excluded in those patients with SPP and TPP. The results suggest that a likely genetic basis for FPP does not contribute to TPP and SPP, despite close similarities among FPP, TPP, and SPP. PMID:16386935

Wang, Weiqing; Jiang, Lei; Ye, Lei; Zhu, Na; Su, Tingwei; Guan, Liqing; Li, Xiaoying; Ning, Guang

2006-04-01

261

21 CFR 874.3730 - Laryngeal prosthesis (Taub design).  

Code of Federal Regulations, 2013 CFR

...3730 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Prosthetic Devices § 874.3730 Laryngeal prosthesis (Taub design). (a)...

2013-04-01

262

21 CFR 874.3730 - Laryngeal prosthesis (Taub design).  

Code of Federal Regulations, 2012 CFR

...3730 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Prosthetic Devices § 874.3730 Laryngeal prosthesis (Taub design). (a)...

2012-04-01

263

21 CFR 874.3730 - Laryngeal prosthesis (Taub design).  

Code of Federal Regulations, 2011 CFR

...3730 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Prosthetic Devices § 874.3730 Laryngeal prosthesis (Taub design). (a)...

2011-04-01

264

21 CFR 874.3730 - Laryngeal prosthesis (Taub design).  

Code of Federal Regulations, 2014 CFR

...3730 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Prosthetic Devices § 874.3730 Laryngeal prosthesis (Taub design). (a)...

2014-04-01

265

Can Laryngeal and Hypopharyngeal Cancers Be Found Early?  

MedlinePLUS

... Cancer + - Text Size Download Printable Version [PDF] » Early Detection, Diagnosis, and Staging TOPICS Document Topics GO » SEE ... Hypopharyngeal Cancer? Causes, Risk Factors, and Prevention Early Detection, Diagnosis, and Staging Treating Laryngeal and Hypopharyngeal Cancer ...

266

ELECTROMYOGRAPHY AS A TECHNIQUE FOR LARYNGEAL INVESTIGATION* Katherine S. Harris+  

E-print Network

ELECTROMYOGRAPHY AS A TECHNIQUE FOR LARYNGEAL INVESTIGATION* Katherine S. Harris+ While, as earlier humans has become possible using the techniques of electromyography. In this paper, I will discuss some

267

Laryngeal findings and acoustic changes in hubble-bubble smokers  

Microsoft Academic Search

The purpose of our investigation was to evaluate the laryngeal findings and acoustic changes in hubble-bubble smokers. A total\\u000a of 42 subjects with history of hubble-bubble smoking were recruited for this study. A corresponding group with a history of\\u000a cigarette smoking and controls were matched. All subjects underwent laryngeal video-endostroboscopic evaluation and acoustic\\u000a analysis. In the hubble-bubble smoking group, 61.9%

Abdul-latif Hamdan; Abla Sibai; Dima Oubari; Jihad Ashkar; Nabil Fuleihan

2010-01-01

268

Severe upper airway obstruction caused by ulcerative laryngitis  

Microsoft Academic Search

AIMSTo present our experience of severe upper airway obstruction caused by ulcerative laryngitis in children.METHODSRetrospective case note review of 263 children with severe upper airway obstruction and a clinical diagnosis of croup admitted to a paediatric intensive care unit (PICU) over a five year period.RESULTSA total of 148 children (56%) underwent microlaryngoscopy (Storz 3.0 rigid telescope). Laryngeal ulceration with oedema

M Hatherill; L Reynolds; Z Waggie; A Argent

2001-01-01

269

Clinical consequences of reinnervation disorders after focal peripheral nerve lesions.  

PubMed

Axonal regeneration and organ reinnervation are the necessary steps for functional recovery after a nerve lesion. However, these processes are frequently accompanied by collateral events that may not be beneficial, such as: (1) Uncontrolled branching of growing axons at the lesion site. (2) Misdirection of axons and target organ reinnervation errors, (3) Enhancement of excitability of the parent neuron, and (4) Compensatory activity in non-damaged nerves. Each one of those possible problems or a combination of them can be the underlying pathophysiological mechanism for some clinical conditions seen as a consequence of a nerve lesion. Reinnervation-related motor disorders are more likely to occur with lesions affecting nerves which innervate muscles with antagonistic functions, such as the facial, the laryngeal and the ulnar nerves. Motor disorders are better demonstrated than sensory disturbances, which might follow similar patterns. In some instances, the available examination methods give only scarce evidence for the positive diagnosis of reinnervation-related disorders in humans and the diagnosis of such condition can only be based on clinical observation. Whatever the lesion, though, the restitution of complex functions such as fine motor control and sensory discrimination would require not only a successful regeneration process but also a central nervous system reorganization in order to integrate the newly formed peripheral nerve structure into the prepared motor programs and sensory patterns. PMID:20656551

Valls-Sole, Josep; Castillo, Carlos David; Casanova-Molla, Jordi; Costa, Joao

2011-02-01

270

[Second generation laryngeal masks : expanded indications].  

PubMed

Since the development of the classic laryngeal mask airway (LMA) in the late 1980s, there has been a continuous increase in the frequency of its use as well as areas of application. While contraindications to its use for elective procedures must be recognized, there are an increasing number of clinical studies on expanded indications for the use of supraglottic airway (SGA) devices, particularly those of the second generation. The present article describes the added features of the second generation LMAs, with special emphasis on the behavior of these devices in position and performance tests. An appraisal is conducted based on the currently available literature on the value of the utility for indications, such as prolonged use, laparoscopic surgery, obesity, prone position and Cesarean section. PMID:25601588

Timmermann, A; Nickel, E A; Pühringer, F

2015-01-01

271

Laryngeal sensation and pharyngeal delay time after (chemo)radiotherapy.  

PubMed

The objective of the study was to evaluate the association between changes in laryngeal sensation and initiation of swallowing reflex or swallowing function before and after (chemo)radiotherapy. A prospective study was conducted in a tertiary referral university hospital. Thirteen patients who received (chemo)radiotherapy for treatment of laryngeal or hypopharyngeal cancer were included. Laryngeal sensation was evaluated at the tip of the epiglottis before and 1, 3 months, and 1 year after (chemo)radiotherapy. Videofluoroscopy was performed at the same time. Quantitative determinations included changes in laryngeal sensation, computed analysis of pharyngeal delay time, the distance and velocity of hyoid bone movement during the phase of hyoid excursion, and pharyngeal residue rate (the proportion of the bolus that was left as residue in the pharynx at the first swallow). Laryngeal sensation significantly deteriorated 1 month after (chemo)radiotherapy, but there was a tendency to return to pretreatment levels 1 year after treatment. Neither pharyngeal delay time nor displacement of the hyoid bone changed significantly before and after (chemo)radiotherapy. In addition, there was no significant difference in the mean velocity of hyoid bone movement and the amount of stasis in the pharynx at the first swallow before and after (chemo)radiotherapy. After (chemo)radiotherapy, laryngeal sensation deteriorated. But, in this study, videofluoroscopy showed that swallowing reflex and function were maintained. PMID:24150543

Maruo, Takashi; Fujimoto, Yasushi; Ozawa, Kikuko; Hiramatsu, Mariko; Suzuki, Atsushi; Nishio, Naoki; Nakashima, Tsutomu

2014-08-01

272

American Dog Tick (Dermacentor variabilis) *Transmits RMSF, tick paralysis, tularemia, ehrlichiosis  

E-print Network

Lone Star Tick (Amblyomma americanum) *Transmits Lyme Disease, tick paralysis, tularemia, ehrlichiosis female Adult male Nymph Larva It's Tick season! · Ticks are very small blood-sucking arachnids) *Transmits RMSF, tick paralysis, tularemia, ehrlichiosis Lone Star Tick (Amblyomma americanum) *Transmits

Engel, Jonathan

273

Nerve Impulses in Plants  

ERIC Educational Resources Information Center

Summarizes research done on the resting and action potential of nerve impulses, electrical excitation of nerve cells, electrical properties of Nitella, and temperature effects on action potential. (GS)

Blatt, F. J.

1974-01-01

274

Collagen nerve wrap for median nerve scarring.  

PubMed

Nerve wrapping materials have been manufactured to inhibit nerve tissue adhesions and diminish inflammatory and immunologic reactions in nerve surgery. Collagen nerve wrap is a biodegradable type I collagen material that acts as an interface between the nerve and the surrounding tissues. Its main advantage is that it stays in place during the period of tissue healing and is then gradually absorbed once tissue healing is completed. This article presents a surgical technique that used a collagen nerve wrap for the management of median nerve tissue adhesions in 2 patients with advanced carpal tunnel syndrome due to median nerve scarring and adhesions. At last follow-up, both patients had complete resolution with no recurrence of their symptoms. Complications related to the biodegradable material were not observed. PMID:25665110

Kokkalis, Zinon T; Mavrogenis, Andreas F; Ballas, Efstathios G; Papagelopoulos, Panayiotis J; Soucacos, Panayotis N

2015-02-01

275

Sporadic hypokalemic paralysis caused by osmotic diuresis in diabetes mellitus.  

PubMed

A wide variety of neurological manifestations are known in patients with diabetes mellitus. We describe a 40-year-old man who presented with hypokalemic paralysis. On evaluation, we found that the cause of the hypokalemia was osmotic diuresis induced by marked hyperglycemia due to undiagnosed diabetes mellitus. The patient had an uneventful recovery with potassium replacement, followed by glycemic control with insulin. Barring a few instances of symptomatic hypokalemia in the setting of diabetic emergencies, to our knowledge uncomplicated hyperglycemia has not been reported to result in hypokalemic paralysis. PMID:24472241

Vishnu, Venugopalan Y; Kattadimmal, Anoop; Rao, Suparna A; Kadhiravan, Tamilarasu

2014-07-01

276

Mumps, Cervical Zoster, and Facial Paralysis: Coincidence or Association?  

PubMed Central

The association of mumps with peripheral facial paralysis has been suggested, but its pathogenesis remains unclear. An 8-year-old girl simultaneously developed left peripheral facial paralysis, ipsilateral cervical herpes zoster, and bilateral mumps sialadenitis. Elevated anti-mumps and anti-varicella zoster virus IgM antibodies in serological testing indicated recent infection of mumps and reactivation of VZV. Molecular studies have provided mounting evidence that the mumps virus dysregulates the host's immune system and enables the virus to proliferate in the infected host cells. This dysregulation of the immune system by mumps virus may have occurred in our patient, enabling the latent VZV infection to reactivate. PMID:24653846

Kanaya, Kaori

2014-01-01

277

Recurrent isolated sleep paralysis: Polysomnographic and clinical findings  

Microsoft Academic Search

Summary\\u000a Question of the study  Sleep paralysis is one of the typical symptoms of narcolepsy, found in about 25% of narcoleptic patients. It also represents\\u000a a separate sleep disorder classified as a REM sleep-related parasomnia. We compared clinical and electrophysiological data\\u000a of patients with recurrent isolated sleep paralysis (RISP) with those of narcoleptic patients and healthy control subjects.\\u000a \\u000a \\u000a \\u000a patients and methods  Structured

Björn W. Walther; Hartmut Schulz

2004-01-01

278

Botulinum toxin induces muscle paralysis and inhibits bone regeneration in zebrafish.  

PubMed

Intramuscular administration of Botulinum toxin (BTx) has been associated with impaired osteogenesis in diverse conditions of bone formation (eg, development, growth, and healing), yet the mechanisms of neuromuscular-bone crosstalk underlying these deficits have yet to be identified. Motivated by the emerging utility of zebrafish (Danio rerio) as a rapid, genetically tractable, and optically transparent model for human pathologies (as well as the potential to interrogate neuromuscular-mediated bone disorders in a simple model that bridges in vitro and more complex in vivo model systems), in this study, we developed a model of BTx-induced muscle paralysis in adult zebrafish, and we examined its effects on intramembranous ossification during tail fin regeneration. BTx administration induced rapid muscle paralysis in adult zebrafish in a manner that was dose-dependent, transient, and focal, mirroring the paralytic phenotype observed in animal and human studies. During fin regeneration, BTx impaired continued bone ray outgrowth, morphology, and patterning, indicating defects in early osteogenesis. Further, BTx significantly decreased mineralizing activity and crystalline mineral accumulation, suggesting delayed late-stage osteoblast differentiation and/or altered secondary bone apposition. Bone ray transection proximal to the amputation site focally inhibited bone outgrowth in the affected ray, implicating intra- and/or inter-ray nerves in this process. Taken together, these studies demonstrate the potential to interrogate pathological features of BTx-induced osteoanabolic dysfunction in the regenerating zebrafish fin, define the technological toolbox for detecting bone growth and mineralization deficits in this process, and suggest that pathways mediating neuromuscular regulation of osteogenesis may be conserved beyond established mammalian models of bone anabolic disorders. PMID:24806738

Recidoro, Anthony M; Roof, Amanda C; Schmitt, Michael; Worton, Leah E; Petrie, Timothy; Strand, Nicholas; Ausk, Brandon J; Srinivasan, Sundar; Moon, Randall T; Gardiner, Edith M; Kaminsky, Werner; Bain, Steven D; Allan, Christopher H; Gross, Ted S; Kwon, Ronald Y

2014-11-01

279

The Frequency and Correlates of Sleep Paralysis in a University Sample  

Microsoft Academic Search

In a sample of 1798 university undergraduates (females, n = 976; males, n = 822) 21% reported one or more episodes of sleep paralysis, and there was no significant sex difference in this regard. Most (98.4%) sleep paralysis sufferers reported at least one psychological symptom (e.g., hallucinations) accompanying their last (or only) episode. A total of 190 sleep paralysis reporters

Nicholas P. Spanos; Stacey A. McNulty; Susan C. DuBreuil; Martha Pires; Melissa Faith Burgess

1995-01-01

280

Prevalence and correlates of sleep paralysis in adults reporting childhood sexual abuse  

Microsoft Academic Search

Sleep paralysis (SP) occurs when rapid eye movement (REM) activity and concomitant paralysis of the skeletal muscles persist as an individual awakens and becomes conscious of his\\/her surroundings. SP is often accompanied by frightening hallucinations that some researchers suggest may be confounded with memories of childhood sexual abuse (CSA; [McNally, R. J., & Clancy, S. A. (2005). Sleep paralysis in

Murray P. Abrams; Ashlee D. Mulligan; R. Nicholas Carleton; Gordon J. G. Asmundson

2008-01-01

281

Connections between the facial, vestibular and cochlear nerve bundles within the internal auditory canal.  

PubMed

The vestibular, cochlear and facial nerves have a common course in the internal auditory canal (IAC). In this study we investigated the average number of nerve fibres, the average cross-sectional areas of the nerves and nerve fibres, and the apparent connections between the facial, cochlear and vestibular nerve bundles within the IAC, using light and scanning electron microscopy. The anatomical localization of the nerves within the IAC was not straightforward. The general course showed that the nerves rotated anticlockwise in the right ear from the inner ear end towards the brainstem end and vice versa for the left ear. The average number of fibres forming vestibular, cochlear, and facial nerves was not constant during their courses within the IAC. The superior and the inferior vestibular nerves showed an increase in the number of nerve fibres from the inner ear end towards the brainstem end of the IAC, whereas the facial and the cochlear nerves showed a reduction in the number of fibres. This suggests that some of the superior and inferior vestibular nerve bundles may receive fibres from the facial and/or cochlear nerves. Scanning electron microscopic evaluations showed superior vestibular-facial and inferior vestibular-cochlear connections within the IAC, but no facial-cochlear connections were observed. Connections between the nerves of the IAC can explain the unexpected vestibular disturbances in facial paralysis or persistence of tinnitus after cochlear neurectomy in intractable tinnitus cases. The present study offers morphometric and scanning electron microscopic data on the fibre connections of the nerves of the IAC. PMID:15255963

Ozdo?mu?, Omer; Sezen, Ozan; Kubilay, Utku; Saka, Erdinç; Duman, U?ur; San, Tangül; Cavdar, Safiye

2004-07-01

282

Neuroimaging investigation of the motor control disorder, dystonia with special emphasis on laryngeal dystonia  

E-print Network

Laryngeal dystonia (LD) is the focal laryngeal form of the neurological movement disorder called dystonia, a condition that often changes in severity depending on the posture assumed and on voluntary activity of the affected ...

Makhlouf, Miriam L

2013-01-01

283

Hyperkalaemic periodic paralysis: a rare presentation of Addison's disease.  

PubMed Central

A 44 year old man with longstanding diabetes mellitus gave a 6-month history of periodic attacks of flaccid quadriplegia. Following one of these episodes he was admitted for assessment. In view of persistent hyperkalaemia, hypoadrenalism was suspected and Addison's disease was confirmed biochemically. Adrenal replacement therapy restored the potassium levels to normal and resulted in no further attacks of paralysis. PMID:2594601

Sowden, J. M.; Borsey, D. Q.

1989-01-01

284

Molecular diagnosis of chronic bee paralysis virus infection  

Microsoft Academic Search

A new RT-PCR test was developed for the diagnosis of chronic bee paralysis virus (CBPV) infection. Used in parallel with an experimental infection test, the RT-PCR test was less fas- tidious and allowed the detection of latent CBPV infection in colonies. The new test is based on the fact that clinical CBPV infections (but not latent infections) yield a high

Carole Triboulot; Laetitia Mathieu; Jean-Paul Faucon

2002-01-01

285

Analysis Paralysis-Developing A Business Continuity Plan  

E-print Network

Analysis Paralysis-Developing A Business Continuity Plan Steve Sadler, UCAR Director of Safety that will cost you your job? ­What resources are absolutely essential? ­What would keep you from responding your organization ­ Looking for a gravy train · Pro's ­ No extra staff ­ Job will get done ­ Fresh set

286

Marek's disease virus induced transient paralysis--a closer look  

Technology Transfer Automated Retrieval System (TEKTRAN)

Marek’s Disease (MD) is a lymphoproliferative disease of domestic chickens caused by a highly cell-associated alpha herpesvirus, Marek’s disease virus (MDV). Clinical signs of MD include depression, crippling, weight loss, and transient paralysis (TP). TP is a disease of the central nervous system...

287

Spatial characteristics of hallucinations associated with sleep paralysis  

Microsoft Academic Search

Introduction. Spatial properties of hallucinations have received relatively little systematic investigation. We present evidence from a web?based study of the spatial properties of a broad array of hallucinations associated with sleep paralysis. Predictions regarding spatial characteristics of hallucinations were based on proposed neurophysiological mechanisms underlying different types of hallucinations. Method. Distributions in three dimensions as well as distance and dispersion

T. A. Girard; J. A. Cheyne

2004-01-01

288

Isolated Sleep Paralysis in African Americans with Panic Disorder  

Microsoft Academic Search

Isolated sleep paralysis (ISP) was assessed in African Americans and Whites diagnosed with panic disorder and other anxiety disorders. Participants were recruited from an outpatient clinic where they were diagnosed with panic disorder, generalized anxiety disorder, obsessive-compulsive disorder, social phobia, and simple phobia. Control groups of volunteers without a history of psychiatric disorder were included. All research participants completed a

Cheryl M. Paradis; Steven Friedman; Marjorie Hatch

1997-01-01

289

The old hag phenomenon as sleep paralysis: A biocultural interpretation  

Microsoft Academic Search

This paper describes a syndrome of psychological and physical symptoms involving body paralysis and hallucinations traditionally interpreted in Newfoundland as an attack of ‘Old Hag’. Folk theories of cause and treatment are outlined based on 13 months of field research in a community on the northeast coast of Newfoundland. Data derived from the responses of 69 adults to the Cornell

Robert C. Ness

1978-01-01

290

Rates of isolated sleep paralysis in outpatients with anxiety disorders  

Microsoft Academic Search

Initial research suggests that rates of isolated sleep paralysis (ISP) are elevated in individuals with panic disorder and particularly low in individuals with other anxiety disorders. To further evaluate these findings, we examined rates of ISP in a sample outpatients with primary diagnoses of panic disorder (n=24), social anxiety disorder (n=18), or generalized anxiety disorder (n=18). We obtained an overall

Michael W. Otto; Naomi M. Simon; Mark Powers; Devon Hinton; Alyson K. Zalta; Mark H. Pollack

2006-01-01

291

Co-existence of panic disorder and sleep paralysis  

Microsoft Academic Search

Sleep paralysis is a clinical phenomenon that is often a feature of narcolepsy. As its co-existence with panic disorder has not been noted before, we report on two cases in which the two conditions co-exist and postulate a neurochemical mechanism.

Danny Allen; David Nutt

1993-01-01

292

Does Recurrent Isolated Sleep Paralysis Involve More Than Cognitive Neurosciences?  

Microsoft Academic Search

Isolated sleep paralysis (ISP) is a poorly understood phenomenon that has attracted increased attention in recent years both in the medical com- munity (Dahlitz & Parkes, 1993; Hishikawa & Shimizu, 1995) and in psy- chological research (Fukuda et al., 1987, 1991; Fukuda, 1993; Takeuchi et al., 1994; Wing et al., 1994 ). Although the occurrence of ISP is relatively common,

JEAN-CHRISTOPHE TERRILLON; SIRLEY MARQUES-BONHAM

293

Surveillance of acute flaccid paralysis in Italy: 1996–1997  

Microsoft Academic Search

The last case of poliomyelitis due to transmission of indigenous wild poliovirus occurred in Italy in 1982. To achieve the certification of the eradication of poliomyelitis in Italy, an active surveillance of acute flaccid paralysis (AFP) in the population aged less than 15 years was set up following the World Health Organization (WHO) guidelines. The survey started in 1996 with

L. Fiore; F. Novello; P. Simeoni; C. Amato; L. Vellucci; D. De Stefano; M. E. Grandolfo; I. Luzzi

1999-01-01

294

Complete A-V block and phrenic paralysis complicating surgical closure of ventricular septal defect--a case report.  

PubMed

The incidence of post-surgical complete A-V block has come down from 16% in the 50's to less than 1% with improvement in technique. Of these, 14% are transient and attributable to post-operative oedema and haemorrhage at the site of block. Permanent damage manifests early, or as late as 15 years, and in these, the risk of sudden death is a reality. Phrenic paralysis has been attributed to inadvertent pinching, cutting, traction on the phrenic nerve, and has been noticed after pericardiectomy, Blalock-Hanlon operation, Mustard repair, performance of a Blalock-Taussig shunt or closure of ASD. It has also been noted to result from hypothermic injury following iced saline slush application for topical hypothermia the so called "Frost Bitten Phrenics". The entity is commoner than appreciated, although its actual incidence has not been properly worked out. It can be unilateral or bilateral. Patients are mostly asymptomatic, the post-operative X-Ray chest revealing the defect. Uninhibited movement of the costal margin away from the midline on the side of paralysis gives clinical clue (Hoover's Sign), and is confirmed by fluoroscopy which shows paradoxic diaphragmatic movement on sudden sniffing (Keinbock's Phenomenon). PMID:2599546

Ghosh, P K; Singh, H; Bidwai, P S

1989-01-01

295

A comparison of fiberoptical guided tracheal intubation via laryngeal mask and laryngeal tube  

PubMed Central

Background: Fiberoptical assisted intubation via a placed laryngeal mask airway (LMA) has been described as save and easy procedure to manage a difficult airway. The laryngeal tube (LT) is a promising alternative to the LMA as supraglottic airway device. Fiberoptical assisted intubation via LT is possible, however considered more difficult. The aim of this study was to compare the fiberoptical assisted intubation via LT and LMA. Materials and Methods: A total of 22 anesthesiologists with different levels of experience participated in the study performed on an adult airway model. Primarily the supraglottic device was placed and correct position was confirmed by successful ventilation. A 5 mm internal diameter tracheal tube was loaded onto a flexible 3.6 mm fiberscope and the so prepared device was inserted into the proximal lumen of the LMA or the LT. The glottis was passed under visual control and the tube advanced into the trachea. After removal of the fiberscope, ventilation was examined clinically by inspection. Success rates, procedure time and observed complications of LMA versus LT were compared (U-test; P < 0.05). Results: Placement of the endotracheal tube was successful in all attempts using both the LMA and LT. There was no difference in the time needed for the placement procedure (33 [26-38] s LMA; 35 [32-38] s LT). Only minor technical complications were observed in both groups. Conclusion: A fiberoptical assisted intubation via LT can be considered as a relevant alternative in advanced airway management. PMID:25558197

Metterlein, Thomas; Plank, Christoph; Sinner, Barbara; Bundscherer, Anika; Graf, Bernhard M.; Roth, Gabriel

2015-01-01

296

Novel Configuration of Laryngeal Mask Airway  

PubMed Central

Objectives Hospital airway emergency teams are often responsible for responding to codes, emergency intubations etc. The individual provider may have to respond quickly to widely separated areas of large medical centers on a moment’s notice. Further, in addition to the urgency, the distance of different sites makes it important that the airway team not have to lug a large medical gear bag with airway supplies and emergency drugs. While the importance of the LMA in emergency airway management has been well established, it is sold as a fairly bulky device that requires a disproportionate space in an airway pack. We sought to examine whether modifying the LMA packaging might reduce the amount of space taken up by the need to carry three different sizes in an airway pack. Methods A commonly used Laryngeal Mask Size Number 3 manufactured by Ambu Company was studied. The volume displacement of the package, and then just the LMA was measured using volumetric techniques. Results Removing the large packaging yielded a much smaller footprint in cubic ml that was only 18% of the original packaging: 43 versus 240 cubic milliliters. Conclusions This configuration of LMA transport allows for transporting more airway equipment in less space. These results have important implications for emergency airway response teams. Removing the original packaging and using this folded-over configuration allows to use 82% less volume in cubic milliliters per LMA in the airway pack. This allows emergency teams to carry more equipment in much less space.

Denny, John T.; Denny, Julia E.

2014-01-01

297

Laryngeal synovial sarcoma: a rare clinical entity.  

PubMed

Introduction. Synovial sarcomas (SS) are aggressive malignant soft tissue tumours that are thought to arise from pluripotent mesenchymal cells. Clinical Report. A 20-year-old male presented with an acute onset of respiratory stridor. Computer tomography scanning confirmed a mass arising from the left supraglottic larynx and an emergency tracheostomy was performed. A diagnosis of biphasic synovial sarcoma was formed. A total laryngectomy and left hemithyroidectomy was performed in conjunction with a left modified radical neck dissection. The patient received adjuvant chemotherapy followed by a course of radiotherapy and remains alive and disease free at 18?months after treatment. Discussion. Prognosis for patients with SS is related to primary tumour extent, grade, and size. The presence of the diagnostic translocation, t(X;18), is being targeted and hopefully will lead to the development of new therapeutics (Guadagnolo et al., 2007). Conclusion. Laryngeal SS remains a rare and poorly understood entity. A multidisciplinary approach to treatment is essential and long-term followup is imperative. PMID:23984145

Saxby, Clair; Bova, Ron; Edwards, Melanie

2013-01-01

298

Transplantation of olfactory ensheathing cells to evaluate functional recovery after peripheral nerve injury.  

PubMed

Olfactory ensheathing cells (OECs) are neural crest cells which allow growth and regrowth of the primary olfactory neurons. Indeed, the primary olfactory system is characterized by its ability to give rise to new neurons even in adult animals. This particular ability is partly due to the presence of OECs which create a favorable microenvironment for neurogenesis. This property of OECs has been used for cellular transplantation such as in spinal cord injury models. Although the peripheral nervous system has a greater capacity to regenerate after nerve injury than the central nervous system, complete sections induce misrouting during axonal regrowth in particular after facial of laryngeal nerve transection. Specifically, full sectioning of the recurrent laryngeal nerve (RLN) induces aberrant axonal regrowth resulting in synkinesis of the vocal cords. In this specific model, we showed that OECs transplantation efficiently increases axonal regrowth. OECs are constituted of several subpopulations present in both the olfactory mucosa (OM-OECs) and the olfactory bulbs (OB-OECs). We present here a model of cellular transplantation based on the use of these different subpopulations of OECs in a RLN injury model. Using this paradigm, primary cultures of OB-OECs and OM-OECs were transplanted in Matrigel after section and anastomosis of the RLN. Two months after surgery, we evaluated transplanted animals by complementary analyses based on videolaryngoscopy, electromyography (EMG), and histological studies. First, videolaryngoscopy allowed us to evaluate laryngeal functions, in particular muscular cocontractions phenomena. Then, EMG analyses demonstrated richness and synchronization of muscular activities. Finally, histological studies based on toluidine blue staining allowed the quantification of the number and profile of myelinated fibers. All together, we describe here how to isolate, culture, identify and transplant OECs from OM and OB after RLN section-anastomosis and how to evaluate and analyze the efficiency of these transplanted cells on axonal regrowth and laryngeal functions. PMID:24637657

Guerout, Nicolas; Paviot, Alexandre; Bon-Mardion, Nicolas; Honoré, Axel; Obongo, Rais; Duclos, Célia; Marie, Jean-Paul

2014-01-01

299

Bilateral common peroneal nerve injury after pediatric cardiothoracic surgery: A case report and review of the literature  

PubMed Central

Nerve injuries after thoracic and cardiovascular surgery have been reported but generally concern the brachial plexus, phrenic nerve, recurrent laryngeal, and facial nerve. Common peroneal nerve injury (CPNI) following cardiopulmonary bypass has been reported in adults (4); however bilateral injury is extremely uncommon. Age, low body weight, co-morbidities such as peripheral arteriosclerotic disease, diabetes mellitus, and arrhythmias were associated with CPNI following cardiothoracic surgery in adults. Common peroneal nerve injury (CPNI) following cardiopulmonary by-pass has been reported in adults; however, bilateral injury is extremely uncommon. The superficial course of CPN makes it vulnerable to traction or compression. We report a 5-year-old girl manifesting with bilateral CPNI following prolonged cardiopulmonary by-pass. To the best of our knowledge, she is the first pediatric patient presenting with bilateral CPNI following cardiothoracic surgery and cardiopulmonary by-pass. PMID:25624938

Setty, G.; Saleem, R.; Harijan, P.; Khan, A.; Hussain, N.

2014-01-01

300

Laryngeal hemiplegia in draft horses. A review of 27 cases.  

PubMed

Case records of 27 draft horses with laryngeal hemiplegia were reviewed. Twenty-one horses were treated by ventriculectomy with or without prosthetic laryngoplasty, and 17 owners were contacted to determine the results. Fifteen horses improved after surgery and were able to perform to the owners' expectations. Performance improved significantly and hospitalization was shorter after ventriculectomy alone. Results of this study indicate that the clinical signs of exercise intolerance and excessive inspiratory noise associated with left laryngeal hemiplegia in draft horses can be treated successfully by ventriculectomy without prosthetic laryngoplasty. PMID:2264284

Bohanon, T C; Beard, W L; Robertson, J T

1990-01-01

301

Laryngeal movement, oropharyngeal pressure, and submental muscle contraction during swallowing.  

PubMed

This study examined temporal relationships of laryngeal movement, oropharyngeal pressure and submental muscle contraction during swallowing. Techniques used to obtain the temporal measures were electroglottography (EGG), oropharyngeal manometry, and submental surface electromyography. Liquid bolus swallows were performed by 40 normal subjects evenly divided by young and elderly, men and women. Results of this investigation suggest that the EGG waveform is reflective of the temporal aspects of laryngeal movement during swallowing and that the EGG has potential as a behavioral modification technique in swallowing therapy. A case study is presented to illustrate the use of the electroglottograph for biofeedback. PMID:8311675

Schultz, J L; Perlman, A L; VanDaele, D J

1994-02-01

302

Critical analysis of robotic surgery for laryngeal tumours.  

PubMed

In recent years, transoral robotic surgery (TORS) with the Da Vinci robot has been used for the removal of laryngeal cancers with the objective to improve functional and aesthetic outcomes without worsening survival. The advantages of TORS are described in this article. However, its disadvantages, mainly high cost amongst others, do not make robotic surgery the current treatment of choice for laryngeal tumours; transoral laser surgery is superior in most cases. Major technical improvements are expected. Smaller, more ergonomic, new-generation robots better adapted to the head and neck will probably be available in the near future. PMID:24626048

Esteban, Francisco; Menoyo, Alicia; Abrante, Antonio

2014-01-01

303

Does an ulnar nerve lesion influence the motion of the index finger?  

PubMed

Clawing of the ring and little fingers and "rolling" during prehension grip are well-known clinical phenomena of ulnar nerve lesions. In contrast to this the index and middle fingers seem to move normally. We compared the movement of right index fingers in healthy people with the right index fingers of people with an ulnar nerve lesion. The movement was measured using a three-dimensional real time motion analysis system based on ultrasound. The angles of the joints were plotted in a rectangular coordinate system. Statistical analysis of the numerical data showed no difference between the two groups. We trained a neural-network (Learning Vector Quantization) with the data of both groups. The network was able to distinguish between people with and without lesions of the ulnar nerve. We conclude that prehension grip of the index finger is also influenced by paralysis of the ulnar nerve. PMID:8732411

Hahn, P; Heindl, E

1996-04-01

304

Facial paralysis and mediastinitis due to odontogenic infection and poor prognosis.  

PubMed

Cervical necrotizing fasciitis (CNF) is a rare, rapidly advancing infection that involves the skin, the subcutaneous fibrofatty tissue, as well as the superficial and deep fascia and can cause life-threatening complications. The most frequent initiating factors in the head and neck region are a primary odontogenic infection, a peritonsillar infection, as well as posttraumatic or iatrogenic skin and mucosal injuries. Necrotizing fasciitis (NF) can expand within hours, and the reported mortality rate is up to 75% with delay interference. If the patients have any risk factors, poor prognosis can be seen. In this study, 1 patient with CNF with a history of peritonsillar infection and 2 patients with CNF who had a history of odontogenic infection with spreading to the temporal region and the mediastinum were described, with information of the literature and a clinical experience that was gained from 5 patients with NF who were seen at our clinic in the recent year, despite the fact that CNF was not seen up to last year. None of the patients had any risk factors. One of them had a worse clinical state with ascending infection to the temporal region, cranial nerve paralysis, and descending necrotizing mediastinitis, but he recovered from NF. After the oral intake began, dyspnea due to aspiration was seen and he died because of sepsis and multiorgan dysfunction. We aimed to attract attention to the importance of dental pathologies and increased mortality in a healthy patient. PMID:24220381

Bucak, Abdulkadir; Ulu, Sahin; Kokulu, Serdar; Oz, Gürhan; Solak, Okan; Kahveci, Orhan Kemal; Ayçiçek, Abdullah

2013-11-01

305

Thyrotoxic periodic paralysis: an endocrine cause of paraparesis.  

PubMed

Periodic paralysis is a muscle disorder that belongs to the family of diseases called channelopathies, manifested by episodes of painless muscle weakness. Periodic paralysis is classified as hypokalemic when episodes occur in association with low potassium levels. Most cases are hereditary. Acquired cases have been described in association with hyperthyroidism. Diagnosis is made on clinical and biochemical grounds. Patients may be markedly hypokalemic during the episode and respond well to potassium supplementation. Episodes can be prevented by achieving a euthyroid state. This report describes a young gentleman presenting with thyrotoxic hypokalemic paraparesis. The condition needs to be considered in the differential diagnosis of neuromuscular weakness in the context of hypokalemia by the treating physicians. PMID:24906287

Munir, Atif

2014-05-01

306

Autonomously functioning thyroid nodule associated with thyrotoxic periodic paralysis.  

PubMed

Thyrotoxic periodic paralysis (TPP) is mainly associated with Graves' disease but rarely with autonomously functioning thyroid nodule (AFTN). We herein report a case of AFTN associated with TPP in which the latter resolved after (131) I therapy for the former. We analyzed the genes encoding thyrotropin receptor (TSHR), the alpha-subunit of the stimulatory G protein (Gsalpha), calcium channel CACNA1S and potassium channel KCNE3, and found that the patient does not carry the known mutations in these genes. Whereas the pathogenesis of TPP and AFTN remains to be understood, the present case suggests that ion channel defects responsible for familial hypokalemic periodic paralysis may not be associated with TPP, and that mutations in TSHR and Gs alpha genes may be less frequent in AFTN patients in the Japanese population. PMID:18202530

Ozaki, Hiroshi; Mori, Kouki; Nakagawa, Yoshinori; Hoshikawa, Saeko; Ito, Sadayoshi; Yoshida, Katsumi

2008-03-01

307

Isolated sleep paralysis, vivid dreams and geomagnetic influences: II.  

PubMed

This report describes a test of the hypothesis that significant changes in the ambient geomagnetic field are associated with altered normal nighttime dream patterns. Specifically, it was predicted that there would be a greater incidence of isolated sleep, paralysis or vivid dreams with abrupt rises and falls of geomagnetic activity. The author's (JC) and a second subject's (KC) daily reports of dream-recall were analyzed in the context of daily fluctuations of geomagnetic activity (K indices). Two analyses of variance indicated (i) significantly higher geomagnetic activity three days before a recorded isolated sleep paralysis event and (ii) significantly lower geomagnetic activity three days before an unusually vivid dream took place. Conversely, geomagnetic activity did not fluctuate significantly for randomly selected days. Testing a large sample over time is required for confirmation and extension of this work. PMID:9347546

Conesa, J

1997-10-01

308

Detection of Diphtheritic Polyneuropathy by Acute Flaccid Paralysis Surveillance, India  

PubMed Central

Diphtheritic polyneuropathy is a vaccine-preventable illness caused by exotoxin-producing strains of Corynebacterium diphtheriae. We present a retrospective convenience case series of 15 children (6 girls) <15 years of age (mean age 5.2 years, case-fatality rate 53%, and 1 additional case-patient who was ventilator dependent at the time of last follow-up; median follow-up period 60 days) with signs and symptoms suggestive of diphtheritic polyneuropathy. All cases were identified through national acute flaccid paralysis surveillance, which was designed to detect poliomyelitis in India during 2002–2008. We also report data on detection of diphtheritic polyneuropathy compared with other causes of acute flaccid paralysis identified by this surveillance system. PMID:23965520

Bahl, Sunil; Khera, Ajay; Sutter, Roland W.

2013-01-01

309

Genetic heterogeneity in hypokalemic periodic paralysis (hypoPP)  

Microsoft Academic Search

Hypokalemic periodic paralysis (hypoPP) is an autosomal dominant disorder belonging to a group of muscle diseases known to involve an abnormal function of ion channels. The latter includes hypokalemic and hyperkalemic periodic paralyses, and non-dystrophic myotonias. We recently showed genetic linkage of hypoPP to loci on chromosome 1q31-32, co-localized with the DHP-sensitive calcium channel CACNL1A3. We propose to term this

Emmanuelle Plassart; Alexis Elbaz; Jose Vale Santos; Jocelyne Reboul; Pascale Lapie; Dominique Chauveau; Karin Jurkat-Rott; Joao Guimaraes; Jean-Marie Saudubray; Jean Weissenbach; Frank Lehmann-Horn; Bertrand Fontaine

1994-01-01

310

Abrupt hypokalemia with paralysis from a clinician’s perspective  

Microsoft Academic Search

Monogenic hypokalemic periodic paralysis (HypoPP) is an autosomal dominant genetic disease. HypoPP is more common in males than females and has a reduced penetrance in females. Attacks generally begin during adolescence. They are aggravated by exercise, sleep, stress, alcohol, and meals rich in carbohydrates and salt. The episodes last 324h. Attacks often feature a prodrome of stiffness or heaviness in

Friedrich C. Luft

2005-01-01

311

The pattern of residual muscle paralysis in poliomyelitis  

Microsoft Academic Search

Summary  Rural schoolchildren between the ages of 6 and 18 years were screened for residual paralysis following poliomyelitis; 503\\u000a (0.85%) out of a total of 58,592 were victims. Of these, only 16 (3.8%) had received poliomylitis vaccine, while the remainder\\u000a had not been immunised. The disease had occurred before the age of 4 years in nearly 90%, the lower limbs being

S. C. Sharma; S. S. Sangwam; R. C. Siwach; Rajiv Aggarwal; C. R. Khatri; V. K. Govila; A. K. Sood

1994-01-01

312

A rare case of thyrotoxic periodic paralysis precipitated by hydrocortisone  

PubMed Central

Thyrotoxic periodic paralysis (TPP) is a rare, but serious condition characterized by acute paralytic attacks and hypokalemia in association with thyrotoxicosis. Although carbohydrate rich meals, strenuous exercise, alcohol, emotional stress are known precipitants of TPP, steroid treatment has rarely been reported to induce TPP. We report a case in which a patient with previously untreated Grave's disease developed TPP following administration of Intravenous hydrocortisone for control of severe anaphylaxis, which to best of our knowledge is very rare.

Chakrabarti, Subrata

2015-01-01

313

Sleep Paralysis, Sexual Abuse, and Space Alien Abduction  

Microsoft Academic Search

Sleep paralysis accompanied by hypnopompic ('upon awaken- ing') hallucinations is an often-frightening manifestation of discordance between the cognitive\\/perceptual and motor aspects of rapid eye movement (REM) sleep. Awakening sleepers become aware of an inability to move, and sometimes experience intrusion of dream mentation into waking consciousness (e.g. seeing intruders in the bedroom). In this article, we summarize two studies. In

RICHARD J. MCNALLY; SUSAN A. CLANCY

2005-01-01

314

Individual differences in lateralisation of hallucinations associated with sleep paralysis  

Microsoft Academic Search

Individual differences were investigated in the lateralisation of two general categories of hypnagogic and hypnopompic hallucinations associated with sleep paralysis: (1) Vestibular?motor (V?M) hallucinations; comprising sensations of floating, flying, illusory locomotion and postural adjustments, out?of?body experiences (OBE), and autoscopy; and (2) Intruder hallucinations; incorporating a sense of the presence, and visual and auditory hallucinations of external, alien agents. Left–right lateralisation

T. A. Girard; J. A. Cheyne

2004-01-01

315

Dengue-associated hypokalemic paralysis: causal or incidental?  

PubMed

Dengue-associated hypokalemic paralysis is considered an important but under-emphasized neuromuscular complication of dengue virus infection. Review of the published literature reveals that 35 instances of hypokalemic paralysis associated with dengue have been recorded from the Indian subcontinent and all but two, were males. The median age of presentation is 29 years and moderate to severe grade pure motor quadriparesis is precipitated during the phase of defervescence of moderate to high-grade fever. Recovery starts within 12h of potassium supplementation and is usually complete in a couple of days. Redistribution or increased loss of potassium from the body is speculated as the pathophysiological mechanism involved in the causation of hypokalemia. It is not possible to derive the exact etiopathological correlation from the published literature either due to a lack of comprehensive reporting or inadequate work-up of the patients. Curious is the fact that only 35 patients had manifest-paralysis when more than two-thirds affected with the dengue virus exhibit hypokalemia; whether this indicates a genetically mediated channel disorder or an incidental association remains to be seen. PMID:24680561

Malhotra, Hardeep Singh; Garg, Ravindra Kumar

2014-05-15

316

Electromechanical Nerve Stimulator  

NASA Technical Reports Server (NTRS)

Nerve stimulator applies and/or measures precisely controlled force and/or displacement to nerve so response of nerve measured. Consists of three major components connected in tandem: miniature probe with spherical tip; transducer; and actuator. Probe applies force to nerve, transducer measures force and sends feedback signal to control circuitry, and actuator positions force transducer and probe. Separate box houses control circuits and panel. Operator uses panel to select operating mode and parameters. Stimulator used in research to characterize behavior of nerve under various conditions of temperature, anesthesia, ventilation, and prior damage to nerve. Also used clinically to assess damage to nerve from disease or accident and to monitor response of nerve during surgery.

Tcheng, Ping; Supplee, Frank H., Jr.; Prass, Richard L.

1993-01-01

317

Nerve conduction velocity  

MedlinePLUS

... to determine the speed of the nerve signals. Electromyography (recording from needles placed into the muscles) is ... Often, the nerve conduction test is followed by electromyography (EMG). In this test, needles are placed into ...

318

Ulnar nerve damage (image)  

MedlinePLUS

... elbow because of elbow fracture or dislocation. The ulnar nerve is near the surface of the body where it crosses the elbow, so prolonged pressure on the elbow or entrapment of the nerve may cause damage. Damage to ...

319

Distal median nerve dysfunction  

MedlinePLUS

... is necessary to look for an underlying medical problem that can affect nerves. Medical conditions such as diabetes and kidney disease can damage nerves. In these cases, treatment is directed at the underlying medical condition. Physical ...

320

Nerve Injuries in Athletes.  

ERIC Educational Resources Information Center

Over a two-year period this study evaluated the condition of 65 athletes with nerve injuries. These injuries represent the spectrum of nerve injuries likely to be encountered in sports medicine clinics. (Author/MT)

Collins, Kathryn; And Others

1988-01-01

321

Peripheral nerve blockade as an exclusive approach to obturator nerve block in anterior cruciate ligament reconstructive surgery  

PubMed Central

Background Obturator nerve block plays an additive role on the quality of analgesia for knee surgery. Since the use of dual guidance increases the success rate of nerve blocks, we investigated the feasibility of performing anterior cruciate ligament reconstruction under dual-guided blockade of obturator with femoral and sciatic nerves. Furthermore, we propose a novel method for the assessment of obturator nerve block. Methods Fifty-seven patients undergoing anterior cruciate ligament repair were studied. Neurostimulating needles were guided out-of-plane by ultrasound. To induce the obturator nerve block, 10 ml of ropivacaine 0.5% were injected after eliciting contractions of adductor longus, brevis and magnus followed by block assessment for 30 minutes by examining the patient lift and left down the leg. Results The sonographic recognition of obturator nerve was easy and quick in all cases. Time for applying the block was 119.9 ± 79.2 sec. Assessing this block with lifting-leaving down the leg gave satisfactory results in 24.0 ± 5.07 min. After performing femoral-sciatic blocks, the inflation of tourniquet resulted in VAS score of > 0 in 2/57 patients and operation in 12/57. Total dose of fentanyl was 120.1 ± 64.6 µg and of midazolam 1.86 ± 0.8 mg. In 6 patients propofol was administered for sedation and 1 of them required ventilation with laryngeal mask airway, converting the anesthesia technique to general anesthesia. Conclusions Our data suggest that anterior cruciate ligament reconstruction can be performed under obturator-femoral-sciatic blocks. Identification of obturator nerve with ultrasound is easy and the block can be assessed by observing how the patient lifts and leaves down the leg. PMID:24363843

Simeoforidou, Marina; Basdekis, George; Tsiaka, Katerina; Chantzi, Eleni; Vretzakis, George

2013-01-01

322

Radiofrequency ablation (coblation): a promising new technique for laryngeal papillomata.  

PubMed

This paper describes a new application for radiofrequency ablation in head and neck surgery. Two patients with extensive laryngeal papillomata were successfully treated using this technology. The technique is described in detail, highlighting the main benefits of this approach as compared with existing techniques. These advantages include limited damage to underlying tissues and a bloodless field. PMID:17040601

Timms, M S; Bruce, I A; Patel, N K

2007-01-01

323

Glottal airflow resistance in excised pig, sheep, and cow larynges.  

PubMed

This study was to investigate glottal flow resistance in excised pig, sheep, and cow larynges during phonation at different oscillation ranges and to examine the relation of the glottal flow resistance to the laryngeal geometry and vocal fold vibration. Several pig, sheep, and cow larynges were prepared, mounted on an excised larynx bench, and set into oscillation with pressurized, heated, and humidified air. Glottal adduction was controlled by either using two-pronged probes to press the arytenoids together, or by passing a suture to simulate the lateral cricoarytenoid muscle action. Each excised larynx was subjected to a series of pressure-flow experiments, with adduction and flow rate as independent variables. The subglottal pressure, fundamental frequency, and glottal flow resistance were treated as dependent variables. The subglottal pressure, electroglottograph (EGG), and flow rate signals were recorded during each experiment. Glottal flow resistance was calculated from the pressure and flow signals, whereas the EGG signal was used to extract fundamental frequency. Preliminary data indicated a nonlinear behavior in the pressure-flow relations of these larynges with increasing glottal resistance due to increases in adduction. The average glottal flow resistance was 35.3+/-14.8 cmH(2)O/(L/s) for the pig, 30.8+/-17.5 cmH(2)O/(L/s) for the sheep, and 26.9+/-14.9 cmH(2)O/(L/s) for the cow. PMID:18023324

Alipour, Fariborz; Jaiswal, Sanyukta

2009-01-01

324

RESEARCH ARTICLE Laryngeal somatosensory deficits in Parkinson's disease  

E-print Network

RESEARCH ARTICLE Laryngeal somatosensory deficits in Parkinson's disease: implications for speech October 2009 / Published online: 15 December 2009 Ã? Springer-Verlag 2009 Abstract Parkinson's disease (PD somatosensory function, speech, and voice in a neurolog- ical disease such as Parkinson's disease (PD) has

Sprott, Julien Clinton

325

Laryngeal obstruction caused by lymphoma in an adult dairy cow  

PubMed Central

A Holstein cow was presented for inspiratory dyspnea. Endoscopic evaluation revealed swollen arytenoids and a presumptive diagnosis of bilateral arytenoidal chondritis was made. A partial arytenoidectomy was performed, the right arytenoid was submitted for histopathology, and a diagnosis of laryngeal lymphoma was made. Due to the poor prognosis, the cow was euthanized. PMID:24489391

Lardé, Hélène; Nichols, Sylvain; Babkine, Marie; Chénier, Sonia

2014-01-01

326

The evolving role of the laryngeal mask airway in obstetrics  

Microsoft Academic Search

HI Sedition of the Journal contains a repor t that can be considered as astounding in tw o regards: first, that 1067 healthy women fo r elective Cesarean section were given a gene ral anesthetic (GA); and second, a laryngeal mask airwa y (LMA) was used for airway management\\/ventilation . 1 Both practices go against the mantra that obstetric ane

Roanne Preston

2001-01-01

327

Observation of the laryngeal movements for throat singing  

NASA Astrophysics Data System (ADS)

Throat singing is a traditional singing style of people who live around the Altai Mountains. Khoomei in Tyva and Khoomij in Mongolia are representative styles of throat singing. The laryngeal voices of throat singing is classified into (i) a drone voice which is the basic laryngeal voice in throat singing and used as drone and (ii) a kargyraa voice which is very low pitched with the range outside the modal register. In throat singing, the special features of the laryngeal movements are observed by using simultaneous recording of high-speed digital images, EGG, and sound wave forms. In the drone voice, the ventricular folds (VTFs) vibrate in the same frequency as the vocal folds (VFs) but in opposite phases. In the kargyraa voice, the VTFs can be assumed to close once for every two periods of closure of the VFs, and this closing blocks airflow and contributes to the generation of the subharmonic tone of kargyraa. Results show that in throat singing the VTFs vibrate and contribute to producing the laryngeal voice, which generates the special timbre and whistle-like overtone.

Sakakibara, Ken-Ichi; Konishi, Tomoko; Murano, Emi Z.; Imagawa, Hiroshi; Kumada, Masanobu; Kondo, Kazumasa; Niimi, Seiji

2002-11-01

328

An OT Account of Laryngealization in Cuzco Quechua.  

ERIC Educational Resources Information Center

Classical phonemic accounts of Cuzco (Peru) Quechua posit three distinct types of stops: plain, aspirated, and glottalized. A later analysis argued instead for a root-level feature of laryngealization governed by a small number of formal mechanisms. This latter analysis is taken one step further, showing that even greater explanatory power may be…

Parker, Steve

329

Laryngeal findings and voice quality in Sjögren's syndrome  

Microsoft Academic Search

Objective:The effect of Sjögren syndrome (SS) on perceptual ratings of the laryngeal findings using the Reflux Finding Score (RFS) and the Reflux Symptom Index (RSI) and the objective voice quality using Jitter (JITT), Pitch Period Perturbation Quotient (PPQ), Shimmer (Shim), Amplitude Perturbation Quotient (APQ) and Noise-to-Harmonic Ratio (NHR) was examined.

Fatih Ogut; Rasit Midilli; Gonca Oder; Erkan Zeki Engin; Bulent Karci; Yasemin Kabasakal

2005-01-01

330

Laryngeal Aerodynamics Associated with Oral Contraceptive Use: Preliminary Findings  

ERIC Educational Resources Information Center

The purpose of this study was to examine possible differences in laryngeal aerodynamic measures during connected speech associated with oral contraceptive (OC) use. Eight women taking an OC, and eight others not taking an OC, participated in the study. Three trials of syllable /p[subscript alpha] /repetitions were obtained using a…

Gorham-Rowan, Mary; Fowler, Linda

2009-01-01

331

Refinements in modeling the passive properties of laryngeal soft tissue.  

PubMed

The nonlinear viscoelastic passive properties of three canine intrinsic laryngeal muscles, the lateral cricoarytenoid (LCA), the posterior cricoarytenoid (PCA), and the interarytenoid (IA), were fit to the parameters of a modified Kelvin model. These properties were compared with those of the thyroarytenoid (TA) and cricothyroid (CT) muscles, as well as previously unpublished viscoelastic characteristics of the human vocal ligament. Passive parameters of the modified Kelvin model were summarized for the vocal ligament, mucosa, and all five laryngeal muscles. Results suggest that the LCA, PCA, and IA muscles are functionally different from the TA and CT muscles in their load-bearing capacity. Furthermore, the LCA, PCA, and IA have a much larger stress-strain hysteresis effect than has been previously reported for the TA and CT or the vocal ligament. The variation in this effect suggests that the connective tissue within the TA and CT muscles is somehow similar to the vocal ligament but different from the LCA, PCA, or IA muscles. Further demonstrating the potential significance of grouping tissues in the laryngeal system by functional groups in the laryngeal system was the unique finding that, over their working elongation range, the LCA and PCA were nearly as exponentially stiff as the vocal ligament. This paper was written in conjunction with an online technical report (http://www.ncvs.org/ncvs/library/tech) in which comprehensive muscle data and sensitivity analysis, as well as downloadable data files and computer scripts, are made available. PMID:17412782

Hunter, Eric J; Titze, Ingo R

2007-07-01

332

Laryngeal Muscles Are Spared in the Dystrophin Deficient "mdx" Mouse  

ERIC Educational Resources Information Center

Purpose: "Duchenne muscular dystrophy (DMD)" is caused by the loss of the cytoskeletal protein, dystrophin. The disease leads to severe and progressive skeletal muscle wasting. Interestingly, the disease spares some muscles. The purpose of the study was to determine the effects of dystrophin deficiency on 2 intrinsic laryngeal muscles, the…

Thomas, Lisa B.; Joseph, Gayle L.; Adkins, Tracey D.; Andrade, Francisco H.; Stemple, Joseph C.

2008-01-01

333

Cranial Nerves Model  

NSDL National Science Digital Library

Lesson is designed to introduce students to cranial nerves through the use of an introductory lecture. Students will then create a three-dimensional model of the cranial nerves. An information sheet will accompany the model in order to help students learn crucial aspects of the cranial nerves.

Juliann Garza (University of Texas-Pan American Physician Assistant Studies)

2010-08-16

334

Phonation threshold pressure and flow in excised human larynges  

PubMed Central

Objectives/Hypothesis 1. To determine the phonation threshold pressure (PTP) and phonation threshold flow (PTF) in excised human larynges. 2. To determine the effects of posterior glottal width, glottal area, and gender on PTP and PTF. 3. To test the hypothesis that hysteresis is present in excised human laryngeal phonation. 4. To compare these results to those from canine experiments and human subject measurements. Study Design Induced phonation of excised human larynges in the laboratory. Methods Nine human larynges were harvested within 24 hours post-mortem. PTP and PTF at phonation onset and offset were measured on a bench apparatus. The effects of posterior glottal width, glottal area, and gender were examined. Results Large inter-subject variability was observed in PTP and PTF. PTP was comparable to those measured in vivo, whereas PTF was substantially higher. One-way ANOVA showed no significant dependence of PTP and PTF on posterior glottal width. Hysteresis was observed, with offset PTP and PTF lower than onset values. Offset measurements had significantly less variability than onset measurements (P = 0.012 for PTP, P = 0.0001 for PTF). Conclusions This study is one of the first to report onset and offset PTP and PTF in fresh excised human larynges. The high PTF observed likely reflects a large DC flow component due to vocal fold bowing. Offset PTP and PTF values may be intrinsically more reliably measured than onset values. The large inter-subject variability in PTP and PTF may have implication for the clinical application of these aerodynamic parameters of phonation. Level of Evidence N/A (Laboratory study). PMID:21792964

Mau, Ted; Muhlestein, Joseph; Callahan, Sean; Weinheimer, Kent T.; Chan, Roger W.

2011-01-01

335

Pepsin promotes proliferation of laryngeal and pharyngeal epithelial cells  

PubMed Central

Objective/Hypothesis Laryngopharyngeal reflux (LPR) is thought to be a significant risk factor for laryngeal squamous cell carcinoma (SCC), but causality has never been proven. It is accepted that chronic reflux into the esophagus can induce metaplastic changes in esophageal mucosa with subsequent increased risk of esophageal adenocarcinoma, but no similar associations have been established for LPR and laryngopharyngeal SCC. The objective of this study was to test the hypothesis that reflux of pepsin into the laryngopharynx can promote carcinogenesis. Study Design Translational research study Methods Normal human laryngeal primary epithelial cell cultures and hypopharyngeal FaDu SCC cells were exposed to human pepsin and analyzed by Human Cancer PathwayFinder and miRNA Superarrays, flow cytometry and Western blot to determine the effect of pepsin on carcinogenesis. Laryngeal biopsy specimens, taken from cancer patients and normal control subjects, were analyzed for the presence of pepsin by Western blot. Results Microarray analysis demonstrated that pepsin significantly altered the expression of 27 genes implicated in carcinogenesis and also affected the expression of 22 microRNAs known to be altered in human head and neck cancers. Pepsin increased proliferation in both FaDu SCC cells and cultured normal laryngeal epithelial primary cells by increasing S phase distribution on flow cytometry analysis in a time and dose dependent manner. Furthermore, pepsin was detected in 60% (3/5) human laryngeal cancer biopsies, absent in all (0/5) normal control specimens. Conclusion These data support a role for refluxed pepsin in the promotion of epithelial proliferation and carcinogenesis of the larynx and pharynx. PMID:22570308

Johnston, Nikki; Yan, Justin C.; Hoekzema, Craig R.; Samuels, Tina L.; Stoner, Gary D.; Blumin, Joel H.; Bock, Jonathan M.

2013-01-01

336

Microbiota in the throat and risk factors of laryngeal carcinoma.  

PubMed

The compositions and abundance of the microbiota in the ecological niche of human throat and their possible relationship between the microbiota and laryngeal cancer are poorly understood. To obtain insight into this, we enrolled 27 laryngeal carcinoma patients and 28 subjects with vocal cord polyps as controls. For each subject, we simultaneously collected swab samples from the upper throat near epiglottis (site I) and tissue samples from the vestibulum laryngis to the subglottic region (site II). The microbiota of the throat were fully characterized by pyrosequencing of barcoded 16S rRNA genes. We found 14 phyla, 20 classes, 38 orders, 85 families, and 218 genera in the throat of enrolled subjects. The main phyla were Firmicutes (54.7%), Fusobacteria (14.8%), Bacteroidetes (12.7%), and Proteobacteria (10.6%). Streptococcus (37.3%), Fusobacterium (11.3%), and Prevotella (10.6%) were identified as the three most predominant genera in the throat. The relative abundances of 23 bacterial genera in the site I were significantly different compared with the site II (p < 0.05). The relative proportions of 12 genera largely varied between laryngeal cancer patients and control subjects (p < 0.05). Collectively, this study outlined the spatial structure of microbial communities in the human throat. The spatial structure of bacterial communities significantly varied in two anatomical sites of the throat. The bacterial profiles in the throat were strongly different between laryngeal cancer patients and control subjects, and several of these microorganisms may be related to laryngeal carcinoma. PMID:25239901

Gong, Hongli; Shi, Yi; Zhou, Xia; Wu, Chunping; Cao, Pengyu; Xu, Chen; Hou, Dongsheng; Wang, Yuezhu; Zhou, Liang

2014-09-19

337

Ultrasonography of peripheral nerves.  

PubMed

With recent improvements in ultrasound (US) imaging equipment and refinements in scanning technique, an increasing number of peripheral nerves and related pathologic conditions can be identified. US imaging can support clinical and electrophysiologic testing for detection of nerve abnormalities caused by trauma, tumors, and a variety of nonneoplastic conditions, including entrapment neuropathies. This article addresses the normal US appearance of peripheral nerves and discusses the potential role of US nerve imaging in specific clinical settings. A series of US images of diverse pathologic processes involving peripheral nerves is presented. PMID:10994689

Martinoli, C; Bianchi, S; Derchi, L E

2000-06-01

338

Na+,K+-pump stimulation improves contractility in isolated muscles of mice with hyperkalemic periodic paralysis  

PubMed Central

In patients with hyperkalemic periodic paralysis (HyperKPP), attacks of muscle weakness or paralysis are triggered by K+ ingestion or rest after exercise. Force can be restored by muscle work or treatment with ?2-adrenoceptor agonists. A missense substitution corresponding to a mutation in the skeletal muscle voltage-gated Na+ channel (Nav1.4, Met1592Val) causing human HyperKPP was targeted into the mouse SCN4A gene (mutants). In soleus muscles prepared from these mutant mice, twitch, tetanic force, and endurance were markedly reduced compared with soleus from wild type (WT), reflecting impaired excitability. In mutant soleus, contractility was considerably more sensitive than WT soleus to inhibition by elevated [K+]o. In resting mutant soleus, tetrodotoxin (TTX)-suppressible 22Na uptake and [Na+]i were increased by 470 and 58%, respectively, and membrane potential was depolarized (by 16 mV, P < 0.0001) and repolarized by TTX. Na+,K+ pump–mediated 86Rb uptake was 83% larger than in WT. Salbutamol stimulated 86Rb uptake and reduced [Na+]i both in mutant and WT soleus. Stimulating Na+,K+ pumps with salbutamol restored force in mutant soleus and extensor digitorum longus (EDL). Increasing [Na+]i with monensin also restored force in soleus. In soleus, EDL, and tibialis anterior muscles of mutant mice, the content of Na+,K+ pumps was 28, 62, and 33% higher than in WT, respectively, possibly reflecting the stimulating effect of elevated [Na+]i on the synthesis of Na+,K+ pumps. The results confirm that the functional disorders of skeletal muscles in HyperKPP are secondary to increased Na+ influx and show that contractility can be restored by acute stimulation of the Na+,K+ pumps. Calcitonin gene-related peptide (CGRP) restored force in mutant soleus but caused no detectable increase in 86Rb uptake. Repeated excitation and capsaicin also restored contractility, possibly because of the release of endogenous CGRP from nerve endings in the isolated muscles. These observations may explain how mild exercise helps locally to prevent severe weakness during an attack of HyperKPP. PMID:21708955

Nielsen, Ole Bækgaard; Clausen, Johannes D.; Pedersen, Thomas Holm; Hayward, Lawrence J.

2011-01-01

339

Optic Nerve Elongation  

PubMed Central

The length of the optic nerves is a reflection of normal postnatal cranio-orbital development. Unilateral elongation of an optic nerve has been observed in two patients with orbital and skull base neoplasms. In the first case as compared to the patient's opposite, normal optic nerve, an elongated length of the involved optic nerve of 45 mm was present. The involved optic nerve in the second patient was 10 mm longer than the normal opposite optic nerve. The visual and extraocular function was preserved in the second patient. The first patient had only light perception in the affected eye. In this paper, the embryology, anatomy, and physiology of the optic nerve and its mechanisms of stretch and repair are discussed. ImagesFigure 1Figure 2Figure 3Figure 4Figure 5Figure 6Figure 7Figure 8Figure 9Figure 10Figure 11Figure 13 PMID:17170975

Alvi, Aijaz; Janecka, Ivo P.; Kapadia, Silloo; Johnson, Bruce L.; McVay, William

1996-01-01

340

Transient Palsy of Recurrent Laryngeal Nerve Postresection of Giant Substernal Goiter  

PubMed Central

We report a case of a female patient aged 46 years with a history of nodular goiter for which she had a subtotal thyroidectomy 31 years ago. She was referred to the emergency department of our hospital because of dyspnea and chest pain for 20 days, then developed cyanosis and edema of the head and upper extremities. Chest X-ray revealed tracheal repulsion. Cervical and thoracic computed tomography showed a giant solid and a cystic mass in the anterior mediastinum and bilateral pleural effusion. The neck ultrasound did not show any thyroid masses. An exploratory thoracotomy with extensive resection considering the anatomical relation of the mass and the adjacent structures was planned. Immediately after the operation, the patient developed airway complications that resolved in 7 days. The tumor was confirmed pathologically as nodular goiter. The overall outcome of the patient was positive; she is healthy after more than 12 months of follow-up. This report examines the approach to diagnosis and management of one of the most common surgical complication associated with substernal goiters. PMID:25798363

Muhoozi, Rwakaryebe; Yu, Fenglei; Tang, Jingqun; Wang, Xiang

2014-01-01

341

Biting the laryngeal mask: an unusual cause of negative pressure pulmonary edema  

Microsoft Academic Search

Purpose: To describe negative pressure pulmonary edema due to biting of the laryngeal mask tube at emergence from general anesthesia.\\u000a \\u000a \\u000a Clinical features: A healthy patient underwent general anesthesia using a laryngeal mask airway and mechanical ventilation. During recovery,\\u000a the patient strongly bit the laryngeal mask and made very forceful inspiratory efforts until the mask was removed. Five minutes\\u000a later, the

Jean-Michel Devys; Christine Balleau; Christian Jayr; Jean-Louis Bourgain

2000-01-01

342

Lansoprazole treatment of patients with chronic idiopathic laryngitis: a placebo-controlled trial  

Microsoft Academic Search

OBJECTIVE:Previous uncontrolled studies suggested a therapeutic benefit for treating gastroesophageal reflux disease (GERD) among patients with laryngitis. The present study is the first randomized, placebo-controlled, double-blind study of gastric acid suppression among patients with laryngitis in the United States.METHODS:Patients diagnosed with idiopathic chronic laryngitis were randomized to receive either lansoprazole 30 mg p.o. b.i.d. or a matching placebo for 3

Hashem B. El-Serag; Patty Lee; Anna Buchner; John M. Inadomi; Michael Gavin; Denis M. McCarthy

2001-01-01

343

Tenofovir induced Fanconi syndrome: A rare cause of hypokalemic paralysis  

PubMed Central

We report a 55-year-old female who presented to the emergency department with acute onset quadriparesis. She was diagnosed to have acquired immunodeficiency syndrome 7 years ago and was on tenofovir based anti-retroviral therapy for past 10 months. As the patient also had hypophosphatemia, glucosuria and proteinuria Fanconi syndrome (FS) was suspected. She improved dramatically over next 12 h to regain normal power and also her renal functions improved over next few days. Tenofovir induced FS presenting as hypokalemic paralysis is very rare complication and is the first case reported from India. PMID:24701043

Venkatesan, E. P.; Pranesh, M. B.; Gnanashanmugam, G.; Balasubramaniam, J.

2014-01-01

344

Experience of isolated sleep paralysis in clinical practice in Nigeria.  

PubMed Central

The supernatural fears associated with the experience of isolated sleep paralysis in the culture of developing countries is sometimes associated with the evolution of somatic symptoms of psychological origin in patients predisposed to neurotic illness. Patients rarely spontaneously volunteer these fears and doctors pay them scant attention. Illustrative case histories that demonstrate the dynamics of the clinical presentation, as well as the treatment approach, are highlighted. It is hoped that doctors in general medical practice and in psychological medicine in developing countries where belief in supernatural causation of illness is rife will consider these factors in order to provide more effective treatment. PMID:1608064

Ohaeri, J. U.

1992-01-01

345

Tenofovir induced Fanconi syndrome: A rare cause of hypokalemic paralysis.  

PubMed

We report a 55-year-old female who presented to the emergency department with acute onset quadriparesis. She was diagnosed to have acquired immunodeficiency syndrome 7 years ago and was on tenofovir based anti-retroviral therapy for past 10 months. As the patient also had hypophosphatemia, glucosuria and proteinuria Fanconi syndrome (FS) was suspected. She improved dramatically over next 12 h to regain normal power and also her renal functions improved over next few days. Tenofovir induced FS presenting as hypokalemic paralysis is very rare complication and is the first case reported from India. PMID:24701043

Venkatesan, E P; Pranesh, M B; Gnanashanmugam, G; Balasubramaniam, J

2014-03-01

346

[Thyrotoxic hypokalemic periodic paralysis in patients of African descent].  

PubMed

Thyrotoxic hypokalemic periodic paralysis (THPP) is an endocrine emergency marked by recurrent attacks of muscle weakness associated with hypokalemia and thyrotoxicosis. Asiatic male patients are most often affected. On the other hand, African descents rarely present this disease. The case described shows an afrodescendant patient with hypokalemia and tetraparesis, whose diagnosis of hyperthyroidism was considered during this crisis. The THPP, although rare, is potentially lethal. Therefore, in cases of flaccid paresis crisis this diagnosis should always be considered, especially if associated with hypokalemia. In this situation, if no previous diagnosis of hyperthyroidism, this should also be regarded. PMID:25372590

Maia, Morgana Lima e; Trevisam, Paula Grasiele Carvalho; Minicucci, Marcos; Mazeto, Glaucia M F S; Azevedo, Paula S

2014-10-01

347

Atypical arrhythmic complications in familial hypokalemic periodic paralysis.  

PubMed

Familial hypokalemic periodic paralysis is an autosomal dominant muscle disorder characterized by episodic attacks of muscle weakness, accompanied by a decrease in blood potassium levels. It is based on genetic mutations in the genes CACNA1S (most frequent, encoding the skeletal muscle calcium channel) and SCN4A (10% of cases, encoding the sodium channel). Few cases have been reported with cardiac dysrhythmia. We report a rare case of a patient with a novel SCN4A mutation who presented, on ECG, extreme bradycardia and syncopal sinus arrest that required a temporary pacemaker implant PMID:19708131

Maffè, Stefano; Signorotti, Fabiana; Perucca, Antonello; Bielli, Massimo; Hladnik, Uros; Ragazzoni, Elena; Maduli, Elisabetta; Paffoni, Paola; Dellavesa, Pierfranco; Paino, Anna Maria; Zenone, Franco; Parravicini, Umberto; Pardo, Nicolò Franchetti; Cucchi, Lorenzo; Zanetta, Marco

2009-01-01

348

Hypokalemic paralysis due to thyrotoxicosis accompanied by Gitelman's syndrome  

PubMed Central

A 35-year-old male patient was admitted with fatigue and muscle weakness. He had been on methimazole due to thyrotoxicosis for 2 weeks. Laboratory tests showed overt hyperthyroidism and hypokalemia. Potassium replacement was started with an initial diagnosis of thyrotoxic hypokalemic periodic paralysis. Later on, despite the euthyroid condition and potassium chloride treatment, hypokalemia persisted. Further investigations revealed hyperreninemic hyperaldosteronism. The patient was considered to have Gitelman's syndrome (GS) and all genetic analysis was done. A c. 1145C>T, p. Thr382Met homozygote missense mutation located on solute carrier family 12, member gene 3, exon 9 was detected and GS was confirmed.

Baldane, S.; Ipekci, S. H.; Celik, S.; Gundogdu, A.; Kebapcilar, L.

2015-01-01

349

Temperature protects insect cells from infection by cricket paralysis virus.  

PubMed

Heat shock is a well-known stress response characterized by a rapid synthesis of a set of proteins which are responsible for protection against stress. We examined the role of temperature on the growth of cricket paralysis virus, a member of the family Dicistroviridae, in insect cells. Heat shock caused an induction of heat shock protein-encoding mRNAs in uninfected cells but not in infected cells. While viral RNA and protein were abundant during heat shock, virion formation was inhibited at higher temperatures. The different susceptibility to pathogens at different temperatures is likely a crucial feature of host-pathogen interaction in cold-blooded animals. PMID:19906924

Cevallos, Randal C; Sarnow, Peter

2010-02-01

350

Cuff leak test and laryngeal survey for predicting post-extubation stridor  

PubMed Central

Background and Aims: Evidence for the predictive value of the cuff leak test (CLT) for post-extubation stridor (PES) is conflicting. We evaluated the association and accuracy of CLT alone or combined with other laryngeal parameters with PES. Methods: Fifty-one mechanically ventilated adult patients in a medical-surgical intensive care unit were tested prior to extubation using; CLT, laryngeal ultrasound and indirect laryngoscopy. Biometric, laryngeal and endotracheal tube (ETT) parameters were recorded. Results: PES incidence was 4%. CLT demonstrated ‘no leak’ in 20% of patients. Laryngeal oedema was present in 10% of the patients on indirect laryngoscopy, and 71% of the patients had a Grades 1-3 indirect laryngoscopic view. Mean air column width on laryngeal ultrasound was 0.66 ± 0.15 cm (cuff deflated), mean ratio of ETT to laryngeal diameter was 0.48 ± 0.07, and the calculated CLT and laryngeal survey composite was 0.86 ± 1.25 (range 0-5). CLT and the CLT and Laryngeal survey composite measure were not associated with or predict PES. Age, sex, peri-extubation steroid use, intubation duration and body mass index were not associated with PES. Conclusion: Even including ultrasonographic and indirect laryngoscopic examination of the airway, no single aspect of the CLT or combination with laryngeal parameters accurately predicts PES. PMID:25788742

Patel, Anit B; Ani, Chizobam; Feeney, Colin

2015-01-01

351

The Furcal Nerve Revisited  

PubMed Central

Atypical sciatica and discrepancy between clinical presentation and imaging findings is a dilemma for treating surgeon in management of lumbar disc herniation. It also constitutes ground for failed back surgery and potential litigations thereof. Furcal nerve (Furcal = forked) is an independent nerve with its own ventral and dorsal branches (rootlets) and forms a link nerve that connects lumbar and sacral plexus. Its fibers branch out to be part of femoral and obturator nerves in-addition to the lumbosacral trunk. It is most commonly found at L4 level and is the most common cause of atypical presentation of radiculopathy/sciatica. Very little is published about the furcal nerve and many are unaware of its existence. This article summarizes all the existing evidence about furcal nerve in English literature in an attempt to create awareness and offer insight about this unique entity to fellow colleagues/professionals involved in spine care. PMID:25317309

Dabke, Harshad V.

2014-01-01

352

The furcal nerve revisited.  

PubMed

Atypical sciatica and discrepancy between clinical presentation and imaging findings is a dilemma for treating surgeon in management of lumbar disc herniation. It also constitutes ground for failed back surgery and potential litigations thereof. Furcal nerve (Furcal = forked) is an independent nerve with its own ventral and dorsal branches (rootlets) and forms a link nerve that connects lumbar and sacral plexus. Its fibers branch out to be part of femoral and obturator nerves in-addition to the lumbosacral trunk. It is most commonly found at L4 level and is the most common cause of atypical presentation of radiculopathy/sciatica. Very little is published about the furcal nerve and many are unaware of its existence. This article summarizes all the existing evidence about furcal nerve in English literature in an attempt to create awareness and offer insight about this unique entity to fellow colleagues/professionals involved in spine care. PMID:25317309

Harshavardhana, Nanjundappa S; Dabke, Harshad V

2014-08-01

353

Thyrotoxic hypokalemic periodic paralysis in an African male: a case report.  

PubMed

Thyrotoxic hypokalemic periodic paralysis is a rare manifestation of thyrotoxicosis and is rarely reported in non-Asian populations. A 26-year-old Ethiopian male who presented with recurrent flaccid tetraparesis, hypokalemia, and hyperthyroidism is reported here. Thyroid function should be routinely checked in patients with acute or recurrent hypokalemic paralysis. PMID:25767707

Belayneh, Dereje K; Kellerth, Thomas

2015-02-01

354

Clinical and Molecular Analysis of Chinese Patients with Thyrotoxic Periodic Paralysis  

Microsoft Academic Search

Although sporadic thyrotoxic periodic paralysis (TPP) has a much higher prevalence in Asian than in all the other populations studied so far, it is also increasingly being seen at the emergency departments of the West, hence, it is vital to stress the importance of recognizing it. TPP shares some similarities with hypokalemic periodic paralysis (HOKPP). However, the pathophysiology of TPP

L. Chen; D. Lang; X. W. Ran; F. Joncourt; S. Gallati; J.-M. Burgunder

2003-01-01

355

Thyrotoxic hypokalemic periodic paralysis in an African male: a case report  

PubMed Central

Key Clinical Message Thyrotoxic hypokalemic periodic paralysis is a rare manifestation of thyrotoxicosis and is rarely reported in non-Asian populations. A 26-year-old Ethiopian male who presented with recurrent flaccid tetraparesis, hypokalemia, and hyperthyroidism is reported here. Thyroid function should be routinely checked in patients with acute or recurrent hypokalemic paralysis.

Belayneh, Dereje K; Kellerth, Thomas

2015-01-01

356

Sleep paralysis in adults reporting repressed, recovered, or continuous memories of childhood sexual abuse  

Microsoft Academic Search

Sleep paralysis typically occurs as individuals awaken from rapid eye movement sleep before motor paralysis wanes. Many episodes are accompanied by tactile and visual hallucinations, often of threatening intruders in the bedroom. Pendergrast [Victims of Memory: Incest Accusations and Shattered Lives, HarperCollins, London, 1996] proposed that individuals who report repressed or recovered memories of childhood sexual abuse (CSA) may misinterpret

Richard J. McNally; Susan A. Clancy

2005-01-01

357

The Prevalence of Sleep Paralysis Among Canadian and Japanese College Students  

Microsoft Academic Search

Although sleep paralysis had been treated as one of the symptoms of narcolepsy, recently it has become recognized as occurring frequently in normal individuals. However, among the few published studies that have examined sleep paralysis, there are great discrepancies in its reported prevalence. These discrepancies could be attributed to differences in survey methods, to the description of the symptom employed

Kazuhiko Fukuda; Robert D. Ogilvie; Lisa Chilcott; Ann-Marie Vendittelli; Tomoka Takeuchie

1998-01-01

358

CP4 Isolated sleep paralysis as a presenting feature of obstructive sleep apnoea  

Microsoft Academic Search

Sleep Paralysis is the persistence of REM atonia into the wakefulness. It is found in normal subjects, but is frequently seen in narcolepsy, in conjunction with hypnogogic hallucinations and cataplexy. We investigated whether sleep paralysis may be associated with sleep disorders other than narcolepsy. A retrospective review of all patients seen at St Thomas' Sleep Disorders Centre over a 9-year

G Leschziner; R S Howard; A Williams; C Kosky

2010-01-01

359

Wasp Venom Blocks Central Cholinergic Synapses to Induce Transient Paralysis in Cockroach Prey  

E-print Network

Wasp Venom Blocks Central Cholinergic Synapses to Induce Transient Paralysis in Cockroach Prey G stinging its prey, the cockroach. It stings into the first thoracic segment inducing 2 to 3 min of transient flaccid paralysis of the front legs. This facilitates a second sting in the cockroach's head

Libersat, Frederic

360

Genetics Home Reference: Infantile-onset ascending hereditary spastic paralysis  

MedlinePLUS

... the arms, legs, and face. This disorder damages motor neurons, which are specialized nerve cells in the brain ... a protein called alsin. Alsin is abundant in motor neurons, but its function is not fully understood. Mutations ...

361

Overview of the Cranial Nerves  

MedlinePLUS

... nerves—the cranial nerves—lead directly from the brain to various parts of the head, neck, and trunk. Some of the cranial nerves are ... cranial nerves emerge from the underside of the brain, pass through ... to parts of the head, neck, and trunk. The nerves are named and numbered, ...

362

Clinical Features and Differential Diagnoses in Laryngeal Mucoepidermoid Carcinoma  

PubMed Central

Mucoepidermoid carcinoma is the most common malignant tumor of salivary glands. However, it is a rare entity in larynx. Laryngeal cases are frequently misdiagnosed with other malignancies and they are under-reported. So, recognizing the clinical and histological features of this tumor is essential. Laryngeal mucoepidermoid carcinoma can arise in supraglottis, glottis and subglottis. Generally, it presents as a submucosal mass; therefore, progressive symptoms without any identifiable lesion in laryngoscopy must be well considered. The prognosis is somehow dependent on the histological features. In high-grade tumors, recurrence is more common and radical surgery with radiotherapy is recommended. In this paper, we provide a thorough literature review on mucoepidermoid carcinoma in the larynx. The most important distinguishing features of mucoepidermoid carcinoma and its two major differential diagnoses (squamous cell carcinoma and adenosquamous carcinoma) are clearly stated and pitfalls in true diagnosis of this tumor are discussed. PMID:22262946

Mokhtari, Sepideh; Mokhtari, Saeedeh

2012-01-01

363

Virological and immunological aspects in the juvenile laryngeal papillomatosis.  

PubMed

The juvenile laryngeal papillomatosis, a disease which in the absence of an adequate monitoring may have an invalidating character, represented for a long time a problem as regards both its treatment and its possible etiology. The use of monoclonal antibodies, as well as of molecular biology techniques, permitted to elucidate some aspects, such as the viral origin of the infection. Twenty five juvenile laryngeal papillomas, removed intra-operatively, were investigated immunohistochemically, a significant increase of the epidermal growth factor (EGF) receptor being found. Ten samples were also analyzed with the PCR technique, for the purpose of detecting the presence of the corresponding DNA sequences of human papillomaviruses (HPV): all were positive. The HPV genotyping showed the presence of only the HPV6 and 11 genotypes. PMID:11601383

Gheorghe, D C; Ardelean, C; Anton, G

1999-01-01

364

Giant laryngeal angioleiomyomas: a case report with review of literature.  

PubMed

We report a recently encountered case of vascular leiomyoma in the larynx, a benign tumor that is rare in the organ, in a 52-year-old man. Chief complaints were a progressive hoarseness, laryngeal pain, deglutitive uncomfortableness and dyspnea in the supine position. Laryngoscope revealed many spherical tumors interlacing together with a smooth surface, measuring approximately 2x4 cm and covered with normal mucosa, found at the side of laryngeal epiglottis from its margin to supraglottis. Tracheotomy was performed under local anesthesia, and laryngosurgery was then carried out under general anesthesia. Histologic study showed smooth muscle cell proliferation, especially surrounded by an abundance of blood vessels, and the tumor was diagnosed as a vascular leiomyoma. Its complete resection was the best therapeutic option. Tracheotomy was required in this case depending on the occurrence site if the tumor and its size. PMID:19410131

Jun, Feng; Li, Li; Ning, Long; Yan, Lin; Siquan, Tang; Shixi, Liu

2009-01-01

365

Nerve and Blood Vessels  

Microsoft Academic Search

From the histologic point of view, nerves are round or flattened cords, with a complex internal structure made of myelinated\\u000a and unmyelinated nerve fibers, containing axons and Schwann cells grouped in fascicles (Fig. 4.1a) (Erickson 1997). Along the course of the nerve, fibers can traverse from one fascicle to another and fascicles can split and merge. Based\\u000a on the fascicular

Maura Valle; Maria Pia Zamorani

366

Midbrain hematoma presenting with isolated bilateral palsy of the third cranial nerve in a Moroccan man: a case report  

PubMed Central

Introduction Bilateral third nerve palsy secondary to a hemorrhagic stroke is exceptional. To the best of our knowledge, no similar case has been reported in the literature. Case presentation We describe the case of a 69-year-old Moroccan man who presented with isolated sudden bilateral third nerve palsy. Computed tomography (CT) of the brain revealed a midbrain hematoma. The oculomotor function gradually and completely improved over eight months of follow-up. Conclusion Stroke should be included in the differential diagnosis of sudden isolated oculomotor paralysis even when it is bilateral because of the severity of the underlying disease and the importance of its therapeutic implications. PMID:22800468

2012-01-01

367

Contralateral facial nerve palsy following mandibular second molar removal: is there co-relation or just coincidence?  

PubMed Central

Peripheral facial nerve palsy (FNP) is the most common cranial nerves neuropathy. It is very rare during dental treatment. Classically, it begins immediately after the injection of local anaesthetic into the region of inferior dental foramen and it's homolateral to the injection. Recovery takes a few hours, normally as long the anaesthetic lasts. The authors present a 44-year-old patient who presented a contralateral delayed-onset facial paralysis arising from dental procedure and discuss the plausible pathogenesis mechanism of happen and a possible relationship between dental procedure and contralateral FNP. PMID:25419300

Zalagh, Mohammed; Boukhari, Ali; Attifi, Hicham; Hmidi, Mounir; Messary, Abdelhamid

2014-01-01

368

Overexpression of SATB1 in Laryngeal Squamous Cell Carcinoma  

Microsoft Academic Search

Objective: To investigate the expression of special AT-rich sequence-binding protein 1 (SATB1), and the relationship between SATB1 and clinicopathological factors of laryngeal squamous cell carcinoma (LSCC). Methods: Real-time PCR, Western blot and immunohistochemistry were used to analyze 80 samples of LSCC and 25 samples of control mucosa. The relationship between SATB1 expression and clinicopathological parameters was evaluated. Results: The SATB1

Xu-Dong Zhao; Wen-yue Ji; Wei Zhang; Li-Xia He; Jing Yang; Hong-Jun Liang; Li-Li Wang

2010-01-01

369

Laryngeal transplantation in minipigs: vascular, myologic and functional outcomes  

Microsoft Academic Search

There is no effective way of replacing all the functions of the larynx in those requiring laryngectomy. Regenerative medicine\\u000a offers promise, but cannot presently deliver implants with functioning neuromuscular units. A single well-documented laryngeal\\u000a transplant in man was a qualified success, but more information is required before clinical trials may be proposed. We studied\\u000a the early response of the larynx

M. A. Birchall; P. J. Kingham; P. J. Murison; S. M. Ayling; R. Burt; L. Mitchard; A. Jones; P. Lear; C. R. Stokes; G. Terenghi; M. Bailey; P. Macchiarini

2011-01-01

370

Three cases of rheumatoid arthritis with laryngeal stridor  

Microsoft Academic Search

The purpose of this is case-based review is to report a series of patients with rheumatoid arthritis who developed stridor\\u000a and highlight this potentially life-threatening manifestation of the disease. We report three cases from the Rheumatology\\u000a Department of University College Hospital, London and review the literature on the prevalence, clinical presentation, histopathological\\u000a features and treatment of laryngeal involvement in rheumatoid

James E. Peters; Christopher J. Burke; Vanessa H. Morris

2011-01-01

371

Postobstructive pulmonary edema associated with biting a laryngeal mask airway.  

PubMed

Laryngeal mask airway (LMA) has established itself as a reliable mode of maintaining a patent airway; however, it is associated with a few complications. This case report describes the presentation, diagnosis, management and treatment of an unusual complication associated with the use of LMA, that is postobstructive pulmonary edema (POPE), which is a potentially life-threatening complication of acute airway obstruction. It develops rapidly but responds quickly to the therapy. PMID:15353145

Shameem, Asad; Malak, Aamer Mahmood; Rahmani, Jamshed Ahmed

2004-09-01

372

Usefulness of ultrasonography in assessment of laryngeal carcinoma  

PubMed Central

Objective: To evaluate the usefulness of ultrasonography in assessing laryngeal cancer. Methods: 72 patients with laryngeal carcinoma proven by surgery and pathology were enrolled. The pre-therapeutic ultrasonography and CT images were retrospectively evaluated, including tumour detection, localisation and invasion of intra- and extralaryngeal structures. A comparative assessment was made between the detection rate, correspondence rate of localisation and sensitivity and specificity of ultrasonography and CT. The mobility of the larynx was observed on real-time ultrasonography and compared with laryngoscopy. Results: The detection rate of ultrasonography [63 (87.5%)/72] was lower than that of CT [72 (100.0%)/72] (p=0.006). The primary foci were accurately located in 59 (93.7%) of 63 lesions using ultrasonography compared with 70 (97.2%) of 72 lesions using CT (p=0.392). In the evaluation of invasion, the sensitivity and specificity of ultrasonography were similar to that of CT in most of the intra- and extralaryngeal structures (p=0.059–1.000). A higher specificity was obtained during the assessment of the paraglottic space involvement when using ultrasonography than CT (94.9% vs 66.7%, p=0.001). For vocal cord fixation, no statistical difference was found between ultrasonography and laryngoscopy (p=0.223). Conclusion: Ultrasonography could be used as a valuable supplementary imaging method to CT and laryngoscopy in the assessment of laryngeal carcinoma, even in male adults with some calcifications of the thyroid cartilage. Advances in knowledge: Our study demonstrates that ultrasonography, which has been used scarcely in the larynx, could supply useful information on the detection, localisation and intra- and extralaryngeal invasion of laryngeal carcinoma. PMID:24004487

Xia, C-X; Zhao, H-X; Yan, F; Li, S-L; Zhang, S-M

2013-01-01

373

Voltage sensor charge loss accounts for most cases of hypokalemic periodic paralysis  

PubMed Central

Background: Several missense mutations of CACNA1S and SCN4A genes occur in hypokalemic periodic paralysis. These mutations affect arginine residues in the S4 voltage sensors of the channel. Approximately 20% of cases remain genetically undefined. Methods: We undertook direct automated DNA sequencing of the S4 regions of CACNA1S and SCN4A in 83 cases of hypokalemic periodic paralysis. Results: We identified reported CACNA1S mutations in 64 cases. In the remaining 19 cases, mutations in SCN4A or other CACNA1S S4 segments were found in 10, including three novel changes and the first mutations in channel domains I (SCN4A) and III (CACNA1S). Conclusions: All mutations affected arginine residues, consistent with the gating pore cation leak hypothesis of hypokalemic periodic paralysis. Arginine mutations in S4 segments underlie 90% of hypokalemic periodic paralysis cases. GLOSSARY HypoPP = hypokalemic periodic paralysis. PMID:19118277

Matthews, E; Labrum, R; Sweeney, M G.; Sud, R; Haworth, A; Chinnery, P F.; Meola, G; Schorge, S; Kullmann, D M.; Davis, M B.; Hanna, M G.

2009-01-01

374

Successful application of preimplantation genetic diagnosis for hypokalaemic periodic paralysis.  

PubMed

Hypokalaemic periodic paralysis is a rare dominant inherited disease where a person suffers sudden falls of circulating potassium concentrations, producing muscle weakness and sometimes severe paralysis. Attacks can occur as frequently as several times a day or once in a year. The age of onset is usually adolescence but symptoms can appear as early as 10 years of age. Muscle weakness can compromise vital functions such as breathing or swallowing and heart arrhythmias are also frequent during attacks. Preimplantation genetic diagnosis, an early form of prenatal diagnosis for couples at risk of transmitting inherited diseases, was used to prevent the transmission of this disease. Six polymorphic short tandem repeat or microsatellite markers (STR) closely linked to the CACNA1S gene were tested. Three fully informative markers were chosen to establish the disease-bearing haplotype in the family and to determine the genetic status of five embryos by multiplex fluorescent heminested PCR. Four of the five embryos tested were diagnosed as non-affected and one as affected. Two embryos were transferred resulting in a singleton pregnancy and the birth of a healthy girl. PMID:20541469

Alberola, Trinitat M; Vendrell, Xavier; Bautista-Llácer, Rosa; Vila, Maria; Calatayud, Carmen; Pérez-Alonso, Manuel

2010-08-01

375

Motor initiation and execution in patients with conversion paralysis.  

PubMed

Motor initiation and motor execution in four patients with conversion paralysis were investigated in a non-affected motor modality (speech). In line with the hypothesis of dissociated control in conversion disorder [Cognit. Neuropsychiatry 8 (1) (2001) 21] motor initiation, but not response duration, was expected to be impaired. The motor initiation times (reaction time: RT) and motor execution times (response duration: RD) were compared on four RT-tasks that required the production of a verbal response: a simple choice RT-task, a mental letter rotation task, and an implicit and an explicit mental hand rotation task. Because conversion disorder is expected to primarily involve an impairment in the initiation of movement, we expected the following task characteristics to uniquely affect RT and not RD: type of instruction (implicit versus explicit instructed imagery), angle of rotation, and target arm (affected versus non-affected arm). The results indeed showed the task characteristics to significantly affect the participants' RT and not their RD. It was concluded that conversion paralysis is associated with a specific impairment in the explicit initiation of processes with a spatial and motor component. PMID:12005227

Roelofs, Karin; van Galen, Gerard P; Keijsers, Ger P J; Hoogduin, Cees A L

2002-05-01

376

Vowel-related differences in laryngeal articulatory and phonatory function.  

PubMed

The purpose of this investigation was to study the interaction between the supralaryngeal and laryngeal components of the speech mechanism by examining vowel-related effects for a variety of vocal fold articulatory and phonatory measures. Secondary issues were to determine if vowel-related differences were influenced by the nature of the speaking task or gender. Between-vowel differences in estimated subglottal air pressure, peak oral air flow, mean phonatory air flow, air flow near the termination of the vowel, electroglottograph cycle width (EGGW), fundamental frequency, and voice onset time were examined for men and women during syllable repetitions and sentence productions. Significant vowel-related differences were found for all of the measures except mean phonatory air flow, and generally were not influenced by speaking task or gender. Vowel-related effects for estimated subglottal air pressure, peak oral air flow, fundamental frequency, and VOT were consistent with some earlier studies. New findings included vowel-related differences in EGGW and air flow near the termination of the vowel. We propose a model that includes the contribution of mechanical forces, reflexive neural activity, and learned neural activity to explain vowel-related effects. When vowel height is varied, changes in laryngeal cartilage positioning and vocal fold and vocal tract tension appear to influence laryngeal articulatory and phonatory function. PMID:9712121

Higgins, M B; Netsell, R; Schulte, L

1998-08-01

377

The presence of facial nerve weakness on diagnosis of a parotid gland malignant process.  

PubMed

The objectives of this article are to assess the frequency and significance of facial paralysis and undiagnosed nerve infiltration in patients with parotid malignancies. 103 patients with parotid gland malignancies were treated in a single institution, the tertiary center for ENT at the University Department in Poznan between 1996 and 2006. Facial palsy at the initial presentation was found in 32 patients. The stage of the primary tumor in the examined group of 103 patients is as follows: 20-T1, 31-T2, 20-T3, 32-T4. The correlation between facial nerve function before treatment and patients' characteristics, including the treatment methods, were analyzed. Intact facial nerve function at patient presentation was a very strong prognostic factor determining the treatment and final outcome for malignant neoplasms of parotid gland. Similarly, T stage and a high-grade malignant histology had a direct influence on the duration of patients' survival. PMID:22179671

Wierzbicka, Ma?gorzata; Kope?, Tomasz; Szyfter, Witold; Kereiakes, Thomas; Bem, Gra?yna

2012-04-01

378

Etiology of Hypokalemic Paralysis in Korea: Data from a Single Center  

PubMed Central

Recognizing the underlying causes of hypokalemic paralysis seems to be essential for the appropriate management of affected patients and their prevention of recurrent attacks. There is, however, a paucity of documented reports on the etiology of hypokalemic paralysis in Korea. We retrospectively analyzed 34 patients with acute flaccid weakness due to hypokalaemia who were admitted during the 5-year study period in order to determine the spectrum of hypokalemic paralysis in Korea and to identify the differences in clinical parameters all across the causes of hypokalemic paralysis. We divided those 34 patients into 3 groups; the 1st group, idiopathic hypokalemic periodic paralysis (HPP), the 2nd, thyrotoxic periodic paralysis (TPP), and the 3rd group, secondary hypokalemic paralysis (HP) without TPP. Seven of the patients (20.6%) were diagnosed as idiopathic HPP considered the sporadic form, and 27 patients (79.4%) as secondary HP. Among the patients diagnosed as secondary HP, 16 patients (47.1%) had TPP. Patients of secondary hypokalemic paralysis without TPP required a longer recovery time compared with those who had either idiopathic HPP or TPP. This is due to the fact that patients of secondary HP had a significantly negative total body potassium balance, whereas idiopathic HPP and TPP were only associated with intracellular shift of potassium. Most of the TPP patients included in our study had overt thyrotoxicosis while 3 patients had subclinical thyrotoxicosis. This study shows that TPP is the most common cause of hypokalemic paralysis in Korea. And we suggest that doctors should consider the presence of TPP in patients of hypokalemic paralysis even if they clinically appear to be euthyroid state. PMID:23508689

Wi, Jung-Kook; Lee, Hong Joo; Kim, Eun Young; Cho, Joo Hee; Chin, Sang Ouk; Rhee, Sang Youl; Moon, Ju-Young; Lee, Sang-Ho; Jeong, Kyung-Hwan; Ihm, Chun-Gyoo

2012-01-01

379

Laryngeal Squamous Cell Carcinoma (SCC) in a 12-Year-old Boy with Cutaneous Metastasis:An Unusual Presentation.  

PubMed

Laryngeal squamous cell carcinoma (SCC) in adolescents is a rare clinical entity and behaves aggressively. The mechanism of laryngeal oncogenesis is complex. Further studies need to be done to know the role that human papilloma virus plays in laryngeal SCC in adolescents.We report a rare case of laryngeal SCC in a 12-year-old boy presenting with cutaneous forehead metastasis. PMID:25177618

Reena, Sinha; Reecha, Singh; Kaushal, Kumar; Kumar, Verma Pranav; J K, Singh

2014-07-01

380

Laryngeal Squamous Cell Carcinoma (SCC) in a 12-Year-old Boy with Cutaneous Metastasis:An Unusual Presentation  

PubMed Central

Laryngeal squamous cell carcinoma (SCC) in adolescents is a rare clinical entity and behaves aggressively. The mechanism of laryngeal oncogenesis is complex. Further studies need to be done to know the role that human papilloma virus plays in laryngeal SCC in adolescents.We report a rare case of laryngeal SCC in a 12-year-old boy presenting with cutaneous forehead metastasis. PMID:25177618

Reecha, Singh; Kaushal, Kumar; Kumar, Verma Pranav; J.K, Singh

2014-01-01

381

STUDIES ON PSEUDORABIES (INFECTIOUS BULBAR PARALYSIS, MAD ITCH)  

PubMed Central

The histology of pseudorabies differs materially in various animal species. In the rabbit, subcutaneous, intradermal or intramuscular inoculation leads to local inflammation and necrosis. The infection ascends the peripheral nerve (possibly both interstitially and by the axis-cylinders) to the corresponding spinal ganglia and segments of the spinal cord, where primary degeneration of nerve and glial cells takes place. The nerve cell changes are probably responsible for the cardinal symptom of the disease, itching. Death ensues soon after virus reaches the medulla, before visible changes have been produced here. Intracerebral inoculation is followed by characteristic lesions in the meninges, in subpial glial cells and in superficially placed nerve cells. Morbid changes in the lungs are not necessarily related to the presence of virus, but specific lesions may be present. Intranuclear inclusions bearing some resemblance to those in herpetic encephalitis, yellow fever, etc., occur in cells derived from all embryonic layers. The disease in the guinea pig resembles closely that in the rabbit and is modified only by the slightly greater resistance of the animal. In the monkey after intracerebral inoculation, widespread degeneration and necrosis of cortical nerve cells are accompanied by the appearance of specific nuclear alterations in nerve and glial cells, but not in cells of mesodermal origin. No lesions are found in other viscera. In the spontaneous disease in the cow lesions approximate more closely to those in the monkey than to those in the rabbit. In the pig vascular and interstitial lesions predominate, nerve cell degeneration is relatively slight and typical inclusions are not observed. These differences probably explain the benign course of the malady following subcutaneous inoculation in this animal. The lymphatic system, too, participates in the reaction to the virus. PMID:19870206

Hurst, E. Weston

1933-01-01

382

Prevalence of pharyngeal, laryngeal and tracheal disorders in thoroughbred racehorses, and effect on performance  

Microsoft Academic Search

Endoscopic examinations were performed on 1005 thoroughbred racehorses in South Africa a mean (sd) 24 (12·3) minutes after racing, to determine the prevalence of pharyngeal, laryngeal and tracheal disorders, and to determine the relationship of these disorders with performance (number of wins and placed finishes). Overall, there was a low prevalence of grade 2 and 3 laryngeal function (LF) (2·2

M. N. Saulez; B. Gummow

2009-01-01

383

Human papilloma virus (HPV) is possibly involved in laryngeal but not in lung carcinogenesis  

Microsoft Academic Search

Data on human papilloma virus (HPV) involvement in preneoplastic and neoplastic lesions of the larynx and lung are limited and conflicting. The presence of HPV was investigated in a series of laryngeal specimens and non-small cell lung carcinomas (NSCLCs). The laryngeal samples (154) comprised 14 cases with hyperplasia without dysplasia, 49 with dysplasia, and 91 squamous cell carcinomas (SqCCs). The

Vassilis G Gorgoulis; Panayotis Zacharatos; Athanassios Kotsinas; Aspasia Kyroudi; Antonios N Rassidakis; John A Ikonomopoulos; Calipso Barbatis; C Simon Herrington; Christos Kittas

1999-01-01

384

Association between tea and coffee consumption and risk of laryngeal cancer: a meta-analysis  

PubMed Central

Objective: Epidemiological studies evaluating the association of tea and coffee consumption and the risk of laryngeal cancer have produced inconsistent results. Thus, we conducted a meta-analysis to assess the relationship between tea and coffee consumption and laryngeal cancer risk. Methods: Pertinent studies were identified by a search in PubMed, Web of Knowledge and Wan Fang Med Online. The random effect model was used based on heterogeneity test. Publication bias was estimated using Egger’s regression asymmetry test. As a result, 11 articles were included in this meta-analysis. Results: For tea consumption and laryngeal cancer, data from 8 studies including 2167 laryngeal cancer cases were used, and the pooled results suggested that highest tea consumption versus lowest level wasn’t associated with the risk of laryngeal cancer [summary RR = 0.909, 95% CI = 0.674-1.227]. Eight studies comprising 2596 laryngeal cancer cases for coffee consumption and laryngeal cancer risk were included, and no association was found (summary RR = 1.218, 95% CI = 0.915-1.622). Conclusions: Finding from this meta-analysis suggested that tea and coffee consumption weren’t associated with the risk of laryngeal cancer. Since the potential biases and confounders could not be ruled out completely in this meta-analysis, further studies are warranted to confirm this result. PMID:25664021

Ouyang, Zhiguo; Wang, Zhaoyan; Jin, Jian

2014-01-01

385

Respiratory and Laryngeal Function during Spontaneous Speaking in Teachers with Voice Disorders  

ERIC Educational Resources Information Center

Purpose: To determine if respiratory and laryngeal function during spontaneous speaking were different for teachers with voice disorders compared with teachers without voice problems. Method: Eighteen teachers, 9 with and 9 without voice disorders, were included in this study. Respiratory function was measured with magnetometry, and laryngeal

Lowell, Soren Y.; Barkmeier-Kraemer, Julie M.; Hoit, Jeannette D.; Story, Brad H.

2008-01-01

386

Acoustic and Perceptual Effects of Left-Right Laryngeal Asymmetries Based on Computational Modeling  

ERIC Educational Resources Information Center

Purpose: Computational modeling was used to examine the consequences of 5 different laryngeal asymmetries on acoustic and perceptual measures of vocal function. Method: A kinematic vocal fold model was used to impose 5 laryngeal asymmetries: adduction, edge bulging, nodal point ratio, amplitude of vibration, and starting phase. Thirty /a/ and /?/…

Samlan, Robin A.; Story, Brad H.; Lotto, Andrew J.; Bunton, Kate

2014-01-01

387

Respiratory and Laryngeal Responses to an Oral Air Pressure Bleed during Speech  

ERIC Educational Resources Information Center

Researchers have hypothesized that the respiratory and laryngeal speech subsystems would respond to an air pressure bleed, but these responses have not been empirically studied. The present study examined the nature of the responses of the respiratory and laryngeal subsystems to an air pressure bleed in order to provide information relevant to the…

Huber, Jessica E.; Stathopoulos, Elaine T.

2003-01-01

388

Tea and Coffee Consumption and Risk of Laryngeal Cancer: A Systematic Review Meta-Analysis  

PubMed Central

Background Tea and coffee are the most commonly consumed beverages in the worldwide. The relationship between tea and coffee consumption on the risk of laryngeal cancer was still unclear. Methods Relevant studies were identified by searching electronic database (Medline and EMBASE) and reviewing the reference lists of relevant articles until Oct. 2013. Observational studies that reported RRs and 95% CIs for the link of tea and coffee consumption on the risk of laryngeal cancer were eligible. A meta-analysis was obtained to combine study-specific RRs with a random-effects model. Results A total of 2,803 cases and 503,234 controls in 10 independent studies were identified. The overall analysis of all 10 studies, including the case-control and cohort studies, found that tea drinking was not associated with laryngeal carcinoma (RR?=?1.03; 95% CI: 0.66–1.61). However, coffee consumption was significantly associated with the laryngeal carcinoma (RR?=?1.47; 95% CI: 1.03–2.11). A dose-response relationship between coffee intake and laryngeal carcinoma was detected; however, no evidence of dose-response link between tea consumption and laryngeal carcinoma risk was detected. Conclusions The results from this meta-analysis of observational studies demonstrate that coffee consumption would increase the laryngeal cancer risk, while tea intake was not associated with risk of laryngeal carcinoma. PMID:25502726

Chen, Jiangbo; Long, Shuo

2014-01-01

389

Acute flaccid paralysis in a patient with sacral dimple  

PubMed Central

Sacral dimples are the most common cutaneous anomaly detected during neonatal spinal examination. Congenital dermal sinus tract, a rare type of spinal dysraphism, occurs along the midline neuraxis from occiput down to the sacral region. It is often diagnosed in the presence of a sacral dimple together with skin signs, local infection, meningitis, abscess, or abnormal neurological examination. We report a case of acute flaccid paralysis with sensory level in a 4 mo old female infant with sacral dimple, diagnosed by magnetic resonance imaging to be a paraspinal subdural abscess. Surgical exploration revealed a congenital dermal sinus tract extending from the subdural abscess down to the sacral dimple and open to the exterior with a minute opening. PMID:25254171

Mostafa, Mohammed; Nasef, Nehad; Barakat, Tarik; El-Hawary, Amany K; Abdel-Hady, Hesham

2013-01-01

390

Pneumothorax spontané secondaire post opératoire compliquant une paralysie récurrentielle  

PubMed Central

Le Pneumothorax spontané est défini par un épanchement gazeux de la grande cavité pleurale en dehors de tout traumatisme ou manipulation instrumentale. Son incidence est estimée à 28/100000 pour les hommes et 6/100000 pour les femmes. Les étiologies sont dominées par la broncho-pneumopathies chroniques et obstructives. Le tableau clinique est souvent grave d'emblé nécessitant une exsufflation à l'aiguille et/ou un drainage thoracique. Les récidives sont assez fréquentes et la mortalité reste assez élevée en comparaison avec les pneumothorax post traumatique ou les pneumothorax primaires. Nous rapportons le cas d'une patiente présentant en post opératoire un pneumothorax spontané sur un poumon métastatique et compliquant une paralysie récurrentielle. PMID:25419334

Joulali, Toufik; Derkaou, Ali; Shimi, Abdelkarim; Khatouf, Mohammed

2014-01-01

391

Clinical and biochemical spectrum of hypokalemic paralysis in North: East India  

PubMed Central

Background: Acute hypokalemic paralysis, characterized by acute flaccid paralysis is primarily a calcium channelopathy, but secondary causes like renal tubular acidosis (RTA), thyrotoxic periodic paralysis (TPP), primary hyperaldosteronism, Gitelman’s syndrome are also frequent. Objective: To study the etiology, varied presentations, and outcome after therapy of patients with hypokalemic paralysis. Materials And Methods: All patients who presented with acute flaccid paralysis with hypokalemia from October 2009 to September 2011 were included in the study. A detailed physical examination and laboratory tests including serum electrolytes, serum creatine phosphokinase (CPK), urine analysis, arterial blood gas analysis, thyroid hormones estimation, and electrocardiogram were carried out. Patients were further investigated for any secondary causes and treated with potassium supplementation. Result: The study included 56 patients aged 15-92 years (mean 36.76 ± 13.72), including 15 female patients. Twenty-four patients had hypokalemic paralysis due to secondary cause, which included 4 with distal RTA, 4 with Gitelman syndrome, 3 with TPP, 2 each with hypothyroidism, gastroenteritis, and Liddle’s syndrome, 1 primary hyperaldosteronism, 3 with alcoholism, and 1 with dengue fever. Two female patients were antinuclear antibody-positive. Eleven patient had atypical presentation (neck muscle weakness in 4, bladder involvement in 3, 1 each with finger drop and foot drop, tetany in 1, and calf hypertrophy in 1), and 2 patient had respiratory paralysis. Five patients had positive family history of similar illness. All patients improved dramatically with potassium supplementation. Conclusion: A high percentage (42.9%) of secondary cause for hypokalemic paralysis warrants that the underlying cause must be adequately addressed to prevent the persistence or recurrence of paralysis. PMID:23956566

Kayal, Ashok K.; Goswami, Munindra; Das, Marami; Jain, Rahul

2013-01-01

392

Tourniquet-Related Iatrogenic Femoral Nerve Palsy after Knee Surgery: Case Report and Review of the Literature  

PubMed Central

Purpose. Tourniquet-induced nerve injuries have been reported in the literature, but even if electromyography abnormalities in knee surgery are frequent, only two cases of permanent femoral nerve palsies have been reported, both after prolonged tourniquet time. We report a case of tourniquet-related permanent femoral nerve palsy after knee surgery. Case Report. We report a case of a 58-year-old woman who underwent surgical treatment of a patella fracture. Tourniquet was inflated to 310?mmHg for 45 minutes. After surgery, patient complained about paralysis of the quadriceps femoris with inability to extend the knee. Electromyography and nerve conduction study showed a severe axonal neuropathy of the left femoral nerve, without clinical remission after several months. Discussion. Even if complications are not rare, safe duration and pressure for tourniquet use remain a controversy. Nevertheless, subtle clinical lesions of the femoral nerve or even subclinical lesions only detectable by nerve conduction and EMG activity are frequent, so persistent neurologic dysfunction, even if rare, may be an underreported complication of tourniquet application. Elderly persons with muscle atrophy and flaccid, loose skin might be in risk for iatrogenic nerve injury secondary to tourniquet. PMID:24371536

Mingo-Robinet, Juan; Castañeda-Cabrero, Carlos; Alvarez, Vicente; León Alonso-Cortés, José Miguel; Monge-Casares, Eva

2013-01-01

393

'The devil lay upon her and held her down' Hypnagogic hallucinations and sleep paralysis described by the Dutch physician Isbrand van Diemerbroeck (1609-1674) in 1664  

Microsoft Academic Search

Hypnagogic and hypnopompic hallucinations are visual, tactile, auditory or other sensory events, usually brief but sometimes prolonged, that occur at the transition from wakefulness to sleep (hypnagogic) or from sleep to wakefulness (hypnopompic). Hypnagogic and hypnopompic hallucinations are often associated with sleep paralysis. Sleep paralysis occurs immediately prior to falling asleep (hypnagogic paralysis) or upon waking (hypnopompic paralysis). In 1664,

E. J. O. Kompanje

2008-01-01

394

Epineurial repair of an iatrogenic facial nerve neurotmesis after total ear canal ablation and lateral bulla osteotomy in a dog with concurrent cranio-mandibular osteopathy.  

PubMed

A 7-year-old male entire West Highland white terrier was referred to the Small Animal Hospital at the University of Glasgow for bilateral, chronic, medically unresponsive otitis media and externa. A history of cranio-mandibular osteopathy was also reported. Bilateral total ear canal ablation and lateral bulla osteotomy was performed with the aid of a pneumatic burr. Extensive bone proliferation was present bilaterally originating from the caudal mandibular ramus and tympanic bulla which incorporated the horizontal canal on each side. The right facial nerve was identified leaving the stylomastoid foramen and running in a cranial direction through a 1.5 cm diameter cuff of bone surrounding the horizontal canal and external acoustic meatus. Despite careful dissection, a facial nerve neurotmesis ensued which required microsurgical epineurial repair. Neurologic examination performed 12 h post-operatively revealed abnormalities consistent with right facial nerve paralysis. At 3 months, the facial nerve function was found to have improved significantly and was assessed to be normal four months after surgery. To the authors' knowledge, this clinical communication described the first reported clinical case where unilateral facial nerve paralysis resulting from iatrogenic facial nerve neurotmesis was successfully treated by microsurgical epineurial repair. PMID:25686402

Calvo, Ignacio; Espadas, Irene; Hammond, Gawain; Pratschke, Kathryn

2014-01-01

395

Recurrent temporary paralysis reported after human rabies post-exposure prophylaxis.  

PubMed

Adverse events can occur after rabies post-exposure prophylaxis (PEP), and linkage to causality is often difficult to determine. We report a case of recurrent temporary paralysis that began immediately after the initiation of rabies PEP in a man exposed to a bat. The recurrent temporary paralysis first occurred in the patient after his initial dose and then again after day 3 of his rabies PEP. The PEP was terminated prior to a serologic response. The patient continued to experience numerous discrete episodes of temporary paralysis for over two years. PMID:24995792

Dato, V M; Campagnolo, E R; Shah, D U; Bellush, M J; Rupprecht, C E

2015-05-01

396

Electronic temperature monitoring during the decompression surgery of the facial nerve.  

PubMed

Despite of its apparent protection by being located deep in a bony canal, the facial nerve is a cranial pair of nerves more vulnerable to traumatic injuries. The surgical accidents are the most frequent causes of intratemporal complications of the facial nerve. Among the postoperative sequelae, the thermal injuries are common due to overheating of the otologic burr resulting in facial paralysis. For the prevention of thermal injuries in the facial nerve was designed a data acquisition board to obtain the temperature measured by thermocouples using a PC and parallel communication. The signals from the temperature sensors passed through conditioning for amplification and analog to digital data conversion. Afterwards, they were stored on a computer for the statistical analysis and the visualization of the curves of variation of the measured temperatures. These curves provide the verification of the facial nerve temperature ascending and descending time during surgery steps to access the nerve. These data provide a substantial safe working margin to the surgeon. PMID:21095674

Paula, Patricia M C; Rodrigues, Suelia S R; Altoe, Mirella Lorrainy; Santos, Larissa S; Rocha, Adson F

2010-01-01

397

Advances in nerve repair.  

PubMed

Patients with peripheral nerve injuries face unpredictable and often suboptimal functional outcome, even following standard microsurgical nerve repair. The challenge of improving such outcomes following nerve surgical procedures has interested many research teams, in both clinical and fundamental fields. Some innovative treatments are presently being applied to a widening range of patients, whereas others will require further development before translation to human subjects. This article presents several recent advances in emerging therapies at various stages of clinical application. Nerve transfers have been successfully used in clinical settings, but new indications are being described, enlarging the range of patients who might benefit from them. Brief direct nerve electrical stimulation has been shown to improve nerve regeneration and outcome in animal models and in a small cohort of patients. Further clinical trials are warranted to prove the efficacy of this exciting and easily applicable approach. Animal studies also suggest a tremendous potential for stem and precursor cell therapy. Further studies will lead to a better understanding of their mechanisms of action in nerve repair and potential applications for human patients. PMID:23250767

Khuong, Helene T; Midha, Rajiv

2013-01-01

398

Changes in nerve microcirculation following peripheral nerve compression?  

PubMed Central

Following peripheral nerve compression, peripheral nerve microcirculation plays important roles in regulating the nerve microenvironment and neurotrophic substances, supplying blood and oxygen and maintaining neural conduction and axonal transport. This paper has retrospectively analyzed the articles published in the past 10 years that addressed the relationship between peripheral nerve compression and changes in intraneural microcirculation. In addition, we describe changes in different peripheral nerves, with the aim of providing help for further studies in peripheral nerve microcirculation and understanding its protective mechanism, and exploring new clinical methods for treating peripheral nerve compression from the perspective of neural microcirculation. PMID:25206398

Gao, Yueming; Weng, Changshui; Wang, Xinglin

2013-01-01

399

Anterior interosseous nerve syndrome  

PubMed Central

Objective: We sought to determine lesion sites and spatial lesion patterns in spontaneous anterior interosseous nerve syndrome (AINS) with high-resolution magnetic resonance neurography (MRN). Methods: In 20 patients with AINS and 20 age- and sex-matched controls, MRN of median nerve fascicles was performed at 3T with large longitudinal anatomical coverage (upper arm/elbow/forearm): 135 contiguous axial slices (T2-weighted: echo time/repetition time 52/7,020 ms, time of acquisition: 15 minutes 48 seconds, in-plane resolution: 0.25 × 0.25 mm). Lesion classification was performed by visual inspection and by quantitative analysis of normalized T2 signal after segmentation of median nerve voxels. Results: In all patients and no controls, T2 lesions of individual fascicles were observed within upper arm median nerve trunk and strictly followed a somatotopic/internal topography: affected were those motor fascicles that will form the anterior interosseous nerve further distally while other fascicles were spared. Predominant lesion focus was at a mean distance of 14.6 ± 5.4 cm proximal to the humeroradial joint. Discriminative power of quantitative T2 signal analysis and of qualitative lesion rating was high, with 100% sensitivity and 100% specificity (p < 0.0001). Fascicular T2 lesion patterns were rated as multifocal (n = 17), monofocal (n = 2), or indeterminate (n = 1) by 2 independent observers with strong agreement (kappa = 0.83). Conclusion: It has been difficult to prove the existence of fascicular/partial nerve lesions in spontaneous neuropathies using clinical and electrophysiologic findings. With MRN, fascicular lesions with strict somatotopic organization were observed in upper arm median nerve trunks of patients with AINS. Our data strongly support that AINS in the majority of cases is not a surgically treatable entrapment neuropathy but a multifocal mononeuropathy selectively involving, within the main trunk of the median nerve, the motor fascicles that continue distally to form the anterior interosseous nerve. PMID:24415574

Bäumer, Philipp; Meinck, Hans-Michael; Schiefer, Johannes; Weiler, Markus; Bendszus, Martin; Kele, Henrich

2014-01-01

400

[Nerve injuries in children].  

PubMed

Management of peripheral nerve lesions in children does not differ fundamentally from that in adults. Nevertheless, difficulty to perform an extensive clinical examination can explain initial misdiagnosis and postoperative follow up can be tricky. The poor compliance of the children in the postoperative care makes a postoperative immobilization mandatory. If the peripheral nerve injuries involving children have a better prognosis reputation than in adults, fundamental studies results do not comfort this conventional wisdom, but rather claim for a better adaptability of the child to the relapses left by the peripheral nerves lesions. PMID:23751426

Legré, R; Iniesta, A; Toméi, F; Gay, A

2013-09-01

401

Techniques of peripheral nerve repair.  

PubMed

Nerve injuries extend from simple nerve compression lesions to complete nerve injuries and severe lacerations of the nerve trunks. A specific problem is brachial plexus injuries where nerve roots can be ruptured, or even avulsed from the spinal cord, by traction. An early and correct diagnosis of a nerve injury is important. A thorough knowledge of the anatomy of the peripheral nerve trunk as well as of basic neurobiological alterations in neurons and Schwann cells induced by the injury are crucial for the surgeon in making adequate decisions on how to repair and reconstruct nerves. The technique of peripheral nerve repair includes four important steps (preparation of nerve end, approximation, coaptation and maintenance). Nerves are usually repaired primarily with sutures applied in the different tissue components, but various tubes are available. Nerve grafts and nerve transfers are alternatives when the injury induces a nerve defect. Timing of nerve repair is essential. An early repair is preferable since it is advantageous for neurobiological reasons. Postoperative rehabilitation, utilising the patients' own coping strategies, with evaluation of outcome are additional important steps in treatment of peripheral nerve injuries. in the rehabilitation phase adequate handling of pain, allodynia and cold intolerance are emphasised. PMID:19211385

Dahlin, L B

2008-01-01

402

Expression of cell adhesion molecules in laryngeal carcinoma – preliminary analysis  

PubMed Central

Aim of the study Intercellular adhesion molecules present in immunocompetent cells as well as endothelium and tumour cells can regulate cell migration, angiogenesis, apoptosis, proliferation, and metastases in solid tumours. The aim of this study was to analyse the sICAM-1 (soluble intercellular adhesion molecule 1) and sVCAM-1 (soluble vascular cell adhesion molecule 1) expression in peripheral blood mononuclear cell (PBMC) cultures, and to find their relationships with clinicomorphological characteristics in laryngeal cancer. Materials and methods The analysis included a group of 50 patients with verified squamous cell carcinoma of the larynx. The control group constituted 30 healthy volunteers. The pathological assessment included pTNM, stage, histological grade, and type of invasion according to the tumour front grading. The expression of adhesion molecules was assessed using the enzyme-linked immunosorbent assay (ELISA). Results Increased expression of sICAM-1 and sVCAM-1 was an indicator of more aggressive laryngeal carcinomas. More advanced local changes evaluated on the pT feature were connected with a higher sVCAM-1 (p = 0.017), but not sICAM-1 level. The presence of lymph node metastases correlated with a higher expression of adhesion molecules (p = 0.012 and p = 0.003, for sICAM-1 and sVCAM-1, respectively). Tumours with more diffuse growth and infiltrating with small cell groups (< 15/hpf) was characterised by the highest level of adhesive proteins (p = 0.001 and p = 0.02 for sICAM and sVCAM, respectively). Moreover, lower levels of sICAM-1 and sVCAM-1 were observed more frequently in patients who lived longer than five years after treatment. Conclusions The study indicates the importance of the sICAM and sVCAM expression as indicators of advanced changes and prognosis in patients with laryngeal carcinoma. PMID:25784838

Morawski, Piotr; Kopta, Renata; Mochocki, Marcin; Brzezi?ska-B?aszczyk, Ewa; Lewy-Trenda, Iwona

2014-01-01

403

Decellularized grafts with axially aligned channels for peripheral nerve regeneration.  

PubMed

At least 2 million people worldwide suffer annually from peripheral nerve injuries (PNI), with estimated costs of $7 billion incurred due to paralysis alone. The current "gold" standard for treatment of PNI is the autograft, which poses disadvantages such as high fiscal cost, possible loss of sensation at donor site and the requirement of two surgeries. Allografts are viable alternatives; however, intensive immunosuppressive treatments are often necessary to prevent host rejection. For this reason, significant efforts have been made to remove cellular material from allografts. These decellularized nerve grafts perform better than other clinically available grafts but not as well as autografts; therefore, current research on these grafts includes the incorporation of additional components such as growth factors and cells to provide chemical guidance to regenerating axons. However, effective cellular and axonal penetration is not achieved due to the small pore size (5-10?m) of the decellularized grafts. The overall objective of this study was to induce axially aligned channels in decellularized nerve grafts to facilitate enhanced cell penetration. The specific aims of this study were to optimize a decellularization method to enhance cellular removal, to induce axially aligned pore formation in decellularized grafts through a novel unidirectional freeze drying method, to study the bulk mechanical properties of these modified decellularized grafts and to assess cell penetration into these grafts. To this end we modified an existing decellularization protocol to improve cellular removal while preserving matrix structure in rat sciatic nerve sections. Standard freeze drying and unidirectional freeze drying were employed to impart the necessary pore architecture, and our results suggest that unidirectional freezing is a pertinent modification to the freeze drying process to obtain axially aligned channels. These highly porous scaffolds obtained using unidirectional freeze-drying possessed similar tensile properties to native nerve tissue and exhibited enhanced cellular penetration after 14 days of culture when compared to non-freeze dried and standard freeze-dried scaffolds. The results of this study not only highlight the importance of aligned pores of diameters ~20-60?m on cellular infiltration, but also presents unidirectional freeze drying as a viable technique for producing this required architecture in decellularized nerves. To the best of our knowledge, this study represents the first attempt to manipulate the physical structure of decellularized nerves to enhance cell penetration which may serve as a basis for future peripheral nerve regenerative strategies using decellularized allografts. PMID:25460409

Sridharan, Rukmani; Reilly, Richard B; Buckley, Conor T

2015-01-01

404

Acquired tracheoesophageal fistula status post laryngeal neoplasm resection  

PubMed Central

A tracheoesophageal fistula (TEF), albeit rare, can be a life-threatening condition that requires prompt identification and treatment. Pulmonary contamination and restriction of proper nutrition are common, unfortunate consequences of untreated TEFs and are often the causes of mortality in this population. In our patient, a history of laryngeal malignancy along with symptoms of chest pain and cough with ingestion of liquids, even without evidence of aspiration pneumonia, appropriately prompted investigation for potential TEF. Initial imaging through barium swallow identified the TEF, and the patient underwent treatment with endoclips by endoscopy with bronchoscopic assistance. PMID:25846352

Luber, Sarah; Alweis, Richard

2015-01-01

405

The quality of voice in patients irradiated for laryngeal carcinoma  

SciTech Connect

Data from 150 patients with laryngeal carcinoma, consecutively treated primarily by radiotherapy from 1965 through 1974 was analyzed to assess the quality of voice. The voice appears to improve in majority of the successfully irradiated patients. In 76% of the evaluable patients in this group, the quality of voice appears to have attained normalcy or near normalcy. Smoking appears to have a negative influence. High incidence of bronchogenic carcinoma along with the negative influence of smoking on the quality of voice in this series of patients indicate that the patients should be advised against smoking in day-to-day clinical practice.

Karim, A.B.; Snow, G.B.; Siek, H.T.; Njo, K.H.

1983-01-01

406

Isolated laryngeal amyloidosis in a patient with a hoarse voice  

PubMed Central

We present a case of a 59-year-old woman with a hoarse voice of 3?weeks duration. A polypoid lesion involving the anterior aspect of the left vocal cord was detected by flexible fibreoptic endoscopic examination. Flexible bronchoscopic examination was unremarkable. Microlaryngoscopy and excisional biopsy of the laryngeal lesion were carried out. Histology of the biopsy showed stroma exhibiting birefringence under polarised light and a diagnosis of laryngotracheal amyloidosis was made. Systemic amyloidosis was ruled out by further investigations including positron emission tomography scan. Her hoarse voice improved following the excisional biopsy and regular follow-up was arranged for early diagnosis of recurrence. PMID:23563679

Park, Jae Hong; Cheng, Hui Mei

2013-01-01

407

Degenerative Nerve Diseases  

MedlinePLUS

Degenerative nerve diseases affect many of your body's activities, such as balance, movement, talking, breathing, and heart function. Many of these diseases are genetic. Sometimes the cause is a medical ...

408

Diabetic Nerve Problems  

MedlinePLUS

... the wrong times. This damage is called diabetic neuropathy. Over half of people with diabetes get it. ... change positions quickly Your doctor will diagnose diabetic neuropathy with a physical exam and nerve tests. Controlling ...

409

Common peroneal nerve dysfunction  

MedlinePLUS

... people: Who are very thin (for example, from anorexia nervosa ) Who have conditions such as diabetic neuropathy or ... other tests are done depend on the suspected cause of nerve dysfunction, and the person's symptoms and ...

410

Vagus Nerve Stimulation.  

PubMed

The vagus nerve is a major component of the autonomic nervous system, has an important role in the regulation of metabolic homeostasis, and plays a key role in the neuroendocrine-immune axis to maintain homeostasis through its afferent and efferent pathways. Vagus nerve stimulation (VNS) refers to any technique that stimulates the vagus nerve, including manual or electrical stimulation. Left cervical VNS is an approved therapy for refractory epilepsy and for treatment resistant depression. Right cervical VNS is effective for treating heart failure in preclinical studies and a phase II clinical trial. The effectiveness of various forms of non-invasive transcutaneous VNS for epilepsy, depression, primary headaches, and other conditions has not been investigated beyond small pilot studies. The relationship between depression, inflammation, metabolic syndrome, and heart disease might be mediated by the vagus nerve. VNS deserves further study for its potentially favorable effects on cardiovascular, cerebrovascular, metabolic, and other physiological biomarkers associated with depression morbidity and mortality. PMID:24834378

Howland, Robert H

2014-06-01

411

Optic Nerve Decompression  

MedlinePLUS

... sinuses directly beside the eye. In particular, the ethmoid and sphenoid sinuses are directly adjacent to the ... double vision, inadequate decompression of the optic nerve, bleeding around the eye, carotid artery injury, leakage of ...

412

Extratemporal facial nerve injury.  

PubMed

Isolated traumatic facial nerve injury, frequently seen in wartime combat, may also be encountered among civilians. The clinical picture occurring as a result of such injury may be confusing because partial, or incomplete, damage to the peripheral nerve may mimic impairment of the central facial motor mechanism. In treating the patient with facial injury, life-threatening aspects of the injury must be assessed and stabilized first. Then, attention may be focused on the injured facial nerve, for which prompt surgical repair is the treatment of choice. Prior to surgery, the assessment of taste and hearing, as well as mastoid and skull x-ray films and electrodiagnostic tests are helpful in localizing the facial nerve injury. PMID:933404

Sternbach, G L; Rosen, P; Meislin, H W

1976-04-01

413

Ulnar nerve dysfunction  

MedlinePLUS

Katirji B, Koontz D. Disorders of peripheral nerves. In: Daroff RB, Fenichel GM, Jankovic J, Mazziotta JC, eds. Bradley’s Neurology in Clinical Practice . 6th ed. Philadelphia, Pa: Saunders Elsevier; 2012: ...

414

Tibial nerve dysfunction  

MedlinePLUS

Katitji B, Koontz D. Disorders of the peripheral nerves. In: Daroff RB, Fenichel GM, Jankovic J, Mazziotta JC. Bradley's Neurology in Clinical Practice. 6th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 76. ...

415

Axillary nerve dysfunction  

MedlinePLUS

... Body-wide (systemic) disorders that cause nerve inflammation Deep infection Fracture of the upper arm bone (humerus) Pressure from casts or splints Improper use of crutches Shoulder dislocation In some cases, no cause can be found.

416

A possible association of hypokalaemic periodic paralysis, autoimmune thyroiditis and neuromyotonia.  

PubMed

Acute hypokalemic periodic paralysis (HPP), a clinical syndrome characterised by acute systemic weakness and low serum potassium (K+), is a rare but treatable cause of acute limb weakness. Hypokalemia can be caused by K+ loss via the kidneys or extra renal routes mainly the gut, or due to transcellular potassium shifts where extracellular K+ will move into the cell. In the latter situation, although there is hypokalaemia, there is no deficit of K+ in the body. The main causes for intracellular shift of K+ are familial hypokalemic periodic paralysis, thyrotoxic periodic paralysis, barium poisoning, insulin excess and alkalosis. Although the association between thyrotoxicosis and HPP is known, HPP with hypothyroidism is extremely rare. We report a case of hypokalemic periodic paralysis associated with hypothyroidism and neuromyotonia. PMID:24385062

Arambewela, M H; Sumanathilaka, M R; Pathirana, K D; Bodinayaka, C K

2013-12-01

417

Thyrotoxic Periodic Paralysis: Case Reports and an Up-to-Date Review of the Literature  

PubMed Central

Objectives. To describe 2 cases of thyrotoxic periodic paralysis. Methods. We report of 2 cases of thyrotoxic periodic paralysis in 2 individuals from 2 different backgrounds with emphasis on their presentation and treatment. We also conducted a literature search to put together an update review of thyrotoxic periodic paralysis. Results. A 47-year-old Chinese and 28-year-old Caucasian male presented with profound yet reversible weakness associated with hypokalemia on admission bloods and thyrotoxicosis. Both were given definitive therapy to prevent recurrence of attacks with any future relapse of thyrotoxicosis. Conclusion. Thyrotoxic periodic paralysis (TPP) is a rare but potentially serious complication of thyrotoxicosis resulting in temporary but severe muscle weakness. Recent discovery of a novel mutation in the KCNJ18 gene which codes for an inwardly rectifying potassium channel and is controlled by thyroid hormones may provide greater insight into the pathogenesis of TPP. PMID:22937292

Lulsegged, Abbi; Wlodek, Christina; Rossi, Michela

2011-01-01

418

Sleep paralysis in medieval Persia – the Hidayat of Akhawayni (?–983 AD)  

PubMed Central

Among the first three manuscripts written in Persian, Akhawayni’s Hidayat al-muta’allemin fi al-tibb was the most significant work compiled in the 10th century. Along with the hundreds of chapters on hygiene, anatomy, physiology, symptoms and treatments of the diseases of various organs, there is a chapter on sleep paralysis (night-mare) prior to description and treatment of epilepsy. The present article is a review of the Akhawayni’s teachings on sleep paralysis and of descriptions and treatments of sleep paralysis by the Greek, medieval, and Renaissance scholars. Akhawayni’s descriptions along with other early writings provide insight into sleep paralysis during the Middle Ages in general and in Persia in particular. PMID:22701323

Golzari, Samad EJ; Khodadoust, Kazem; Alakbarli, Farid; Ghabili, Kamyar; Islambulchilar, Ziba; Shoja, Mohammadali M; Khalili, Majid; Abbasnejad, Feridoon; Sheikholeslamzadeh, Niloufar; Shahabi, Nasrollah Moghaddam; Hosseini, Seyed Fazel; Ansarin, Khalil

2012-01-01

419

Sleep paralysis in medieval Persia - the Hidayat of Akhawayni (?-983 AD).  

PubMed

Among the first three manuscripts written in Persian, Akhawayni's Hidayat al-muta'allemin fi al-tibb was the most significant work compiled in the 10th century. Along with the hundreds of chapters on hygiene, anatomy, physiology, symptoms and treatments of the diseases of various organs, there is a chapter on sleep paralysis (night-mare) prior to description and treatment of epilepsy. The present article is a review of the Akhawayni's teachings on sleep paralysis and of descriptions and treatments of sleep paralysis by the Greek, medieval, and Renaissance scholars. Akhawayni's descriptions along with other early writings provide insight into sleep paralysis during the Middle Ages in general and in Persia in particular. PMID:22701323

Golzari, Samad Ej; Khodadoust, Kazem; Alakbarli, Farid; Ghabili, Kamyar; Islambulchilar, Ziba; Shoja, Mohammadali M; Khalili, Majid; Abbasnejad, Feridoon; Sheikholeslamzadeh, Niloufar; Shahabi, Nasrollah Moghaddam; Hosseini, Seyed Fazel; Ansarin, Khalil

2012-01-01

420

Dentoalveolar nerve injury.  

PubMed

Nerve injury associated with dentoalveolar surgery is a complication contributing to the altered sensation of the lower lip, chin, buccal gingivae, and tongue. This surgery-related sensory defect is a morbid postoperative outcome. Several risk factors have been proposed. This article reviews the incidence of trigeminal nerve injury, presurgical risk assessment, classification, and surgical coronectomy versus conventional extraction as an approach to prevent neurosensory damage associated with dentoalveolar surgery. PMID:21798439

Auyong, Thomas G; Le, Anh

2011-08-01

421

Comparison of classic laryngeal mask airway with Ambu laryngeal mask for tracheal tube exchange: A prospective randomized controlled study  

PubMed Central

Background and Aim: Exchanging endotracheal tube (ETT) with classic laryngeal mask airway™ (CLMA™) prior to emergence from anaesthesia is a safe technique to prevent the coughing and haemodynamic changes during extubation. We had compared CLMA™ and AMBU laryngeal mask™ (ALM™) during ETT/laryngeal mask (LM) for haemodynamic changes and other parameters. Methods: A total of 100 American Society of Anesthesiologist Grade I and II adult female patients undergoing elective laparoscopic cholecystectomy under general anaesthesia were selected and randomly divided into two groups of 50 patients each. In Group I, CLMA™ and in Group II, ALM™ was placed prior to tracheal extubation. Haemodynamic parameters were recorded during ETT/LM exchange. Glottic view was seen through the LM using flexible fibrescope. Coughing/bucking during removal of LM, ease of placement and post-operative sore throat for both groups were graded and recorded. Statistical Analysis: Data within the groups was analysed using paired t-test while between the groups was analysed using unpaired t-test. Chi-square test was used to analyse grades of glottic view, coughing, and post-operative sore throat. Results: In Group I, there was a significant rise in systolic blood pressure and heart rate in contrast to insignificant rise in Group II. Glottis view was significantly better in Group II. Incidence of coughing, ease of placement and post-operative sore throat was identical between both groups. Conclusion: ALM™ is superior to CLMA™ for exchange of ETT before extubation due to greater haemodynamic stability during exchange phase and is better positioned. PMID:23983284

Jain, Shruti; Khan, Rashid M; Ahmed, Syed M; Singh, Manpreet

2013-01-01

422

A novel mutation in the calcium channel gene in a family with hypokalemic periodic paralysis  

Microsoft Academic Search

Hypokalemic periodic paralysis (HypoPP) type 1 is an autosomal dominant disease caused by mutations in the Ca(V)1.1 calcium channel encoded by the CACNA1S gene. Only seven mutations have been found since the discovery of the causative gene in 1994. We describe a patient with HypoPP who had a high serum potassium concentration after recovery from a recent paralysis, which complicated

Makito Hirano; Yosuke Kokunai; Asami Nagai; Yusaku Nakamura; Kazumasa Saigoh; Susumu Kusunoki; Masanori P. Takahashi

2011-01-01

423

Sleep paralysis in narcolepsy: more than just a motor dissociative phenomenon?  

Microsoft Academic Search

Sleep paralyses are viewed as pure motor phenomena featured by a dissociated state in which REM-related muscle atonia coexists\\u000a with a wakefulness state of full consciousness. We present a 59-year-old man diagnosed with narcolepsy experiencing sleep\\u000a paralysis, who failed to establish the boundaries between real experience and dream mentation during the paralysis: the patient’s\\u000a recall was indeed featured by uncertainty

Michele Terzaghi; Pietro Luca Ratti; Francesco Manni; Raffaele Manni

424

Congenital vocal cord paralysis with possible autosomal recessive inheritance: Case report and review of the literature  

SciTech Connect

We describe an infant with congenital vocal cord paralysis born to consanguineous parents. While autosomal dominant and X-linked inheritance have been previously reported in this condition, we conclude that the degree of parental consanguinity in this case strongly suggests autosomal recessive inheritance. Although we cannot exclude X-linked inheritance, evidence from animal studies demonstrates autosomal recessive inheritance and provides a possible molecular basis for congenital vocal cord paralysis. 14 refs., 1 fig.

Koppel, R.; Friedman, S.; Fallet, S. [Long Island Campus for the Albert Einstein College of Medicine, New Hyde Park, NY (United States)] [Long Island Campus for the Albert Einstein College of Medicine, New Hyde Park, NY (United States)

1996-08-23

425

Quantitative Proteomics Approach to Screening of Potential Diagnostic and Therapeutic Targets for Laryngeal Carcinoma  

PubMed Central

To discover candidate biomarkers for diagnosis and detection of human laryngeal carcinoma and explore possible mechanisms of this cancer carcinogenesis, two-dimensional strong cation-exchange/reversed-phase nano-scale liquid chromatography/mass spectrometry analysis was used to identify differentially expressed proteins between the laryngeal carcinoma tissue and the adjacent normal tissue. As a result, 281 proteins with significant difference in expression were identified, and four differential proteins, Profilin-1 (PFN1), Nucleolin (NCL), Cytosolic non-specific dipeptidase (CNDP2) and Mimecan (OGN) with different subcellular localization were selectively validated. Semiquantitative RT-PCR and Western blotting were performed to detect the expression of the four proteins employing a large collection of human laryngeal carcinoma tissues, and the results validated the differentially expressed proteins identified by the proteomics. Furthermore, we knocked down PFN1 in immortalized human laryngeal squamous cell line Hep-2 cells and then the proliferation and metastasis of these transfected cells were measured. The results showed that PFN1 silencing inhibited the proliferation and affected the migration ability of Hep-2 cells, providing some new insights into the pathogenesis of PFN1 in laryngeal carcinoma. Altogether, our present data first time show that PFN1, NCL, CNDP2 and OGN are novel potential biomarkers for diagnosis and therapeutic targets for laryngeal carcinoma, and PFN1 is involved in the metastasis of laryngeal carcinoma. PMID:24587265

Wang, Chengyu; Miao, Lei; Zhang, Jianpeng; Wang, Jiasen; Jiao, Binghua; Zhao, Shuwei

2014-01-01

426

Effect of Antisense Oligodeoxynucleotides Glucose Transporter-1 on Enhancement of Radiosensitivity of Laryngeal Carcinoma  

PubMed Central

Purpose: Laryngeal carcinomas always resist to radiotherapy. Hypoxia is an important factor in radioresistance of laryngeal carcinoma. Glucose transporter-1 (GLUT-1) is considered to be a possible intrinsic marker of hypoxia in malignant tumors. We speculated that the inhibition of GLUT-1 expression might improve the radiosensitivity of laryngeal carcinoma. Methods: We assessed the effect of GLUT-1 expression on radioresistance of laryngeal carcinoma and the effect of GLUT-1 expressions by antisense oligodeoxynucleotides (AS-ODNs) on the radiosensitivity of laryngeal carcinoma in vitro and in vivo. Results: After transfection of GLUT-1 AS-ODNs: MTS assay showed the survival rates of radiation groups were reduced with the prolongation of culture time (p<0.05); Cell survival rates were significantly reduced along with the increasing of radiation dose (p<0.05). There was significant difference in the expression of GLUT-1mRNA and protein in the same X-ray dose between before and after X-ray radiation (p<0.05). In vivo, the expressions of GLUT-1 mRNA and protein after 8Gy radiation plus transfection of GLUT-1 AS-ODNs were significant decreased compared to 8Gy radiation alone (p<0.001). Conclusion: Radioresistance of laryngeal carcinoma may be associated with increased expression of GLUT-1 mRNA and protein. GLUT-1 AS-ODNs may enhance the radiosensitivity of laryngeal carcinoma mainly by inhibiting the expression of GLUT-1. PMID:23983599

Yan, Sen-Xiang; Luo, Xing-Mei; Zhou, Shui-Hong; Bao, Yang-Yang; Fan, Jun; Lu, Zhong-Jie; Liao, Xin-Biao; Huang, Ya-Ping; Wu, Ting-Ting; Wang, Qin-Ying

2013-01-01

427

Nerve conduction study of the medial and lateral plantar nerves.  

PubMed

The medial and lateral plantar nerves may be evaluated through the recordings of the compound sensory nerve action potentials (CSNAP), compound mixed nerve action potentials (CMNAP) and compound muscular action potentials (CMAP). As some of these potentials are not easily and always obtainable in normal individuals, our purpose was to verify the consistency of these potentials for the study of these nerves. Fifty-one normal adult volunteers were examined. The CSNAP, CMNAP and CMAP, related to the medial and lateral plantar nerves were evaluated bilaterally. CSNAP were not obtained in 7.8% and in 17.6% from the medial and lateral plantar nerves respectively. CMNAP from the lateral plantar nerve were not obtained in 15.6%. CMNAP from the medial plantar nerves and CMAPs from the abductor hallucis and abductor digiti quinti were obtained for all nerves tested. Our results, therefore, suggest that these last 3 parameters are the ones more reliable for clinical application. PMID:10812535

Antunes, A C; Nobrega, J A; Manzano, G M

2000-01-01

428

Identification of the transmitter and receptor mechanisms responsible for REM sleep paralysis.  

PubMed

During REM sleep the CNS is intensely active, but the skeletal motor system is paradoxically forced into a state of muscle paralysis. The mechanisms that trigger REM sleep paralysis are a matter of intense debate. Two competing theories argue that it is caused by either active inhibition or reduced excitation of somatic motoneuron activity. Here, we identify the transmitter and receptor mechanisms that function to silence skeletal muscles during REM sleep. We used behavioral, electrophysiological, receptor pharmacology and neuroanatomical approaches to determine how trigeminal motoneurons and masseter muscles are switched off during REM sleep in rats. We show that a powerful GABA and glycine drive triggers REM paralysis by switching off motoneuron activity. This drive inhibits motoneurons by targeting both metabotropic GABA(B) and ionotropic GABA(A)/glycine receptors. REM paralysis is only reversed when motoneurons are cut off from GABA(B), GABA(A) and glycine receptor-mediated inhibition. Neither metabotropic nor ionotropic receptor mechanisms alone are sufficient for generating REM paralysis. These results demonstrate that multiple receptor mechanisms trigger REM sleep paralysis. Breakdown in normal REM inhibition may underlie common sleep motor pathologies such as REM sleep behavior disorder. PMID:22815493

Brooks, Patricia L; Peever, John H

2012-07-18

429

MicroRNA-196a Is a Putative Diagnostic Biomarker and Therapeutic Target for Laryngeal Cancer  

PubMed Central

Background MicroRNA (miRNA) is an emerging subclass of small non-coding RNAs that regulates gene expression and has a pivotal role for many physiological processes including cancer development. Recent reports revealed the role of miRNAs as ideal biomarkers and therapeutic targets due to their tissue- or disease-specific nature. Head and neck cancer (HNC) is a major cause of cancer-related mortality and morbidity, and laryngeal cancer has the highest incidence in it. However, the molecular mechanisms involved in laryngeal cancer development remain to be known and highly sensitive biomarkers and novel promising therapy is necessary. Methodology/Principal Findings To explore laryngeal cancer-specific miRNAs, RNA from 5 laryngeal surgical specimens including cancer and non-cancer tissues were hybridized to microarray carrying 723 human miRNAs. The resultant differentially expressed miRNAs were further tested by using quantitative real time PCR (qRT-PCR) on 43 laryngeal tissue samples including cancers, noncancerous counterparts, benign diseases and precancerous dysplasias. Significant expressional differences between matched pairs were reproduced in miR-133b, miR-455-5p, and miR-196a, among which miR-196a being the most promising cancer biomarker as validated by qRT-PCR analyses on additional 84 tissue samples. Deep sequencing analysis revealed both quantitative and qualitative deviation of miR-196a isomiR expression in laryngeal cancer. In situ hybridization confirmed laryngeal cancer-specific expression of miR-196a in both cancer and cancer stroma cells. Finally, inhibition of miR-196a counteracted cancer cell proliferation in both laryngeal cancer-derived cells and mouse xenograft model. Conclusions/Significance Our study provided the possibilities that miR-196a might be very useful in diagnosing and treating laryngeal cancer. PMID:23967217

Saito, Koichiro; Inagaki, Koji; Kamimoto, Takahiro; Ito, Yoko; Sugita, Toshiaki; Nakajo, Satoko; Hirasawa, Akira; Iwamaru, Arifumi; Ishikura, Takashi; Hanaoka, Hideki; Okubo, Keisuke; Onozaki, Tokio; Zama, Takeru

2013-01-01

430

Phonatory characteristics of excised pig, sheep, and cow larynges  

PubMed Central

The purpose of this study was to examine the phonatory characteristics of pig, sheep, and cow excised larynges and to find out which of these animal species is the best model for human phonation. Excised pig, sheep, and cow larynges were prepared and mounted over a tapered tube on the excised bench that supplied pressurized, heated, and humidified air in a manner similar to that for excised canine models. Each excised larynx was subjected to a series of pressure-flow experiments with adduction as major control parameter. The subglottal pressure, electroglottograph (EGG), mean flow rate, audio signal, and sound pressure level were recorded during each experiment. EGG signal was used to extract the fundamental frequency. It was found that pressure-frequency relations were nonlinear for these species with large rate of frequency changes for the pig. The average oscillation frequencies for these species were 220±57 Hz for the pig, 102±33 Hz for the sheep, and 73±10 Hz for the cow. The average phonation threshold pressure for the pig was 7.4±2.0 cm H2O, 6.9±2.9 cm H2O for the sheep, and 4.4±2.3 cm H2O for the cow. PMID:18537405

Alipour, Fariborz; Jaiswal, Sanyukta

2008-01-01

431

Phonatory characteristics of excised pig, sheep, and cow larynges.  

PubMed

The purpose of this study was to examine the phonatory characteristics of pig, sheep, and cow excised larynges and to find out which of these animal species is the best model for human phonation. Excised pig, sheep, and cow larynges were prepared and mounted over a tapered tube on the excised bench that supplied pressurized, heated, and humidified air in a manner similar to that for excised canine models. Each excised larynx was subjected to a series of pressure-flow experiments with adduction as major control parameter. The subglottal pressure, electroglottograph (EGG), mean flow rate, audio signal, and sound pressure level were recorded during each experiment. EGG signal was used to extract the fundamental frequency. It was found that pressure-frequency relations were nonlinear for these species with large rate of frequency changes for the pig. The average oscillation frequencies for these species were 220+/-57 Hz for the pig, 102+/-33 Hz for the sheep, and 73+/-10 Hz for the cow. The average phonation threshold pressure for the pig was 7.4+/-2.0 cm H(2)O, 6.9+/-2.9 cm H(2)O for the sheep, and 4.4+/-2.3 cm H(2)O for the cow. PMID:18537405

Alipour, Fariborz; Jaiswal, Sanyukta

2008-06-01

432

Laryngeal cancer and occupational exposure to sulfuric acid  

SciTech Connect

Workers on an ethanol unit which used sulfuric acid in strong concentrations at a large refinery and chemical plant in Baton Rouge, Louisiana were reported in 1979, at excess risk for upper respiratory cancer. The carcinogen implicated by indirect evidence was diethyl sulfate. However, with the continued use of sulfuric acid in the same plant, and with additional cases not attributable to the ethanol process, the hypothesis of an association between sulfuric acid exposure and upper respiratory cancer was tested. Each of 50 confirmed cases of upper respiratory cancer diagnosed between 1944 and 1980, was matched to at least three controls on sex, race, age, date of initial employment, and duration of employment. Thrity-four of the 50 cases were laryngeal cancers. Data were obtained from existing plant records. Retrospective estimates of exposure were made without regard to case or control status. Findings from conditional logistic regression techniques were supported by other statistical methods. Among workers classified as potentially highly exposed, four-fold relative risks for all upper respiratory cancer sites combined were exceeded by the relative risk for laryngeal cancer specifically. Exposure-response and consistency across various comparisons after controlling statistically for tobacco-use, alcoholism and other previously implicated risk factors, suggest increased cancer risk with higher exposure.

Soskolne, C.L.; Zeighami, E.A.; Hanis, N.M.; Kupper, L.L.; Herrmann, N.; Amsel, J.; Mausner, J.S.; Stellman, J.M.

1984-09-01

433

Contribution of TIP30 to chemoresistance in laryngeal carcinoma  

PubMed Central

Laryngeal squamous cell carcinoma (LSCC) is one of the most common carcinomas of the head and neck. Despite advances in diagnosis and treatment, the survival of patients with LSCC has not improved in the past two decades. TIP30, a newly identified tumour suppressor, appears to be involved in multiple processes during tumour development. Here, we investigated the involvement of TIP30 in chemoresistance of LSCC in vitro and in vivo. We showed that TIP30 expression decreased significantly in drug-selected cells (DSCs) of laryngeal carcinoma. Suppressing TIP30 enhanced resistance capability to multiple chemotherapy drugs, cell proliferation and self-renewal in Hep2 cells. Additionally, decreased self-renewal capacity and chemotherapeutic resistance were observed in DSCs overexpressing TIP30. Furthermore, TIP30 negatively regulated tumourigenesis and chemoresistance in LSCC cells subcutaneously transplanted into nude mice. Moreover, decreased TIP30 expression contributed to chemoresistance, self-renewal and proliferation of LSCC cells via nuclearlisation of ?-catenin, a cell–cell adhesion and stem cell renewal regulator. Consistently, Kaplan–Meier and Cox proportional hazards regression modelling analyses showed that decreased TIP30 expression independently predicted poor survival in patients with LSCC. Taken together, our results reveal that TIP30 has a crucial role in chemoresistance of LSCC through the AKT/glycogen synthase kinase-3?/?-catenin signalling pathway and may be a promising candidate for improving LSCC chemotherapy. PMID:25321475

Zhu, M; Yin, F; Yang, L; Chen, S; Chen, R; Zhou, X; Jing, W; Fan, X; Jia, R; Wang, H; Zheng, H; Zhao, J; Guo, Y

2014-01-01

434

Functional organ preservation in laryngeal and hypopharyngeal cancer  

PubMed Central

The principles of open versus laser microsurgical approaches for partial resections of the larynx are described, oncologic as well as functional results discussed and corresponding outcomes following primary radiotherapy are opposed. Over the last decade, the endoscopic partial resection of the larynx has developed to an accepted approach in the treatment of early glottic and supraglottic carcinomas thus leading to a remarkable decline in the use of open surgery. Comparing the various surgical approaches of laryngeal partial resections, the oncological outcome of the patients, as far as survival and organ preservation are concerned, are comparable, whereas functional results of the endoscopic procedures are superior with less morbidity. The surgical procedures put together, are all superior to radiotherapy concerning organ preservation. Transoral laser microsurgery has been used successfully for vocal cord carcinomas with impaired mobility or fixation of the vocal cord, supraglottic carcinomas with infiltration of the pre- and/or paraglottic space as well as for selected hypopharyngeal carcinomas. It has been well documented that laser microsurgery achieves good oncological as well as functional results with reasonable morbidity. However, patients with those tumours have been successfully treated by open partial resections of the larynx at medical centres with appropriate expertise. The initially enthusiastic assessment of study results concerning the efficacy of various protocols of chemoradiation with the intent of organ preservation for laryngeal and hypopharyngeal carcinomas are judged more cautious, today, due to recent reports of rather high rates of late toxicity complications. PMID:22558052

Ambrosch, Petra; Fazel, Asita

2012-01-01

435

[Recent advances in the treatment of laryngeal and hypopharyngeal carcinoma].  

PubMed

The prognosis of squamous epithelial cell carcinoma of the upper aerodigestive tract has improved considerably in the last 30 years. Patients presenting with stage I or II disease are treated with surgery or radiation therapy with curative intent. Although the efficacy is comparable between the two methods, surgery is usually preferred so that the side effects and late toxic effects of radiation can be avoided. For the treatment of advanced stages of disease, surgery, radiotherapy, chemotherapy and immunotherapy are usually combined. The introduction of concurrent administration of chemotherapy and radiotherapy (chemoradiotherapy) has been a major advancement. This has resulted in local control and survival rates comparable to those seen following radical surgery and postoperative radiotherapy, but with preservation of the larynx in most patients. However, recent epidemiological observations have shown declining survival rates in laryngeal cancer patients, raising concern about uncritical and too frequent use of this approach. The rationale for choosing treatment options for patients with laryngeal and hypopharyngeal carcinoma is discussed. PMID:22282006

Eckel, H E

2012-01-01

436

Isolated Laryngeal Leishmaniasis in Immunocompetent Patients: An Underdiagnosed Disease  

PubMed Central

We describe a case of isolated primary laryngeal leishmaniasis in an immunocompetent Italian patient with a previous medical history negative for visceral or cutaneous leishmaniasis, presenting with hoarseness. We also summarize the epidemiological, clinical, and diagnostic features and the therapeutic management of other cases of laryngeal leishmaniasis in immunocompetent subjects, described in the literature. Considering the insidious and nonspecific clinical presentation, the increasing number of different forms of mild or underestimated immunosuppressive conditions, and the number of people travelling in endemic zones, along with the ability of Leishmania amastigotes to survive for a long period in the body, we believe it is important for pathologists and clinicians to be aware of this unusual form of leishmaniasis in order to avoid delayed recognition and treatment. The rarity of the presentation and the lack of guidelines on mucosal leishmaniasis may contribute to the potential undiagnosed cases or delayed diagnosis, the possible relapses, as well as the correct pharmacological and/or surgical therapeutic approach. PMID:23662221

Cocuzza, Salvatore; Strazzulla, Alessio; Pinzone, Marilia Rita; Cosentino, Stefano; Serra, Agostino; Caltabiano, Rosario; Lanzafame, Salvatore; Cacopardo, Bruno; Nunnari, Giuseppe

2013-01-01

437

Isolated laryngeal leishmaniasis in immunocompetent patients: an underdiagnosed disease.  

PubMed

We describe a case of isolated primary laryngeal leishmaniasis in an immunocompetent Italian patient with a previous medical history negative for visceral or cutaneous leishmaniasis, presenting with hoarseness. We also summarize the epidemiological, clinical, and diagnostic features and the therapeutic management of other cases of laryngeal leishmaniasis in immunocompetent subjects, described in the literature. Considering the insidious and nonspecific clinical presentation, the increasing number of different forms of mild or underestimated immunosuppressive conditions, and the number of people travelling in endemic zones, along with the ability of Leishmania amastigotes to survive for a long period in the body, we believe it is important for pathologists and clinicians to be aware of this unusual form of leishmaniasis in order to avoid delayed recognition and treatment. The rarity of the presentation and the lack of guidelines on mucosal leishmaniasis may contribute to the potential undiagnosed cases or delayed diagnosis, the possible relapses, as well as the correct pharmacological and/or surgical therapeutic approach. PMID:23662221

Cocuzza, Salvatore; Strazzulla, Alessio; Pinzone, Marilia Rita; Cosentino, Stefano; Serra, Agostino; Caltabiano, Rosario; Lanzafame, Salvatore; Cacopardo, Bruno; Nunnari, Giuseppe

2013-01-01

438

Intraglottal geometry and velocity measurements in canine larynges  

PubMed Central

Previous flow velocity measurements during phonation in canine larynges were done above the glottal exit. These studies found that vortical structures are present in the flow above the glottis at different phases of the glottal cycle. Some vortices were observed to leave the glottis during the closing phase and assumptions were proposed regarding their formation mechanism. In the current study, intraglottal velocity measurements are performed using PIV, and the intraglottal flow characteristics are determined. Results from five canine larynges show that at low subglottal pressure the glottis assumes a minimal divergence angle during closing and the flow separates at the glottal exit. Vortical structures are observed above the glottis but not inside. As the subglottal pressure is increased, the divergence angle between the folds during closing increases and the location of the flow separation moves upstream into the glottis. Entrainment flow enters the glottis to fill the void that is formed between the glottal jet and the fold. Vortical structures develop near the superior edge at medium and high subglottal pressures from the flow separation. The magnitude of their swirling strength changes as a function of the wall dynamics. PMID:24437778

Oren, Liran; Khosla, Sid; Gutmark, Ephraim

2014-01-01

439

Coordination of oral cavity and laryngeal movements during swallowing.  

PubMed

In this study, dynamic imaging was used to track the movements of oral cavity and laryngeal structures during swallowing in 10 normal adults subjects. The movements of tiny lead pellet markers attached to the lips, tongue, mandible, and soft palate, as well as anatomic landmarks on the hyoid bone, were measured in relation to a reference pellet affixed to the upper central incisors. Sagittal views of the oral cavity were obtained using standard videofluorography. Each subject produced 10 swallows of 12 ml of tap water followed by 5 swallows with a bite block placed between the molars. The recorded video images were input to a microcomputer where the x- and y-coordinates of the pellets were measured. Results of the analyses revealed considerable temporal overlap in the timing of oral cavity and laryngeal movements, widespread individual variability in coordination patterns and movement trajectories, and selective effects of the bite block. These data suggest the existence of individual adaptive strategies in the programming and control of swallowing movements. PMID:7961257

Gay, T; Rendell, J K; Spiro, J; Mosier, K; Lurie, A G

1994-07-01

440

Clinical experiences of NBI laryngoscope in diagnosis of laryngeal lesions  

PubMed Central

Endoscopy is essential for the diagnosis and treatment of cancers derived from the larynx. However, a laryngoscope with conventional white light (CWL) has technical limitations in detecting small or superficial lesions on the mucosa. Narrow band imaging especially combined with magnifying endoscopy (ME) is useful for the detection of superficial squamous cell carcinoma (SCC) within the oropharynx, hypopharynx, and oral cavity. A total of 3675 patients who have come to the outpatient clinic and complained of inspiratory stridor, dyspnea, phonation problems or foreign body sensation, were enrolled in this study. We describe the glottic conditions of the patients. All 3675 patients underwent laryngoscopy equipped with conventional white light (CWL) and NBI system. 1149 patients received a biopsy process. And 1153 lesions were classified into different groups according to their histopathological results. Among all the 1149 patients, 346 patients (312 males, 34 females; mean age 62.2±10.5 years) were suspected of having a total of 347 precancerous or cancerous (T1 or T2 without lymphnode involvement) lesions of the larynx under the CWL. Thus, we expected to attain a complete vision of what laryngeal lesions look like under the NBI view of a laryngoscope. The aim was to develop a complete description list of each laryngeal conditions (e.g. polyps, papilloma, leukoplakia, etc.), which can serve as a criteria for further laryngoscopic examinations and diagnosis. PMID:25419362

Qi, Xinmeng; Yu, Dan; Zhao, Xue; Jin, Chunshun; Sun, Changling; Liu, Xueshibojie; Cheng, Jinzhang; Zhang, Dejun

2014-01-01

441

 

PubMed Central

SUMMARY The superior laryngeal nerve (SLN) has been attributed much less clinical significance than the recurrent laryngeal nerve. It has sometimes been described as the 'neglected' nerve in thyroid surgery, although injury to this nerve can cause significant disability. The external branch of the SLN is the only motor supply to the cricothyroid muscle, which increases the tension of the ipsilateral vocal fold during highfrequency phonation, particularly in women and voice professionals. Damage to this nerve can manifest as ipsilateral cricothyroid muscle paralysis, and clinical symptoms may include a hoarse, breathy voice, frequent throat clearing, vocal fatigue or diminished vocal frequency range, especially when rising pitch. SLN paralysis can be a significant issue for those whose careers depend largely on a full range of voice. The famous opera soprano, Amelita Galli-Curci, suffered SLN injury during thyroid surgery with distressing consequences. PMID:23620644

MARCHESE-RAGONA, R.; RESTIVO, D.A.; MYLONAKIS, I.; OTTAVIANO, G.; MARTINI, A.; SATALOFF, R.T.; STAFFIERI, A.

2013-01-01

442

Assembly of Recombinant Israeli Acute Paralysis Virus Capsids  

PubMed Central

The dicistrovirus Israeli Acute Paralysis Virus (IAPV) has been implicated in the worldwide decline of honey bees. Studies of IAPV and many other bee viruses in pure culture are restricted by available isolates and permissive cell culture. Here we show that coupling the IAPV major structural precursor protein ORF2 to its cognate 3C-like processing enzyme results in processing of the precursor to the individual structural proteins in a number of insect cell lines following expression by a recombinant baculovirus. The efficiency of expression is influenced by the level of IAPV 3C protein and moderation of its activity is required for optimal expression. The mature IAPV structural proteins assembled into empty capsids that migrated as particles on sucrose velocity gradients and showed typical dicistrovirus like morphology when examined by electron microscopy. Monoclonal antibodies raised to recombinant capsids were configured into a diagnostic test specific for the presence of IAPV. Recombinant capsids for each of the many bee viruses within the picornavirus family may provide virus specific reagents for the on-going investigation of the causes of honeybee loss. PMID:25153716

Ren, Junyuan; Cone, Abigail; Willmot, Rebecca; Jones, Ian M.

2014-01-01

443

Cardiac arrhythmias in hypokalemic periodic paralysis: Hypokalemia as only cause?  

PubMed

It is unknown how often cardiac arrhythmias occur in hypokalemic periodic paralysis (HypoPP) and if they are caused by hypokalemia alone or other factors. This systematic review shows that cardiac arrhythmias were reported in 27 HypoPP patients. Cases were confirmed genetically (13 with an R528H mutation in CACNA1S, 1 an R669H mutation in SCN4A) or had a convincing clinical diagnosis of HypoPP (13 genetically undetermined) if reported prior to the availability of genetic testing. Arrhythmias occurred during severe hypokalemia (11 patients), between attacks at normokalemia (4 patients), were treatment-dependent (2 patients), or unspecified (10 patients). Nine patients died from arrhythmia. Convincing evidence for a pro-arrhythmogenic factor other than hypokalemia is still lacking. The role of cardiac expression of defective skeletal muscle channels in the heart of HypoPP patients remains unclear. Clinicians should be aware of and prevent treatment-induced cardiac arrhythmia in HypoPP. PMID:25088161

Stunnenberg, Bas C; Deinum, Jaap; Links, Thera P; Wilde, Arthur A; Franssen, Hessel; Drost, Gea

2014-09-01

444

Life-threatening hypokalemic paralysis in a young bodybuilder.  

PubMed

We report a case of life-threatening hypokalemia in a 28-year-old bodybuilder who presented with sudden onset bilateral lower limbs paralysis few days after his bodybuilding competition. His electrocardiogram (ECG) showed typical u-waves due to severe hypokalemia (serum potassium 1.6?mmol/L, reference range (RR) 3.5-5.0?mmol/L). He was admitted to the intensive care unit (ICU) and was treated with potassium replacement. The patient later admitted that he had exposed himself to weight loss agents of unknown nature, purchased online, and large carbohydrate loads in preparation for the competition. He made a full recovery after a few days and discharged himself from the hospital against medical advice. The severe hypokalemia was thought to be caused by several mechanisms to be discussed in this report. With the ever rising number of new fitness centers recently, the ease of online purchasing of almost any drug, and the increasing numbers of youngsters getting into the bodybuilding arena, clinicians should be able to recognize the possible causes of sudden severe hypokalemia in these patients in order to revert the pathophysiology. PMID:24660073

Cheung, Kitty K T; So, Wing-Yee; Kong, Alice P S; Ma, Ronald C W; Chow, Francis C C

2014-01-01

445

Severe prognosis in a large family with hypokalemic periodic paralysis.  

PubMed

Hypokalemic periodic paralysis (HypoPP) is a channel disorder caused primarily by mutations in the human skeletal muscle alpha1 subunit (CACNA1S) of the dihydropyridine-sensitive calcium channel. Molecular, clinical, and biochemical studies were aimed at establishing genotype/phenotype correlations in a large Italian family affected by a severe form of HypoPP. Whereas patients with HypoPP usually show a normal life span, in this family three male patients died young, one of them from anesthetic complications resembling malignant hyperthermia. Our patients carried the c1583G>A genetic lesion (R528H), which has been associated with a mild phenotype and with incomplete penetrance in women. Surprisingly, the R528H amino acid substitution in the family presented here correlated with an unfavorable prognosis in both male and female patients. We conclude that genetic characterization is an important requirement to alert physicians about the management of similar patients, especially when anesthesia is considered. PMID:12548523

Caciotti, Anna; Morrone, Amelia; Domenici, Raffaele; Donati, Maria Alice; Zammarchi, Enrico

2003-02-01

446

Extracellular potassium homeostasis: insights from hypokalemic periodic paralysis.  

PubMed

Extracellular potassium makes up only about 2% of the total body's potassium store. The majority of the body potassium is distributed in the intracellular space, of which about 80% is in skeletal muscle. Movement of potassium in and out of skeletal muscle thus plays a pivotal role in extracellular potassium homeostasis. The exchange of potassium between the extracellular space and skeletal muscle is mediated by specific membrane transporters. These include potassium uptake by Na(+), K(+)-adenosine triphosphatase and release by inward-rectifier K(+) channels. These processes are regulated by circulating hormones, peptides, ions, and by physical activity of muscle as well as dietary potassium intake. Pharmaceutical agents, poisons, and disease conditions also affect the exchange and alter extracellular potassium concentration. Here, we review extracellular potassium homeostasis, focusing on factors and conditions that influence the balance of potassium movement in skeletal muscle. Recent findings that mutations of a skeletal muscle-specific inward-rectifier K(+) channel cause hypokalemic periodic paralysis provide interesting insights into the role of skeletal muscle in extracellular potassium homeostasis. These recent findings are reviewed. PMID:23953801

Cheng, Chih-Jen; Kuo, Elizabeth; Huang, Chou-Long

2013-05-01

447

Extracellular Potassium Homeostasis: Insights from Hypokalemic Periodic Paralysis  

PubMed Central

The extracellular potassium makes up only about 2% of the total body potassium store. The majority of the body potassium is distributed in the intracellular space, and of which about 80% is in skeletal muscle. Movement of potassium in and out of skeletal muscle thus plays a pivotal role in extracellular potassium homeostasis. The exchange of potassium between the extracellular space and skeletal muscle is mediated by specific membrane transporters. These include potassium uptake by Na+, K+-ATPase and release by inward rectifier K+ channels. These processes are regulated by circulating hormones, peptides, ions, and by physical activity of muscle as well as dietary potassium intake. Pharmaceutical agents, poisons and disease conditions also affect the exchange and alter extracellular potassium concentration. Here, we review extracellular potassium homeostasis focusing on factors and conditions that influence the balance of potassium movement in skeletal muscle. Recent findings that mutations of a skeletal muscle-specific inward rectifier K+ channel cause hypokalemic periodic paralysis provide interesting insights into the role of skeletal muscle in extracellular potassium homeostasis. These recent findings will be reviewed. PMID:23953801

Cheng, Chih-Jen; Kuo, Elizabeth; Huang, Chou-Long

2014-01-01

448

Life-Threatening Hypokalemic Paralysis in a Young Bodybuilder  

PubMed Central

We report a case of life-threatening hypokalemia in a 28-year-old bodybuilder who presented with sudden onset bilateral lower limbs paralysis few days after his bodybuilding competition. His electrocardiogram (ECG) showed typical u-waves due to severe hypokalemia (serum potassium 1.6?mmol/L, reference range (RR) 3.5–5.0?mmol/L). He was admitted to the intensive care unit (ICU) and was treated with potassium replacement. The patient later admitted that he had exposed himself to weight loss agents of unknown nature, purchased online, and large carbohydrate loads in preparation for the competition. He made a full recovery after a few days and discharged himself from the hospital against medical advice. The severe hypokalemia was thought to be caused by several mechanisms to be discussed in this report. With the ever rising number of new fitness centers recently, the ease of online purchasing of almost any drug, and the increasing numbers of youngsters getting into the bodybuilding arena, clinicians should be able to recognize the possible causes of sudden severe hypokalemia in these patients in order to revert the pathophysiology. PMID:24660073

Cheung, Kitty K. T.; So, Wing-Yee; Kong, Alice P. S.; Ma, Ronald C. W.; Chow, Francis C. C.

2014-01-01

449

Acellular Nerve Allografts in Peripheral Nerve Regeneration: A Comparative Study  

PubMed Central

Background Processed nerve allografts offer a promising alternative to nerve autografts in the surgical management of peripheral nerve injuries where short deficits exist. Methods Three established models of acellular nerve allograft (cold-preserved, detergent-processed, and AxoGen® -processed nerve allografts) were compared to nerve isografts and silicone nerve guidance conduits in a 14 mm rat sciatic nerve defect. Results All acellular nerve grafts were superior to silicone nerve conduits in support of nerve regeneration. Detergent-processed allografts were similar to isografts at 6 weeks post-operatively, while AxoGen®-processed and cold-preserved allografts supported significantly fewer regenerating nerve fibers. Measurement of muscle force confirmed that detergent-processed allografts promoted isograft-equivalent levels of motor recovery 16 weeks post-operatively. All acellular allografts promoted greater amounts of motor recovery compared to silicone conduits. Conclusions These findings provide evidence that differential processing for removal of cellular constituents in preparing acellular nerve allografts affects recovery in vivo. PMID:21660979

Moore, Amy M.; MacEwan, Matthew; Santosa, Katherine B.; Chenard, Kristofer E.; Ray, Wilson Z.; Hunter, Daniel A.; Mackinnon, Susan E.; Johnson, Philip J.

2011-01-01

450

Repair of sciatic nerve defects using tissue engineered nerves.  

PubMed

In this study, we constructed tissue-engineered nerves with acellular nerve allografts in Sprague-Dawley rats, which were prepared using chemical detergents-enzymatic digestion and mechanical methods, in combination with bone marrow mesenchymal stem cells of Wistar rats cultured in vitro, to repair 15 mm sciatic bone defects in Wistar rats. At postoperative 12 weeks, electrophysiological detection results showed that the conduction velocity of regenerated nerve after repair with tissue-engineered nerves was similar to that after autologous nerve grafting, and was higher than that after repair with acellular nerve allografts. Immunohistochemical staining revealed that motor endplates with acetylcholinesterase-positive nerve fibers were orderly arranged in the middle and superior parts of the gastrocnemius muscle; regenerated nerve tracts and sprouted branches were connected with motor endplates, as shown by acetylcholinesterase histochemistry combined with silver staining. The wet weight ratio of the tibialis anterior muscle at the affected contralateral hind limb was similar to the sciatic nerve after repair with autologous nerve grafts, and higher than that after repair with acellular nerve allografts. The hind limb motor function at the affected side was significantly improved, indicating that acellular nerve allografts combined with bone marrow mesenchymal stem cell bridging could promote functional recovery of rats with sciatic nerve defects. PMID:25206507

Zhang, Caishun; Lv, Gang

2013-07-25

451

Using intact nerve to bridge peripheral nerve defects: an alternative to the use of nerve grafts.  

PubMed

This preliminary study was conducted to determine whether a regenerating peripheral nerve in a rat model can use the epineurium of an intact nerve to bridge a nerve gap defect. To create the intact nerve bridge a 1-cm segment of the peroneal nerve is resected leaving a gap defect. The proximal and distal peroneal nerve stumps are sutured 1-cm apart, in an end-to-side fashion, to the epineurium of the intact tibial nerve. The following experimental groups were used (n = 12): group A, immediate primary repair of resected segment; group B, intact nerve bridge technique; group C, nerve autograft; and group D, gap in situ control. Evaluation 12 weeks after surgery included measurement of the tibialis anterior muscle contraction force, axonal counting, wet weight of the tibialis anterior muscle, and histologic examination. The results of this animal study support 3 main conclusions: regenerating axons can use the epineurium of an intact nerve to bridge a gap in nerve continuity; when using functional recovery to assess regeneration, there is no significant difference between standard nerve autografts and the intact nerve bridge technique; and based on histologic examination, the intact nerve bridge technique does not injure the intact tibial nerve used to bridge the gap defect. Taken together, the results of this preliminary animal study suggest that the intact nerve bridge technique may be a potential alternative to standard nerve autografts in appropriate circumstances. Further investigation in a higher animal model is warranted before considering clinical application of the intact nerve bridge technique. PMID:11279579

McCallister, W V; Cober, S R; Norman, A; Trumble, T E

2001-03-01

452

Primary localized laryngeal amyloidosis presenting with hoarseness and dysphagia: a case report  

PubMed Central

Introduction Primary localized laryngeal amyloidosis is an extremely rare condition. It usually presents with hoarseness, pain and/or difficulty in breathing. Case presentation We present the case of a 23-year-old woman with primary localized laryngeal amyloidosis who presented with hoarseness and dysphagia. Conclusion A search of PubMed shows that dysphagia in patients with laryngeal amyloidosis has been reported only once, although this symptom is relatively common in other conditions presenting with laryngeal mass. There were no signs of any systemic disease in our patient and diagnosis was established histopathologically. She was treated surgically by microlaryngoscopy under general anesthesia and the mass was excised using a CO2 laser technology method. PMID:19918287

2009-01-01

453

What Should You Ask Your Doctor about Laryngeal and Hypopharyngeal Cancer?  

MedlinePLUS

... or hypopharyngeal cancer? What should you ask your doctor about laryngeal or hypopharyngeal cancer? It is important ... we can decide on treatment? Are there other doctors I need to see? How much experience do ...

454

A pilot investigation of changes in laryngeal function pre and post cochlear implant surgery.  

PubMed

This pilot investigation was undertaken to determine if there were any measurable changes in laryngeal function when comparing pre and post operative status with regard to cochlear implant surgery. The subjects, all totally deafened adults with varying aetiologies, were unable to monitor speech/voice production acoustically prior to surgery. The study aimed to evaluate whether change was effected to laryngeal function, and therefore voice quality, once an auditory feedback loop had been re-established and no direct therapeutic intervention had taken place. All the subjects were implanted with a multi-channel cochlear implant device (Nucleus 22: SPEAK strategy). Results indicate that a significant change can be measured in laryngeal function when comparing pre and post operative status of cochlear implant surgery. Furthermore, the assessment of laryngeal function identifies the source of acoustic findings which facilitates effective management of voice quality during rehabilitation following cochlear implantation. PMID:9428050

Hamrouge, S E; Ascott, F M; Hargreaves, S P

1997-01-01

455

A Case of Vogt-Koyanagi-Harada Syndrome with Persistent Dyspnea Secondary to Laryngeal Edema  

PubMed Central

Purpose We report a case of laryngeal edema associated with the Vogt-Koyanagi-Harada (VKH) syndrome. Patient and Methods A 32-year-old African-American female presented with a 12-day prodrome, including headache, tinnitus and shortness of breath, which preceded sudden photophobia and bilateral visual loss. Examination and clinical testing were most consistent with VKH, and the patient improved with intravenous methylprednisolone therapy. Results The patient had persistent dyspnea, which was out of proportion to chest CT findings and which was exacerbated during a recurrence of VKH. Flexible fiberoptic laryngoscopy with stroboscopy revealed diffuse laryngeal edema. Symptoms were alleviated with breathing exercises. Conclusions Several autoimmune diseases may cause diffuse laryngeal edema. In this case, VKH was associated with the patient's glottic edema and dyspnea. We recommend that laryngeal edema be considered in the differential diagnosis for patients with dyspnea and VKH.

Mantopoulos, Dimosthenis; deSilva, Brad W.; Cebulla, Colleen M.

2014-01-01

456

Management of the Facial Nerve in Lateral Skull Base Surgery Analytic Retrospective Study  

PubMed Central

Background: Surgical approaches to the jugular foramen are often complex and lengthy procedures associated with significant morbidity based on the anatomic and tumor characteristics. In addition to the risk of intra-operative hemorrhage from vascular tumors, lower cranial nerves deficits are frequently increased after intra-operative manipulation. Accordingly, modifications in the surgical techniques have been developed to minimize these risks. Preoperative embolization and intra-operative ligation of the external carotid artery have decreased the intraoperative blood loss. Accurate identification and exposure of the cranial nerves extracranially allows for their preservation during tumor resection. The modification of facial nerve mobilization provides widened infratemporal exposure with less postoperative facial weakness. The ideal approach should enable complete, one stage tumor resection with excellent infratemporal and posterior fossa exposure and would not aggravate or cause neurologic deficit. The aim of this study is to present our experience in handling jugular foramen lesions (mainly glomus jugulare) without the need for anterior facial nerve transposition. Methods: In this series we present our experience in Kasr ElEini University hospital (Cairo—Egypt) in handling 36 patients with jugular foramen lesions over a period of 20 years where the previously mentioned preoperative and operative rules were followed. The clinical status, operative technique and postoperative care and outcome are detailed and analyzed in relation to the outcome. Results: Complete cure without complications was achieved in four cases of congenital cholesteatoma and four cases with class B glomus. In advanced cases of glomus jugulare (28 patients) (C and D stages) complete cure was achieved in 21 of them (75%). The operative complications were also related to this group of 28 patients, in the form of facial paralysis in 20 of them (55.6%) and symptomatic vagal paralysis in 18 of them (50%). Conclusions: Total anterior rerouting of the facial nerve carries a high risk of facial paralysis. So it should be reserved for cases where the lesion extends beyond the vertical ICA. Otherwise, for less extensive lesions and less aggressive pathologies, less aggressive approaches could be adopted with less hazards. PMID:24179402

El Shazly, Mohamed A.; Mokbel, Mahmoud A.M.; Elbadry, Amr A.; Badran, Hatem S.

2011-01-01

457

21 CFR 882.5275 - Nerve cuff.  

Code of Federal Regulations, 2013 CFR

...Neurological Therapeutic Devices § 882.5275 Nerve cuff. (a) Identification. A nerve cuff is a tubular silicone rubber sheath used to encase a nerve for aid in repairing the nerve (e.g., to prevent ingrowth of scar tissue)...

2013-04-01

458

21 CFR 882.5275 - Nerve cuff.  

Code of Federal Regulations, 2010 CFR

...Neurological Therapeutic Devices § 882.5275 Nerve cuff. (a) Identification. A nerve cuff is a tubular silicone rubber sheath used to encase a nerve for aid in repairing the nerve (e.g., to prevent ingrowth of scar tissue)...

2010-04-01

459

21 CFR 882.5275 - Nerve cuff.  

Code of Federal Regulations, 2011 CFR

...Neurological Therapeutic Devices § 882.5275 Nerve cuff. (a) Identification. A nerve cuff is a tubular silicone rubber sheath used to encase a nerve for aid in repairing the nerve (e.g., to prevent ingrowth of scar tissue)...

2011-04-01

460

21 CFR 882.5275 - Nerve cuff.  

Code of Federal Regulations, 2012 CFR

...Neurological Therapeutic Devices § 882.5275 Nerve cuff. (a) Identification. A nerve cuff is a tubular silicone rubber sheath used to encase a nerve for aid in repairing the nerve (e.g., to prevent ingrowth of scar tissue)...

2012-04-01

461

21 CFR 882.5275 - Nerve cuff.  

Code of Federal Regulations, 2014 CFR

...Neurological Therapeutic Devices § 882.5275 Nerve cuff. (a) Identification. A nerve cuff is a tubular silicone rubber sheath used to encase a nerve for aid in repairing the nerve (e.g., to prevent ingrowth of scar tissue)...

2014-04-01

462

[Laryngeal papillomatosis in children: therapeutic problems apropos of 39 cases at the Lomé University Hospital Center].  

PubMed

The retrospective study about 39 cases of laryngeal papillomatosis emphasizes the management difficulties due to slenderness of therapeutical resources, delayed consultations because of health under education of the community and patients' discouragement during treatment of such a relapsing disease. Consequently, tracheostomy was needed immediately (25.64%), breaking of the voice (48.72%) was noted as well as school backwardness. The use of laser and interferon in laryngeal papillomatosis treatment is for the future in Togo. PMID:8677369

Kpemissi, E; Agbere, A R; Sossou, K

1995-01-01