ABSTRACT
Facial nerve palsy due to temporal bone metastasis of hepatocellular carcinoma (HCC) has rarely been reported. We experienced a rare case of temporal bone metastasis of HCC that initially presented as facial nerve palsy and was diagnosed by surgical biopsy. This patient also discovered for the first time that he had chronic hepatitis B and C infections due to this facial nerve palsy. Radiation therapy greatly relieved the facial pain and facial nerve palsy. This report suggests that hepatologists should consider metastatic HCC as a rare but possible cause of new-onset cranial neuropathy in patients with chronic viral hepatitis.
Subject(s)
Humans , Male , Middle Aged , Carcinoma, Hepatocellular/complications , Facial Nerve Diseases/diagnosis , Facial Pain/etiology , Facial Paralysis/diagnosis , Hepatitis B, Chronic/diagnosis , Hepatitis C, Chronic/diagnosis , Immunohistochemistry , Liver Neoplasms/complications , Magnetic Resonance Imaging , Positron-Emission Tomography , Skull Neoplasms/diagnosis , Tomography, X-Ray ComputedABSTRACT
Sarcoidosis is a multi system disorder of unknown cause most commonly affecting the young and middle age adults and frequently presents bilateral hilar lymph-adenopathy. The diagnosis of sarcoidosis is often delayed following the onset of symptoms. The reason being first, the disease is often sub clinical; second as the disease affects any system, the diagnosis of sarcoidosis may not be considered; third, the symptoms are not disease specific hence often treated as other chronic pulmonary diseases; finally economic issues or barriers to access for further workup may affect the timeliness of the diagnosis. No laboratory diagnosis is specific for diagnosing sarcoidosis but histological confirmation from the lymph nodes accessible for biopsy either direct or by intervention may be more specific.
Subject(s)
Administration, Oral , Adult , Diagnosis, Differential , Facial Nerve Diseases/diagnosis , Female , Follow-Up Studies , Glucocorticoids/administration & dosage , Humans , Male , Middle Aged , Sarcoidosis/complications , Tomography, X-Ray ComputedABSTRACT
Dor orofacial é um campo da odontologia dedicado ao diagnóstico e tratamento de dores orofaciais crônicas e complexas, além d e desordens motoras. Essa especialidade odontológica tem se desenvolvido por vários anos com o objetivo de prover um melhor entendimento de um grupo de pacientes que, de alguma forma, näo tinham dores de origem dentária e nem condiçöes óbvias médicas que explicassem suas dores na face. Depois de um longo período propondo tratamentos baseados apenas no aspecto mecanicista da doença, nossa profissäo percebeu a importância de entender mecanismos básicos de diagnóstico diferencial para melhor controlar esses casos. Essa mudança de mentalidade tem levado a modificaçöes na educaçäo em odontologia, assim como nos procedimentos clínicos executados. Historicamente considerada como um "problema de oclusäo", as dores orofaciais obtiveram recentemente o reconhecimento como especialidade em nosso país. Baseado nisso, o objetivo desse artigo é discutir diferenças básicas entre os tipos mais comuns de dor orofacial, assim como ressaltar a importância do conhecimento de mecanismos de conduçäo de dor para a formulaçäo de um plano de tratamento efetivo
Subject(s)
Facial Pain , Diagnosis, Differential , Facial Nerve Diseases/diagnosis , Facial Nerve Diseases/therapyABSTRACT
Facial myokymia is a rare presenting feature of a vestibular schwannoma. We present a 48 year old woman with a large right vestibular schwannoma, who presented with facial myokymia. It is postulated that facial myokymia might be due to a defect in the motor axons of the 7th nerve or due to brain stem compression by the tumor.
Subject(s)
Diagnosis, Differential , Facial Nerve Diseases/diagnosis , Female , Humans , Magnetic Resonance Imaging , Middle Aged , Neuroma, Acoustic/complicationsABSTRACT
Dacryocystographic examination was performed in two groups of patients: patients having leprosy and those not having leprosy, in order to look for early failure of the facial nerve. The results of this study show that this kind of examination does not improve diagnosis of leprosy.
Subject(s)
Adolescent , Adult , Aged , Contrast Media , Diatrizoate Meglumine/diagnosis , Facial Nerve Diseases/diagnosis , Female , Humans , Lacrimal Apparatus/physiopathology , Leprosy/complications , Male , Middle AgedABSTRACT
Múltiples factores pueden lesionar el nervio facial en su trayecto produciendo una parálisis facial, siendo esencial averiguar el sitio de la lesión para comprender el cuadro clínico. El presente artículo considera el valor diagnóstico, terapéutico y pronóstico de pruebas clínicas específicas realizadas en nueve casos de parálisis de Bell, junto con revisión de la literatura
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Facial Nerve/injuries , Facial Nerve/physiopathology , Facial Paralysis/classification , Facial Paralysis/diagnosis , Facial Paralysis/etiology , Adrenal Cortex Hormones/therapeutic use , Facial Nerve Diseases/diagnosis , Facial Nerve/anatomy & histology , Facial Muscles/physiopathologySubject(s)
Adolescent , Adrenal Cortex Hormones/administration & dosage , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Cranial Nerve Neoplasms/diagnosis , Facial Nerve Diseases/diagnosis , Facial Paralysis/drug therapy , Humans , Male , Mediastinal Neoplasms/diagnosis , Paraneoplastic Syndromes/diagnosis , Precursor Cell Lymphoblastic Leukemia-Lymphoma/diagnosis , Remission InductionABSTRACT
O neuroma do Nervo Facial é um tumor de baixa incidência e considerado de diagnóstico pouco freqüente. O diagnóstico é baseado na história clínica e em exames neuroradiológicos. Na maioria dos casos os pacientes apresentam-se com paralisia facial, mas alguns apresentam-se com perda auditiva e funçäo normal do Nervo Facial, o que torna o diagnóstico mais difícil. O tratamentoconsiste na completa excisäo do tumor. As opçöes para a restauraçäo das funçöes do Nervo Facial säo: anastomose términino-terminal, enxêrto autógeno de nervo, anastomose Hipolglosso-Facial, transposiçäo, tranposiçäo de Músculo Temporal ou transplante de músculos. Neste relato apresentaremos 5 caso diagnosticados no nosso serviço no período de 1985 a 1990. Todos os casos foram submetidos a tratamento cirúrgico, sendo em 4 empregado enxerto autógeno do Nervo Grande Auricular, e em um paciente "cross-face" com transferência de Músculo Gracilis