• The Korean Journal of Pain
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• v.5 no.2
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• pp.263-268
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• 1992

Involvement of the facial nerve(herpes zoster oticus, Ramsay Hunt Syndrome) is a rather common clinical syndrome. It begins with unilateral ear pain, followed shortly by a peripheral facial palsy. Paresis or paralysis may affect the muscles of facial expression, which also close the eyelids. The levator palpebrae which is innervated by the 5th cranial nerve is spared, so the eye may remain open. The rash is usually confined to the tympanic membrane and the external auditory canal. It may spread to involve the outer surface of the lobe of the ear, anterior pillar or the fauces and mastoid. There also may be a loss of taste in the anterior two thirds of tongue. At time, the auditory nerve involvement produces tinnitus, deafness and vertigo. The 5th, 8th and 10th nerves and even the upper cervical spinal nerve can be involved presumedly on the base of spread of the infective process along anastomotic connections between the facial nerve. The facial paralysis is identical to that of Bells palsy. Frequently the recovery of facial nerve function is incomplete, leaving the patient with some residual facial weak ness. We experienced 2 cases of Ramsay Hunt Syndrome. The first patients, 55 year old male, visited our pain clinic on the day when his left facial nerve start to paralyze. We injected 6 ml of 0.25% bupivacaine into his left stellate ganglion 15 times. TENS was also applicated simultaneously. His facial paralysis was recovered completely 3 weeks after treatment without any complications. Another one, 53 year old male, visited us 7 weeks after onset of facial paralysis. He has been treated conventional oriental method(acupuncture, massage, warm application, etc). But the degree of his left facial paralysis didn't improve at all He has been treating with SGB 50 times and TENS for 2 months. Temporal and zygomatic branch of his left facial nerve recovered nearly completely but buccal and mandibular branch did not recover completely. We are willing to insist on the early treatment is the best choice in managing of Ramsay Hunt Syndrome.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.17 no.3
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• pp.126-130
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• 2004

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

• Journal of Veterinary Clinics
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• v.40 no.5
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• pp.336-340
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• 2023

A dog (2-year old, female, Shih-Tzu) presented with hyperthermia and right-sided facial paralysis characterized by the inability to close the right eye and drooling from the right side of the mouth after H3N2 influenza vaccination [A/Canine/Korea/01/07(H3N2) strain; Caniflu-Max, Bionote, Hwaseong, Gyeonggi-do, ROK]. To determine the cause of the fever and neurological symptoms, physical examination, ophthalmic examination, thoracic and abdominal radiography, abdominal ultrasonography, complete blood counts, serum chemistry values, and electrolyte levels were determined. In addition, Cerebrospinal fluid analysis, antinuclear antibody test, fever of unknown origin polymerase chain reaction (PCR) panel, tick-borne pathogen PCR panel were performed. As a result, hyperthermia, leukocytosis, and elevated C-reactive protein were confirmed. In addition, neurological examination revealed decreased right eyelid reflexes, corneal reflexes, threat response, and facial sensation, it was possible to suspect problems with the trigeminal and facial nerves of the cranial nerve. Magnetic resonance imaging revealed a lesion suggestive of myositis in the right muscular lesion at atlanto-occipital junction level on site of vaccine injection. Therefore, right-sided facial paralysis was tentatively determined to be a secondary cause of nerve damage caused by myositis. The patient was treated with immunosuppressants such as prednisolone and mycophenolate mofetil. After 3 months of immunosuppressant therapy, the patient's symptoms improved.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.35 no.6
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• pp.494-498
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• 2009

Schwannomas are tumors which originate from the neuroectodermal Schwann cell of cranial, intraspinal, peripheral and autonomic nerve sheaths, and they are solitary, benign, slow growing and well encapsulated neoplasm. Schwannomas are usually asymptomatic. No strong gender or age predominance exists. The incidence of extracranial schwannomas in the head and the neck region varies from 25~45%. In addition, schwannomas are rare in the maxillary sinus or buccal space. In this paper, it diagnosed and treated a 54-years old female patient, who had schwannoma in the maxillary sinus derived from infraorbital nerves, the branch of the left trigeminal nerve, and a 19-years old male patient, who had schwannoma arose in the buccal space derived from the buccal branch of the right facial nerve. There was no particular complication except sensory extinction of the nerve in the female patient and paralysis by the nerve in the male patient. It is determined those two cases of schwannoma in the rare portion is valuable and herein, it reports those with literature discussions.

• Tuberculosis and Respiratory Diseases
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• v.47 no.2
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• pp.247-254
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• 1999

Respiratory failure is the most serious manifestation and usual cause of death in acute organophosphate poisoning, and is common in acute cholinergic crisis. But the respiratory failure may appear suddenly in a patient who is recovering from the cholinergic crisis, even while receiving conventional therapy. These are case report of 37 years old male and 24 years old female with intermediate syndrome in organophosphate poisoning. The two patients ingested organophosphate(fenthion and mixture of DDVP with chlorpyrifos respectively) incidentally and in a sucide attempt respectively. After apparent recovery from the cholinergic crisis with a conventional therapy but before the expected onset of delayed polyneuropathy, the respiratory failure appeared suddenly with a muscular weakness, affecting predominantly the proximal limb muscles, neck flexors, territories of several motor cranial nerves. The two patients needed mechanical ventilatory support and recovery from the intermediate syndrome was complete in both patients, although one subsequently developed hypoxic encephalopathy. The clinical manifestation and electrophysiologic study support the clinical diagnosis of intermediate syndrome. The syndrome carries a risk of death. because of respiratory paralysis, if not recognized early and treated adequatedly. Prompt endotrachial intubation and mechanical ventilatory support is the cornerstone of treatment of the intermediate syndrome. Therefore, all patient should be observed in a hospital for up to 5 days after poisoning.