• Title/Summary/Keyword: cranial nerve

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Femoral Nerve Injury after Rectus Abdominis Muscle Slap Harvesting: A Case Report (복직근 유리피판 거상 후 합병된 대퇴 신경손상 1례)

  • Kim, Jino;Lew, Dae Hyun;Tark, Kwan Chul
    • Archives of Plastic Surgery
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    • v.33 no.4
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    • pp.510-513
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    • 2006
  • Purpose: The Rectus abdominis muscle free flap is utilized in various reconstruction surgeries due to easiness in harvesting, consistency of vascular pedicle and reduced donor site morbidity. But rarely, femoral nerve injury during rectus abdominis harvesting can be resulted. We report a case of femoral nerve injury after rectus muscle harvesting and discuss the injury mechanism with the follow-up process of this injury. Methods: To reconstruct the defect of middle cranial base after wide excision of cystic adenocarcinoma of the external ear, rectus muscle free flap was havested in usual manner. To achieve a long vessel, inferior epigastric artery was dissected to the dividing portion of femoral artery and cut. Results: One week after the surgery, the patient noted sensory decrease in the lower leg, weakness in muscle strength, and disabilities in extension of the knee joint resulting in immobilization. EMG and NCV results showed no response on stimulation of the femoral nerve of the left leg, due to the defects in femoral nerve superior to the inguinal ligament. With routine neurologic evaluations and physical therapy, on the 75th day after the operation, the patient showed improvement in pain, sensation and muscle strength, and was able to move with walking frame. In 6 months after the operation, recovery of the muscle strength of the knee joint was observed with normal flexion and extension movements. Conclusion: Rarely, during dissection of the inferior epigastric artery, injuries to the femoral nerve can be resulted, probably due to excessive traction or pressure from the blade of the traction device. Therefore, femoral nerve injury can be prevented by avoiding excessive traction during surgery.

Numb Chin Syndrome as the First Symptom of Diffuse Large B-cell Lymphoma

  • Oh, Duwon;Woo, Keoncheol;Kim, Seong Taek;Ahn, Hyung Joon;Choi, Jong-Hoon;Kwon, Jeong-Seung
    • Journal of Oral Medicine and Pain
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    • v.41 no.4
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    • pp.200-204
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    • 2016
  • Numb chin syndrome, or mental neuropathy is a rare sensory neuropathy characterized by abnormal sensation such as hypoesthesia, paresthesia, or dysesthesia in the chin and lower lip innervated by the mental nerve. Sensory neuropathy of mental nerve is somewhat familiar to dentists because it can occur following nerve damage by trauma or dental treatment such as implant surgery or third molar extraction. It can also result from dental causes including abscess or osteomyelitis. However, it can be the first sign of the systemic disease or malignancy if it is not related to dental causes. In this study, we present the case of a patient who present with hypoesthesia and pain in chin area without other symptoms and is later diagnosed with diffuse large B-cell lymphoma.

Zoster sine herpete: a review

  • Zhou, Junli;Li, Juan;Ma, Lulin;Cao, Song
    • The Korean Journal of Pain
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    • v.33 no.3
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    • pp.208-215
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    • 2020
  • Zoster sine herpete (ZSH) is one of the atypical clinical manifestations of herpes zoster (HZ), which stems from infection and reactivation of the varicella-zoster virus (VZV) in the cranial nerve, spinal nerve, viscera, or autonomic nerve. Patients with ZSH display variable symptoms, such as neuralgia, however, different from HZ, ZSH show no zoster, which makes clinical diagnosis difficult. ZSH not only causes initial symptoms, such as neuropathic pain in the affected nerve, Bell palsy, and Ramsay Hunt syndrome, but also postherpetic neuralgia and fatal complications such as VZV encephalitis and stroke. The misdiagnosis of ZSH and tardy antiviral treatment may lead to severe ZSH sequelae. We review the publications related to ZSH, especially its diagnosis with VZV DNA and/or anti-VZV immunoglobulin (IgG and IgM). More work about ZSH, especially ZSH epidemiological survey and guidelines for its diagnosis and treatment, are needed because most of the present studies are case reports.

The Effect of Animal Physiotherapy on Balance and Walking in Dog with Sciatic Nerve Injury and Degenerative Joint Disease, Case Report

  • Lee, Shinho;Cha, Yuri
    • Physical Therapy Rehabilitation Science
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    • v.11 no.3
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    • pp.279-284
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    • 2022
  • Objective: This study was conducted to confirm the effect of physiotherapy on the balance and walking in dog with sciatic nerve injury and degenerative arthritis of stifle joints. Design: Single case study Methods: The dog walked abnormally for six months and was administrated in S animal hospital. The dog's right hindlimb was operated for cranial cruciate ligament repair and the dog had been taking a nonsteroidal anti-inflammatory analgesic before being refered. There was severe degenerated osteoarthritis in the right hindlimb. During stance and walking, the right hindlimb was often shown partial weight bearing. The dog's left hindlimb was shown plantigrade stance and walking. The radiograph was shown an intact calcaneal tendon in the left hindlimb. In the neurologic examination, sciatic nerve injury in the left hindlimb was confirmed. The dog was treated using muscle strengthening, proprioceptive exercise, underwater treadmill and Laser therapy two, or three times a week for 3 months. At the 10th and 17th treatment, it was evaluated through stance and gait analyzer system to measure dog's balance and walking. Results: 3 months following physiotherapy, the dog's balance was improved in center of pressure(COP). And peak vertical force(PVF), vertical impulse(VI) was increased in right hindlimb and double stance was decreased. Conclusions: Physiotherapy may have improved the prognosis in this dog with severe osteoarthritis and sciatic nerve injury. This study suggested that animal physiotherapy is a valuable way to improve balance and walking.

Improved Symptoms of Peripheral Facial Nerve Palsy in ChAdOx1 nCoV-19 Vaccine Recipients Following Complex Korean Medicine Treatment

  • Jang, Woo Seok;Jang, Jung Eun;Jung, Chan Yung;Kim, Kyung Ho
    • Journal of Acupuncture Research
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    • v.39 no.2
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    • pp.139-144
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    • 2022
  • Peripheral facial nerve palsy is a neurological condition/disease characterized by unilateral paralysis of the facial muscles. We report the effects of complex Korean medicine treatment in 2 patients diagnosed with Bell's palsy who developed symptoms 3-4 days following vaccination with ChAdOx1 nCoV-19 and who received oral steroids and antiviral medications. Complex Korean medicine treatments including acupuncture, electroacupuncture, bee venom acupuncture, cupping therapy, herbal medicine, and physical therapy were performed. Symptom improvement was evaluated daily using the Numerical Rating Scale, House-Brackmann Grade, and Yanagihara's Score. Patient 1 was hospitalized for 22 days and Patient 2 visited the outpatient clinic 20 times. In both cases, postauricular pain caused by Bell's palsy disappeared, and symptoms of facial paralysis improved following completion of treatment. These findings could suggest that combined Korean medicine treatment may improve symptoms of peripheral facial nerve palsy.

Neuromorphic Sensory Cognition-Focused on Touch and Smell (뉴로모픽 감각 인지 기술 동향 - 촉각, 후각을 중심으로)

  • K.-H. Park;H.-K. Lee;Y. Kang;D. Kim;J.W. Lim;C.H. Je;J. Yun;J.-Y. Kim;S.Q. Lee
    • Electronics and Telecommunications Trends
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    • v.38 no.6
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    • pp.62-74
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    • 2023
  • In response to diverse external stimuli, sensory receptors generate spiking nerve signals. These generated signals are transmitted to the brain along the neural pathway to advance to the stage of recognition or perception, and then they reach the area of discrimination or judgment for remembering, assessing, and processing incoming information. We review research trends in neuromorphic sensory perception technology inspired by biological sensory perception functions. Among the various senses, we consider sensory nerve decoding technology based on sensory nerve pathways focusing on touch and smell, neuromorphic synapse elements that mimic biological neurons and synapses, and neuromorphic processors. Neuromorphic sensory devices, neuromorphic synapses, and artificial sensory memory devices that integrate storage components are being actively studied. However, various problems remain to be solved, such as learning methods to implement cognitive functions beyond simple detection. Considering applications such as virtual reality, medical welfare, neuroscience, and cranial nerve interfaces, neuromorphic sensory recognition technology is expected to be actively developed based on new technologies, including combinatorial neurocognitive cell technology.

Epidermoid Tumor of Posterior Fossa : Analysis of 10 Cases (후두개와 유표피낭종 : 10례 분석)

  • Lim, Hyo Joo;Ahn, Jae Sung;Kwon, Yang;Lee, Jung Kyo;Kwun, Byung Duk
    • Journal of Korean Neurosurgical Society
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    • v.29 no.6
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    • pp.744-747
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    • 2000
  • Objectives : The purpose of this study was to evaluate the clinical features of the epidermoid tumor of posterior fossa and to assess the surgical outcome. Methods : We reviewed the clinicoradiological records of 10 epidermoid tumor of posterior fossa, treated surgically at our hospital between 1991 and 1996. Results : The mean age of onset was 36 years old and mean duration of symptom was 5.2 years. Six were men and four were women. The location of tumors were cerebellopontine angle(CPA) 5 cases, cerebellum(Cbll)& 4th ventricle 3 cases, foramen magnum 1 case, and pineal region extended to Cbll and 4th ventricle 1 case. Common clinical features were trigeminal neuralgia in 3 cases, cerebellar signs 2 case, headache 2 cases, hemifacial spasm with deafness 1 case, cbll signs and multiple cranial nerve dysfunctions 1 case. One CPA epidermoid had no clinical symptom and sign associated with the tumor. The surgical approaches were suboccipital approach in 9 cases and one transcallosal approach to the tumor of pineal region. The extent of surgical removal was gross total resection in 5 cases and near total or subtotal resection in 5. Two patients with CPA tumor were complicated with facial paresis. One patient with tumor located in cerebellum extended into cisterna magna had postoperative vocal cord paresis. All complicated cases had severe adhesion of tumor capsule with brainstem or cranial nerve. The mean duration of follow up was 26 months. The overall outcome was improvement of symptoms and signs in 6 cases and stationary 4 cases. During follow up, imaging study was done in 7 patients and none of them had finding of tumor recurrence. Conclusion : We conclude that recurrence of tumor is rare in both total and subtotal resected cases, but long-term follow-up is required. Aggressive removal of tumor capsule that adhesed to brianstem or cranial nerve is avoided for preventing severe postoperative complication.

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Schwannoma in the maxillary sinus and buccal space: Case report (협간극과 상악동에서 발생한 신경초종 : 증례보고)

  • Choi, Byung-Hwan;Park, Soo-Won;Son, Jang-Ho;Cho, Yeong-Cheol;Sung, Iel-Yong;Byun, Ki-Jung;Kim, Young-Min
    • 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.

The Analysis of Quantitative EEG to the Left Cranial Cervical Ganglion Block in Beagle Dogs (비글견에서 좌측앞쪽목신경절 차단에 대한 정량적 뇌파 분석)

  • Park, Woo-Dae;Bae, Chun-Sik;Kim, Se-Eun;Lee, Soo-Han;Lee, Jung-Sun;Chang, Wha-Seok;Chung, Dai-Jung;Lee, Jae-Hoon;Kim, Hwi-Yool
    • Journal of Veterinary Clinics
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    • v.24 no.4
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    • pp.514-521
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    • 2007
  • The sympathetic nerve block improves the blood flow in the innervated regions. For this region, the sympathetic nerve block has been performed in the neural and cerebral disorders. However, the cerebral blood flow regulation of the cranial cervical ganglion block in dogs have not been well defined and the correlation to the changes in the cerebral circulation and the changes in the electroencephalogram is not well defined in dogs yet. Therefore, we investigated the hypothesis that changes in the EEG could be affected by the changes in cerebral blood flow following the cranial cervical ganglion block in dogs. Twenty five beagle dogs were divided into 3 groups; group I(LCCGB, n=10) underwent left sided cranial cervical ganglion block using the 1% lidocaine, group II(L, n=10) injected the 1% lidocaine into the right or left sided digastricus muscle, group III(N/SCCGB, n=5, served as control) underwent the left sided cranial cervical ganglion block using saline. A statistical difference was not found between the control group and the LCCGB group in the 95% spectral edge frequency(SEF) and the median frequency(MF). In the relative band power, the $\delta$ frequency was decreased during 5-25 min, while the $\alpha$ frequency was increased during the same time(p<0.05). But the $\theta$ frequency and the $\beta$ frequency were not shown the significant changes compared with the control group during the same time(p<0.05). These results suggest that the left cranial cervical ganglion block does not induce the change of the cerebral blood flow and its effect is insignificant.

Dolichoectasia of vertebrobasilar artery presenting as facial pain: a case report

  • Prasanna Vadhanan
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.23 no.4
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    • pp.237-240
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    • 2023
  • Dolichoectasia of the intracranial arteries is a rare condition characterized by elongated and tortuous arteries due to progressive destruction of the vessel walls. Although most patients present with cerebrovascular accidents, our patient presented with intractable facial pain along the distribution of the trigeminal nerve. Clinical examination revealed involvement of the 5th, 7th, and 8th cranial nerves, and subsequent MRI showed dolichoectasia of the left basilar artery. The patient experienced symptomatic relief after a trial of carbamazepine along with botulinum toxin injections.