Recurrent Facial Palsy Research Articles

Facial nerve neuroma in the geniculate ganglion extending into the internal auditory canal: A case report

Facial nerve schwannoma is a very rare benign tumor representing less than 1% of intrapetrous lesions. Our patient is a forty-one year old female who has suffered from recurrent right facial palsy for the last six years. She was first misdiagnosed as having Bell’s palsy and received corticosteroids which resulted in little improvement. She then had facial nerve decompression surgery which resulted in a partial improvement. Since then, she has suffered from recurrent attacks of facial palsy. Two years ago, she came to our hospital seeking further treatment options. The final diagnosis made by MRI was a possible facial nerve tumor. To obtain a better facial outcome, total tumor removal was performed through the middle cranial fossa approach along with facial-hypoglossal nerve end-to-side anastomosis through transmastoid approach. Her hearing was preserved, and she obtained a better facial outcome than that of her preoperative level. In conclusion, facial nerve schwannoma has the potential to be misdiagnosed as Bell’s palsy which might lead to a delay in diagnosis, and end-to-side neurorrhaphy may be an effective alternative in a selected case.

The Association of Recurrent Peripheral Facial Palsy and Familial Mediterrenean Fever

60 Ya z›fl ma Ad re si/Ad dress for Cor res pon den ce Dr. Sanem Yilmaz, Ege Universitesi Tip Fakultesi, Cocuk Sagligi ve Hastaliklari Anabilim Dali, Izmir, Turkiye Tel.: +90 232 390 11 40 E-posta: sanem.yilmaz@ege.edu.tr Ge lis ta ri hi/Re cei ved: 04.07.2015 Ka bul ta ri hi/Ac cep ted: 01.09.2015 1Ege Universitesi Tip Fakultesi, Cocuk Sagligi ve Hastaliklari Anabilim Dali, Izmir, Turkiye 2Yuzuncu Yil Universitesi Tip Fakultesi, Cocuk Sagligi ve Hastaliklari Anabilim Dali, Van, Turkiye Sanem Yilmaz1, Ilyas Aydin2

Successful treatment of Melkersson-Rosenthal syndrome with dapsone: a case report and review of the literature

Melkersson-Rosenthal syndrome (MRS) is a rare disease characterized by a triad of relapsing or persistent orofacial edema, recurrent lower motor neuron facial nerve palsy and fissured tongue. Acute, painless, non-erythematosus orofacial edema is observed in all patients. We report a case of a 13-year-old girl who presented with a 2-year history of swelling of the upper lip, facial paralysis, and fissured tongue; she was treated successfully with dapsone.

Combining acupuncture and copper-tube moxibustion for 39 cases of recurrent peripheral facial paralysis

Objective To observe the clinical effect of acupuncture combined with copper-tube moxibustion on peripheral facial paralysis.

Idiopathic recurrent facial palsy: Facial nerve decompression via middle cranial fossa approach

ObjectiveTo introduce our experience of preventing further episodes of idiopathic recurrent facial palsy by facial nerve decompression via middle cranial fossa approach. MethodsTwelve cases (surgery group) who had idiopathic recurrent facial palsy underwent facial nerve decompression via middle cranial fossa approach, and 6 cases (control group) who declined surgery accepted conservative treatment. Further episodes of facial palsy and final outcomes of facial nerve were recorded. Facial nerve function was assessed by House–Brackmann facial nerve grade system. ResultsOnly 8.3% of the patients (one case) in the surgery group had further episodes of facial palsy on the surgical side, but up to 64.7% of the patients (4 cases) in the control group suffered further episodes (p<0.05). 11 patients (91.7%) in the surgery group recovered to Grade I or Grade II in contrast to 3 cases (50%) in the control group. ConclusionsFacial nerve decompression via middle cranial fossa approach was able to prevent further episodes of idiopathic recurrent facial palsy, and surgical decompression seemed to achieve better outcomes of facial nerve than conservative treatment.

Glomus tumour masquerading as an aural polyp in chronic middle ear disease: A case report

Abstract Paraganglioma is an uncommon benign tumour of the temporal bones. It usually causes pulsatile tinnitus, recurrent ear bleeds, deafness or facial palsy and is rarely associated with chronic suppurative otitis media (CSOM). The latter may lead to false histopathological findings. We present an unusual case of a 45-year-old female with a right ear glomus tumour that was associated with CSOM and a large polyp protruding from the auditory canal. Despite preoperative investigations including computed tomography, diagnosis of the tumour could not be established. After taking a biopsy, a curative operation had to be abandoned because of a torrential intra-operative haemorrhage. The initial biopsy report suggested cholesteatoma; however, further histopathological studies including S-100 protein immune-staining revealed it to be paraganglioma. Large aural polyps and granulation tissues in CSOM can mask the characteristic histopathological features of these vascular tumours. We recommend including glomus tumour in the differential diagnosis of similar cases and performing optimum preoperative radiological investigations and immunological staining to confirm the diagnosis.

Melkersson-Rosenthal Syndrome: A Case Report

Melkersson-Rosenthal syndrome (MRS) is an autosomal dominant transmission disease. The gene responsible is localised in “9p11''. MRS is considered as a rare disorder which consists of a triad of recurrent and persistant peripherical facial paralysis, orofacial edema and fissured tongue. MRS is affirmed to be the consequence of herpes simplex infections, genetic predisposition, immune deficiency, monosodium glutamate and stress. However, it's etiology is still considered unknown. By following the development of MRS, we can prevent the patients from developing both of crohn's and sarcoidosis diseases.

Paralysie faciale à bascule révélatrice d’une infection à Human T-lymphotropic virus type 1 (HTLV-1)

IntroductionNeurological involvement of Human T-lymphotropic virus type 1 (HTLV-1) mainly results in myelopathy (tropical spastic paraparesis). However, cranial nerve impairment, including facial nerve damage, is rare in patients with HTLV-1 infection. ObservationWe report the case of a patient, originally from Caribbean islands, who developed recurrent bilateral facial palsy (six recurrences during the 7-year follow-up). Both blood and cerebrospinal fluid serologies were positive for HTLV-1. The diagnosis of recurring bilateral facial palsy revealing HTLV-1 infection was made. ConclusionOur case report underscores that HTLV-1 infection should be considered in patients, coming from endemic areas (Caribbean islands, South America, Japan and Africa), who exhibit recurrent bilateral facial palsy. Our data therefore indicate that HTLV-1 serology should be routinely performed in these patients.

Melkersson-Rosenthal Syndrome in Pediatric Age Group

Melkersson-Rosenthal Syndrome (MRS) is a disease characterized by peripheral facial paralysis, facial edema and fissured tongue. Appearance of this triad is rare, generally monosymptomatic or oligosymptomatic involvement is observed and difficulties or delays in diagnosis can occur due to scarcity of the disease. One or two of the findings and presence of cheilitis granulomatosa in biopsy are sufficient for the diagnosis. Melkersson Rosenthal Syndrome should be considered in differential diagnosis of recurrent facial paralysis. Although findings of the syndrome can regress spontaneously or with medical treatment, it can take a progressive course in some patients, requiring surgical treatment (facial nerve decompression). In this article a pediatric case with diagnosis of Melkersson Rosenthal Syndrome is presented.

Melkersson-Rosenthal Syndrome with Orofacial Swelling and Recurrent Lower Motor Neuron Facial Nerve Palsy: A Case Report and Review of the Literature.

Melkersson-Rosenthal Syndrome (MRS) is a rare otoneurologic condition, which is poorly understood and often underdiagnosed. Etiology and incidence are unclear, although infectious, inflammatory, and genetic causes have been implicated. Recurrent facial nerve palsy, facial swelling, and fissured tongue are the symptoms and signs of this condition. However, this triad is not typical in all patients as patients may present with one or more of the symptoms, which makes management of this condition difficult. Steroids may prove to be useful especially in patients who have facial nerve palsy. In this case report, we have described a 46 year-old Caucasian male who presented to the clinic for the evaluation of orofacial swelling and left facial deviation with a history of multiple treatments for recurrent lower motor neuron type facial nerve palsy.

Recurrent facial paralysis for 12 years.

Recurrent facial paralysis for 12 years.

Melkersson–Rosenthal syndrome with involvement of masticatory muscles

Melkersson–Rosenthal syndrome (MRS) is a rare syndrome of nknown aetiology characterised by a triad of relapsing orofacial wellings, recurrent lower motor neuron facial nerve palsy and fisured tongue [1–3]. Diagnosis is often difficult as incomplete forms re more common. Other clinical manifestations and associated disrders reported have included intraoral and ocular lesions, other ranial nerve palsies, migraine or autoimmune diseases [1–4]. In ome cases, the association between these symptoms and MRS emains uncertain and magnetic resonance imaging (MRI) is often a seful tool in identifying soft tissue and cranial nerve inflammation 3,5]. We report a patient with MRS who presented with recurrent rofacial swelling, bilateral facial diplegia and jaw muscle weakess. MRI confirmed inflammation of the masticatory muscles and he right trigeminal nerve. To the best of our knowledge, these linical findings have not been previously described.

Recurrent facial palsy in Melkersson Rosenthal syndrome: total facial nerve decompression is effective to prevent further recurrence

ObjectiveTo study the role of total facial nerve decompression in preventing further recurrence of facial palsy in Melkersson Rosenthal syndrome (MRS). MethodsTotal facial nerve decompression was performed on nine patients with recurrent facial palsy in MRS, and prednisolone treatment was given to 6 cases who declined surgery. They were incorporated into surgery group and control group, respectively. Patients in surgery group and control group were followed up for 5.4±1.4 years (range, 4 to 8 years) and 6.0±1.4 years (range, 4 to 8 years), respectively. ResultsFurther episodes of facial palsy affected none of 9 cases (0.0%) in surgery group, while they affected 3 of 6 cases (50.0%) in control group, with significant difference (p<0.05). ConclusionsTotal facial nerve decompression was effective to prevent further episodes of facial palsy in MRS.

Melkersson-Rosenthal syndrome.

Melkersson-Rosenthal syndrome.

Outcomes of recurrent facial palsy in Melkersson Rosenthal syndrome.

The objective of the study was to investigate outcomes of recurrent facial palsy in Melkersson Rosenthal syndrome (MRS). We carried out a prospective investigation on patients who had recurrent facial palsy in MRS and visited an outpatient department of otolaryngology from January 2002 to January 2012, focusing on their facial nerve outcomes. They were followed up for 12 months. The patients who visited our department due to recurrent Bell's palsy during the same period were selected as controls. Oral prednisolone alone was given to each patient. A total of 22 patients with recurrent facial palsy in MRS and 73 patients with recurrent Bell's palsy were included in the study. Twelve months later, only 3 of 22 patients (13.6%) who had recurrent facial palsy in MRS recovered to House-Brackmann grade I, whereas 52 of 73 patients (71.2%) who had recurrent Bell's palsy recovered completely. The difference was statistically significant (P<.01). Compared to recurrent Bell's palsy, recurrent facial palsy in MRS had much worse prognosis.

Facial nerve palsy after reactivation of herpes simplex virus type 1 in diabetic mice.

Bell's palsy is highly associated with diabetes mellitus (DM). Either the reactivation of herpes simplex virus type 1 (HSV-1) or diabetic mononeuropathy has been proposed to cause the facial paralysis observed in DM patients. However, distinguishing whether the facial palsy is caused by herpetic neuritis or diabetic mononeuropathy is difficult. We previously reported that facial paralysis was aggravated in DM mice after HSV-1 inoculation of the murine auricle. In the current study, we induced HSV-1 reactivation by an auricular scratch following DM induction with streptozotocin (STZ). Controlled animal study. Diabetes mellitus was induced with streptozotocin injection in only mice that developed transient facial nerve paralysis with HSV-1. Recurrent facial palsy was induced after HSV-1 reactivation by auricular scratch. After DM induction, the number of cluster of differentiation 3 (CD3)(+) T cells decreased by 70% in the DM mice, and facial nerve palsy recurred in 13% of the DM mice. Herpes simplex virus type 1 deoxyribonucleic acid (DNA) was detected in the facial nerve of all of the DM mice with palsy, and HSV-1 capsids were found in the geniculate ganglion using electron microscopy. Herpes simplex virus type 1 DNA was also found in some of the DM mice without palsy, which suggested the subclinical reactivation of HSV-1. These results suggested that HSV-1 reactivation in the geniculate ganglion may be the main causative factor of the increased incidence of facial paralysis in DM patients.

RETRACTED ARTICLE: Total facial nerve decompression in severe idiopathic recurrent facial palsy.

The Editor in Chief and the Publisher have decided to retract this article. Upon investigation carried out according to the Committee on Publication Ethics guidelines, it has been found that the authors have duplicated substantial parts from the following article: ‘Subtotal facial nerve decompression in preventing further recurrence and promoting facial nerve recovery of severe idiopathic recurrent facial palsy’, by Shu-hui Wu, Xiang Chen, Jie Wang, Hua Liu, Xiao-zhong Qian, Xin-liang Pan, DOI:10.1007/ s00405-014-2991-9.

Facial nerve schwannoma: A case report and review of the literature.

A vestibular schwannoma, often termed an acoustic neuroma, is a type of benign primary intracranial tumor of the myelin-forming cells of the vestibulocochlear nerve. The typical clinical presentation often includes ipsilateral sensorineural hearing loss/deafness, vertigo and tinnitus. In the present study, the case of a young male patient who presented with recurrent unilateral facial palsy without hearing impairment is presented. The patient was diagnosed with vestibular schwannoma and received steroidal treatment with prednisolone for two weeks. The patient’s facial weakness recovered three weeks following treatment, however, the tumor subsequently grew. The patient then underwent Gamma Knife radiosurgery with a margin dose of 13 Gy. Six months after the radiosurgery, the tumor was stable without progression, and the patient’s facial nerve function and hearing remained intact.

Melkersson Rosenthal Sendromu Tanısı Atlanıyor Mu

Melkersson Rosenthal Syndrome (MRS) is a neuromucocutaneous granulomatous disease characterized by recurrent facial paralysis, orofacial oedema and fissured tongue. The etiopathogenesis is not known yet, but genetic susceptibility, immunocompromised individual, infectious agents, food intolerance, stress are thought to be responsible. Classic triad is seldomly observed. Generally, monosymptomatic or oligosymptomatic findings are seen. The diagnosis of disease is with clinical findings, and histopathology with non-caseous granulomatous cheilitis further supports the diagnosis. We herein report a patient who previously diagnosed and treated as angioedema and cellulitis in different centers, finally diagnosed as MRS with the classic triad; scrotal tongue, recurrent facial paralysis and orofacial edema; and want to call attention to inadvertent physical examination can miss the diagnosis of MRS.

ALARM BELLS RINGING FOR MELKERSSON-ROSENTHAL SYNDROME?

Melkersson-Rosenthal Syndrome (MRS) is a rare mucocutaneous disorder, characterised by a clinical triad of facial nerve palsy, facial oedema, and tongue furrowing (lingua plicata). We present the case of a...