Treatment of muscle spasticity in patients with cerebral palsy using BTX-A: a pilot study

This study was designed to verify the safety and efficacy of botulinum toxin type A (BTX-A) used as a neuromuscular block on spastic masticatory musculature of children with cerebral palsy. Six patients who had spastic-tetraplegic cerebral-palsy, aged 5 to 20 years were selected. All patients had spasticity of the jaw muscles, bruxism, lower lip trauma, limited mouth opening, and difficulties in cleaning the oral cavity. The patients were sedated under general anesthesia, while the dentist injected the masseter and temporalis muscles bilaterally with 150 and 75 units of BTX-A each. Clinical examinations were conducted at 7, 14, 30, and 90 days after the initial appointment. We found statistically significant decreases in muscle spasticity and bruxism ( p = 0.002), improved inter-incisal opening ( p = 0.002), improved oral hygiene ( p = 0.031), and less lower lip trauma ( p = 0.060) after the neuromuscular blocking.     

应用自体静脉套和脑细胞生长肽对面神经损伤恢复影响的临床研究

目的研究采用自体静脉管套入吻合口并注入脑细胞生长肽的方法,对面神经损伤后功能恢复的影响.方法吻合神经断端后用自体静脉管套入吻合口并注入脑细胞生长肽.分析肌电图和观察表情肌功能恢复,比较两种方法对损伤的面神经功能恢复的影响.结果自体静脉管套入吻合口并注入脑细胞生长肽的方法,比传统方法表情肌功能恢复时间明显缩短,且一期修复比二期修复功能恢复时间明显缩短,差异具有非常显著性意义(P＜0.01).两种方法修复面神经损伤,表情肌功能恢复后检测面神经传导速度差异无显著性意义(P＞0.05).结论自体静脉管套入吻合口并注入脑细胞生长肽的方法是一种比较有前途的面神经修复方法.     

神经生长因子几丁质管修复兔面神经缺损

目的：评价神经生长因子(nerve growth factor，NGF)几丁质管在修复兔面神经缺损中的作用。方法：在16只新西兰兔的两侧面神经上颊支上分别造成8mm缺损，左侧用管腔内注入NGF的几丁质管修复，右侧用自体神经移植修复作对照。术后8周和16周分别取8只动物进行电生理和组织学检查及计算机图像分析。结果：术后8周，实验组的再生神经已通过近远中吻合口，神经纤维密集成束；术后16周，再生神经纤维的数量增加，神经纤维束增粗，形态接近于正常神经。电生理检测和图像分析显示实验组和对照组的神经传导速度和有髓神经轴突总截面积均无显著差异(P＞0．05)。结论：NGF几丁质管可为免面神经缺损提供良好的修复环境。     

Foix-Chavany-Marie-syndrome — neurological,neuropsychological, CT,MRI, and SPECT findings in a case progressive for more than 10 years

Summary In a 66-year-old woman signs and symptoms of bilateral opercular syndrome (Foix-Chavany-Marie-syndrome) developed progressively over a period of more than 10 years. Facio-linguo-velo-pharyngeo-masticatory diplegia with automatic-vol-untary dissociation was accompanied by motor aphasia and oral apraxia leading to a state of almost complete anarthria. Although it initially resembled the anterior biopercular syndrome there are also features indicating involvement of the posterior opercula. Although the aetiology remains obscure without pathological data, a bilateral focal brain atrophy is assumed. This is probably the first case documented by MRI and SPECT.Supported by the Hirnliga, Heidelberg, Federal Republic of Germany     

Selective attention to facial emotion and identity in schizophrenia.

The selective attention to facial emotion and identity was investigated in 12 patients with schizophrenia and 12 healthy participants. Both patients and controls were required to perform two classification tasks (according either to identity or emotion). Two separate values for identity (person A/person B) and for emotion (fear/anger) were used. When the classification task was on one dimension, the other dimension was either correlated, constant, or orthogonal (Garner WR. The Processing of Information and Structure. Potomac, MD: Erlbaum, 1974, Garner WR. Interaction of stimulus dimensions in concept and choice processes. Cognitive Psychology 1976;8:98-123). Results indicated that both patients and healthy participants had an asymmetrical pattern of performance: they were able to selectively attend to the identity of the face presented, regardless of the emotion expressed on the face, but variation in identity interfered with the classification of facial emotion. Moreover, a correlational study indicated that the identity interference on emotion classification for schizophrenic patients covaried with the severity of their negative symptoms. The selective attention competencies in schizophrenia and the independence hypothesis of emotion and face recognition are discussed in the framework of current face recognition models.     

Cross-face nerve grafting in facial paralysis —A long-term follow-up

Summary The long term results of 21 cases of cross-face nerve grafting are presented and analyzed to evaluate the value of the procedure. The follow-up period extended beyond 3 years in all cases as the final assessment of the facial reanimation is only possible after a very long time interval. A satisfactory or good reanimation of the face occurred in 80% of the patients. In well defined cases the procedure may be considered a valuable tool in the rehabilitation of the paralyzed face.     

The prognostic value of facial electroneurography in Bell's palsy

Twenty six patients with Bell's palsy were studied at presentation using electroneurography. Ninety-four per cent of those who recovered completely could have been predicted by ENoG within 10 days of onset. Of the 18 patients who recovered completely, 13 had a total palsy at presentation.     

An approach to fractures of the midface: An interactive tutorial

Purpose: To describe an educational computer aided instruction program dealing with diagnosis and classification of facial fractures. Methods: A program was created for use on Macintosh computers using a graphic presentation package. This program allows for the display of high resolution digitized radiographic images and illustrations, along with integrated voice and text information. Users can interact with the program to review complex concepts or study additional cases. Case material was obtained from selected high quality plain radiographs and computed tomography (CT) scans obtained in the trauma center of one institution, and was scanned on a high resolution digital scanner with image parameters optimized for viewing on the Macintosh high resolution color monitor. Results: The program has been installed in the computer aided instructional laboratories or trauma centers at The University of Texas Health Science Center, Houston; The University of Alabama, Birmingham; Emory University School of Medicine, Atlanta, Georgia; and The University of North Carolina, Chapel Hill. The program is available to radiology residents and medical students rotating on the trauma radiology services at these institutions. Completion of the program requires 30–45 minutes. Conclusion: Based on our initial experience, the program has been used by residents in the training programs of all institutions with favorable results.     

颈阔肌的应用解剖

用手术显微镜对50例成人的颈阔肌作了观察和测量。将每侧颈部分为9个区,颈阔肌位于前6区。肌的内侧界约相当于颏舌骨连线中点稍下到锁骨胸骨端稍外侧处的连线,左右侧肌夹有40°角;外侧界为下颌角稍后到锁骨肩峰端内侧3cm处的连线;下界在第一肋间隙平面,有的肌下份出现一些较宽的裂隙;上界在下颌骨体,并与某些表情肌相连续。肌的面积约150cm~2,锁骨上部约占120cm~2。后份肌纤维略呈S形弯曲。肌与深层结构联系较松。本文还对面神经和颈丛与颈阔肌有关的分支,进行了观察。对和颈面部临床应用等有关的问题进行了讨论。