Bell's palsy is one of the most common outpatient problems in neurologic clinics. The diagnosis of Bell's palsy is typically made through clinical evaluation. Characteristic findings include the acute onset of unilateral lower motor neuron facial paralysis, reaching its peak within 72 hours. However, there are numerous diagnostic pitfalls related to the differential diagnosis, including neoplasms, autoimmune disorders, trauma, and infections. For an accurate diagnosis, recognizing the anatomical background and identifying atypical clinical features of Bell's palsy is crucial. Oral steroids are considered the optimal treatment, and antiviral agents may play a beneficial role. Even without treatment, the prognosis for Bell's palsy is generally favorable, but long-standing sequelae are also possible and should be considered for functional, aesthetic, and psychological aspects.
Facial nerve palsy is one of major accompanying features in Guillain-Barré syndrome (GBS). In most of the cases, facial weakness develops simultaneously with other symptoms such as motor weakness, sensory change and other cranial neuropathies. However, facial palsy also occurs after the nadir of neurological deficits or even after the beginning of limb weakness improvement, called delayed facial palsy (DFP). DFP has been reported in Miller Fisher syndrome, but it rarely found from the acute motor axonal neuropathy subtype of GBS. Recently, we experienced a patient who diagnosed acute motor axonal neuropathy accompanying with delayed facial diplegia.
Evaluation of diaphragm function is challenging because no single test has a high diagnostic yield. We describe ultrasound findings in three cases with acquired unilateral diaphragmatic elevation. These cases confirm that sonographic evaluation is a valid tool for identifying diaphragm dysfunction. In addition, ultrasound measurements of diaphragm thickness and the
contractility can be used to determine if a diaphragm is paralyzed and suggest the duration of paralysis (i.e., acute or chronic).
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Clinical and sonographic evaluation of the diaphragm after plication in adults with unilateral eventration: a retrospective study Mohamed Abdel-Bary, Alaa Rashad, Hamed Elgendy, Mohammed Zaki, Mahmoud Youssef Abdelhamid, Morris Beshay, Khaled Mohamed Abdelaal The Egyptian Journal of Bronchology.2022;[Epub] CrossRef
Ultrasound Imaging of the Diaphragm Jung Im Seok Journal of the Korean Neurological Association.2021; 39(4): 270. CrossRef
Neuromuscular Ultrasound in Amyotrophic Lateral Sclerosis Jung Im Seok Journal of Neurosonology and Neuroimaging.2019; 11(1): 73. CrossRef
Foot drop is usually derived from peroneal nerve injury. Traumatic causes of peroneal nerve injury are more common than insidious causes including metabolic syndromes and mass lesions. We present a case with common peroneal neuropathy due to schwannoma, which is extremely rare. Complete excision of the mass lead to a gradual improvement of the symptoms. Schwannoma should be considered as a cause of common peroneal neuropathy.
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The Rare Large Common Peroneal Nerve’s Schwannoma—A Case Report and Literature Review Rudiansyah Harahap, Nurmaliannysa Dwinandia Harahap, Jose I. Mayordomo Case Reports in Oncological Medicine.2024; 2024: 1. CrossRef
Thyrotoxic periodic paralysis (PP) is the most common acquired form of PP in Asian populations, and its cardinaland biochemical abnormality is hypokalemia. We describe a 39-year-old man who had acute bilateral limb motorweakness and paresthesia, and showed normokalemia during attack. Thyroid studies showed subclinical thyrotoxic Goiter.Control of the hyperthyroidism nearly eliminated his PP. Regardless of normokalemia, our patient might be a case ofhypokalemic PP because of improvement from anti-thyroid medication.
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