Idiopathic facial nerve palsy Health Dictionary

No known cause.... idiopathic

See VESTIBULOCOCHLEAR NERVE.... auditory nerve

The term used to describe a group of conditions characterised by varying degrees of paralysis and originating in infancy or early childhood. In some 80 per cent of cases this takes the form of spastic paralysis (muscle sti?ness), hence the now obsolete lay description of sufferers as ‘spastics’. The incidence is believed to be around 2 or 2·5 per 1,000 of the childhood community. In the majority of cases the abnormality dates from well before birth: among the factors are some genetic malformation of the brain, a congenital defect of the brain, or some adverse e?ect on the fetal brain as by infection during pregnancy. Among the factors during birth that may be responsible is prolonged lack of oxygen such as can occur during a di?cult labour; this may be the cause in up to 15 per cent of cases. In some 10–15 per cent of cases the condition is acquired after birth, when it may be due to KERNICTERUS, infection of the brain, cerebral thrombosis or embolism, or trauma. Acute illness in infancy, such as meningitis, may result in cerebral palsy.

The disease manifests itself in many ways. It may not be ?nally diagnosed and characterised until the infant is two years old, but may be apparent much earlier – even soon after birth. The child may be spastic or ?accid, or the slow, writhing involuntary movements known as athetosis may be the predominant feature. These involuntary movements often disappear during sleep and may be controlled, or even abolished, in some cases by training the child to relax. The paralysis varies tremendously. It may involve the limbs on one side of the body (hemiplegia), both lower limbs (paraplegia), or all four limbs (DIPLEGIA and QUADRIPLEGIA). Learning disability (with an IQ under 70) is present in around 75 per cent of all children but children with diplegia or athetoid symptoms may have normal or even high intelligence. Associated problems may include hearing or visual disability, behavioural problems and epilepsy.

The outlook for life is good, only the more severely affected cases dying in infancy. Although there is no cure, much can be done to help these disabled children, particularly if the condition is detected at an early stage. Assistance is available from NHS developmental and assessment clinics, supervised by community paediatricians and involving a team approach from experts in education, physiotherapy, occupational therapy and speech training. In this way many of these handicapped children reach adulthood able to lead near-normal lives. Much help in dealing with these children can be obtained from SCOPE (formerly the Spastics Society), and Advice Service Capability Scotland (ASCS).... cerebral palsy

The seventh cranial nerve (arising from the BRAIN), supplying the muscles of expression in the face, being purely a motor nerve. It enters the face immediately below the ear after splitting up into several branches. (See BELL’S PALSY.)... facial nerve

The 12th cranial nerve, which supplies the muscles of the tongue, together with some others lying near it. This nerve is responsible for movements required for swallowing and talking. (See also NERVOUS SYSTEM.)... hypoglossal nerve

See ANAESTHESIA – Local anaesthetics.... nerve block

See EYE.... optic nerve

Another name for PARALYSIS. CEREBRAL PALSY involves total or partial paralysis of a limb or limbs due to a perinatal or early infancy brain lesion.... palsy

A nerve is a bundle of conductory ?bres called axons (see AXON) that emanate from neurones (see NEURON(E)) – the basic anatomical and functional units of the NERVOUS SYSTEM. Nerves make up the central nervous system (BRAIN and SPINAL CORD) and connect that system to all parts of the body, transmitting information from sensory organs via the peripheral nerves to the centre and returning instructions for action to the relevant muscles and glands.

Nerves vary in size from the large pencil-sized sciatic nerve in the back of the thigh muscles to the single, hair-sized ?bres distributed to the skin. A nerve, such as the sciatic, possesses a strong, outer ?brous sheath, called the epineurium, within which lie bundles of nerve-?bres, divided from one another by partitions of ?brous tissue, in which run blood vessels that nourish the nerve. Each of these bundles is surrounded by its own sheath, known as the perineurium, and within the bundle ?ne partitions of ?brous tissue, known as endoneurium, divide up the bundle into groups of ?bres. The ?nest subdivisions of the nerves are the ?bres, and these are of two kinds: medullated and non-medullated ?bres. (See NEURON(E) and NERVOUS SYSTEM for more details on structure and functions of neurons and nerves.)... nerve

This NERVE arises from the BRACHIAL plexus in the axilla. At ?rst descending posteriorly and then anteriorly, it ends just above the elbow by dividing into the super?cial radial and interosseous nerves. It supplies motor function to the muscles which extend the arm, wrist, and some ?ngers, and supplies sensation to parts of the posterior and lateral aspects of the arm, forearm and hand.... radial nerve

The fourth cranial nerve (arising from the BRAIN), which acts upon the superior oblique muscle of the EYE.... trochlear nerve

A major NERVE in the arm, it runs from the brachial plexus to the hand. The nerve controls the muscles that move the ?ngers and thumb and conveys sensation from the ?fth and part of the fourth and from the adjacent palm. Muscle weakness and numbness in the areas supplied by the nerve is usually caused by pressure from an abnormal outgrowth from the epicondyle at the bottom of the humerus (upper-arm bone).... ulnar nerve

Also called the pneumogastric nerve, this is the tenth cranial nerve, with many fibers leading to parasympathetic ganglia in internal organs, and can be considered the presynapse starter for the upper parts of the parasympathetic functions.... vagus nerve

The ?fth cranial nerve (arising from the BRAIN). It consists of three divisions: (1) the ophthalmic nerve, which is purely sensory in function, being distributed mainly over the forehead and front part of the scalp; (2) the maxillary nerve, which is also sensory and distributed to the skin of the cheek, the mucous membrane of the mouth and throat, and the upper teeth; and (3) the mandibular nerve, which is the nerve of sensation to the lower part of the face, the tongue and the lower teeth, as well as being the motor nerve to the muscles concerned in chewing. The trigeminal nerve is of special interest, owing to its liability to NEURALGIA – TRIGEMINAL NEURALGIA, or tic douloureux as it is also known, being the most painful form known.... trigeminal nerve

The eighth cranial nerve. It consists of two sets of ?bres, which constitute two separate nerves. One is known as the vestibular nerve, which connects the semicircular canals and inner ear to the BRAIN and conveys information on posture and movement of the body; it is the nerve of equilibration or balance. The other is known as the cochlear nerve, which links the COCHLEA (organ that responds to sounds) with the brain and is the nerve of hearing. Disturbance of the former causes giddiness (VERTIGO), whilst disturbance of the latter causes DEAFNESS.... vestibulocochlear nerve

Paralysis of the 7th (facial) nerve which controls muscles of the face. One-sided stiffness and distortion of the face which lacks expression. Inability to close eyes or whistle. Rarely painful.

Aetiology. Injury, virus infection, cold, stroke. Recovery usually spontaneous. Herpes Simp. Alternatives. Chamomile, Wood Betony, Bryonia, Black Cohosh, Barberry, Asafoetida, Lobelia, Rosemary, Valerian, Sage. Echinacea has been used with convincing results internally and externally.

Tea. Equal parts. Chamomile, Wood Betony. Sage. 1 heaped teaspoon to each cup boiling water; infuse 15 minutes. 1 cup 3 times daily.

Decoctions. Black Cohosh, Rosemary, Valerian, Echinacea.

Tablets/capsules. Black Cohosh. Ginseng. Echinacea. Valerian.

Powders. Formula. Rosemary 1; Echinacea 2; Valerian 1. Dose: 500mg (two 00 capsules or one-third teaspoon) thrice daily.

Tinctures. Formula. Echinacea 2; Rosemary 1; Black Cohosh 1; Pinch Tincture Capsicum. 1-2 teaspoons 3 times daily.

Evening Primrose oil. 4 × 500mg capsules daily.

Aromatherapy. 10 drops Oil Juniper to eggcup Almond oil; gentle massage affected side of face. Diet. Lacto-vegetarian.

Vitamin E. (400iu daily). ... bell’s palsy

This is the sixth nerve rising from the brain and controls the external rectus muscle of the EYE, which turns the eye outwards. It is particularly liable to be paralysed in diseases of the nervous system, thus leading to an inward squint.... abducent nerve

Bell’s palsy, or idiopathic facial nerve palsy, refers to the isolated paralysis of the facial muscles on one or both sides. It is of unclear cause, though damage to the seventh cranial, or FACIAL NERVE, possibly of viral origin, is thought likely. Occurring in both sexes at any age, it presents with a facial pain on the affected side, followed by an inability to close the eye or smile. The mouth appears to be drawn over to the opposite side, and ?uids may escape from the angle of the mouth. Lines of expression are ?attened and the patient is unable to wrinkle the brow. Rare causes include mastoiditis, LYME DISEASE, and hypertension.

Treatment Oral steroids, if started early, increase the rate of recovery, which occurs in over 90 per cent of patients, usually starting after two or three weeks and complete within three months. Permanent loss of function with facial contractures occurs in about 5 per cent of patients. Recurrence of Bell’s palsy is unusual.... bell’s palsy

Crutch palsy is weakness or paralysis of muscles in the wrist and hand, due to pressure exerted by the CRUTCH head on the nerves that control the affected muscles. It usually occurs because the crutch is too long for the individual, and/or if he or she attempts too much walking. The nerve damage is temporary and symptoms disappear if the crutch is properly used or left aside for a time.... crutch palsy

A branch of the ophthalmic nerve supplying the lacrimal gland and conjunctiva of the EYE.... lacrimal nerve

See NEURON(E).... nerve cell

The NERVE which chie?y supplies the DIAPHRAGM. A phrenic nerve arises on each side of the SPINAL CORD from the third, fourth and ?fth cervical spinal nerves; both follow a long course down the neck, and through the chest to the diaphragm. They play a key part in RESPIRATION through control of the diaphragm. Injury to one nerve paralyses one half of the diaphragm. Occasionally the phrenic nerve may be surgically crushed as part of the treatment to repair a HIATUS HERNIA or, rarely, to stop intractable hiccups.... phrenic nerve

The nerve that operates the lowest muscles of the ?oor of the PELVIS and also the anal SPHINCTER muscle. It may be damaged in childbirth, resulting in INCONTINENCE.... pudendal nerve

Many causes, including neuralgia, frontal sinusitis, eye troubles (pain of glaucoma being referred to the temples), dental problems, shingles, psychogenic, migraine; pain referred from lungs or heart. See appropriate entries for each of these complaints.

Maria Treben’s Facial Pack: of any of the following – Thyme, Mullein, Chamomile or Yarrow. Fill small muslin bag and steep in boiling water. Ring out. Apply as hot as possible.

Internal: Chamomile tea. ... facial pain

The 11th cranial nerve. Unlike the other cranial nerves, most of the accessory nerve originates from the spinal cord. The small part of the nerve that originates from the brain supplies many muscles of the palate, pharynx (throat), and larynx (voice box). Damage to this part of the nerve may cause difficulty in speaking and swallowing. The spinal part of the nerve supplies large muscles of the neck and back, notably the sternomastoid and trapezius. Damage to the spinal fibres of the nerve paralyses these muscles.... accessory nerve

The part of the vestibulocochlear nerve (the 8th cranial nerve) that is concerned with hearing. It is also known as the auditory nerve.... acoustic nerve

One of the main nerves of the leg. The nerve fibres making up the femoral nerve emerge from the lower spine and run down into the thigh, where they branch to supply the skin and quadriceps muscles.

Damage to the femoral nerve (which impairs the ability to straighten the knee) is usually caused by a slipped disc in the lumbar region of the spine (see disc prolapse). Damage may also result from a backward dislocation of the hip or a neuropathy.... femoral nerve

The ninth cranial nerve.

This nerve performs both sensory and motor functions.

It conveys sensations, especially taste, from the back of the tongue, regulates secretion of saliva by the parotid gland, and controls movement of the throat muscles.... glossopharyngeal nerve

The 3rd cranial nerve, controlling most of the muscles that move the eye. The oculomotor nerve also supplies the muscle that constricts the pupil, that which raises the upper eyelid, and the ciliary muscle, which focuses the eye. The nerve may be damaged due to a fracture to the base of the skull or a tumour. Symptoms include ptosis, squint, dilation of the pupil, inability to focus the eye, double vision, and slight protrusion of the eyeball. (See also trochlear nerve; abducent nerve.)... oculomotor nerve

The first cranial nerve, which conveys sensations of smell as nerve impulses from the nose to the brain. Each of the 2 olfactory nerves has receptors in the mucous membrane lining the nasal cavity. These receptors detect smells and send signals along nerve fibres, which pass through tiny holes in the roof of the nasal cavity and combine to form the olfactory bulbs. From here, nerve fibres come together to form the olfactory nerve, leading to the olfactory centre in the brain. Sense of smell may be lost or impaired due to damage to the olfactory nerves, usually as a result of head injury.... olfactory nerve

The main nerve in each leg and the largest nerve in the body.The sciatic nerves are formed from nerve roots in the spinal cord.... sciatic nerve

See TENS.... transcutaneous electrical nerve stimulation

Perform surgery to the mouth and face. This not only includes removal of buried teeth but also treatment for fractured facial bones, removal of cancers and the repair of missing tissue, and the cosmetic restoration of facial anomalies such as CLEFT PALATE or large or small jaws.... oral and maxillo-facial surgeons

Sometimes described as thrombocytopenia, this is an autoimmune disorder in which blood PLATELETS are destroyed. This disturbs the blood’s coagulative properties (see COAGULATION) and spontaneous bleeding (PURPURA) occurs into the skin. The disease may be acute in children but most recover without treatment. Adults may develop a more serious, chronic variety which requires treatment with CORTICOSTEROIDS and sometimes SPLENECTOMY. Should the disease persist despite these treatments, intravenous immunoglobulin or immunosuppressive drugs (see IMMUNOSUPPRESSION) are worth trying. Should the bleeding be or become life-threatening, concentrates of platelets should be administered.... idiopathic thrombocytopenic purpura (itp)

Previously called juvenile rheumatoid arthritis and juvenile chronic arthritis, this is a set of related conditions of unknown cause affecting children. Characteristically, the synovial membrane of a joint or joints becomes in?amed and swollen for at leat six weeks (and often very much longer – even years). About 1 in 10,000 children develop it each year, many of whom have certain HLA genetic markers, thought to be important in determining who gets the illness. In?ammatory CYTOKINES play a big part.

Clinical features There are various types. The oligoarthritic type involves 1–4 joints (usually knee or ankle) which become hot, swollen and painful. One complication is an in?ammation of the eyes – UVEITIS. The condition often ‘burns out’, but may reappear at any time, even years later.

The polyarthritic type is more like RHEUMATOID ARTHRITIS in adults, and the child may have persistent symptoms leading to major joint deformity and crippling.

The systemic type, previously called Still’s disease, presents with a high fever and rash, enlarged liver, spleen and lymph nodes, and arthritis – although the latter may be mild. In some children the illness becomes recurrent; in others it dies down only to return as polyarthritis.

Complications These include uveitis, which can lead to loss of vision; a failure to thrive; osteoporosis (see under BONE, DISORDERS OF); joint deformity; and psychosocial diffculties.

Treatment This includes ANTIPYRETICS and ANALGESICS, including NON-STEROIDAL ANTIINFLAMMATORY DRUGS (NSAIDS), intra-articular steroid injections, anti-tumour necrosis factor drugs and steroids.

Physiotherapy is vital, and children may need to wear splints or other orthotic devices to alleviate deformity and pain. Orthopaedic operative procedures may be necessary.... juvenile idiopathic arthritis (jia)

A branch of the vagus NERVE which leaves the latter low down in its course, and – hooking around the right subclavian artery on the right side and round the arch of the aorta on the left

– runs up again into the neck, where it enters the larynx and supplies branches to the muscles which control the vocal cords.... recurrent laryngeal nerve

Another name for writer’s cramp (see MUSCLES, DISORDERS OF).... scrivener’s palsy

A method of electrical stimulation that is being used for the relief of PAIN, including that of MIGRAINE, NEURALGIA and phantom limbs (see AMPUTATION). Known as TENS, its mode of action appears to have some resemblance to that of ACUPUNCTURE. Several controlled trials suggest that it provides at least a modicum of relief of pain after operations, thereby reducing the amount of ANALGESICS that may be called for.... transcutaneous electrical nerve stimulation (tens)

In October 1967, after three previous surgically removed growths, an 85-year-old cattleman of Mesa, Arizona, refused treatment on the same fourth-recurrent growth, documented as malignant melanoma, in favour of “Chaparral tea”, an old Indian remedy. Of this tea he drank 2-3 cups a day. In September 1968 he was re-examined by the Medical Centre, Utah, USA. They found the growth had decreased from the size of a large lemon to that of a dime. No other medication was used, only the Chaparral tea. In eleven months he gained a needed 25lb with improvements in general health, as previous to Chaparral treatment he was pale, weak and lethargic. (“Indian Herbology”, Alma Hutchens. Pub: Merco, Ontaria).

The facial lesion finally disappeared. ... cancer – facial

See: SEDATIVE. ... nerve relaxant

All degenerative changes in the nervous system arise from breakdown of cell integrity through causes including stress, disease or faulty nutrition. J.M. Thurston classifies the restorative effect of herbs as:

Stomach and intestines: Wild Cherry bark, Black Haw.

Heart: Lily of the Valley, Cactus. Liver: Wild Yam.

Eye: Blue Cohosh, Poke root.

Brain: Oats, Black Cohosh.

Spine: Damiana, Oats, Kola, Unicorn root (Aletris). Hops. Womb: False Unicorn root (Helonias).

General Restoratives: St John’s Wort, Vervain. ... nerve restoratives

Often necessary to bring added vitality to the body or one of its parts. Often combined with circulatory stimulants to help support the nervous system in the presence of nerve weakness and paralysis.

Ephedra, Ginseng, Siberian Ginseng, Oats, Damiana, Kola, Gotu Kola, Thuja, Vervain. ... nerve stimulants

To invigorate and restore. Regarded as nutrients for strengthening nerve fibres and their protective sheaths. Help resolve effects of stress and replace mineral deficiencies in nerve tissue. They bring a new vigour in place of enervation and debility.

Betony, Damiana, Oats, St John’s Wort, Skullcap, Vervain.

Combination. Tea: Equal parts, Skullcap, Betony, Vervain. 1 heaped teaspoon to each cup boiling water; infuse 15 minutes. Half-1 cup freely. ... nerve tonics

Nervous excitability, irritability, prone to over-reaction by anger or other destructive emotion.

Teas. Cowslip flowers, St John’s Wort flowers, Passion flower, Valerian, Hops, Lime flowers, Balm, Motherwort, Woodruff, Skullcap, Oats.

Formula, tea: equal parts, Balm, Motherwort, Passion flower. 1 heaped teaspoon to each cup boiling water; infuse 5-10 minutes. 1 cup thrice daily.

Tablets. Valerian. Pulsatilla. Natracalm. (English Grains) 500mg Passion flower tablets: 1 tablet thrice daily.

See: SEDATIVES. ... nerve tension

 Trigeminal Neuralgia. Severe lancing pain along one or more branches of the fifth cranial nerve.

Causes include: dental problems, ill-fitting dentures, laughing, yawning, bad teeth.

Symptoms: nervous exhaustion, contracted pupils, flushed face.

Alternatives. Black Cohosh, Cactus, Celery seed, Bogbean, Chamomile, Lady’s Slipper, Ginseng, Hops, Jamaica Dogwood, White Willow, Wild Lettuce, Skullcap, St John’s Wort, Valerian.

Tea. Combine equal parts: Chamomile, Hops, Skullcap. 1 heaped teaspoon to each cup boiling water; infuse 5-10 minutes. 1 cup freely.

Decoction. Combine: Rosemary 2; Ladyslipper 1; Jamaica Dogwood 1.1 heaped teaspoon to each cup water gently simmered 20 minutes. Half-1 cup every 2-3 hours.

Tablets. Passion flower. Ginseng. St John’s Wort, White Willow.

Formula. Equal parts: Jamaica Dogwood, Wild Lettuce, Valerian. Dose: Liquid extracts: 1 teaspoon. Tinctures: 2 teaspoons. Powders: 500mg (two 00 capsules or one-third teaspoon). Thrice daily.

Cayenne pepper (Capsicum). Frequently successful.

Practitioner. Tincture Gelsemium BPC (1973). Dose: 0.3ml (5 drops).

Topical. Poultice: Chamomile, Hops, Linseed or Bran. Acute cases (cold), chronic cases (hot). Grated or bruised Horseradish root. Evening Primrose oil. Hot cider vinegar. Tincture Arnica or Hypericum. Aromatherapy. 2 drops each: Juniper, Lavender, Chamomile to 2 teaspoons vegetable oil. Light massage. Diet, and supplements. Same as for general neuralgia. Australian researchers found that hot curries and spices actually trigger the trigeminal nerve causing a burning sensation. ... neuralgia, facial

Weakness of the facial muscles due to inflammation of or damage to the facial nerve. The condition is usually temporary and affects only one side of the face.

Facial palsy is most often due to Bell’s palsy, which occurs for no known reason. Less commonly, facial palsy is associated with herpes zoster affecting the ear and facial nerve. Facial palsy may also result from surgical damage to this nerve or compression of the nerve by a tumour.

Facial palsy usually comes on suddenly. The eyelid and corner of the mouth droop on one side of the face and there may be pain in the ear on that side. The sense of taste may be impaired or sounds may seem to be unnaturally loud.

In many cases, facial palsy clears up without treatment. Pain can be relieved by taking analgesic drugs, and exercising the facial muscles may aid recovery. In some cases, it may be necessary to tape the eyelid shut at bedtime in order to avoid the risk of corneal abrasion. Bell’s palsy may be treated with corticosteroid drugs to reduce inflammation and speed recovery. Re-routing or grafting of nerve tissue may help people with palsies as a result of injury or a tumour.... facial palsy

An uncommon disorder in which there is frequent twitching of facial muscles, which are supplied by the facial nerve. Facial spasm affects predominantly middle-aged women and is of unknown cause.... facial spasm

(ITP) An autoimmune disorder in which platelets are destroyed, leading to bleeding beneath the skin (see purpura).... idiopathic thrombocytopaenic purpura

One of a pair of nerves that carry instructions from the brain to the larynx and send sensations from the larynx to the brain.... laryngeal nerve

One of the main nerves of the arm. It is a branch of the brachial plexus and runs down the arm from the shoulder into the hand. The median nerve controls the muscles that carry out bending movements of the wrist, fingers, and thumb, and that rotate the forearm palm-inwards. The nerve also conveys sensations from the thumb and first 3 fingers, and from the region of the palm at their base.

Damage to the nerve may result from injury to the shoulder, a Colles’ fracture just above the wrist, or pressure on the nerve where it passes through the wrist (carpal tunnel syndrome).

Symptoms of damage include numbness and weakness in areas controlled by the nerve.... median nerve

Tests carried out to assess the extent of nerve damage caused by disorders of the peripheral nervous system (see neuropathy). In the test, an electrical stimulus is applied to a nerve, and the speed at which the nerve responds to the stimulus and transmits a signal is recorded.

nerve injury Damage or severance of conducting fibres within a nerve as a result of trauma, causing loss of skin sensation and muscle power. (See neuropathy for nerve damage from cause.

other than injury.)

If a peripheral nerve (a nerve outside the brain or spinal cord) is only partially severed, the cut fibres may be able to regenerate. Provided the severed ends are still aligned, new fibres can grow across the cut to rejoin the connection, restoring function. If a nerve is totally severed, the individual fibres cannot regenerate successfully and there is no recovery of function. Nerve tracts within the brain and spinal cord are structurally different from the peripheral nerves, and severed fibres in these tracts do not regenerate. For example, vision cannot be restored if the optic nerves are cut.Microsurgery can sometimes be used to stitch a severed peripheral nerve into place, but recovery is rarely complete.... nerve conduction studies

Compression or stretching of a nerve, causing numbness, tingling, weakness, and, sometimes, pain. Common examples of a trapped nerve include carpal tunnel syndrome, in which pressure on the median nerve as it passes through the wrist causes symptoms in the thumb, index, and middle fingers; a disc prolapse, in which pressure on the nerve root leading from the spinal cord produces symptoms in the back and legs; and crutch palsy, in which the radial nerve presses against the humerus (upper-arm bone), producing symptoms in the wrist and hand.

A damaged nerve may take some time to heal. In severe cases, surgical decompression to relieve pressure on the nerve may be necessary.... nerve, trapped

Any of the air-filled cavities in the bones surrounding the nose. These include 2 frontal sinuses in the

lower forehead; 2 ethmoidal sinuses between the eyes; 2 maxillary sinuses in the cheekbones; and the sphenoidal sinuses in the skull behind the nose. Mucus drains from each sinus along a channel that opens into the nose. Infection of a sinus causes sinusitis.... sinus, facial

See nerve, trapped.... trapped nerve

the sixth *cranial nerve (VI), which supplies the lateral rectus muscle of each eyeball, responsible for turning the eye outwards.... abducens nerve

see persistent idiopathic facial pain.... atypical facial pain

see persistent idiopathic facial pain.... chronic idiopathic facial pain

a mixed sensory and motor nerve of the upper arm. It arises from the fifth and sixth cervical segments of the spinal cord and is distributed to the deltoid muscle of the shoulder and the overlying skin.... circumflex nerve

(acoustic nerve, auditory nerve) the nerve connecting the cochlea to the brain and therefore responsible for transmitting the nerve impulses relating to hearing. It forms part of the *vestibulocochlear nerve (cranial nerve VIII).... cochlear nerve

either of two nerves that supply the teeth; they are branches of the trigeminal nerve. The inferior dental nerve supplies the lower teeth and for most of its length exists as a single large bundle; thus anaesthesia of it has a widespread effect (see inferior dental block). The superior dental nerve, which supplies the upper teeth, breaks into separate branches at some distance from the teeth and it is possible to anaesthetize these individually with less widespread effect for the patient.... dental nerve

paralysis of the facial nerve, causing weakness and loss of function of the muscles it serves. It occurs in *Bell’s palsy. The commonest cause is infection with the herpes simplex virus.... facial paralysis

(House–Brackmann score, House–Brackmann scale, House–Brackmann facial weakness scale) a six-point grading system for patients with *Bell’s palsy or other forms of facial nerve palsy. Grade I is normal function; grade VI is a total palsy. [J. W. House and D. E. Brackmann (21st century), US otorhinolarygologists]... house–brackmann facial nerve grading system

(ITP) an *autoimmune disease in which platelets are destroyed, leading to spontaneous bruising (see purpura). Acute ITP is a relatively mild disease of children, who usually recover without treatment. A chronic form of the disease, typically affecting adults, is more serious, requiring treatment with corticosteroids or, if there is no response, with splenectomy. If both fail, immunosuppressant drugs may be effective. Platelet concentrates are used for life-threatening bleeding.... idiopathic thrombocytopenic purpura

(myelinated nerve fibre) see myelin.... medullated nerve fibre

weakness or paralysis of the shoulder and arm usually caused by injury to the upper roots of the *brachial plexus during traumatic childbirth. This may happen if, during a difficult delivery, excess traction applied to the head damages the fifth and sixth cervical roots of the spinal cord. The muscles of the shoulder and the flexors of the elbow are paralysed and the arm hangs at the side internally rotated at the shoulder with the forearm pronated (waiter’s-tip deformity). Recovery may be spontaneous, but in some cases nerve grafts or muscle transfers are required. [W. H. Erb (1840–1921), German neurologist]

ERCP (endoscopic retrograde cholangiopancreatography) the technique in which a catheter is passed through a *duodenoscope into the *ampulla of Vater of the common bile duct and injected with a radiopaque medium to outline the pancreatic duct and bile ducts radiologically. Magnetic resonance cholangiopancreatography (MRCP; see cholangiography) is often used to diagnose biliary and pancreatic disease followed by ERCP for diagnostic confirmation and therapeutic intervention. ERCP facilitates the removal of gallstones from the common bile duct, biopsy of lesions, and insertion of biliary *stents. See also papillotomy.... erb’s palsy

(benign intracranial hypertension, pseudotumour cerebri) a syndrome of raised pressure within the skull in the absence of a clear structural cause, such as a tumour. Although the cause is not certain, proposed mechanisms include impaired reabsorption of cerebrospinal fluid or venous outflow from the brain. The symptoms include headache, vomiting, double vision, and *papilloedema. The diagnosis is made by finding a high opening pressure at *lumbar puncture in the absence of a causative structural abnormality on brain imaging. It can improve spontaneously but drug therapy or neurosurgical treatment may be required to protect the patient’s vision.... idiopathic intracranial hypertension

(IPF) a serious interstitial lung disease, formerly called cryptogenic fibrosing alveolitis (see alveolitis). It is characterized by progressive fibrous scarring of the lung and increased numbers of inflammatory cells in the alveoli and surrounding tissues. The disease is usually diagnosed on clinical grounds on a basis of worsening breathlessness, inspiratory crackles at the lung bases on auscultation, clubbing of the fingers or toes, bilateral radiographic shadowing predominantly in the lower zones of the chest X-ray, subpleural *honeycomb change on CT scanning of the chest, and restrictive lung function on spirometry. It is also called usual interstitial pneumonia (UIP; see interstitial pneumonia), a term used by lung pathologists for the most common cellular pattern seen on biopsy. Treatment includes *pirfenidone, corticosteroids, and immunosuppressants.... idiopathic pulmonary fibrosis

(JIA, Still’s disease) any one of a group of conditions characterized by inflammation of the joints lasting longer than 6 weeks and occurring before the age of 16. The causes are unknown but immunological and infective mechanisms are suspected. JIA can affect either four or fewer joints (pauciarticular JIA) or more than four (polyarticular JIA). There are two recognized types of pauciarticular JIA: type 1, which generally affects girls below the age of four; and type 2 (juvenile-onset spondylarthropathy), which generally affects boys over the age of nine. There are also two types of polyarticular JIA, depending on the presence or absence of a particular antibody in the blood. There is a great range of severity of these diseases. Treatment consists of pain management and prevention of subsequent deformity or limitation of movement (e.g. contractures). Long-term joint damage is prevented by use of medications similar to those used in rheumatoid arthritis.... juvenile idiopathic arthritis

one of the nerves that carry impulses outwards from the central nervous system to bring about activity in a muscle or gland. Compare sensory nerve.... motor nerve

a nerve of the *brachial plexus that supplies some muscles of the arm and the skin of the lateral part of the forearm.... musculocutaneous nerve

a test done to assess the peripheral nervous system. It involves activating the nerves electronically with electrical pulses and measuring the responses obtained.... nerve conduction study

the final part (terminal) of one of the branches of a nerve fibre, where a *neuron makes contact either with another neuron at a synapse or with a muscle or gland cell at a neuromuscular or neuroglandular junction.... nerve ending

any syndrome resulting from pressure on a nerve from surrounding structures. Examples include the *carpal tunnel syndrome and *meralgia paraesthetica.... nerve entrapment syndrome

the long fine process that extends from the cell body of a *neuron and carries nerve impulses. Bundles of nerve fibres running together form a *nerve. Each fibre has a sheath, which in medullated nerve fibres is a relatively thick layer containing the fatty insulating material *myelin.... nerve fibre

any gas that disrupts the normal functioning of nerves and thus of the muscles they supply. There are two groups, the G agents and the V agents. The latter are more than 300 times as deadly as mustard gas: one inhalation can kill by paralysing the respiratory muscles. V agents also act through the skin, therefore gas masks are ineffective protection against them.... nerve gas

(NGF) a protein (see growth factor), consisting of two polypeptide chains, that is required for the development and longevity of some neurons, including those in the sympathetic nervous system and some central nervous system and sensory neurons. Nerve growth factor is necessary for axon growth and also for initiating new neuronal connections with other cells. The role of NGFs in preventing the degeneration of brain cells is being explored in research into Alzheimer’s disease.... nerve growth factor

the electrical activity in the membrane of a *neuron that – by its rapid spread from one region to the next – is the means by which information is transmitted within the nervous system along the axons of the neurons. The membrane of a resting nerve is charged (polarized) because of the different concentrations of ions inside and outside the cell. When a nerve impulse is triggered, a wave of *depolarization spreads, and ions flow across the membrane (see action potential). Until the nerve has undergone *repolarization no further nerve impulses can pass.... nerve impulse

the growth of new nerve tissue, which occurs at a very slow rate (1–2 mm per day) after a nerve has been severed and is often partially or totally incomplete. *Microsurgery has improved the results by facilitating primary repair in the immediate aftermath of injury. See also axonotmesis; neurotmesis.... nerve regeneration

the smallest of the three branches of the *trigeminal nerve. It supplies sensory fibres to the eyeball, conjunctiva, and lacrimal gland, to a small region of the nasal mucous membrane, and to the skin of the nose, brows, and scalp.... ophthalmic nerve

(atypical facial pain, chronic idiopathic facial pain) a chronic pain in the face that has no known cause and does not fit the classic presentation of other cranial neuralgias. It may be stress-related, and in some cases appears to be associated with defective metabolism of *tyramine. Treatment may involve the use of antidepressants.... persistent idiopathic facial pain

(Steele–Richardson–Olszewski syndrome) a progressive neurological disorder resulting from degeneration of the motor neurons, basal ganglia, and brainstem. Starting in late middle age, it is characterized by a staring facial expression due to impaired ability to move the eyes up and down, progressing to difficulties in swallowing, speech, balance, and movement and general spasticity. The condition enters the differential diagnosis of *parkinsonism, with which it is often confused in its early stages.... progressive supranuclear palsy

a large branch of the *femoral nerve that arises in the upper thigh, travels down on the inside of the leg, and supplies the skin from the knee to below the ankle with sensory nerves.... saphenous nerve

a nerve that carries information inwards, from an outlying part of the body towards the central nervous system. Different sensory nerves convey information about temperature, pain, touch, taste, etc., to the brain. Compare motor nerve.... sensory nerve

an archaic name for Parkinson’s disease (see parkinsonism).... shaking palsy

a small subdivision of the *vestibular nerve that carries information from the posterior *semicircular canal to the brain. Singular neurectomy is a surgical procedure to divide the singular nerve, occasionally used in the treatment of *benign paroxysmal positional vertigo.... singular nerve

see accessory nerve.... spinal accessory nerve

any nerve, usually belonging to the autonomic nervous system, that controls the circulation of blood through blood vessels by its action on the muscle fibres within their walls or its action on the heartbeat. The *vagus nerve slows the heart and reduces its output, but sympathetic nerves increase the rate and output of the heart and increase blood pressure by causing the constriction of small blood vessels at the same time.... vasomotor nerve

the division of the *vestibulocochlear nerve that carries impulses from the semicircular canals, utricle, and saccule of the inner ear to the brain, conveying information about the body’s posture and movements in space and allowing coordination and balance.... vestibular nerve