Análise da evolução de pacientes com paralisia facial periférica submetidos a reabilitação

INTRODUÇÃO: A paralisia facial periférica (PFP) consiste no acometimento do sétimo nervo craniano, de forma aguda, podendo ser precedida por dor na região mastoidiana e resultando em paralisia completa ou parcial da mímica facial. É, na sua grande maioria, de causa idiopática ou apresenta diversas etiologias como diabetes mellitus, hipertensão arterial, herpes zoster, viroses, otites médias, infecções (lepra, sífilis, doença de Lyme), sarcoidose, traumatismo e tumores. Apesar da paralisia facial periférica ter sido descrita em 1821, por Sir Charles Bell, ainda hoje existe muita controvérsia a respeito da etiologia e tratamento. A incidência da PFP encontra-se entre 20 a 30 casos por 100 mil habitantes, com prevalência ligeiramente maior entre as mulheres. Baseado nessas premissas, este estudo teve por objetivo avaliar a evolução de pacientes com paralisia facial periférica submetidos a um protocolo de reabilitação. METODOLOGIA: No estudo foram incluídos 30 pacientes com diagnóstico de paralisia facial periférica idiopática, atendidos no Centro de Estudos e Reabilitação em Fisioterapia (CEAFIR), da FCT-UNESP, campus de Presidente Prudente. O presente estudo adotou como procedimento fisioterapêutico os protocolos I, II, III e IV. Antes de realizar qualquer técnica, abaixo mencionada, foi explicado ao paciente cada passo, para evitar surpreendê-lo. Conforme os pacientes apresentassem melhora e evoluções nas reavaliações elétricas, foram feitas recomendações de exercícios para mímica facial, em frente ao espelho. As repetições eram aumentadas gradativamente, posteriormente os mesmos exercícios, mas agora ativos resistidos. RESULTADOS: Os valores das variáveis reobase, cronaxia e acomodação, nos garantem que o protocolo usado permite avaliar a condução nervosa do facial, o grau de evolução da condução nervosa, bem como acompanhar... (Resumo completo, clicar acesso eletrônico abaixo)

Peripheral facial palsy in the past: contributions from Avicenna, Nicolaus Friedreich and Charles Bell

Este estudo apresenta documentos de paralisia facial periférica nas artes plásticas no Egito antigo, Grécia e Roma, Idade Média, Renascimento e também dos últimos 4 séculos. Pensamos que a história da paralisia facial periférica acompanha a história da própria espécie humana. São apresentadas as contribuições de Avicenna e Nicolaus Friedreich, e são mostradas controvérsias sobre a descrição original de Charles Bell.

AFASIA MOTORA, PARALISIA FACIAL E HEMIPLEGIA DIREITA APOS ABSCESSO DENTARIO A ESQUERDA

The authors report a case of a 6 year old child who presented with dental abscess associated with a parietal and frontal cerebrite, right facial paralysis and motor aphasia. The clinical findings, radiological examination including computerized tomography and type of treatment are presented. At beginning, the patient did not respond to antimicrobial therapy and only after drainage of her dental abscess revealed good clinical evolution.

Double muscle innervation using end-to-side neurorrhaphy in rats

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Efeito da estimulação do músculo tibial cranial após neurorrafia término-lateral do nervo fibular em ratos

Pós-graduação em Bases Gerais da Cirurgia - FMB

Dupla inervação muscular com neurorrafia término-lateral: estudo em ratos

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Estratégias de reparo utilizadas na substituição de segmento consonantal em portadores da síndrome de Moebius: uma análise otimalista

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Horner-s Syndrome following common carotid artery translocation in a horse: case report

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Doença vestibular periférica decorrente de osteoartropatia temporoioídea em um eqüino

Um eqüino com 22 anos de idade apresentou síndrome vestibular periférica associada à paralisia de nervo facial esquerdo devido à osteoartropatia temporoioídea. O exame endoscópico das bolsas guturais mostrou alteração de contorno da bula timpânica esquerda e aumento de volume da extremidade proximal do osso estiloióide do mesmo lado.

Habilidades expressivas de um grupo de alunos com paralisia cerebral na atividade de jogo

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Assistência Odontológica em Crianças com Paralisia Cerebral e Perspectivas Tecnológicas de Reabilitação

The improvement of oral health and quality of life is closely related to transdisciplinary dialogue, technological development and social responsibility. In patients with cerebral palsy, the lesion of motor areas of the brain compromises the development and function of the craniofacial complex. Considering all the ethiopathogenic conditions, the treatment of such patients involves great difficulties. The dentist and other professionals related to their rehabilitation need to deal with difficulty in chewing, respiration, phonation, besides the poor oral hygiene resulted from abnormal involuntary movements of facial and masticatory musculature, tongue, and upper limb. It is also relevant the lack of understanding about the importance of oral health care due to mental deficits of these individuals. This study aims to review some aspects of oral health in patients with cerebral palsy proposing rehabilitation associated to technology. Few studies concerned about the effectiveness of therapies for oral rehabilitation in patients with cerebral palsy. Laser therapy, electromyography, electrostimulation and LED therapy should be analyzed as options for treatment of patients with cerebral palsy. Following research projects should focus more attention on the dynamic and oral function of these patients to achieve positive repercussions in their overall health. © ArquiMed, 2010.

Estudo clínico e eletromiográfico da dinâmica do sistema mastigatório em pacientes adultos com paralisia cerebral

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Implicações clínicas da doença de Lyme em região facial: revisão da literatura

Lyme disease (LD) is a systemic infl ammatory changes resulting from direct action and the immune response to the spirochete Borrelia burgdoferi transmitted by inoculation of the fl ow of the genus Ixodes tick and is most commonly found in North America, Europe and Asia. This disease can lead to facial and peripheral neurological manifestations, such as Bell’s palsy, eye changes, disorders in the temporo-mandibular joint in addition to paresthesia of superior and inferior alveolar nerves. In Brazil, the diagnosis of LD is primarily based on clinical presentation, the erythema migrans skin, and epidemiological information of the patient. Recognition of the onset of the DL by health professionals is essential for the correct antibiotic treatment preventing the progression of the disease, and also relevant preventive guidelines for those living or working in endemic areas.

Long-term facial artery catheter implantation for serial arterial blood sampling and invasive arterial blood pressure measurement in horses

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Eficácia da imunoterapia no tratamento de pitiose facial em equino

Background: Pythiosis in horses is a proliferative and ulcerative disease that primarily affects the skin and subcutaneous tissue of limbs, thoracic-abdominal region and head. This disease sometimes can also affect limb bones or cause tumoral masses in abdomen. Usually, the cutaneous cases are confused with habronemiasis. The disease is more common in marshy areas, places with formation of slow drainage ponds and aquatic vegetation under high temperatures. The aim of this study was to describe the development of facial lesions in a horse caused by pythiosis in Cuiaba, Mato Grosso, and, additionally to discuss relevant issues regarding the diagnosis, clinical course and response to immunotherapy treatment.Case: One five years old mare of unknown breed, created in property located in the Cerrado region, had a wound on its face difficult to be healed and non-responsive to several treatments based on ivermectin and organophosphate administrated by either topical or systemic via. The animal was assisted on the farm of origin by the veterinary team of the Clinical Medicine sector, of the Veterinary Hospital, Universidade Federal de Mato Grosso (HOVET-UFMT). on the occasion of the visit, which occurred 60 days after onset of signs, the animal showed a circular single large lesion, ulcerative with serous discharge on the right part of its face, between the eyes and nostrils. There were some necrotic foci with sinus, from which kunkers were extracted; a condition compatible with pythiosis. The diagnosis was confirmed by histology, ELISA and PCR.Discussion: Assuming pythiosis from data obtained from the survey and profile of the lesion (secretory aspect, emaciation and presence of sinus and kunkers), immunotherapy treatment was immediately applied. The advanced clinical aspects and the fact that early diagnosis and treatment are essentials to satisfactory therapeutic response were also taken into consideration for starting the treatment. The remission of signs was achieved after five subcutaneous applications with 14 days between each application. From the second application, it was observed clinical improvement and after 60 days of treatment there was almost complete remission of signs. The signs for a satisfactory response in the injury site followed the order of decreasing secretory aspect, decreasing borders, decrease the itching and bringing the edges together with the formation of a thin layer of crust on the surface. Pythiosis cases with lesions on the face and lower abdomen are commonly confused with habronemiasis by macroscopic and widespread similarity between technicians and attendants, and essential support to the diagnosis through laboratory tests, which in turn are still underutilized. In this case, the authors demonstrated the therapeutic efficacy of immunotherapy as an advantage, considering the possibility of applying it in cases of lesions in areas of difficult surgical access, treatment conditions in the field, with low cost and ease of application. Further studies approaching this alternative therapy are necessary, since side effects have been observed in some cases.