Ramsay Hunt syndrome : characteristics and patient self-assessed long-term facial palsy outcome

Purpose To explore the characteristics, medical treatments, and long-term facial palsy outcome in Ramsay Hunt syndrome. Methods Patient questionnaire including self-assessment of long-term facial palsy outcome and retrospective chart review. Initial facial palsy grade was compared to self-assessed or patient record stated palsy outcome. Occurrence of different characteristics (blisters, hearing loss, vertigo, etc.) of the syndrome were assessed. Results Altogether 120 patients were included of which 81 answered the questionnaire. All but one patient had received virus medication (aciclovir, valaciclovir), and half received simultaneous corticosteroids. If the medication was started within 72 h of Ramsay Hunt diagnosis, facial palsy recovered totally or with only slight sequelae in over 80% of the patients. Only a minority of the patients experienced varicella blisters simultaneously with facial palsy, blisters more often preceded or followed the palsy. Approximately 20% of the patients had their blisters in hidden places in the ear canal or mouth. Conclusions The long-term outcome of facial palsy in medically treated Ramsay Hunt syndrome was approaching the outcome of Bell's palsy. It is crucial to ask and inform the patient about the blisters and look for them since, more often than not, the blisters precede or follow the palsy and can be in areas not easily seen.Peer reviewe

Facial palsy in children : long-term outcome assessed face-to-face and follow-up revealing high recurrence rate

Purpose To evaluate the long-term (minimum of 2 years from the palsy onset) outcome of pediatric facial palsy by patient questionnaire and face-to-face assessment by the Sunnybrook facial grading system, House-Brackmann grading system, and Facial Nerve Grading System 2.0. To compare the outcome results of self-assessment with the face-to-face assessment. To assess the applicability of the grading scales. To assess the palsy recurrence rate (minimum of a 10-year follow-up). Methods 46 consecutive pediatric facial palsy patients: 38 (83%) answered the questionnaire and 25 (54%) attended a follow-up visit. Chart review of 43 (93%) after a minimum of 10 years for the facial palsy recurrence rate assessment. Results Of the 25 patients assessed face-to-face, 68% had totally recovered but 35% of them additionally stated subjective sequelae in a self-assessment questionnaire. Good recovery was experienced by 80% of the patients. In a 10-year follow-up, 14% had experienced palsy recurrence, only one with a known cause. Sunnybrook was easy and logical to use, whereas House-Brackmann and the Facial Nerve Grading System 2.0 were incoherent. Conclusions Facial palsy in children does not heal as well as traditionally claimed if meticulously assessed face-to-face. Patients widely suffer from subjective sequelae affecting their quality of life. Palsy recurrence was high, much higher than previously reported even considering the whole lifetime. Of these three grading systems, Sunnybrook was the most applicable.Peer reviewe

Probiotics and Upper Respiratory Tract - a Review

Peer reviewe

Mitä erikoistuja haluaa?

NLY:n koulutuspaikkakyselyssä heikosti menestynyt HUS on ¬selvittänyt sekä erikoistujien tyytymättömyyden syitä että ¬onnistuneiksi koettuja käytäntöjä. Kyselyn mukaan klinikoiden ja toimialojen käytännöt vaihtelevat yllättävän paljon

Tutkimus kuuluu yliopistosairaaloiden hoitohenkilökunnankin työnkuvaan

Tutkimuksista on tiedotettu vain sen verran, kuin tutkija on katsonut välttämättömäksi

Antibiotics by bolus or infusion for bacterial meningitis? : [Authors’ reply]

Non peer reviewe

Tuleeko toisiolaista tutkimuksen tulppa vai kasvumoottori?

Rekisteritietojen yhdistäminen ei ole vain tekninen ongelma, vaan edellyttää myös sisällön yhteismitallisuutta. Paras kliinisen ¬informatiikan osaaminen on yliopistosairaaloissa. Sitä ei pidä heittää hukkaan

Biopankkilainsäädännön muuttuva kenttä : uhkat ja mahdollisuudet

Teema : biopankk

Acquired Jugular Vein Aneurysm

Venous malformations of the jugular veins are rare findings. Aneurysms and phlebectasias are the lesions most often reported. We report on an adult patient with an abruptly appearing large tumorous mass on the left side of the neck identified as a jugular vein aneurysm. Upon clinical examination with ultrasound, a lateral neck cyst was primarily suspected. Surgery revealed a saccular aneurysm in intimate connection with the internal jugular vein. Histology showed an organized hematoma inside the aneurysmal sac, which had a focally thinned muscular layer. The terminology and the treatment guidelines of venous dilatation lesions are discussed. For phlebectasias, conservative treatment is usually recommended, whereas for saccular aneurysms, surgical resection is the treatment of choice. While an exact classification based on etiology and pathophysiology is not possible, a more uniform taxonomy would clarify the guidelines for different therapeutic modalities for venous dilatation lesions