A rare case of facial nerve schwannoma masked by a concomitant temporomandibular disorder pain

Facial nerve schwannoma (FNS) is an uncommon benign tumor that arises from the Schwann cells of the facial nerve (FN). Although rare, this is the most frequent type of FN tumor, potentially affecting any segment of the nerve. Nevertheless, a higher incidence of intracranial lesions and a predilection for the geniculate ganglion has been reported. Hearing loss, facial paresis and tinnitus are the most frequent symptoms. Conversely, pain, is not among the most prominent complaints and when present, it can be misdiagnosed as an orofacial pain of other source, including pain due to a temporomandibular disorder (TMD). In this paper, we describe a rare case of a patient presenting a FNS located in the intratemporal part and geniculate ganglion of the FN, which was initially masked by the symptoms of a coexistent TMD. It highlights the importance of considering intracranial tumors in the differential diagnosis of orofacial pains. Keywords: Facial nerve schwannoma, Intracranial tumors, Facial paralysis, Orofacial pain, Temporomandibular disorde

Performance of the visual analogue scale of happiness and of the Cornell scale for depression in dementia in the tremembé epidemiological study, Brazil [Desempenho Na Escala Analógica Visual De Felicidade E Na Escala Cornell De Depressão Em Demência No Estudo Epidemiológico De Tremembé, Brasil]

Made available in DSpace on 2019-09-12T16:26:03Z (GMT). No. of bitstreams: 0 Previous issue date: 2014Depression is a major growing public health problem. Many population studies have found a significant relationship between depression and the presence of cognitive disorders. Objective: To establish the correlation between the Visual Analogue Scale of Happiness and the Cornell Scale for Depression in Dementia in the population aged 60 years or over in the city of Tremembé, state of São Paulo, Brazil. Methods: An epidemiological survey involving home visits was carried out in the city of Tremembé. The sample was randomly selected by drawing 20% of the population aged 60 years or older from each of the city’s census sectors. In this single-phase study, the assessment included clinical history, physical and neurological examination, cognitive evaluation, and application of both the Cornell Scale and the Analogue Scale of Happiness for psychiatric symptoms. The presence of depressive symptoms was defined as scores greater than or equal to 8 points on the Cornell Scale. Results: A total of 623 subjects were evaluated and of these 251 (40.3%) had clinically significant depressive symptoms on the Cornell Scale, with a significant association with female gender (p<0.001) and with lower education (p=0.012). One hundred and thirty-six participants (21.8%) chose the unhappiness faces, with a significant association with age (p<0.001), female gender (p=0.020) and low socioeconomic status (p=0.012). Although there was a statistically significant association on the correlation test, the correlation was not high (rho=0.47).  Conclusion: The prevalence of depressive symptoms was high in this sample and the Visual Analogue Scale of Happiness and Cornell Scale for Depression in Dementia should not be used as similar alternatives for evaluating the presence of depressive symptoms, at least in populations with low educational level. © 2014, Academia Brasileira de Neurologia. All rights reserved.César, K.G., Cognitive and Behavioral Neurology Unit, Department of Neurology, University of São Paulo, Brazil, University of Taubaté, BrazilBrucki, S.M., Cognitive and Behavioral Neurology Unit, Department of Neurology, University of São Paulo, BrazilTakada, L.T., Epidemiologic Study (TES) Group, Cognitive and Behavioral Neurology Unit, Department of Neurology, University of São Paulo, BrazilNascimento, L.F.C., University of Taubaté, BrazilGomes, C.M., Epidemiologic Study (TES) Group, Cognitive and Behavioral Neurology Unit, Department of Neurology, University of São Paulo, BrazilAlmeida, M.C., Epidemiologic Study (TES) Group, Cognitive and Behavioral Neurology Unit, Department of Neurology, University of São Paulo, BrazilOliveira, M.O., Epidemiologic Study (TES) Group, Cognitive and Behavioral Neurology Unit, Department of Neurology, University of São Paulo, BrazilPorto, F.H., Epidemiologic Study (TES) Group, Cognitive and Behavioral Neurology Unit, Department of Neurology, University of São Paulo, BrazilSenaha, M.L., Epidemiologic Study (TES) Group, Cognitive and Behavioral Neurology Unit, Department of Neurology, University of São Paulo, BrazilBahia, V.S., Epidemiologic Study (TES) Group, Cognitive and Behavioral Neurology Unit, Department of Neurology, University of São Paulo, BrazilSilva, T.B.L., Epidemiologic Study (TES) Group, Cognitive and Behavioral Neurology Unit, Department of Neurology, University of São Paulo, BrazilIanof, J.N., Epidemiologic Study (TES) Group, Cognitive and Behavioral Neurology Unit, Department of Neurology, University of São Paulo, BrazilSpíndola, L., Epidemiologic Study (TES) Group, Cognitive and Behavioral Neurology Unit, Department of Neurology, University of São Paulo, BrazilSchmidt, M.T., Epidemiologic Study (TES) Group, Cognitive and Behavioral Neurology Unit, Department of Neurology, University of São Paulo, BrazilJorge, M.S., Epidemiologic Study (TES) Group, Cognitive and Behavioral Neurology Unit, Department of Neurology, University of São Paulo, BrazilVale, P.H., Epidemiologic Study (TES) Group, Cognitive and Behavioral Neurology Unit, Department of Neurology, University of São Paulo, BrazilCecchini, M.A., Epidemiologic Study (TES) Group, Cognitive and Behavioral Neurology Unit, Department of Neurology, University of São Paulo, BrazilCassimiro, L., Epidemiologic Study (TES) Group, Cognitive and Behavioral Neurology Unit, Department of Neurology, University of São Paulo, BrazilSoares, R.T., Epidemiologic Study (TES) Group, Cognitive and Behavioral Neurology Unit, Department of Neurology, University of São Paulo, BrazilGonçalves, M.R., Epidemiologic Study (TES) Group, Cognitive and Behavioral Neurology Unit, Department of Neurology, University of São Paulo, BrazilSmid, J., Epidemiologic Study (TES) Group, Cognitive and Behavioral Neurology Unit, Department of Neurology, University of São Paulo, BrazilPorto, C.S., Epidemiologic Study (TES) Group, Cognitive and Behavioral Neurology Unit, Department of Neurology, University of São Paulo, BrazilCarthery-Goulart, M.T., Epidemiologic Study (TES) Group, Cognitive and Behavioral Neurology Unit, Department of Neurology, University of São Paulo, BrazilYassuda, M.S., Epidemiologic Study (TES) Group, Cognitive and Behavioral Neurology Unit, Department of Neurology, University of São Paulo, BrazilMansur, L.L., Epidemiologic Study (TES) Group, Cognitive and Behavioral Neurology Unit, Department of Neurology, University of São Paulo, BrazilNitrini, R., University of São Paulo Medical School, Cognitive and Behavioral Neurology Unit, Department of Neurology, University of São Paulo, Brazi