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P P Devriese

Publications and source records attributed to P P Devriese.

At least 37 records · Page 2Linked to original sources
PubMed1993

[Blepharospasm; results of treatment with botulin].

OBJECTIVE: Discussion of clinical symptoms and differential diagnosis of blepharospasm and treatment with botulinum A toxin. Blepharospasm is an involuntary spasmodic contraction of the eyelids. Within a few years 35%-70% of the patients becomes severely disabled. DESIGN: Prospective, open study. SETTING: Academical Medical Centre, Amsterdam. METHOD: In the period 1985-1992 we have seen 85 patients with blepharospasm. Of these 69 were treated with botulinum toxin, a total of 436 treatments, with a mean dose of 25 IU for each eye. RESULTS: The cause of blepharospasm was unknown in 71 patients. Secondary blepharospasm occurred in: peripheral facial palsy (one patient), herpes zoster infection of the trigeminal nerve (2), brain infarct (1), use of neuroleptics (2), progressive supranuclear palsy (2), Shy-Drager syndrome (1), kernicterus (1), and morbus Sjögren (4). There were 18 patients with autoimmune diseases. 77 (91%) patients had a (very) severe form of blepharospasm. Electromyographic registration revealed a dysfunction of M. levator palpebrae in 7 patients. More than 70% of the patients were free of symptoms for a mean period of two months after each treatment. Local side effects were seen in 61 (14%) of the 436 treatments: ptosis, haematoma, dry eyes, and diplopia. CONCLUSION: Blepharospasm is a disabling disease and occurs sometimes in association with other neurological and ophthalmological diseases. Botulinum A toxin is a safe and effective therapy. Electrophysiological investigation is important in the differential diagnosis; it is unnecessary to do CT or MRI routinely.

Aged↗
PubMed1993

Facial palsy after sagittal split osteotomies. A survey of 1747 sagittal split osteotomies.

Facial nerve palsy following a sagittal split osteotomy is a rare but serious complication. The incidence of facial nerve injury in a group of 1747 patients who had undergone a bilateral sagittal split osteotomy (3494 sagittal splits) was determined and proved to be 0.26% (9 cases). The case histories of 2 patients are presented, and the etiology, diagnosis, treatment and prevention of this complication are discussed.

Adult↗
PubMed1992

Absence of Lyme borreliosis among patients with presumed Bell's palsy.

In a prospective study, 69 patients with a presumed idiopathic (Bell's) peripheral facial palsy were clinically and serologically evaluated for the presence of Lyme borreliosis. In addition, their clinical spectrum was compared with clinical manifestations collected retrospectively in nine patients with symptomatic peripheral facial palsy due to Lyme borreliosis. The seroprevalence of Borrelia burgdorferi antibodies, determined by flagellum enzyme-linked immunosorbent assay, among 69 patients with idiopathic peripheral facial palsy (6%) and 153 healthy controls (4.5%) was not significantly different (odds ratio, 1.28; 95% confidence interval, 0.27 to 5.25). None of the patients with idiopathic peripheral facial palsy had or experienced the development of Lyme borreliosis. All patients with Lyme peripheral facial palsy had additional manifestations not present in patients with idiopathic peripheral facial palsy. These findings show that patients with a Lyme peripheral facial palsy can be differentiated from patients with idiopathic peripheral facial palsy by clinical examination. Therefore, screening of antibodies to B burgdorferi among patients with idiopathic peripheral facial palsy without additional manifestations is not recommended.

Adolescent↗
PubMed1991

[The treatment of hemifacial spasms using botulin].

At the Academic Medical Center of the University of Amsterdam the results of treatment of hemifacial spasms (HFS) with botulinum toxin type A were evaluated in a pilot study. Five men and 21 women with HFS were treated with toxin injections. The mean age was 65 years. Most patients were referred from other centers and had been previously treated without success with various medications or with surgical treatment. Treatment took place at the outpatient department. The toxin was injected into the M. orbicularis oculi at the medial and lateral sides of the upper and lower lids. The total dose varied between 6 and 16 LD50. Patients were reinjected on demand. All patients except for one reported satisfying improvement of their spasm. The onset of the beneficial effect was 1-2 days after the injection and the effect lasted about 3 months. All patients were re-examined 1 to 2 weeks after each treatment and showed reduction or disappearance of synkinesias. No systemic side effects occurred and local complications were mild and transient. We conclude that local injection of botulinum toxin appears to be a successful alternative in the current treatment of hemifacial spasm.

Adult↗
PubMed1991

Lip-length and snout indices in Bell's palsy. A comparison with the House grading system.

The lip-length (LL) and snout (S) indices provide information on peri-oral muscular function. They were determined in 18 patients suffering from Bell's palsy and compared with the results obtained by scoring according to the House grading system. A high correlation was found. LL and S indices are continuous variables, which facilitates their statistical evaluation. Results of the House scoring system are given in an ordinal scale and reflect overall facial muscular function. It is concluded that the indices and the House scoring system produce a different kind of information, but they are complementary to each other in the assessment of facial muscular function.

Facial Muscles↗
PubMed1990

Incidence, prognosis and recovery of Bell's palsy. A survey of about 1000 patients (1974-1983).

Over a 10-year period the diagnosis Bell's palsy was made in 1293 patients. The files of 1235 patients were studied; the relevant data were stored in a computer and analysed. Factors analysed included the source of referral of the patients as well as their age and sex, the time of onset of the paralysis, recurrence, side of the face, and pregnancy. The incidence of hypertension, diabetes and other diseases was evaluated. The fate of the nerve is determined to a large extent in the first week of the disease. The nerve excitability test is a reliable predictor of the final outcome. The system of classification of recovery we have used for many years is compared to the International Facial Nerve grading system. If denervation and poor recovery are to be prevented as far as possible, early examination and treatment of selected patients with prednisone is mandatory. An important factor in recovery is the age of the patient.

Adolescent↗
PubMed1988

Serology in facial paralysis caused by clinically presumed herpes zoster infection.

In some cases of peripheral facial palsy due to a clinically suspected varicella zoster virus (VZV) infection, the clinical diagnosis is not supported by serological tests. In a retrospective study, we examined the sera from 63 patients with clinical findings compatible with VZV infection: 57 had paired sera and 6 had single sera. In the paired-sera group, 18 cases were serologically negative initially by complement fixation (CF), while 9 of these cases were actually positive for VZV when CF was combined with ELISA. Moreover, evidence for a recent mumps virus infection was found in 6 patients and 1 patient was diagnosed as having recent mumps and cytomegalo-virus (CMV) infections. In the 6 single sera studied, the ELISA was suggestive of a recent infection with VZV (4 cases) and CMV (1 case).

Antibodies, Viral↗
PubMed1988

Clinical experiences with recurrences of Bell's palsy.

In a retrospective study of 2568 patients with peripheral facial palsies seen during a 10-year period, 106 (8.2%) of 1293 patients (50.4%) with Bell's palsy suffered a recurrence. A recurrence at the same side of the face was called a "recurrent" one, but was considered to be an "alternating" one at the other side. Ninety-eight patients (52 men, 46 women) were studied for this report. Of these patients, 70% suffered from a second attack of Bell's palsy within 10 years of the first attack. Fourteen patients had more than one recurrence. Of some note, 33 of the 98 patients had their second palsy in the last months of the year. Recovery of facial function after a recurrent palsy was worse in 39.6% and was 32.1% after an alternating palsy. The recovery after multiple palsies appears to be worse than after a single palsy.

Adolescent↗
PubMed1988

The natural history of facial paralysis in herpes zoster.

A group of 102 patients with facial palsy caused by herpes zoster was studied in order to determine the course and prognosis without treatment. In most cases, the eruption and the paralysis appeared at the same time. The maximal degree of loss of function was usually reached within 1 week and was clearly related to the age of the patient. Recovery was better when the vesicles preceded complete loss of function. Complete recovery was achieved in about 10% of patients after a complete loss of function and in about 66% after an incomplete loss.

Adult↗
PubMed1984

Facial nerve function after suboccipital removal of acoustic neurinoma.

The recovery of facial nerve function after suboccipital removal of 91 acoustic neurinomas is presented. The results after anatomical preservation of the nerve (60 cases), direct anastomosis of the nerve (7 cases), nerve grafting (16 cases), and facial hypoglossal anastomosis (8 cases) are presented after a follow-up period of 31.2 months. A simplified classification was used to describe motor function. The results are compared to those in the literature.

Adolescent↗
PubMed1984

Bell's palsy in children.

The diagnosis Bell's palsy was made in 54 children. Three boys presented with 2 occurrences of Bell's palsy. Age, sex distribution, treatment and outcome of recovery are described and compared to data in the literature.

Adolescent↗