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Lin H, Hu H. Bilateral facial palsy caused by HIV infection: A case report and literature review. Medicine (Baltimore) 2023; 102:e33263. [PMID: 36930128 PMCID: PMC10019170 DOI: 10.1097/md.0000000000033263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 12/16/2022] [Indexed: 03/18/2023] Open
Abstract
OBJECTIVE Bilateral facial palsy (BFP) has been identified as a possible neurological complication of human immunodeficiency virus (HIV) infection, but only a limited number of cases have been reported in the literature. The purpose of this study was to deepen our understanding of the etiology of BFP. Case report: We report the case of a 46-year-old married bisexual man with BFP associated with HIV infection. The patient underwent serological testing for HIV and was positive. In the absence of any other evidence of underlying systemic disease, facial palsy is thought to be secondary to HIV infection. After antiretroviral therapy, the patient recovered completely from facial palsy within 3 months. Results: HIV infection often involves BFP. The pathophysiology of this clinical presentation is thought to be related to the immune response to the systemic transmission of the virus. Conclusions: Most patients with BFP have underlying systemic causes, particularly autoimmune diseases. The exclusion of HIV infection in patients with BFP is essential for the early diagnosis and management of HIV.
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Affiliation(s)
- Huiqian Lin
- Department of Neurology, Shijiazhuang People’s Hospital, Hebei, China
| | - Haojie Hu
- Department of Neurology, Guiyang First People’s Hospital, Guizhou, China
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Singh RK. Leprosy and HIV can cause recurrent facial palsy. BMJ 2022; 379:o2632. [PMID: 36368704 DOI: 10.1136/bmj.o2632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Motwani L, Asif N, Patel A, Vedantam D, Poman DS. Neuropathy in Human Immunodeficiency Virus: A Review of the Underlying Pathogenesis and Treatment. Cureus 2022; 14:e25905. [PMID: 35844323 PMCID: PMC9278792 DOI: 10.7759/cureus.25905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/13/2022] [Indexed: 11/05/2022] Open
Abstract
This article explores the various causes of the human immunodeficiency virus (HIV), and its associated neuropathy, including the effects of HIV on the nervous system and the long-standing therapy that is often provided to patients with HIV. Several studies regarding the neurotoxic effects of combined antiretroviral therapy (cART) and HIV were reviewed and various hypotheses were discussed. Furthermore, we present the nature of HIV-sensory neuropathy (HIV-SN) among different demographic populations and their subsequent risk factors predisposing them to this condition. It was observed that the incidence of the disease increases in increased survival of the patients as well as in males. Finally, the current approach to HIV-SN and its overlapping features with other causes of peripheral neuropathy have been discussed which demonstrates that a clinical examination is the most important clue for a healthcare professional to suspect the disease. Our main aim was to study the current perspectives and guidelines for diagnosing and managing a patient with HIV-SN to reduce disease prevalence and bring about a more aware frame of mind when following up with an HIV patient.
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Giammello F, Vitale C, Rizzo V, Toscano A, Girlanda P. Bilateral facial palsy as the first sign of HIV infection. Neurol Sci 2022; 43:6983-6985. [PMID: 35945381 PMCID: PMC9362960 DOI: 10.1007/s10072-022-06327-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Accepted: 08/05/2022] [Indexed: 02/03/2023]
Affiliation(s)
- Fabrizio Giammello
- grid.10438.3e0000 0001 2178 8421International PhD Translational Molecular Medicine and Surgery, Department of Biomedical, Dental Science and Morphological and Functional Images, Polyclinic Hospital, University of Messina, Via Consolare Valeria 1, 98125 Messina, Italy ,grid.10438.3e0000 0001 2178 8421Department of Clinical and Experimental Medicine, Polyclinic Hospital, University of Messina, Messina, Italy
| | - Chiara Vitale
- grid.10438.3e0000 0001 2178 8421Department of Clinical and Experimental Medicine, Polyclinic Hospital, University of Messina, Messina, Italy
| | - Vincenzo Rizzo
- grid.10438.3e0000 0001 2178 8421Department of Clinical and Experimental Medicine, Polyclinic Hospital, University of Messina, Messina, Italy
| | - Antonio Toscano
- grid.10438.3e0000 0001 2178 8421Department of Clinical and Experimental Medicine, Polyclinic Hospital, University of Messina, Messina, Italy
| | - Paolo Girlanda
- grid.10438.3e0000 0001 2178 8421Department of Clinical and Experimental Medicine, Polyclinic Hospital, University of Messina, Messina, Italy
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Ladzinski AT, George NB, Jagger BW. Bilateral peripheral facial paralysis during pregnancy: a presentation of acute HIV seroconversion. BMJ Case Rep 2021; 14:14/5/e242150. [PMID: 34035026 DOI: 10.1136/bcr-2021-242150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
A G7P5A1 woman in her 40s presented to the emergency department at 37 weeks 3 days' estimated gestational age (EGA) with headache, lip tingling and several days of difficulty speaking. Physical examination demonstrated bilateral facial weakness in a peripheral distribution, as well as decreased corneal reflexes and cervical lymphadenopathy. Routine fourth generation HIV screening had previously been negative at 14 and 28 weeks' EGA. Brain MRI was unremarkable, and lumbar puncture disclosed a low-grade, mononuclear cerebrospinal fluid pleocytosis; the patient was treated supportively. She returned for induction of labour at 39 weeks, at which time HIV infection was unexpectedly diagnosed. While unilateral idiopathic peripheral facial paralysis is associated with the third trimester of pregnancy and the early postpartum period, bilateral facial paralysis is rare and should prompt work-up for an underlying systemic cause, such as HIV infection.
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Affiliation(s)
- Adam T Ladzinski
- Department of Medicine, Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, Michigan, USA
| | - Nicholas B George
- Departments of Medicine and Pediatric & Adolescent Medicine, Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, Michigan, USA
| | - Brett W Jagger
- Department of Medicine, Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, Michigan, USA
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Abstract
Salivary gland diseases are rare. In the European Union (EU) a disease is considered to be rare if not more than 5 of 10,000 people are affected by it. According to estimates in Germany are about 4 million people with a rare disease. In the EU are about 30 million people with rare diseases [1]. In the present work most of the described diseases of salivary glands and of the facial nerve fall in this category. They form a very heterogeneous group whose treatment takes place mainly in specialized centers. Still, it is essential for the otolaryngologist to identify and to diagnose these diseases in order to initiate the right therapeutic steps. The work is a compilation of innate andacquired rare salivary gland disorders and of rare facial nerve disorders. The etiologies of inflammatory diseases, autoimmune disorders and tumors are taken into account. For the individual topics, the current literature, if available, was evaluated and turned into summarized facts. In this context the development of new processes, diagnostics, imaging and therapy are considered. Genetic backgrounds of salivary gland tumors and the trends in the treatment of tumorous lesions of the facial nerve are picked up. Furthermore, also rare diseases of the salivary glands in childhood are described. Some of them can occur in adults as well, but differ in frequency and symptoms. Due to the rarity of these diseases, it is recommended to tread these in centers with special expertise for it. Finally, the difficulties of initiation of studies and the problems of establishing disease registries concerning salivary gland disorders are discussed. This is very relevant because these pathologies are comparatively seldom.
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Affiliation(s)
- Claudia Scherl
- Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie,
Universitätsklinikum Mannheim
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Salepci E, Turk B, Ozcan SN, Bektas ME, Aybal A, Dokmetas I, Turgut S. Symptomatology of COVID-19 from the otorhinolaryngology perspective: a survey of 223 SARS-CoV-2 RNA-positive patients. Eur Arch Otorhinolaryngol 2020; 278:525-535. [PMID: 32794002 PMCID: PMC7426010 DOI: 10.1007/s00405-020-06284-1] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 08/10/2020] [Indexed: 12/22/2022]
Abstract
PURPOSE To determine prevalence, severity, duration, and time from onset to diagnosis of general and Otorhinolaryngologic symptoms related to COVID-19 in whole disease spectrum: from mild to critical patients. METHODS All adult patients with positive SARS-CoV-2 RNA found in nasopharyngeal and oropharyngeal swabs between March 10 and April 21, 2020 were surveyed by the authors for new onset symptoms during disease course. Demographic features, general symptoms, and Otorhinolaryngological symptoms were evaluated and compared by disease severity. RESULTS Of 223 included patients, 18.4% had mild, 61.4%; moderate, 14.3%; severe, and 5.8%; critical disease. Median age was 51 (range 20-93), 113 (50.7%) were male and 110 (49.3%) were female. The most common general symptoms were fatigue, cough, and fever with respective frequencies of 71.3%, 54.3%, and 50.7%. The most common Otorhinolaryngologic symptoms were taste loss, smell loss, and sore throat with respective frequencies of 34.5%, 31.8%, and 26%. Fatigue, fever, and dyspnea were more common in severe-critical patients compared to mild-moderate patients (p = 0.029, p = 0.016, and p < 0.001, respectively). Only smell loss was more common in mild-moderate group (p = 0.003). Prevalence of other symptoms did not differ between groups. Symptom durations and onset time to diagnosis varied. CONCLUSION When compared to the previous studies, while general symptoms were less common, Otorhinolaryngologic symptoms were more common in our study population. Considering high infection risks, Otorhinolaryngologists should be aware of COVID-19 patients presenting with Otorhinolaryngologic complaints.
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Affiliation(s)
- Egehan Salepci
- Department of Otorhinolaryngology, University of Health Sciences, Sisli Hamidiye Etfal Training and Research Hospital, Etfal Sk. No: 1, 34371, Sisli, Istanbul, Turkey.
| | - Bilge Turk
- Department of Otorhinolaryngology, University of Health Sciences, Sisli Hamidiye Etfal Training and Research Hospital, Etfal Sk. No: 1, 34371, Sisli, Istanbul, Turkey
| | - Safiye Nur Ozcan
- Department of Clinical Microbiology and Infectious Diseases, University of Health Sciences, Sisli Hamidiye Etfal Training and Research Hospital, 34371, Sisli, Istanbul, Turkey
| | - Merve Ekici Bektas
- Department of Otorhinolaryngology, University of Health Sciences, Sisli Hamidiye Etfal Training and Research Hospital, Etfal Sk. No: 1, 34371, Sisli, Istanbul, Turkey
| | - Alperen Aybal
- Department of Otorhinolaryngology, University of Health Sciences, Sisli Hamidiye Etfal Training and Research Hospital, Etfal Sk. No: 1, 34371, Sisli, Istanbul, Turkey
| | - Ilyas Dokmetas
- Department of Clinical Microbiology and Infectious Diseases, University of Health Sciences, Sisli Hamidiye Etfal Training and Research Hospital, 34371, Sisli, Istanbul, Turkey
| | - Suat Turgut
- Department of Otorhinolaryngology, University of Health Sciences, Sisli Hamidiye Etfal Training and Research Hospital, Etfal Sk. No: 1, 34371, Sisli, Istanbul, Turkey
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Fieux M, Franco-Vidal V, Devic P, Bricaire F, Charpiot A, Darrouzet V, Denoix L, Gatignol P, Guevara N, Montava M, Roch JA, Tankéré F, Tronche S, Veillon F, Vergez S, Vincent C, Lamas G, Tringali S. French Society of ENT (SFORL) guidelines. Management of acute Bell's palsy. Eur Ann Otorhinolaryngol Head Neck Dis 2020; 137:483-488. [PMID: 32636146 DOI: 10.1016/j.anorl.2020.06.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
AQFThe authors present the guidelines of the French Society of ENT and Head and Neck Surgery (SFORL) regarding the management of Bell's palsy in adults. After a literature review by a multidisciplinary workgroup, guidelines were drawn up based on retrieved articles and group-members' experience, then read over by an independent group to edit the final version. Guidelines were graded A, B, C or "expert opinion" according to decreasing level of evidence. Thorough ENT and neurological clinical examination is recommended in all patients presenting with peripheral facial palsy to confirm diagnosis of Bell's palsy. MRI with gadolinium enhancement should explore the entire course of the facial nerve, if possible within the first month. ENMG should be performed to assess prognosis for recovery. In confirmed Bell's palsy, corticosteroid therapy should be implemented as early as possible (ideally within 72h) at a dose of 1mg/kg/day for 7-10 days. Antiviral therapy should be associated to steroids in patients with severe and early-onset disease and in Ramsay-Hunt syndrome. Isolated antiviral therapy is not recommended. To date, there is no evidence that surgical facial nerve decompression provides benefit.
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Affiliation(s)
- M Fieux
- Service d'Otologie et d'Otoneurologie, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Chemin du Grand Revoyet, 69495 Pierre-Bénite, France
| | - V Franco-Vidal
- Service ORL et Chirurgie Cervico-Faciale, Hôpital Pellegrin, Place Amélie Raba-Léon, 33076 Bordeaux, France
| | - P Devic
- Service de Neurologie Clinique et Fonctionnelle, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Chemin du Grand Revoyet, 69495 Pierre-Bénite, France
| | - F Bricaire
- Service des Maladies Infectieuses, Hôpital Pitié-Salpêtrière, AP-HP, 47-83, Boulevard de l'Hôpital, 75013 Paris, France
| | - A Charpiot
- Service ORL et Chirurgie Cervico-Faciale, Hôpital de Hautepierre, 1, Avenue de Molière, 67200 Strasbourg, France
| | - V Darrouzet
- Service ORL et Chirurgie Cervico-Faciale, Hôpital Pellegrin, Place Amélie Raba-Léon, 33076 Bordeaux, France
| | - L Denoix
- Service d'Otologie et d'Otoneurologie, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Chemin du Grand Revoyet, 69495 Pierre-Bénite, France
| | - P Gatignol
- Service ORL et Chirurgie Cervico-Faciale, Hôpital Pitié-Salpêtrière, AP-HP, 47-83 Boulevard de l'Hôpital, 75013 Paris, France
| | - N Guevara
- Service ORL et Chirurgie Cervico-Faciale, Centre Hospitalier de Nice, IUFC, 31, Avenue de Valombrose, 01600 Nice, France
| | - M Montava
- Service ORL et Chirurgie Cervico-Faciale, Hôpital de la Conception, AP-HM, 147, Boulevard Baille, 13005 Marseille, France
| | - J A Roch
- Service de Radiologie, Hôpital Privé Jean Mermoz, 55, Avenue Jean Mermoz, 69008 Lyon, France
| | - F Tankéré
- Service ORL et Chirurgie Cervico-Faciale, Hôpital Pitié-Salpêtrière, AP-HP, 47-83 Boulevard de l'Hôpital, 75013 Paris, France
| | - S Tronche
- SFORL, 26, Rue Lalo, 75016 Paris, France
| | - F Veillon
- Service de Radiologie, Hôpital de Hautepierre, 1, Avenue de Molière, 67200 Strasbourg, France
| | - S Vergez
- Service ORL et Chirurgie Cervico-Faciale, Hôpital Larrey, 24, Chemin de Pouvourville, 31059 Toulouse, France
| | - C Vincent
- Service ORL et Chirurgie Cervico-Faciale, Hôpital Salengro, Rue Michel Polonowski, 59037 Lille, France
| | - G Lamas
- Service ORL et Chirurgie Cervico-Faciale, Hôpital Pitié-Salpêtrière, AP-HP, 47-83 Boulevard de l'Hôpital, 75013 Paris, France
| | - S Tringali
- Service d'Otologie et d'Otoneurologie, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Chemin du Grand Revoyet, 69495 Pierre-Bénite, France.
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