Facial numbness and weakness, transient with air travel.
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Facial numbness and weakness, transient with air travel.
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I have recently seen a patient who has suffered unilateral facial paralysis and numbness which occurred on descent and resolved on landing in an aircraft. This has happened three times now. The effect
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Facial numbness and weakness, transient with air travel.
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Facial numbness and weakness, transient with air travel.
posted at 7/8/2012 4:06 AM BST
on bmj.com
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Posts: 2949
First: 10/3/2009 Last: 24/5/2013 |
I have recently seen a patient who has suffered unilateral facial paralysis and numbness which occurred on descent and resolved on landing in an aircraft. This has happened three times now. The effect lasted about 20 minutes and initially was very frightening. This has been seen in divers too. Does anyone know what it is called or have seen a patient with this? I know the answer, but just thought I would throw this unusual one into the ring. Talking about rings, how many on the Olympic emblem and what do they stand for. Which is unique/atypical? |
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Re: Facial numbness and weakness, transient with air travel.
posted at 7/8/2012 11:02 PM BST
on bmj.com
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Posts: 3045
First: 27/3/2012 Last: 20/5/2013 |
1) An interesting discussion! Baroparesis was first described in divers. A facial nerve palsy, as a result of middle-ear high pressure, is a rare complication of sub-aqua diving. It may occur as a result of an acute pressure change in the middle ear during ascent/descent in those patients who have experienced difficulty equalizing their middle-ear pressure during the prior descent. The correct diagnosis of this condition is important if unnecessary, and potentially hazardous, recompression treatment is to be avoided. If impaired eustachian tube function causes an overpressure to remain in the middle ear after ascent in diving or aviation in a subject with a defect in the wall of the facial canal, an ischemic neurapraxia of the seventh cranial nerve may occur. This type of facial palsy is designated facial baroparesis, baroparesis facialis, or alternobaric facial palsy. If the middle ear pressure is asymmetric the subject may also have alternobaric vertigo. A causative relationship between middle ear overpressure and facial palsy is supported by the palsy's rapid onset following a reduction in ambient pressure and by its quick disappearance after either an increase in ambient pressure or release of the middle ear overpressure. Transient compression-induced ischemic neurapraxia of the facial nerve is also demonstrated in animal experiments. A similar palsy, ischemic neurapraxia of the fifth cranial nerve due to compression in the maxillary sinus, has been reported in divers. It is important to be aware of its existence, because misdiagnosis as type II DCS or air embolism results in unnecessarily long recompression treatments and pointless delay of resumption of diving. In the worst case, a misdiagnosis might cause a diving license to be revoked. 2) The symbol of the Olympic Games is composed of five interlocking rings, coloured blue, yellow, black, green, and red on a white field. This was originally designed in 1912 by Baron Pierre de Coubertin, the founder of the modern Olympic Games. According to de Coubertin, the ring colours with the white background stand for those colors that appeared on all the national flags that competed in the Olympic games at that time. |
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Re: Facial numbness and weakness, transient with air travel.
posted at 8/8/2012 4:37 AM BST
on bmj.com
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Posts: 2949
First: 10/3/2009 Last: 24/5/2013 |
In Response to Re: Facial numbness and weakness, transient with air travel.: 1) An interesting discussion! Baroparesis was first described in divers. A facial nerve palsy, as a result of middle-ear high pressure, is a rare complication of sub-aqua diving. It may occur as a result of an acute pressure change in the middle ear during ascent/descent in those patients who have experienced difficulty equalizing their middle-ear pressure during the prior descent. The correct diagnosis of this condition is important if unnecessary, and potentially hazardous, recompression treatment is to be avoided. If impaired eustachian tube function causes an overpressure to remain in the middle ear after ascent in diving or aviation in a subject with a defect in the wall of the facial canal, an ischemic neurapraxia of the seventh cranial nerve may occur. This type of facial palsy is designated facial baroparesis , baroparesis facialis , or alternobaric facial palsy . If the middle ear pressure is asymmetric the subject may also have alternobaric vertigo. A causative relationship between middle ear overpressure and facial palsy is supported by the palsy's rapid onset following a reduction in ambient pressure and by its quick disappearance after either an increase in ambient pressure or release of the middle ear overpressure. Transient compression-induced ischemic neurapraxia of the facial nerve is also demonstrated in animal experiments. A similar palsy, ischemic neurapraxia of the fifth cranial nerve due to compression in the maxillary sinus, has been reported in divers. It is important to be aware of its existence, because misdiagnosis as type II DCS or air embolism results in unnecessarily long recompression treatments and pointless delay of resumption of diving. In the worst case, a misdiagnosis might cause a diving license to be revoked. 2) The symbol of the Olympic Games is composed of five interlocking rings , coloured blue, yellow, black, green, and red on a white field. This was originally designed in 1912 by Baron Pierre de Coubertin , the founder of the modern Olympic Games. According to de Coubertin, the ring colours with the white background stand for those colors that appeared on all the national flags that competed in the Olympic games at that time. Posted by Dr. K. Ashutosh Thank you my colleague for your masterful reply. An interesting paresis and Greek compound word. I understand there are five rings for the five continents. Australia is both a continent and a country and is thus unique in the five rings. Please correct me if I am wrong. |
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Re: Facial numbness and weakness, transient with air travel.
posted at 8/8/2012 9:50 AM BST
on bmj.com
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Posts: 2059
First: 12/3/2010 Last: 23/5/2013 |
Weeeeeeeeeeeeeeeelll, allowing for Aussie braggadicio, up to a point Lord Odysseus. Various definitions of continents exist, of from four to seven: http://en.wikipedia.org/wiki/Five_continents They all contain "Australia" but the maps clearly indicate, as geology dictates that this should be "Australasia", including the islands of New Guinae, New Zealand et al. The five Olympic rings on the side of the Aquatic Centre are all white; they may be internally illuminated, but they weren't last night. And on a completely different note, tried to buy an Olympic flag, the five rings on a white ground, so that I might have a flag to wave that reflected my clinical detachment and impartiality (and my ingrained Internationalism). You can't get 'em. Even at the Park. Another sign of the frantic brand protection that IOC and LOCOG have inflicted? John |
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Re: Facial numbness and weakness, transient with air travel.
posted at 8/8/2012 10:14 AM BST
on bmj.com
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Posts: 2949
First: 10/3/2009 Last: 24/5/2013 |
I only mentioned the five rings continents bit as I was reading in a Greek lesson last night about the Athens Olympics and the book stated this. I was interested to see if it was correct. I was not bragging about my continental country as I really don't give a continental if it is so or not. We always regard New Zealand as part of the Australasia but funnily not New Guinea which is separated from us by a stone's thrown as it was all joined once. If any Olympic experts can set us straight... |
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Re: Facial numbness and weakness, transient with air travel.
posted at 9/8/2012 5:22 AM BST
on bmj.com
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Posts: 4
First: 9/8/2012 Last: 4/12/2012 |
According to the Olympic Charter (In force as from 8 July 2011), The Olympic symbol consists of five interlaced rings of equal dimensions (the Olympic rings), used alone, in one or in five different colours. When used in its five-colour version, these colours shall be, from left to right, blue, yellow, black, green and red. The rings are interlaced from left to right; the blue, black and red rings are situated at the top, the yellow 21 Olympic Charterand green rings at the bottom in accordance with the following graphic reproduction. The Olympic symbol expresses the activity of the Olympic Movement and represents the union of the five continents and the meeting of athletes from throughout the world at the Olympic Games. However, Wikipedia mentioned that the old official handbook stated that each colour corresponded to a particular continent (Europe, Asia, Africa, Australia+Oceania, Americas). The association of continents with colours have since been removed because it was not what the original designer intended. And it seems the continents are now referred to as 'Regions'. |
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