WordNet

related to the key issue but not of central importance; "a peripheral interest"; "energy is far from a peripheral issue in the economy"; "peripheral issues"
(computer science) electronic equipment connected by cable to the CPU of a computer; "disk drives and printers are important peripherals" (同)computer peripheral, peripheral device
on or near an edge or constituting an outer boundary; the outer area; "Russias peripheral provinces"; "peripheral suburbs"
of or pertaining to the outside surface of an object
care for the face that usually involves cleansing and massage and the application of cosmetic creams
cranial nerve that supplies facial muscles (同)facial_nerve, nervus_facialis, seventh_cranial_nerve
of or concerning the face; "a facial massage"; "facial hair"; "facial expression"
a condition marked by uncontrollable tremor
affect with palsy
become friends; act friendly towards (同)pal up, chum up

PrepTutorEJDIC

周囲の; 周辺（装置）の・末梢的な・重要でない; （...に比べて）瑣末な (to); 【医】末端部の; コンピュータの周辺装置
顔の;顔用の / (マッサージや化粧品による)顔の手入れ
麻痺(まひ),中風 / …‘を'麻痺させる(paralyze)
《話》『友達』,仲間,親友 / (…と)仲よくなる《[『up』]『with』+『名』》

UpToDate Contents

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1. ベル麻痺：成人における病因、臨床的特徴、および診断 bells palsy pathogenesis clinical features and diagnosis in adults
2. 小児における顔面神経麻痺 facial nerve palsy in children
3. ベル麻痺：成人における予後および治療 bells palsy prognosis and treatment in adults
4. 神経サルコイドーシス neurologic sarcoidosis
5. 成人における詳細な神経学的検査 the detailed neurologic examination in adults

English Journal

Cerebral microbleeding in varicella-zoster viral meningitis: An early sign of vasculopathy?

Ohtomo R1, Shirota Y, Iwata A, Shimizu J, Tsuji S.Author information 1From the Graduate School of Medicine, The University of Tokyo, Japan.AbstractA 75-year-old man undergoing chemotherapy for prostate cancer for 3 months presented with headache after having blisters in his left ear canal and auricle. His body temperature at presentation was 38°C. Neurologic examination revealed nuchal stiffness and left peripheral facial palsy. We also noted leukocytopenia (2,000/µL) and elevated serum C-reactive protein (8.51 mg/dL). CSF analysis showed no erythrocytes, elevated leukocytes (640/µL; 3% monocytes, 97% neutrophils), an increased protein level (473 mg/dL), and slightly decreased glucose level (51 mg/dL, serum glucose 120 mg/dL). Brain MRI and magnetic resonance angiography (MRA) on the day of admission were normal except for irregular gadolinium (Gd) enhancement of the cerebral sulci and basal meninges consistent with meningitis (figure, A-E). Upon noting Ramsay Hunt syndrome from the patient's clinical history and considering the known predominance of neutrophils in CSF in early cases of varicella-zoster virus (VZV) infection of the nervous system,(1) we initiated treatment with IV acyclovir (ACV; 1,800 mg/day) for suspicion of VZV meningitis. The patient's symptoms then gradually improved. Existence of VZV within CSF was later confirmed by PCR testing and high anti-VZV immunoglobulin M (IgM) antibody index (1.68; normal range <0.8) results. Two weeks after ACV treatment initiation, follow-up MRI showed attenuated Gd enhancement of the meninges; unexpectedly, diffusion-weighted imaging (DWI) showed a small acute infarction of the right insula (figure, F), and T2-weighted imaging (T2*WI) showed microbleeding in the left anterior cingulate gyrus (figure, G) and the midbrain interpeduncular fossa (figure, H). MRA revealed no apparent narrowing or malformation of the arteries. Without risk factors for cerebrovascular disease such as arrhythmia, hypertension, or coagulation abnormality, our clinical and radiologic findings taken together with patient history suggested small-vessel vasculopathy associated with VZV infection; therefore, oral dexamethasone (DEX; 1 mg/day) was added to the original treatment. Both ACV and DEX were continued for 2 months until the CSF testing and the anti-VZV IgM antibody index returned to normal. No clinical or radiologic signs of relapse were detected during the therapeutic course.
Neurology.Neurology.2014 Mar 4;82(9):814-5. doi: 10.1212/WNL.0000000000000165. Epub 2014 Jan 24.
A 75-year-old man undergoing chemotherapy for prostate cancer for 3 months presented with headache after having blisters in his left ear canal and auricle. His body temperature at presentation was 38°C. Neurologic examination revealed nuchal stiffness and left peripheral facial palsy. We also noted
PMID 24463624

Vocal cord paralysis associated with Ramsay Hunt syndrome: looking back 50 years.

Rasmussen ER1, Mey K.Author information 1Department of Otorhinolaryngology Head and Neck Surgery, Koege Hospital, Koege, Denmark.AbstractRamsay Hunt syndrome is defined by herpes zoster oticus and peripheral facial nerve palsy which is often associated with otalgia. The syndrome is, in rare cases, associated with other cranial nerve paralyses including the vagal nerve causing unilateral vocal cord paralysis. Vocal cord paralysis is more often seen as a symptom of various other diseases, that is, malignant tumours, neurodegenerative illness, cerebrovascular assaults, inflammatory processes or as a result of intubation or surgical procedures. The symptoms of unilateral vocal cord paralysis are mainly hoarseness, dyspnoea and dysphagia. We present a case of Ramsay Hunt syndrome combined with unilateral hearing loss and left vocal cord paralysis. The patient underwent MRI, CT and a lumbar puncture causing anxiety in the patient and delaying the initiation of antiviral and anti-inflammatory treatment, which is only efficient when initiated within 72 h. We hope to raise the awareness of this disease.
BMJ case reports.BMJ Case Rep.2014 Feb 6;2014. pii: bcr2013201038. doi: 10.1136/bcr-2013-201038.
Ramsay Hunt syndrome is defined by herpes zoster oticus and peripheral facial nerve palsy which is often associated with otalgia. The syndrome is, in rare cases, associated with other cranial nerve paralyses including the vagal nerve causing unilateral vocal cord paralysis. Vocal cord paralysis is m
PMID 24503657

Outcome-dependent coactivation of lip and tongue primary somatosensory representation following hypoglossal-facial transfer after peripheral facial palsy.

Rottler P1, Schroeder HW, Lotze M.Author information 1Functional Imaging Department, Institute of Diagnostic Radiology and Neuroradiology, University of Greifswald, Germany; Department of Neurosurgery, University of Greifswald, Greifswald, Germany.AbstractA hypoglossal-facial transfer is a common surgical strategy for reanimating the face after persistent total hemifacial palsy. We were interested in how motor recovery is associated with cortical reorganization of lip and tongue representation in the primary sensorimotor cortex after the transfer. Therefore, we used functional magnetic resonance imaging (fMRI) in 13 patients who underwent a hypoglossal-facial transfer after unilateral peripheral facial palsy. To identify primary motor and somatosensory tongue and lip representation sites, we measured repetitive tongue and lip movements during fMRI. Electromyography (EMG) of the perioral muscles during tongue and lip movements and standardized evaluation of lip elevation served as outcome parameters. We found an association of cortical representation sites in the pre- and postcentral gyrus (decreased distance of lip and tongue representation) with symmetry of recovered lip movements (lip elevation) and coactivation of the lip during voluntary tongue movements (EMG-activity of the lip during tongue movements). Overall, our study shows that hypoglossal-facial transfer resulted in an outcome-dependent cortical reorganization with activation of the cortical tongue area for restituded movement of the lip.
Human brain mapping.Hum Brain Mapp.2014 Feb;35(2):638-45. doi: 10.1002/hbm.22206. Epub 2012 Nov 5.
A hypoglossal-facial transfer is a common surgical strategy for reanimating the face after persistent total hemifacial palsy. We were interested in how motor recovery is associated with cortical reorganization of lip and tongue representation in the primary sensorimotor cortex after the transfer. Th
PMID 23124599