What's the diagnosis when facial swelling and paralysis develop?

Article Abstract:

The case history is presented of a 44-year-old woman who developed facial swelling and paralysis on the left side of the face about one week after she contracted an upper respiratory infection. Other symptoms included fatigue, difficulty swallowing, and dry mouth, as well as numbness on regions of the trunk and limbs. Several examinations were performed, including X-ray and laboratory studies, nuclear medicine scans, and biopsy of a salivary gland from the lower lip. Evaluation of the biopsy showed abnormal areas of fibrous tissue growth and the presence of granulomas (clusters of cells associated with inflammation). Possible diagnoses for this combination of signs and symptoms are discussed. The diagnosis was neurosarcoidosis (sarcoid), a condition in which granulomas form in organs throughout the body, including on nerves. To distinguish neurosarcoidosis from an autoimmune disorder (Sjogren's syndrome), biopsy of the lower lip is often performed, which helps confirm the diagnosis. Other biopsy sites are the liver (associated with complications) and skin sites (often ineffective). The symptoms of sarcoid include fatigue, weight loss, facial swelling, and eye and skin lesions. Symptoms vary according the organs affected; ultimately, the diagnosis is made by excluding other possibilities. A lengthy discussion of the diagnostic work-up is presented. Patients with sarcoid have a good prognosis, and are usually treated with corticosteroid drugs. Many (65 percent) recover, but many have minimal or permanent damage. Approximately 10 percent die because of pulmonary or cardiac complications (related to the pulmonary changes). The patient's sensory abnormalities were successfully treated with corticosteroids. (Consumer Summary produced by Reliance Medical Information, Inc.)

Case studies, Diagnosis, Causes of, Prognosis, Edema, Sarcoidosis, Paralysis, Facial, Facial paralysis

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The diagnosis and treatment of central giant cell granuloma

Article Abstract:

Central giant cell granulomas (CGCG) are benign tumors which may sometimes be found in the jaw area. An eight-year-old girl was found to have a 4 cm round CGCG in the front lower jaw, which prevented several of her teeth from erupting. The tumor and three of the primary teeth were removed by an oral surgeon. CGCG tumors should be completely removed, as they can recur 10% to 15% of the time. Other benign and malignant tumors of the jaw are discussed. CGCG of the jaw occur more often in female children and young adults.

Mouth tumors, Giant cell tumors

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Intralesional corticosteroid injection for treatment of central giant-cell granuloma

Article Abstract:

The authors describe a lesion diagnosed in the jawbone of a 10-year old girl. Such lesions are generally treated with surgery, but because of the risk of deformity, other than a biopsy, the authors tried a nonsurgical approach, using a series of six weekly corticosteroid injections, and the therapy was successful, eliminating the lesion.

Drug therapy

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