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Tumours, Facial Palsy and Cerebral Palsy |
Tumours
Tumours may arise in various components of the CNS and may be primary or metastatic, the latter being more common in the brain. Benign brain tumours are still a significant problem as they may cause pressure effects and may not be amenable to surgery due to their site. Headaches are characteristically worse in the morning. Tumours from which cerebral metastases arise include lung, breast, GIT and kidney.
Facial Palsy
A facial palsy may have a known cause or be idiopathic If the cause is not known the name Bell's Palsy is applied. In Bell's Palsy the onset is rapid, unilateral and there may be an ache beneath the ear. The weakness worsens over one to two days. If presentation is early, most clinicians give Prednisolone for 5 days, the aim being to reduce neuronal oedema. An eye patch is of value to protect the cornea. The paralysis is of a lower motor neurone type in which all the facial muscles are affected on that side. In an upper motor neurone lesion e.g. stroke, the forehead is spared since this region is bilaterally represented in the cortex. Looking for 'forehead sparing' is thus a way of differentiating between upper and lower motor neurone causes of facial weakness.
Cerebral Palsy
Cerebral Palsy is primarily a disorder of motor function secondary to cerebral damage, most frequently associated with birth injury or hypoxia. It is the most common cause of a congenital physical handicap, the patterns of which are variable. There are three main subtypes - spastic, ataxic and athetoid varieties. 1. In the spastic type the muscles are contracted and there may be associated epilepsy. 2. In the ataxic type, a cerebellar lesion is responsible for a disturbance of balance. 3. Writhing movements characterise the athetoid type of cerebral palsy.
REF: British Dental Journal 12 July 2003; Volume 195, No. 1
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