Klippel-Feil Syndrome

Alright folks. Here is something interesting and cool looking, but not cool for the patient. I am going to talk about Klippel-Feil Syndrome which is a condition where portions of the spine fuses together. There are three different classifications of Klippel-Feil Syndrome. Type one is when all of the cervical vertebrae and the upper thoracic vertebra are fused together. Type two Klippel-Feil Syndrome is where there are a few cervical vertebrae that are fused together, and Type three Klippel-Feil Syndrome is when there is also thoracic and Lumbar fusion along with the cervical vertebrae. This is commonly found with individuals who are born with this condition.

SYMPTOMS OF KLIPPEL-FEIL SYNDROME

There are three main symptoms that seem to be apparent with individuals who have Klippel-Feil syndrome. These individuals will have a low hair line, short neck, and a neck that has low mobility. Most of the times individuals who have this condition do not even know that they have it and it is found by incidental findings. For hose individuals who have severe cases of Klippel-Feil syndrome will come in with wry neck, which is abnormal twisting of the neck to one side or the other, sometimes with twitching. Patients will also present with severe abnormalities of the urinary system and some neurological symptoms of numbness, tingling or or weakness due to the vertebrae may be impeding on the nerves and vessels of the spine. Klippel-Feil syndrome is believed to occur during the eighth week of gestation and so that is why physicians belive that there is a relationship with individuals who have Klippel-Feil syndrome and abnormalities of the urinary system.

TREATMENT

For these individuals most of the time treatment will not be needed, however for those individuals with severe cases, they might need surgery to fix the cervical fusion, which will release any pressure that might be impeding on the vessels of the neck or nerves. Physical Therapy is also an option that can aid in the mobility of the neck.

BOW HUNTERS SYNDROME

Bow hunter's syndrome is an interesting syndrome in that it is named after how a bow hunter's who usually turn their head significantly to shoot the bow and arrow. Bow Hunter's syndrome is a condition where the contralateral vertebral artery is stenosed, compressed, or occluded. Since the vertebral arteries supply blood to the posterior portion of the cranium, then patients are going to have issues with sight, vertigo and occasions of syncopy. When the condition is severe then when the patient turns their head toward the effected side of the neck then the patient will experience serious symptoms of syncopy and will be temporarily resolved once the patient turns their head back to a neutral position. If the condition does worsen then a patient will have what is called a Bow Hunter's Stroke, also known as an ischemic stroke.

Physicians are able to use CT angiography to see the seriousness of the vertebral artery. The patient will have to turn their heads throughout the study so that images of the vertebral artery in different positions can be viewed. Other ways to view the possibility of diagnosing Bow Hunter's syndrome could be Dopler Ultrasound and/or Cerebral Angiography.

If the patient is having compression from the vertebral bone of C1 or C2 then a surgeon can go in and perform surgery to release the compression of the artery. Many times ligaments or tendons in the neck are compressing on the artery and then measures can be taken to release the compression of the artery by those surrounding structures.

carcinoma of the tongue

Can you imagine only having half of your face left because of carcinoma of the tongue that has metastasized to other portions of your face? I do believe that would make life a bit harder, but would definitely teach you a good lesson in life about why we should take care of ourselves.

First of all you need to understand that there are two parts of the tongue. There is the part that is considered the oral tongue and there is the part that is identified as the base of the tongue. This is important because the patient will exhibit different signs and there are different treatments whenever a patient is diagnosed with carcinoma of the tongue.

Squamous Cell Carcinoma of the tongue is by large the main type of cancer that occurs in the tongue, but there are other types of rare forms of cancer. Usually an individual will come to a physician complaining of tongue pain, a lesion that just will not go away, sensitivity of a lesion that is easily irritated and bleeds easily for a long period of time, difficulty swallowing, change in the sound of the patients voice, or sometimes a patient will exhibit a sense of being full. Most of the time the lesion is located on one side of the tongue and strays from the normal pink hue that a tongue usually has, when referring to cancer of the oral tongue. Now with carcinoma of the base of the tongue the patient is going to exhibit the symptoms that seem to be a little more severe, like the changing of the sound of the voice, difficulty swallowing, possible neck pain( due to metastasizing).

Most of the time a patient who has been diagnosed with have two main options. The individual will be given the opportunity of surgery or radiation therapy. Most of the time surgery is pushed due to the fact that a patient who may have recurring lesions, then radiation therapy will be an option. Some patients might complain about how surgery could possibly disfigure there tongue therefore causing issues with speech, but doctors like to point out that there is hardly in change in how a patient might speak if any change. It is debatable though about what method is best for the patient. those individuals who do have poor heart health and would be put in a dangerous situation if placed under anaesthesia, then these individuals are good candidates for radiation therapy.

Unfortunately many individuals will let tongue cancer go and this will cause metastisation that will travel down to the neck and up to the brain. Individuals are recommended to see a dentist on a regular basis so that they may be able to get check ups regularly to monitor any possibilities of carcinoma of the tongue to occur.

Nasal Polypsosis

I could not pass this picture up. Hello Nasal polyposis!!!!!!!!!!!!!!!!!!!!!!

O.K. Nasal polyposis is a condition where the patient has polyps in the nasal septum. Patients will normally have symptoms difficulty breathing through the nostrils, a hyponasal voice and dysgeusias, which is an abnormal change in the sense of taste. Misdiagnosis is not uncommon with nasal polyposis because of the like symptoms that go with allergies or sinusitis.

TREATMENT

I thought this was interesting. I found out that nasal polyps were actually considered an ailment in ancient Egypt over three thousand years ago. They would cure these "polyps" by taking a sponge that had a string attached with a tin piece attached to the end and would run the sponge through the nose and have the sponge come out of the mouth. This would bring the polyps out through the mouth. Now days we usually can either use a topical steroid cream or for patients who have very large nasal polyps then the decision of surgically removing the polyps is an option. However those patients who do have nasal polyps usually have a very high percentage rate of forty to sixty percent.

Brown's Syndrome

Brown's syndrome is a syndrome that usually occurs at birth or can occur with time. Cases of Brown's disease being originated through heredity are very rare. Other causes could come from surgeries, trauma to the eye, or conditions of chronic inflammation like rheumatoid arthritis or sinusitis.

The tell tale sign of Brown's disease is that an individual has an eye that looks strange whenever they look up or inward toward their nose. Now when you look at this picture you would think that the child's right eye (in anatomical view) is the one that is effected, but it is actually the child's left eye that is effected. With Brown's syndrome, the superior oblique tendon or muscle of the patients eye is unable to move around freely, due to hardening or inflammation of the tendon, and so the individuals lower eye is unable to look up freely. Something that I found interesting was from the website http://www.aapos.org/displaycommon.cfm?an=1&subarticlenbr=71 was that most individuals who have Brown's syndrome have this occur in their right eye. This is not true for this child in the picture above.

Some other symptoms that can occur and this is usually with severe cases is severe double vision, binocular vision is affected (the ability of both eyes to work together), or you start to notice that the patients head in comparison to where they are looking does not look normal.

There are different classifications of Brown's syndrome and it all depends on the severity of the eye. In the most severe of cases the individual will be looking forward and their affected eye will be looking toward the ground. In mild cases the affected eye will usually only be affected when the patient looks up, but in moderate cases the eye will start to appear to be looking down a bit when ever the patient looks in toward their nose.

The treatment of the patient will depend on the severity and origin of the Brown's syndrome. For the cases that are severe, patients will be advised to have surgery. For the moderate cases, medication can be given to reduce the inflammation of the tendon and hopefully give the tendon some more elasticity to move around freely. With the mild cases, parents and physicians will usually just monitor the child closely to make sure the condition does not worsen. In the cases where the Brown's syndrome is brought on by surgery or trauma, those patients may either need surgery to correct the issue or the condition may better itself with time.

PROLACTINOMA

Prolactinoma is a condition where there is a tumor on the pituitiary gland and it causes the overproduction of prolactin into the body, which is known is hyperprolactinemia. This can do several things to the body and I will go over that today.

SYMPTOMS

Just like an adenoma, the prolactinoma has two classifications, a microprolactinoma and a macroprolactinoma. The size of the prolactinoma will determine what kind of symptoms that an individual will have. I was able to find some information about how a prolactinoma affects men and women differently. With a prolactinoma that is very large in size, this will of course effect your vision because the optic nerves criss cross right above the pituitary gland and so if you have a tumor that is large enough in size, this will push up on those optic nerves causing inflammation which there fore will affect your vision.

For prolactinoma' s that are not large in size some other symptoms for women that may occur but are not limited to amenorrhea (cease in menstruation) and galactorrhea (milk production) when the female is not pregnant.

Some symptoms that may occur for men would be gynecomastia, which is unexplained beast enlargement, shrinkage of the testes, a sex drive that has diminished or is non-existent, and the possibility of being infertile if the prolactinoma is left untreated.

TREATMENT

Treatment for a prolactinoma is usually not surgical. Most of the time an individual will be given medication to reduce the production of prolactin and this will most often then not shrink the tumor which will decrease the symptoms that occur with prolactinoma. Usually the only time that an individual will receive surgery is if the pain or vision affects the patient to where it is unbearable or if the patient cannot handle the medications that can be given to decrease the release of prolactin.

LABYRINTHITIS

Hello to you all. How on earth are you doing? Well here we are again and now we are going to learn about Labyrinthitis. I thought that this picture was really cool because I don't know about you guys but I always thought that Labyrinth was a pretty interesting movie. Alrighty roo here we go.

DESCRIPTION

Labyrinthitis is a condition where the inner ear becomes inflamed in the area called the labyrinth or what we would know it as, the three semicircular canals and the cochlea. Remember that we learned that the cochlea deals with hearing and the semicircular canals deal with balance and equilibrium. A labyrinth is just what it says, basically a labyrinth of fluid-filled canals and sacs that are all connected. These canals connect to the vestibule, which is the portion that sends information to the brain, hence the vestibular nerve. So you can understand that if this area becomes inflamed then there is information that is going to the brain that is inaccurate and how it might affect an individuals ability to hear or their balance.

Another interesting aspect that I learned about Labyrinthitis is that we see things around us all the time and that we are able to stand up and walk and balance on one leg. So if you are seeing something and your body is not receiving the same information, in regards to balance, then you start to feel vertigo. So lets say that you are walking in a straight line and you turn around a corner to walk on a different street then the information that your vestibular nerve is sending to the brain will not match what you are seeing, so you will become dizzy or experience vertigo.

CAUSES OF LABYRINTHITIS

There are actually several possibilities for the cause of labyrinthitis, but most of the time this condition will proceed an upper respiratory infection or an infection that is viral or bacterial in origin, like the common cold or the flu. Other possibilities could be allergies, trauma to the hear and/or ear, alcohol abuse, a tumor that occurs in the middle ear, and certain medications like Dilantin (medication used to control seizures), some antibiotics administered intravenously, Lasix (which is used for the treatment of edema due to congestive heart failure ), and aspirin. Also severe stress so you should probably start doing some yoga if you find yourself getting too stressed.

SYMPTOMS

Some symptoms that can occur with labyrinthitis can be vertigo, nausea, loss of balance, and vomiting. Other symptoms that could occur would be headaches, tinnitus( a ringing or rushing noise that occurs within the ear), some hearing loss.

TREATMENTS

Treatments would include to monitor your diet and cut back on the salt and sugar that you digest, you can also lie down on your side, you also should probably cut back on the chocolate, cigarettes, and coffee if you have labyrinthitis. Medicinal treatments can be a route because of the origin of the labyrinthitis to begin with is usually from a viral or bacterial infection. There are also some exercises that you can do that can help speed up the recovery time of labyrinthitis. The exercises are called Brandt and Daroff exercises and the Epley maneuver. You can look at www.emedicinehealth.com/labyrinthitis for an explanation of all of the exercises, but I will give you a quick run down. You would look to your right side really fast and then lie down on your left side while keeping your head facing toward the right, and you repeat this on the opposite side as well. You do repetitions of the different exercises and this is suppose to aid in your recovery time.