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In this article the indications and surgical treatment options for patients with facial nerve palsy are discussed. A distinction is made between static and dynamic surgical procedures. Static reconstructions for example are used to restore the eyelid closure function. For smile reconstruction, which is important for the psychosocial life of the patient, dynamic procedures are used. Depending on the duration of the facial nerve paralysis, there are several possibilities to restore the smile. In this work the masseteric branch transposition to the buccal branch, the hypoglossal-facial nerve anastomosis, the Labbé procedure and the gracilis flap as a free muscle transplant are discussed. The surgical procedures are compared and the advantages and disadvantages of the intervention are presented. A spontaneous smile is aimed, this cannot always be achieved. With the masseteric branch transposition to the buccal branch and the Labbé procedure the smile is initially triggered by chewing. A spontaneous smile is possible through cortical adaptation. With the gracilis flap, however, a nerve anastomosis with the contralateral 'healthy' facial nerve is possible, either directly or via a so-called cross facial nerve grafting, whereby a spontaneous smile can be achieved., Competing Interests: Erklärung zu finanziellen InteressenForschungsförderung erhalten: nein; Honorar/geldwerten Vorteil für Referententätigkeit erhalten: nein; Bezahlter Berater/interner Schulungsreferent/Gehaltsempfänger: nein; Patent/Geschäftsanteile/Aktien (Autor/Partner, Ehepartner, Kinder) an Firma (Sponsor der Veranstaltung): nein; Patent/Geschäftsanteile/Aktien (Autor/Partner, Ehepartner, Kinder) an Firma (Nicht-Sponsor der Veranstaltung): nein.Erklärung zu nichtfinanziellen InteressenDie Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht., (Thieme. All rights reserved.)

In the second half of the 20 th century, the sexual revolution went hand in hand with changes in common sexual practices. At the turn of the millennium, an increase in the detection rate of HPV-positive oropharyngeal carcinomas (OPC) in the USA was observed for the first time. An increase in the OPC was also observed in Europe. It was shown that this increase was due to HPV-positive OPC. However, the detection rate of the HPV-positive OPC has national and regional differences. Within Europe, the highest detection rate is in Northern Europe (56,5 %), followed by Central Europe (37,6 %). An association between patients with OPC and ≥ 6 sexual partners (OR = 1,25) and ≥ 4 oral sex partners (OR = 2,25) has been described. An HPV infection is usually asymptomatic and eliminated by the immune system within a few months. The persistence of the virus is oncogene. Smoking favors virus persistence, which is why the combination of smoking and oral sex with ≥ 5 partners is a particular risk factor. It was also examined whether partners from patients with cervical cancer have an increased oropharyngeal HPV infection rate. There was no definite declaration on this, but further investigations are required. Oral condoms or dental dams are suitable for the prevention of an oral HPV infection. The studies regarding the effectiveness of HPV vaccination for the prevention of an OPC are poor. Authors described a significantly lower detection rate of oral HPV infection in vaccinated people than in non-vaccinated people (0,11 % vs. 1,61 %; p = 0,008)., Competing Interests: Erklärung zu finanziellen InteressenForschungsförderung erhalten: nein; Honorar/geldwerten Vorteil für Referententätigkeit erhalten: nein; Bezahlter Berater/interner Schulungsreferent/Gehaltsempfänger: nein; Patent/Geschäftsanteile/Aktien (Autor/Partner, Ehepartner, Kinder) an Firma (Sponsor der Veranstaltung): nein; Patent/Geschäftsanteile/Aktien (Autor/Partner, Ehepartner, Kinder) an Firma (Nicht-Sponsor der Veranstaltung): nein.Erklärung zu nichtfinanziellen InteressenDie Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht., (© Georg Thieme Verlag KG Stuttgart · New York.)

In the legal judgment of suicidal cases following brain trauma the emphasis is put on the causality between trauma and suicide on the one hand, and on the question of free determination of intent, on the other hand. These problems are investigated empirically in the present study and an explanatory model based on act theory is proposed. At first, an annual sample of suicides in the region of Salzburg is put through a multidimensional diagnosis (suicidal axis syndrome-Mitterauer 1981). The suicidal axis syndrome consists of the following three components: 1. Suicide attempts in the history 2. Diagnosis of exogenous or (and) endogenous brain dysfunction 3. Suicide-positive history. Of a total of 130 exactly interpretable suicide cases there were 16 cases with a brain trauma followed by an organic brain syndrome in the history. Of these, 11 had announced their suicidal attempts previously and 4 presented with a suicide-positive family history. Although the assessment of suicide in the family history is difficult due to insufficient information, the suicidal axis syndrome was definitely confirmed in 4 suicide cases. We attempt to show that at least in those cases with a suicidal axis syndrome, the free determination of intent is to be negated at the moment of suicide, and that due to the existing chronic brain syndrome a causality between trauma and suicide seems to be given in a neuropsychiatric sense.

This study investigated the usefulness of the Contingent Negative Variation (CNV) in the assessment of therapeutic efficacy of a nootropic substance, Cerebrolysin. A total of 41 geriatric patients with the diagnosis of moderate organic brain syndrome of different etiology were included in this randomized placebo-controlled double-blind study. After ten Cerebrolysin- plus multi-vitamins-Infusions, the treatment group of 27 patients showed a significant CNV-amplitude increase as compared to pre-treatment values. In the placebo group of 14 patients CNV-amplitudes even decreased after ten Infusions with multi-vitamins alone. These findings were interpreted in line with the vigilance model of nootropic drug effects as a vigilance-increasing effect of Cerebrolysin, i.e. as an increased neuronal performance readiness. The results confirmed the usefulness of the CNV method by providing an EEG-index of nootropic drug effects.

The method given by the slimming institute "Figurella International", to lose weight without applying chemistry or dieting, is scrutinized critically. The ozone treatment, one of the compounds of the method, proves to be useless. To overcome the general problem caused by photochemical oxidants the company should be set under pressure to stand back from producing ozone, which proves to be a major air pollutant but not to have any effect on the result of the slimming programme.

A computerized analysis of EEg-records from 96 multiple sclerosis (MS) patients yielded about twice as many abnormal results (79%) in comparison to the usual visual EEG-evaluation (39%). The statistically significant (p less than 0.05) increase in slow frequencies in addition to beta frequencies to the cost of alpha, but especially the reduction in total percentage of alpha contribution to overall EEG-power discriminated most efficiently between MS-patients and our normal population. Thus, alpha index alone allowed for 87% correct classification of the normal population, and 73% of patients with normal visual EEG-records were correctly classified as belonging to the MS-population. Extending the patient group to include pathological visual EEG-records as well, the corresponding figures were 95% and 89%, respectively. The computerized EEG-analysis was thus clearly superior to the usual visual inspection.

Stereotyped acts of a mentally defective girl. 6;6 years old, were observed from 6 a.m. till 8 p.m. during 16 days. Alternating phases of more or less frequent stereotyped hand waving showed a prominent periodicity of about 90 minutes. Sleep stages were also determined polygraphically during 10 nights. As statistically proved the mean peak-to-peak interval of the stereotyped activity at days corresponded to the mean REM- to REM period of nights. This suggests, that the stereotyped behavior of this child was driven by the basic rest activity cycle already described by Kleitman. The mean periodicity of sleep stages was represented by modeled rhythms adapted to the scored sleep stages. If the model rhythms of all 10 nights were extended backward to the preceding days, they paralleled the stereotyped activity. Half periods found in phase with REM stages corresponded to the maxima of the stereotyped activity. It will be discussed that the basic rest activity cycle triggers sensory as well as motor mechanisms characterizing both the phases of enhanced stereotyped activity and REM stages.

Symptoms such as tinnitus, hearing and taste disorders and facial palsy seldom occur in multiple sclerosis. Although ENT symptoms are few, vestibular and acoustic stapedius reflex tests combined with brainstem auditory evoked potentials (BAEPs) are available, and may give very useful evidence of the existence of MS. 52 patients with definite MS, and 13 patients with probable MS were examined (classified according to the McAlpine criteria). The vestibular and acoustic stapedius reflex tests were abnormal in 51%/61% and 61%/53% respectively of both groups. The corresponding figures for BAEP were 69% and 63%. The combination of the three tests on all patients showed at least one pathological finding.

EMG as well as EEG of a two years old girl with cerebral palsy was recorded continuously during four days and nights. Mathematical analysis (autocorrelations and spectra of variance) revealed an ultradian periodicity (1.5--2.5 hours) of all recorded functions. Especially, a 1.5-hour period was seen in records of EMG (m. triceps surae) during days. These findings are discussed with respect to Kleitman's basic rest activity cycle. The ultradian rhythm of motor activity in children with cerebral palsy should be taken into account, especially with respect to timing and programs of physical therapy.

A central topic of recent research on multiple sclerosis (MS) concerns the development of sensitive neurophysiological techniques with the ability to detect lesions at the earliest possible stage. Specifically, the recording of evoked potentials has during the past decade demonstrated its diagnostic value by disclosing clinically silent lesions especially of the optic nerve and brainstem region. The visual evoked potential (VEP) was registered in 177 patients with definite, probable and possible MS (McAlpine). Abnormal latencies were obtained in 86/46/34% of these three patient groups, respectively. 44% of all MS-patients without clinical or anamnestic evidence of optic nerve dysfunction showed delayed VEPs. The brainstem auditory evoked potential (BAEP) enables topodiagnostic statements to be made regarding brainstem lesion site. This is very valuable, since the brainstem region is especially prone to demyelination, which clinically as well as morphologically often evades detection. 74/60/48% of our definite, probable and possible MS-patients had pathological BAEPs. 50% of asymptomatic patients had an abnormal BAEP-result. Computer tomography yielded brainstem pathology in only 10% of all MS-patients.