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Byline: Scott Pitoniak The prognosis was beyond gloomy. It sounded more like a death sentence. Ricky Palermo was told that not only would he never walk again after being paralyzed [...]

A possible complication of total hip replacement surgery is nerve palsy, the temporary or permanent loss of sensation or loss the ability to move. This complication occurs in from 0.6 to 3.7 percent of patients who have total hip replacement procedures. Peripheral nerve injuries can occur as a result of nerve laceration, ischemia (decreased blood supply), mechanical injury such as compression or separation, or a combination of these circumstances. A review was undertaken of all patients who developed nerve palsy following total hip replacement during a 17-year period to determine long-term follow-up and prognosis and to identify patients at risk. There were 3,126 operations performed; the overall incidence of nerve palsy was 1.7 percent. The incidence of nerve palsy was significantly higher for patients with congenital dislocation of the hip (5.2 percent) and for patients who underwent revision procedures (3.2 percent) than for patients who had joint replacement for osteoarthritis (1.0 percent). The sciatic nerve (the body's largest nerve which passes from the lower spine down the back of the thigh) was involved in 80 percent of the neuropathies. Fifty-three extremities were reevaluated at follow-ups ranging from 1 to 16.5 years after surgery. Only 7 limbs recovered complete neurologic function; 18 limbs had mild weakness, sensory loss and/or mild dysesthesia (abnormal sensations such as numbness or tingling on the skin); and 15 limbs had more severe weakness. Six additional patients had limited walking ability, and seven patients had severely impaired motor function. All patients who had a nerve palsy had decreased walking ability. Patients younger than 48 years who had undergone primary hip replacement had the greatest disability. The degree of nerve injury influenced the prognosis of neurological recovery. All patients who maintained motor function or recovered some motor function during hospitalization made a good recovery. Patients with severe dysesthesia did not recover neurological function. (Consumer Summary produced by Reliance Medical Information, Inc.)

Foix-Chavany-Marie syndrome (FCMS) or anterior opercular syndrome is a rare neurological syndrome most commonly caused by cerebrovascular accident. The anatomical substrate of the classical (clinical type A) FCMS is constituted by any combination of bilateral cortical (opercular) or subcortical (subopercular) lesion, typically as a result of subsequent strokes. FCMS is characterized by facio-labio-pharyngo-glosso-masticatory paralysis with automatic-voluntary dissociation where involuntary movements of the affected muscles are preserved. A 79 year old woman with FCMS is presented to discuss the assessment, treatment and prognosis for patient's eventual return to oral feeding. Keywords: Foix-Chavany-Marie syndrome | Anterior opercular syndrome | Rehabilitation | Dysphagia, Introduction Foix-Chavany-Marie syndrome or anterior opercular syndrome was first reported by Magnus in 1837. (1) It is also known as facio-labio-pharyngo-glosso-masticatory paralysis with automatic-voluntary dissociation. FCMS is a rare cortico-subcortical [...]

It's usually not a promising prognosis for patients once the connection between the brain and muscles becomes severed or disrupted in some way. Whether through spinal cord injury, a stroke, [...]