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Background: Congenital unilateral lower lip palsy (CULLP), also referred to as congenital asymmetric crying facies (ACF), is a rare condition that causes pronounced depression of the unaffected lower lip when crying, despite symmetric appearance of the mouth and lips at rest. Unlike the acquired form of ACF, CULLP is idiopathic and often involves permanent defect., Methods and Results: We present a case-based review of CULLP, including a thorough analysis of the relevant literature and a discussion of the exemplary case of 5-year-old patient presenting with unilateral facial asymmetry resulting from left-sided facial weakness. The patient was diagnosed with ACF at birth, and documentation from a previous neurologic consultation specifies the root cause of the asymmetry as developmental aplasia of the left depressor anguli oris muscle (DAOM). However, there is no record of electrodiagnostic testing or B-scan ultrasound imaging that would support this conclusion, and the patient's dysarthric speech may suggest lower motor neuron involvement. Botox chemodenervation of the right, unaffected side was recommended to deanimate the contralateral lower lip and achieve facial symmetry, in addition to potentially resolving some of the patient's speech difficulties., Conclusions: There are several approaches, both surgical and non-surgical, to the management and correction of CULLP. These include weakening the muscles of the contralateral side or increasing muscular tension on the ipsilateral side, referred to as deanimation and reanimation procedures, respectively., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Objective: To identify the dietary supplements most commonly promoted online for brain health and to compare their major ingredients over 18 months. Mild cognitive impairment and Alzheimer's disease are increasing globally with few effective treatments available. Dietary supplements are widely promoted in the media and online for brain health and memory improvement despite minimal evidence of an actual effect. Methods: Incognito mode on Google Chrome was used to conduct four separate searches using the terms: memory supplement, brain health supplement, Alzheimer's supplement, and dementia supplement. The four separate searches for products were conducted through CVS, Walgreens, Walmart, GNC, Amazon, Yahoo, and Google. For each website, the top 10 supplement products and their ingredients were documented in August 2017 and again in January 2019. Results: Of the four terms used, "memory supplement" and "brain health supplement" provided the most results. The most common products were Prevagen®, Procera®, and Neuro Health®. Amazon had the most repeated products in 2017 and 2019, while Google and CVS had the least. Focus Factor® appeared 11 times in 2019 compared with once in 2017. At both time points, the most commonly promoted products were proprietary blends of Ginkgo biloba, vitamins, particularly vitamin B12 and folic acid, huperzine-A, Bacopa monnieri, and phosphatidylserine. Conclusions: Though the 2017 and 2019 datasets showed diverse products, the primary ingredients were similar. These supplements have insufficient evidence of efficacy and are expensive. Health professionals must be knowledgeable about dietary supplements for brain health to appropriately counsel individuals.

Paired helical filaments (PHF) are the main component of the Alzheimer neurofibrillary tangle; however, other elements, such as 10 and 15 nm straight filaments and granular amorphous components, are observed. In the present study, the localization of the antigenic determinants recognized by an antiserum to PHF fractions that does not recognize normal nervous tissue components is examined by electron microscopic immunocytochemistry. Employing the peroxidase-antiperoxidase procedure on neurofibrillary tangles in intact tissue, we found that the antiserum reacts with PHF and with granular amorphous material within the tangle. Following isolation of PHF by treatment with ionic detergent and labeling with immunogold, the antigenic determinants often occur at intervals rather than being uniformly distributed along the PHF. The distribution of the antigenic determinants recognized by this antiserum is similar to that previously observed for PHF determinants recognized by antibodies to neurofilament and microtubule-associated proteins. We conclude that PHF are heterogenous structures which contain PHF-specific as well as cytoskeleton-derived antigenic determinants.