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"description": "",
"etiology": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Физиологические причины</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">У здорового человека подергивание верхнего века потенцируется следующими факторами:</span></p>\r\n<ul>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Стрессовые состояния. При интенсивном остром или умеренном хроническом стрессе симптом вызывается выраженными отрицательными эмоциями и психоэмоциональным перенапряжением.</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Недосып. Из-за плохого качества или недостаточного количества сна мышцы в области верхнего века не расслабляются. Длительное перенапряжение становится причиной подергиваний.</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Высокая зрительная нагрузка. Наблюдается при неправильном подборе очков и контактных линз, продолжительной работе за компьютером или использовании гаджетов.</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Лекарства и напитки. Нарушение может возникать на фоне приема спиртного, злоупотребления кофеинсодержащими напитками, лечения антигистаминными препаратами и некоторыми антидепрессантами.</span></li>\r\n</ul>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Неврит лицевого нерва</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Патология чаще манифестирует болями за ухом. Через некоторое время становится заметным одностороннее подергивание века с последующим развитием асимметрии лица: опущением уголка рта, сглаживанием носогубной складки, невозможностью полностью закрыть глаз. Мимические движения при неврите на пораженной стороне ослаблены или отсутствуют, вкусовые ощущения снижены. Возможно слезотечение.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Неоплазия ствола мозга</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Для опухолей ствола мозга характерна значительная вариабельность симптоматики, обусловленная большим количеством различных структур, расположенных в этой области. Симптом возникает вследствие сдавления или прорастания ядра лицевого нерва, сопровождается другими проявлениями неврита. Возможны косоглазие, нистагм, тугоухость, ухудшение координации движений, реже – парезы.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Идиопатический блефароспазм</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Является вариантом локальной торсионной мышечной дистонии, развивается на фоне расстройств кровообращения и органических поражений церебральных структур. На начальной стадии блефароспазм проявляется неинтенсивным подергиванием век, которое в последующем переходит в двухстороннее зажмуривание, не поддающееся сознательному контролю. Приступы в среднем продолжаются 3-5 минут, возникают без связи с внешними воздействиями. В последующем спазмы распространяются на мышцы лица и шеи.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Другие неврологические болезни</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Подергивание верхнего века может наблюдаться при следующих заболеваниях:</span></p>\r\n<ul>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Боковой амиотрофический склероз. Время появления признака зависит от формы патологии. На начальном этапе симптом иногда выявляется при БАС с прогрессирующим бульбарным параличом. У пациентов с шейным и поясничным дебютом нарушение присоединяется на развернутой стадии.</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Рассеянный склероз. Существует множество вариантов манифестации, в том числе – с подергиванием век, оптическим невритом, нистагмом, головокружением. Часто отмечаются слабость в ногах, онемение. В последующем формируются парезы, мозжечковые и пирамидные расстройства.</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Синдром Гийена-Барре. Как правило, первыми проявлениями становятся сенсорные расстройства и слабость мышц, распространяющиеся от нижних конечностей к верхним. В отдельных случаях ранними признаками являются подергивание верхнего века, глазодвигательные нарушения, дисфагия и дисфония. Затем развиваются симметричные парезы различной степени выраженности.</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Нейромиотония. Постоянное подергивание разных мышц, включая мускулатуру верхних век, является основным признаком патологии. Отмечаются усиление мышечного напряжения, продолжительные тонические сокращения, постуральная неустойчивость, вегетативные расстройства.</span></li>\r\n<li></li>\r\n</ul>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Психические расстройства</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 7pt; font-family: Verdana; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Подергивание верхнего века выявляется при неврозах у взрослых. Наиболее характерно для неврастении, психических расстройств с преобладанием вегетативных и соматических симптомов. В рамках неврозов у детей также обнаруживается при неврастении, иногда – при неврозе навязчивых состояний. Является характерным признаком одной из разновидностей малосимптомного невротического расстройства – тиков.</span></p>\r\n<p><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\"> </span></p>",
"pathogenesis": "",
"diagnostics": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Диагностические мероприятия осуществляются врачом-неврологом. Пациентов с болезнями глаз направляют на консультацию к офтальмологу. При подозрении на наличие невроза требуется участие клинического психолога, психотерапевта или психиатра. Специалист уточняет время первого появления, частоту и продолжительность приступов, выявляет другие жалобы. В рамках дополнительного обследования назначаются следующие процедуры:</span></p>\r\n<ul>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Неврологический осмотр. У здоровых людей нарушения отсутствуют. При неврозах возможно незначительное повышение рефлексов. У больных с невритом обнаруживается асимметрия, односторонний парез различной тяжести. При других неврологических патологиях могут определяться парезы, мозжечковая атаксия, офтальмоплегия, расстройства чувствительности, иные нарушения.</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">МРТ головного мозга. Является ведущей диагностической методикой, позволяющей дифференцировать опухоли, идиопатический блефароспазм, рассеянный склероз, БАС и прочие неврологические поражения. Позволяет определить характер, локализацию и распространенность патологического процесса, оценить состояние церебральных структур, оболочек, интракраниальных сосудов. Для повышения информативности может проводиться с использованием контраста.</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Электрофизиологические методы. Пациентам с идиопатическим блефароспазмом назначают реоэнцефалографию для исключения ишемической природы патологии. При БАС, неврите и рассеянном склерозе применяют электромиографию, электронейрографию, исследование вызванных потенциалов для уточнения уровня поражения, оценки скорости проведения импульсов, выявления фасцикуляций и фибрилляций.</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Офтальмологические исследования. При аллергическом конъюнктивите в ходе осмотра определяют характерные изменения (покраснение, отек, гиперплазию сосочков). При сухости глаз производят биомикроскопию, флуоресцентную пробу, тест Ширмера. Больным с идиопатическим блефароспазмом выполняют офтальмоскопию и биомикроскопию глаза.</span></li>\r\n</ul>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>",
"treatment": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">При эпизодическом подергивании верхнего века рекомендуют исключить провоцирующие факторы: уменьшить уровень стресса или зрительную нагрузку, высыпаться, отказаться от алкоголя и кофеина. Стоит обратить внимание на свое психоэмоциональное состояние, возможно, воспользоваться помощью психолога.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">При приеме медикаментов, которые могут вызывать появление симптома, необходимо обратиться к лечащему врачу для уменьшения дозы или замены препарата. Если нарушение сохраняется долгое время, распространяется на оба века или оба глаза, другие мышцы, требуется консультация специалиста.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Консервативная терапия</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Тактику лечения определяют с учетом характера провоцирующей патологии:</span></p>\r\n<ul>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Поражение лицевого нерва. На начальной стадии применяют глюкокортикоиды, сосудорасширяющие и противоотечные препараты, солюкс. Со второй недели назначают УВЧ, ЛФК, массаж, с третьей – фонофорез и ультразвук. При сохранении остаточных явлений на протяжении 2-3 месяцев рекомендованы биостимуляторы.</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Идиопатический блефароспазм. В дебюте могут быть эффективными иглорефлексотерапия и психотерапия. В последующем осуществляют инъекции ботулотоксина, применяют холинолитики и бензодиазепины. Иногда дополнительно назначают миорелаксанты, антидепрессанты, нейролептики. При ксерофтальмии показаны местные средства для увлажнения глаз.</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">БАС. Немедикаментозные мероприятия включают лечебную физкультуру, использование ортопедических приспособлений. При бульбарных расстройствах и нарушениях дыхания требуются специальное питание, кислородные ингаляции, ИВЛ. В рамках лекарственной терапии применяют холиноблокаторы, антиконвульсанты, миорелаксанты. Для очищения дыхательных путей полезны муколитики.</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Рассеянный склероз. В периоды обострений проводят пульс-терапию глюкокортикоидами, иногда – плазмаферез. В фазе ремиссии назначают иммуномодуляторы и иммуносупрессанты. Симптоматическое лечение включает антидепрессанты, бета-адреноблокаторы, антиконвульсанты, миорелаксанты, антихолинергические средства.</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Офтальмологические болезни. При ксерофтальмии производятся инстилляции препаратов искусственной слезы, иммунотропных, противовоспалительных, метаболических средств. Аллергический конъюнктивит является показанием для использования глазных противоаллергических капель и антигистаминных лекарств общего действия.</span></li>\r\n</ul>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">При неоперабельных неоплазиях ствола проводят химиотерапию и лучевую терапию. 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"clinical_picture": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Наиболее часто подергивание глаза развивается только с одной стороны. Редко можно встретить и двустороннюю форму. Она образуется в постоянной или временной форме.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Чаще состояние образуется самостоятельно, но может идти в комплексе и с другой клинической симптоматикой:</span></p>\r\n<ul>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">слабость, усталость, сонливость и другие признаки недомогания;</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">боль на лице, которая может сопровождаться образованием участков онемения;</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">воспалительные состояния глаз, сопровождающиеся покраснением, воспалением, отечностью, выделением слезной жидкости, спазмом век;</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">психические отклонения;</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">покраснение лица, вздутие вен;</span></li>\r\n<li><span style=\"font-size: 7pt; font-family: Verdana; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">другие неврологические расстройства, например, тремор рук, парестезии конечностей.</span></li>\r\n</ul>\r\n<p> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Мышечные подергивания для других людей незаметны. Их ощущает только сам пациент. Часто состояние беспокоит человека. Но бывают и такие нервные тики, которые проявляются чрезмерно сильно и на протяжении продолжительного времени.</span></p>\r\n<p><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\"> </span></p>",
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