On Sunday, January 25, 1998 6:02 AM, Robert Treharne Jones
[SMTP:[log in to unmask]] wrote:
> Chap turned up the other evening with a vague ache down the left side of
his neck, no nodes, and some tingling at the angle of his mouth - on the
other side. I had no idea what it was, and told him so - see SOS etc.
>
> The next day, presumably cliically advanced, he presents in A&E and the
make the diagnosis of Bell's palsy. They give him a week's course of
high-dose oral steroids. Who did they do this?
>
> a. Tried, trusted, and medically approved, according to recent EBM
> b. They had to do something, and it seemed like a good idea
> c. Something else.
>
> Answers please.
>
I had a quick look at Bandolier and turned this up.
http://www.jr2.ox.ac.uk/bandolier/band21/b21-3.html
It would appear there is still a lack of good evidence although the recent
trial they examined seemed to show benefit if treatment with steroids was
started within 24hours of onset
The trial they refer to is listed in the Cochrane database. There are also
a couple of other interesting trials there using acyclovir in one trial and
Methylcobalamin in another. B12 injections would seem a cheap enough option
if it works.
With the New Forest on a doorstep a few Bell's Palsy are due to Lyme's
disease so I now send off for the Borelia Burgdorferi titres
Stuart
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Stuart Skeates [log in to unmask]
Romsey, Hants
General Medical Practitioner
PGP ID: 102AB451: 58 A1 3A D4 30 54 E2 17 5D E7 84 79 42 8B 79 D1
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