>
>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.
a. As I understand the evidence suggests the effects of high dose
steroids, i.e. 1mg/kg/day , not just the 30-40mg doses we have used in
the past, have only a marginal effect in certain groups, those who have
a greater chance of incomplete recovery including the elderly, those
with complete Palsy.
ref BJGP 46 : 1996 743-747.
b. I don't usually prescribe but refer to physio for acupuncture. Our
local department have had some good results. It is one thing telling
someone with a cold that they will get better on their own, but when
confronted by a man who thinks he is having a stroke.....who can blame
the Cas SHO/Med SHO for trying to show concern by "doing something".
Dr Francisco Machado,
Abersychan Surgery, Old Road, Abersychan, Torfaen, NP4 7BQ
website http://www.abersychan.demon.co.uk/home.htm
%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
|