Bell's palsy and the two meanings idiopathic origin 
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 Bell's palsy and the two meanings idiopathic origin

JS> what is Bell's palsy ?
JS> what are the symptoms and causes ?
JS> what is the treatment for this disorder ?

MD David Nye answered:

DN> Idiopathic (meaning cause unknown) paralysis of the
DN> {*filter*} nerve

DN> As above.  In some cases it seems to be set off by pregnancy, a
DN> vaccination, a viral illness, or exposure of the face to cold.

DN> In 90% of cases the weakness will resolve spontaneously over weeks to
DN> months.  In the remaining 10%, {*filter*} nerve decompression or a
DN> re-innervation procedure may be necessary.  Steroids or other
DN> medications, physical therapy, and electrical stimulation of the weak
DN> side of the face have been tried in the past but seem to be of no value.

DN> David Nye, MD * Neurology Dept., Midlefort Clinic, Eau Claire, Wisconsin
DN> This is patently absurd; but whoever wishes to become a philosopher
DN> must learn not to be frightened by absurdities. -- Bertrand Russell

From my point of view, Davids answer is incomplete and
appropriated to suggest, there is nothing to do, if one gets
a {*filter*} palsy. I am unable to let this suggestion

A unilateral {*filter*} nerve weakness (or paresis) is wide
spread (look George Bush, for example) and harmless in most
cases (see David's answer above), but its cause must be
investigated, because in more rare cases it is the first
symptom of a harmful disease requiring a soon treatment to
avoid unilateral hearing loss, vertigo, meningitis or death.
Before a physician considers a {*filter*} palsy to be of
"unknown" (idiopathic) origin, he must explicitly exclude
all causes with therapeutic consequences. More than 30
origins are investigateable today. Additional he must
investigate the site of the nerve lesion.

If a {*filter*} palsy is heavy or complete (a paralysis), a
frequent cause is a nerve injury during a surgery procedure
on the ear or the salivary glands. A soon nerve repair by a
experienced specialist is the only chance of an acceptable
recovery in this case. Many ENT-surgeons, however, don't
have enough "ethics" to arrange this. To avoid critical
newspaper articles about the qualification of the surgeon or
the clinic, the {*filter*} palsy frequently is declared to be of
idiopathic origin ignoring the necessary diagnostic tests.
This is the second and more important meaning of "Bell's
palsy". Last month a german ENT-chiefsurgeon was condemned
to 23 month of jailhouse after such a procedure, which is
recognized to be of wide spread use over the whole world.

A physician, ENT-specialist or neurologist only has to
recognize, that idiopathic means "uninvestigateable" or "all
origins with therapeutic consequences excluded" rather than
"cause unknown" or "cause unwanted to be known", to prevent
himself from a forensic follow on in the treatment of
"Bell's" palsy.

Symptoms: the victim is unable to move any of the mimics
muscles on the paralysed side of the face. The eyebrow can
not be lifted, the eye can not be closed and the impacted
half of the mouth is forceless{*filter*} down. If the victim
tries to smile, a (sometimes terrible) grimace results. The
harmonic embedding into the social environment gets lost
over the years. Dependent on the site of the lesion, a dry
eye (sometimes leading to a complete loss of the eye),
unilateral noise sensitivity, reduced salivation, and
irritated taste may occur.

If a complete {*filter*} palsy consists since more than 1 year,
no use should be made from the offer of many surgeons, to do
a late surgery procedure (except corrections of the lower
eyelid). This late treatments are successful only to the
surgeons cash, but unsuccessful to the health of the victim.

Karl (=Charles) H. Zeller

Mon, 02 Sep 1996 01:48:23 GMT
 [ 1 post ] 

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