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I have three comments regarding this article (1):

  • Cortisone should only be administered once an infection with borrelia bacteria has been ruled out. I remember a young patient who attended a neurology hospital with acute unilateral facial paresis, and he was administered cortisone. On the fourth day he came to me as a medical emergency. The facial paresis had become bilateral, and the patient had a headache and clear meningism. The cortisone had led to an “explosion” of neuroborreliosis, and the patient was admitted to intensive care.
  • Electrotherapy is effective and shortens the disease course. It has to be administered early and on working days. Patients will have to perform the necessary facial exercises in front of a mirror three times every day.
  • If symptoms are slow to recede or even persist, ultrasound scanning of the parotid region should be undertaken in order to rule out a possible tumor.

DOI: 10.3238/arztebl.2020.0175b

Dr. med. Franz-Ulrich Beutner

Burgdorf

fub_bu@me.com

1.
Heckmann JG, Urban PP, Pitz S, Guntinas-Lichius O, Gágyor I: The diagnosis and treatment of idiopathic facial paresis (Bell´s palsy). Dtsch Arztebl Int 2019; 116: 692–702 VOLLTEXT
1.Heckmann JG, Urban PP, Pitz S, Guntinas-Lichius O, Gágyor I: The diagnosis and treatment of idiopathic facial paresis (Bell´s palsy). Dtsch Arztebl Int 2019; 116: 692–702 VOLLTEXT

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