Facial Palsy (Bell's Palsy)

Acute Idiopathic Facial Palsy Information for health care professionals click on brain to return to index page Neuroland Search site Neuro Med Neuro Note Texas Dr Practice hint Relax page PubMed CNS staff CNS Dr password required Office web YSL Acute Idiopathic Facial Palsy (Bell's Palsy) Overview Acute peripheral paralysis of the face produced by a viral immune-mediated disease. Possible pathogenesis: After a primary infection, herpes simplex virus became latent in the cranial and spinal sensory ganglia. Reactivation of the virus leads to replication of virus within the ganglion cells. Virus travels up and down the axons, induces an inflammatory response. Results in segmental demyelination presented as nerve paralysis. Incidence: between 15 - 40 / 100,000 population per year No evidence of racial predilection Incidence of Bell's palsy increases with age. Sexual predilection: Age 10 - 19 years, twice as common in women Age 40, 1.5 times more common in men. Pregnant women have 3.3 times more risk than nonpregnant women in the same age group. Diabetic patients: 4.5 times more likely to develop Bell's palsy. In 10% of the patients, a positive family history of Bell's palsy is present. Clinical features Sudden onset Full extent of the paralysis is usually reached in 1 to 14 days. Early phase: retroauricular pain, facial numbness, epiphora, parageusia, decreased tearing, and hyperacusis. Physical findings: Peripheral Facial paresis Hypoesthesia or dysesthesia of cranial nerves V and IX Motor paresis of cranial nerves IX and X Papillitis of the tongue. When severe retroauricular pain is present, Ramsay Hunt syndrome has to be considered. Differential diagnosis of VII weakness Bells' palsy, usually unilateral, 10% bilateral Differential of Unilateral Facial weakness Sarcoid Lyme's disease Neoplasm or mass Otitis media Trauma: skull fracture, facial injury Differential for bilateral VII palsy Melkersson-Rosenthal syndrome Recurrent facial palsy with facial edema, Unilateral or bilateral Lingua plicata (Scrotal tongue) Mbius syndrome: Facial paresis with ophthalmoplegia Guillain-Barr Syndrome Myasthenia gravis Motor neuron disease Prognosis Complete recovery in 60 to 80% Prognostic factors: Age: younger patient has better prognosis. Incomplete paralysis tends to recover completely. If recovery begins between days 10 and 21, a satisfactory result is obtained. Presence of systemic diseases, such as diabetes, increases chance of unsatisfactory recovery. Treatment Acyclovir and prednisone produce better results than prednisone and placebo. Steroid: There is debate about the efficacy of steroids Seems to have strong support in the literature for the use of steroid. Steroids relieve pain and reduce denervation. Dosage: Prednisone is 1 mg/ kg of body weight daily for 15 days, tapering to 0 during the next 5 days. Acyclovir (Zovirax): Reduces pain and degree of denervation. Dosage: 200 mg five times per day for 10 days. Not FDA approved for this indication. Eye Care: artificial tears five times per day and to tape the eye closed during sleep. Surgical Decompression: probably not beneficial. Neuromuscular Retraining: Visual feedback (mirror feedback), using a mirror to change the motor facial pattern and to reinforce proper responses Biofeedback or surface electromyography feedback Further reading Facial paralysis - anatomy, differential - Baylor Anatomy, Clinical, Differential, bilateral Bell's - Washington Univ Voluntary control of facial nerves - Univ of Utah Facial nerve paralysis after surgery - Harvard Ocular management in complete facial paralysis - Harvard Patient information - Medicine Net Return to index page

Foot Scrub Moisturizers >

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skincare products? by Alom

Skincare myths Brain Strain Fun Stuff The Facts Other Site Map RSS Feed Guide to RSS Feeds Skincare myths Is there truth behind the science used to sell skincare products? by Alom Shaha One of the few places we regularly see science on TV these days is in adverts for cosmetics. Theyre filled with pretty graphics showing you how the active ingredients work and feature lots of complicated words like active liposomes and boswelox (which seems to be a word invented solely for the purpose of selling a face cream). Im a big fan of the LOral adverts: they always have a gorgeous woman, like Rachel from Friends, telling you to pay attention to the science and a recent one even had Eva Longoria saying: I love it when they talk science. Its unlikely that Jennifer Aniston or Eva Longoria is ever going to date a physicist, but a boy can dream. Scientific terminology is used extensively to market skincare products but is the science featured in these adverts reliable? Is it worth spending more money on a particular brand of face cream and, as a bloke, should I buy products designed for men? According to Professor Andrew Finlay of the Department of Dermatology at Cardiff University, there is no point forking out lots of money for a designer-branded product rather than a generic brand. Hywel Williams, Professor of Dermato-Epidemiology at Nottingham University conceded that some products may be better than others in terms of being more comfortable, having a nicer smell and being less likely to give allergic responses but its all a matter of personal taste. In the name of research, I visited a cosmetics counter at a department store where the resident skincare expert advised me to cleanse, tone and moisturise my skin. Unlike professors Finlay or Williams she wasnt a dermatologist, but I believed her when she told me that cleansing and moisturising might be useful. However, she couldnt explain exactly why I should tone my skin and I wasnt convinced that it did anything useful. I was not alone: Prof. Williams later told me that he had also never understood what toning the skin means. Nina Goad, press officer for the British Skin Foundation, told me that toners are generally not necessary. They were originally designed to supplement the effectiveness of cleansers, however most modern cleansers are effective on their own and do not require the use of a toner. So thats at least one product that seems to be completely unnecessary, despite what the lady at the cosmetics counter told me. Feels soft, but how are the ingredients actually affecting my skin? Photo by Anwar Khan More and more products seem to be enriched with additional ingredients like vitamins and boswelox that are supposed to be absorbed through your skin. Its well-established that a lack of vitamins in your diet can be bad for your skin, but there is little evidence to suggest that applying vitamins directly to the skin is useful, even though some substances can be absorbed through the skin, like nicotine in nicotine patches. Ben Goldacre, a medical doctor who also writes the Bad Science column in The Guardian newspaper says that skincare companies are really good at making pseudo-scientific claims. Theyll say, in technical terms, that vitamin E and collagen are essential for the cross-molecular structure of whatever without making any claim that the specific ingredient will have any effect on your skin. While the added ingredients may be useless, simple moisturisers are useful because they do what they say on the tin: they add moisture to the skin. Basically, all of these creams add water to the cells in the outer layer of your skin which plumps them up and makes the skin look and feel smoother. This is a temporary effect, so you have to keep applying it. In addition to marketing the ingredients in skin creams, major designer brands also market ranges for men. According to the LOral website, mens skin is significantly different from womens, and thus needs to be treated and cared for in a significantly different way. Prof. Finlay disagrees, telling me that there is not a big difference between male and female skin and that in his opinion, moisturisers are only labelled as male or female for marketing reasons. Prof. Williams says that there are subtle biological differences in male and female skin, for example, blood vessel responses in the skin, susceptibility to irritants and possible ultraviolet burning, but not big differences that would require a different type of moisturiser. Of course, there is one big difference: men tend to have more facial hair than women and shaving can cause irritation and dryness. But according to Nina Goad, a moisturiser that is designed for women will still be effective for men with dry skin. Female skin products probably work equally well on men's skin and vice versa. Photo by Anwar Khan I did receive one consistent piece of advice from the scientists I contacted as well as from Nina Goad of the British Skin Foundation: they all agreed that protecting your skin from the sun was important. Her most important piece of advice for both men and women was to protect their skin from the sun. Ultraviolet rays cause wrinkles and creases, mainly because the radiation makes collagen break down at a higher rate than it would naturally with age. The good news is that more and more moisturisers now include sun protection, usually by means of a chemical ingredient that either blocks or absorbs UV radiation, and thats the one ingredient thats worth looking out for when buying a face cream. For more info: Professor Finlay Homepage - http://www.cardiff.ac.uk/medicine/dermatology/staff/finlay.htm Professor Hywel Williams - http://www.nottingham.ac.uk/dermatology/williams.htm British Skin Foundation - http://www.britishskinfoundation.org.uk/ Ben Goldacres Bad Science Homepage - http://www.badscience.net/ Alom Shaha homepage http://www.resonancetv.com/ Want to comment on this article? Send us an e-mail and we'll publish your most interesting views on our comments page.

Facial Skin Care

The Body Shop: Natural Skin Care Products, Facial Skin Care | | My Account | Login | Favorites | View Cart Body Butter Lotions Creams Other Moisturizers Hand Care Foot Care Massage Spa Scrubs Sun Care Accessories Gift Ideas Strawberry Bath Shower Soap Scrubs Accessories Gift Ideas Cleansers Toners Moisturizers Scrubs and Masks Treatments Lips Eye Care Make-up Removers Sun Care Accessories Palettes Lips Eyes Face Make-Up Tools Oils Aroma Jars Candles & Accessories Gift Ideas Eau de Toilette Perfume Oils Body Sprays Lotions Shower Bath Lifestyle Fragrances Invent Your Scent Gift Ideas Scent-Me Collection Shampoo Conditioner Treatment Styling Products Brushes Essential Oils Massage Lotions Bath & Shower Home Fragrance Bergamot Lavender Ylang-Ylang Mandarin Gift Ideas Shaving & Face Hair & Body Fragrance Accessories Massage Gift Ideas Bath Hair Brushes Hand & Foot Massage Skin Accessories Make-Up Tools Bags & Cases Support a Cause Books Gift Ideas Sign up to receive discounts and special offers. Skin Care Best Sellers Vitamin E Nourishing Night Cream Vitamin E Moisture Cream Chamomile Gentle Eye Make-Up Remover Tea Tree Oil Facial Wash 24-Hour Treatment Lotion with Kinetin Skin Care Rich in vitamins, these best-selling skin-savers soften, smooth and condition. Daily moisturizers enhanced with everyday sun protection brighten and nourish while blocking harmful UVA/UVB rays. Vitamin E Facial Day Lotion SPF 15 $12.00 Vitamin E Moisture Cream $12.00 Vitamin C Skin Boost $20.00 Vitamin C Moisturizer SPF 15 $14.00 SKIN CARE PRODUCT CATEGORIES Cleansers Toners Moisturizers Scrubs and Masks Treatments Lips Eye Care Make-up Removers Sun Care Accessories I NEED HELP WITH... | Dry or sensitive skin | Normal to dry skin | Normal to oily skin | Oily or blemished skin | Corporate Site | News | Employment Opportunities | The Body Shop Canada | The Body Shop UK | Terms & Conditions | Privacy Policy | About Us Affiliate Program | Store Locator | Site Map | Help | Contact Us Gifts | Body | Bath | Skin Care | Make-Up | Home Fragrance | Fragrance | Hair | Aromatherapy | Men's | Accessories © 2005 The Body Shop International plc. All Rights Reserved.

Botox ® According to

Botox® for Migraines Drug Profiles: Botox® (botulinum toxin) CAUTION: Federal law prohibits dispensing without prescription. What is Botox ® According to a recent University Of California, San Francisco study delivered in a presentation at the American Society of Dermatologic Surgery meeting (held November 2-5, 2000), Richard Glogau, MD, UCSF professor of dermatology, reported that 75 percent of patients in his case study experienced four to six months of Migraine relief following injections of Botox® (botulinum toxin A derived from bacteria) to muscles of the face and head. Glogau's small study of 24 patients adds weight to previous reports that botulinum toxin A can relieve Migraines. Since 1992, Botox®, the same bacteria that causes deadly food poisoning, has been used in purified and diluted form to temporarily paralyze the muscles that bring the eye brows together, thereby eliminating wrinkles in this region. practice injected with botulinum toxin A in the upper third of the face for treatment of cosmetic frown lines (who coincidentally suffered from Migraines) have reported the added benefit of Migraine relief. How Botox® Is Currently Being Used To Treat Migraine Disease Following this serendipitous discovery by the University Of California, San Francisco professor Glogau and other researchers began to evaluate injection points and dosages that could alleviate Migraines. Glogau's results indicate that botulinum toxin A injected into the muscles of the brow, eyes, forehead, side of the head and back of the head near the neck (a point that earlier investigators have neglected) induce sometimes immediate Migraine relief and provide benefit for up to six months, he said. Botox® dosage in his case studies averaged 80 units per patient. There are no published, randomized, double-blind trials that show the safety and efficacy of Botox® for treatment of Migraines, Glogau said. In fact, most of the data consists of case reports and meeting abstracts. Two previous studies were presented at the 1999 meeting of the American Association for the Study of Headache (Now know as the American Headache Society). In the first study, reported by researchers at the Michigan Head Pain and Neurological Institute in Ann Arbor and Michigan State University, a one-time dose of 25 units of botulinum toxin A injected into the muscles of the brow, forehead and side of the head, reduced the frequency of Migraines, the severity of pain, vomiting, and the use of pain medications for up to three months. A 75-unit treatment yielded Migraine relief, but also side effects like eyelid drooping. In another study, reported by researchers at the University of California, Los Angeles, 51 percent of 96 patients reported complete improvement of their Migraine pain. Cost & Use of this Preventive Migraine Treatment One limitation for botulinum toxin's (Botox®) use in treating Migraines is cost. Unlike other treatments for Migraines, such as the prescription drug Imitrex® and nasal sprays (and other triptans or ergotomine drugs), Botox® injections are not covered by insurance and cost about $350 for each targeted area, (and will likely be used in multiple areas) so it appears expensive. But the cost has to be looked at divided by the 4 to 6 months that this preventive works between doses as compared to other preventive drug costs. In addition, it is important to note that prescription drugs like Imitrex® and nasal sprays are abortive treatments and not designed to replace nor use like Botox®, which is to be used as a preventative or prophylactic Migraine treatment. Possibly with some Migraineurs, they may find this botulinum toxin's use can prevent all of their attacks for up to four or more months. But for others, like many Migraine sufferers using prophylactic Migraine treatments, may discover it greatly lowers the frequency and severity of an intractable Migraineur’s attacks. These individuals can then turn to abortive the prescription drugs Imitrex® (or other equally good triptans) and nasal sprays or use rescue drugs like butorphanol tartrate (Stadol®) to deal with the breakthrough attacks. So discuss this with your physician as part of an overall Migraine treatment plan including trying the Botox® for preventive treatment, as well as a good abortive treatment plan, trigger management, and pain management plan to deal with your Migraines. History of Botulinum Toxin Type A Clostridium botulinum produces 7 distinct toxins, types A through G. Botulinum toxin type A is the most studied of the 7 stereotypes produced by the anaerobic bacterium Clostridium botulinum. Minute quantities of botulinum toxin type A offer significant potential in treating a wide variety of disorders associated with muscle overactivity. Work with botulinum toxin type A as a therapeutic agent to treat human disease began in the late 1960s through the collaboration of Alan B. Scott, MD, of the Smith-Kettlewell Eye Research Foundation and Edward J. Schantz, PhD, director of food microbiology and toxicology at the University of Wisconsin. This is when botulinum toxin type A was first considered not as an agent of human sickness and disease but as a powerful therapeutic agent to treat symptoms of neurological disorders. In 1989, the rights to a form of botulinum toxin type A, currently commercialized under the trade name BOTOX®, were acquired by Allergan, Inc. In December of that same year, BOTOX® was approved for use in strabismus and blepharospasm associated with dystonia in patients 12 years of age and above. Through the collaboration of Drs. Scott and Schantz, and the pioneering efforts of Allergan, BOTOX® was added to the armamentarium of drugs used to treat these conditions. Clinical Development BOTOX® is currently in various stages of clinical development for a number of neuromuscular treatments. If successful, these treatments could offer new tools with potential to improve various patient conditions. Allergan's BOTOX® (Botulinum Toxin Type A) Purified Neurotoxin Complex is used in the treatment of certain neuromuscular disorders characterized by involuntary muscle contractions or spasms. Allergan markets BOTOX® in the United States and in 61 other countries. The approved indications for BOTOX® in the United States are for the treatment of blepharospasm (the uncontrollable contraction of the eyelid muscles that can force the eye closed and result in functional blindness) and strabismus (misalignment of the eyes) in people 12 years of age and over. For approved uses outside of the United States, please contact our global offices. Manufacture and Storage BOTOX® is supplied sterile in glass vials, each containing 100 units. BOTOX® must be diluted with sterile, nonpreserved saline immediately prior to its injection. Summary The clinical use of BOTOX® represents one of the most dramatic role reversals in modern medicine: a biologic toxin transformed into a therapeutic agent. For More Detailed Information For more detailed information regarding BOTOX® Allergan’s (the manufacture) webpage at: http://www.botox.com/noflash_index.html . We would like to credit the University Of California, San Francisco as an original source for part of this section. You may also wish to visit the following link for more background on the botulinum toxin Migraine studies. http://www.sciencedaily.com/releases/2000/11/001120074720.htm [ Botox® Tear Sheet ] [ Return to Drug Profiles ] [ Return to Treatment & Management ] [ Return to M.A.G.N.U.M. ]