Monday 22 October 2007

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Health Report 29 min 2 speakers 8 chapters transcribed 3 days ago

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Transcript generated automatically by AI and may contain errors.

What is the focus of today’s Health Report episode?

Unknown 0:00

Welcome to another ABC Radio National podcast. For more information, go to abc.net.au slash rn.

Norman Swann 0:10

Hello, I'm Norman Swann and you're listening to the Health Report. In this program, the fiftieth anniversary of an Australian discovery which revolutionized thinking about how the body worked. A more recent Australian discovery about how HIV hides in cells, which could help to revolutionize treatment, and a condition that's common, frightening, and which doctors have

Paul 0:29

been treating blind. I was out with some friends. I was overseas in America and had gone out for a meal and as the meal progressed I felt myself slurring more and more and I hadn't really had a lot to drink so I knew that it wasn't incurred through alcohol. You

Norman Swann 0:43

think we're having a stroke or something?

Paul 0:45

Well when I went back to my hotel and looked in the mirror and smiled, only one side of my face was working. And that was the initial thought. But then I as I realised I could move my hand and I had no other form of paralysis or nothing else felt strange. And were you feeling ill? No, but I had prior to it, about two weeks before I had a a flu and I'd felt quite unwell leading up to that. And it wasn't until the next day when nothing had changed and I really was aware that something serious had happened. And what happened? Well, I went to actually the casualty department in a little town in the middle of California and they were great. They picked it straight off the bat and I was prescribed steroids and uh antivirals.

Paul 1:24

You got the antiviral as well? I got the antiviral as well and an eye patch and I used a lot of lubrication on my eye and that certainly helped a lot. What happened after that? I'd say six and a half weeks all up, I was back to normal. Were you scared at any point? When it happened I was incredibly scared because given that I didn't know what it was, and you know, I would keep going back to the mirror, I remember the next morning waking up thinking I'd dreamt it. And just that look on you know, when you you certainly can't close your eye and just one side of your face is smiling and the other side isn't. That was incredibly scary. Paul had

Norman Swann 1:56

He had Bell's palsy and he was given what until this week would have been standard therapy early steroids like prednisolone and an antiviral drug called a cyclovir. What happened this week was a trial of Bell's palsy treatment that many said couldn't be done, was done, in Scotland in fact, and reported in the New England Journal of Medicine. Frank Sullivan is Professor of Research and Development in General Practice at the University of Dundee.

Frank Sullivan 2:20

Bell's palsy is one of the causes of acute facial paralysis. And there's also an effect on taste and often a bit of pain behind the ear. caused by this unknown swelling of the facial nerve as it goes through uh bony canal in the skull before it emerges out uh into the the face.

Norman Swann 2:45

And how do you know you've got it?

Frank Sullivan 2:46

If there's a a sudden onset of paralysis of the face, so the person would often feel that the face felt a bit unusual, often on wakening. When they look in the mirror they will see that For an older person, the wrinkles on the affected side won't be as pronounced as on the other side. It would be difficult to close the eye on the affected side.

Norman Swann 3:09

So it's almost like mass botox.

Frank Sullivan 3:12

Yeah.

Norman Swann 3:12

Is there any danger to Bell's policy?

Frank Sullivan 3:15

The main immediate danger is to the eye, where failure to close the eye will mean that anything that blows into the eye may cause scratches to the the front of the eye, corneal abrasion.

How does Bell’s palsy present and why is early treatment important?

Frank Sullivan 3:27

And they would want to make sure that the eye was protected.

Norman Swann 3:30

Now is it fair to say that doctors have been shooting in the dark with Bell's policy?

Frank Sullivan 3:34

Yes, since Charles Bell described it first in eighteen twenty one. There's been no definite effective treatment for quite a long time. Steroids uh started to come in in nineteen forties and fifties. They were starting to be used But there was no good evidence that steroids were effective. One of the reasons we were commissioned by the Health Technology Assessment Board of the NHS in the UK to do this was that a Cochrane review had only three trials with a hundred and seventeen patients in it in total.