Wednesday, August 27, 2014

Pill-rolling Tremors

Pill-rolling tremor refers to the slow regular movement of hand which involves flexion and extension of fingers and adduction and abduction of thumb. Pill-rolling tremors occur at rest and are seen in Parkinson's disease in the elderly. Most often, Pakinsonian tremors are asymmetrical. Other causes of pill-rolling tremors include drugs like haloperidol, chlorpromazine and some other conditions.

Keywords: Pill-rolling tremors, Pill-rolling movements, Parkisnson's disease, at rest, Parkinsonian tremors

Thursday, August 14, 2014

Treatment of Bell's Palsy

Bell's palsy treatment is as follows: 
1. Reassure the patient: Relax the patient and relieve the anxiety. Eighty percent cases recover completely while twenty percents recover partially or do not recover.
2. Protect the eye: Use eye bandage or dark glasses. Use antibiotic eye ointment at bed time and lubricant eye drops (i.e. artificial tears) in day time. Instruct the patient to avoid reading or near-work related activities till some recovery.
3. Steroid Therapy: If the patient presents within the first 6 days of Bell's Palsy onset, start tablet Prednisolone 5mg (Deltacortil 50-60mg or 4 tablets thrice for 5 days and then 2 tablets twice for next 5 days). Dose of deltacortil (prednisolone) is 1-2 mg/kg/day.
4. Antiviral Therapy: Some experts advise antiviral therapy. Give tablet Acylex 400mg thrice.
5. Physiotherapy:
Physiotherapy like exercise, massage, biofeedback, laser, electrotherapy (galvanic stimulation) and thermotherapy helps the recovery.
6. Pregnancy: Prognosis is worse in pregnancy (50% recovery instead of 80% in non-pregnant). Steroid therapy is prohibited during pregnancy.

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Keywords: Bell's palsy treatment, Bell's palsy management, Treatment of Bell's palsy, Eye protection, Steroid therapy, Prednisolone, Antiviral therapy, Physiotherapy, Pregnancy

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