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Mime therapy improves facial symmetry in people with long-term facial nerve paresis: a randomised controlled trial.

QUESTION: What is the effect of mime therapy on facial symmetry and severity of paresis in people with facial nerve paresis? DESIGN: Randomised controlled trial. PARTICIPANTS: 50 people recruited from the Outpatient department of two metropolitan hospitals with facial nerve paresis for more than nine months. INTERVENTION: The experimental group received three months of mime therapy consisting of massage, relaxation, inhibition of synkinesis, and co-ordination and emotional expression exercises. The control group was placed on a waiting list. OUTCOME MEASURES: Assessments were made on admission to the trial and three months later by a measurer blinded to group allocation. Facial symmetry was measured using the Sunnybrook Facial Grading System. Severity of paresis was measured using the House-Brackmann Facial Grading System. RESULTS: After three months of mime therapy, the experimental group had improved their facial symmetry by 20.4 points (95% CI 10.4 to 30.4) on the Sunnybrook Facial Grading System compared with the control group. In addition, the experimental group had reduced the severity of their paresis by 0.6 grade (95% CI 0.1 to 1.1) on the House-Brackmann Facial Grading System compared with the control group. These effects were independent of age, sex, and duration of paresis. CONCLUSION: Mime therapy improves facial symmetry and reduces the severity of paresis in people with facial nerve paresis.

Adult↗

Locus of lesion in impaired pantomime recognition.

This study was concerned with the relationship between intrahemispheric locus of lesion and defective pantomime recognition in a population of left hemisphere damaged aphasics. Defects in pantomime recognition appeared to result from lesions in basal ganglia and areas 40, 39, 37 and 22. At the same time, however, a significant minority of aphasics with lesions in these various loci did not show defects in pantomime recognition.

Adult↗

Sleep of the great.

Both Lewis Carroll and William Shakespeare appear to have made clinical observations of sleep apnea syndromes long before they were discovered by medical science, and to have understood something about their physiological mechanisms. The somnolent dormouse in Alice in Wonderland indicates that his problem is one of sleep and breathing and is subject to modern treatment for obstructive apnea. Shakespeare in Henry IV presents a case of obstructive apnea along with a case of Cheyne-Stokes breathing and uses the plot of these history plays to explain by analogy the theoretical basis for periodic breathing.

Cheyne-Stokes Respiration↗

Thomas Bowdler: censor, philanthropist, and doctor.

A recent biography of the physician William Osler credits him with having generated a verb, to "oslerize", as a synonym for euthanasia. Actually, Osler had been mocking his own impending senescent uselessness at the time of his move from Baltimore to Oxford. That neologism did not last. Two earlier doctors who did make it to the dictionaries in a verbally eponymous way were F A Mesmer and Thomas Bowdler, and Bowdler, at least, would not have liked the recognition. The first use of the verb to "bowdlerise" seems to have been in 1836, with a reference to "names in the writings of the apostles which modern ultrachristians would probably have Bowdlerized". However, Bowdler is better remembered for his cleaning up of the plays of Shakespeare.

Drama↗

Television entertainment and the US health-care debate.

Some experts on the media say that entertainment can be more successful than news at providing insights into certain institutions, medicine being a good example. US television series that feature physicians as the central characters have been immensely popular. In the early series, dating back to the 1952 debut of City Hospital, the physician was an all-powerful hero working in a sparkling centre of healing, with medicine portrayed as a resource freely available to all. The programmes began to change in the 1970s. Plots centred more around the physicians' personal problems than on the patients, but economic and health-policy issues were still rarely discussed adequately. In the end, what viewers come away with may lead them towards false expectations, and they may increasingly blame doctors for decisions that others make and enforce.

Drama↗