OPINION
Reply
Sir,
Concerning the controversy about facial peripheral palsy and Charles Bell1, we will reply to the author's specific doubts in this opinion section:
[1] Abu Ali Al Hussayn Ibn Abadalla Ibn Sina's (Avicenna) work was written in ancient Arabic, in the century X (AC), obviously unavailable. Therefore, we used a translation by Professor Kataye, Professor of Otology at the Medical School of Alep, Syria, published in 19752;
[2] Concerning Nicolaus Friedreich, we did not refer to his Latin publication in 1797; we referred to Bird's citation published in the Annals of Medicine in 18003;
[3] The probable right facial paralysis of Charles Bell, mentioned by Jongkees4,5, was based on the analysis of a black and white, good quality portrait5;
[4] We agree that a first case report of facial palsy (not an idiopathic peripheral facial palsy), was published in 1821. The second case was mentioned by Bird as published in 1828. For this, Bird probably used the text published by Bell in the London Medical Gazette6;
[5] Concerning the so called mistakes and "innacuracies" in our paper, they were not seen by Professor Jongkees and by Professor Werner Kindler, who agree with our positions;
[6] In relation to our Fig 1D: Professor Kindler describes... "Dr. M. Hertl offered a photograph taken by himself. It shows a Roman vase, which was found in the region by Mount Madalena - not far away from Klagenfurt"7. Klagenfurt, Celovec, in Slovenia, is in Austria nowadays, very close to the frontier with Slovenia;
[7] In relation to our Fig 4D, it shows not only a facial palsy, but it seems to be a parotis tumor involving the facial nerve, as it looks from the lateral view8. So, there are several causes of disproportionate impairment between the superior and inferior facial folds;
[8] The Fig 7C is a didactic photo of a patient in electrotherapy, a method for the treatment of facial paralysis. We did not describe this patient as having facial paralysis;
[9] In relation to the Figs 1C, 4D and 6D, the authors seem to be confused in relation to the semiology of the VIIth cranial nerve. Déjérine9describes a left facial paralysis of central origin (Figure), in a 27 year-old female with left hemiplegy by embolism, caused by mitral insuficency. On this photograph, taken on the 50th day of evolution, it is clearly seen that: [A] the superior fold is paralysed; [B] that the left eye is more open than the right; [C] the eyebrow is more elevated. DeJong stated that ..."occasionally, a patient with incompletely developed Bell's palsy will have relative sparing of the upper face, causing confusion with a central facial paralysis"10. In conclusion, the analysis of the superior fold is not the best criterious to separate peripheral facial paralysis from facial paralysis of central origin.
Luiz Antonio de Lima Resende
- 1. Resende LAL, Weber SAT. Peripheral facial palsy in the past. Contributions from Avicenna, Nicolaus Friedreich and Charles Bell. Arq Neuropsiquiatr 2008;66:765-769.
- 2. Kataye S. La paralysie faciale selon Avicenne. Ann Oto-Laryng (Paris) 1975; 92:79-82.
- 3. Bird TD, Nicolaus A. Friedreich's description of peripheral facial nerve paralysis in 1798. J Neurol Neurosurg Psichatry 1979;42:56-58.
- 4. Jongkees LBW. Bemerkungen zur Geschichte der Fazialislähmung. HNO 1979;27:325-333.
- 5. Resende LAL, Weber SAT. Letter to the editor. Arq Neuropsiquiatr 2009; 67:784.
- 6. Bell C (1828). Partial paralysis of the face. London Medical Gazette, 1, 747-750, 769-770. Cited by Bird (1979) - 5.
- 7. Kindler W. Die Fazialislähmungen in der darstellenden Kunst seit mehr als 4 Jahrtausenden. Z Laryng Rhinol 1969;48:135-139.
- 8. Kindler W. Die Fazialislähmungen in der darstellenden Kunst seit mehr als 4 Jahrtausenden. Z Laryng Rhinol Otol 1961;40:417.
- 9. Déjérine J. Sémiologie des affections du systeme nerveux. Paris: Masson, 1914:170-174.
- 10. Campbell WW. DeJong's. The neurological examination. 6th Ed, Philadelphia: Lippincott Williams & Wilkins, 1992:212-224.
Publication Dates
-
Publication in this collection
26 Apr 2011 -
Date of issue
Apr 2011
