Correspondence (letter to the editor): Essential Comments

I have three comments regarding this article (1):

• Cortisone should only be administered once an infection with borrelia bacteria has been ruled out. I remember a young patient who attended a neurology hospital with acute unilateral facial paresis, and he was administered cortisone. On the fourth day he came to me as a medical emergency. The facial paresis had become bilateral, and the patient had a headache and clear meningism. The cortisone had led to an “explosion” of neuroborreliosis, and the patient was admitted to intensive care.

• Electrotherapy is effective and shortens the disease course. It has to be administered early and on working days. Patients will have to perform the necessary facial exercises in front of a mirror three times every day.

• If symptoms are slow to recede or even persist, ultrasound scanning of the parotid region should be undertaken in order to rule out a possible tumor.