Management of peripheral facial nerve palsy

Peripheral facial nerve palsy (FNP) may (secondary FNP) or may not have a detectable cause (Bell’s palsy). Three quarters of peripheral FNP are primary and one quarter secondary. The most prevalent causes of secondary FNP are systemic viral infections, trauma, surgery, diabetes, local infections, tumor, immunological disorders, or drugs. The diagnosis of FNP relies upon the presence of typical symptoms and signs, blood chemical investigations, cerebro-spinal-fluid-investigations, X-ray of the scull and mastoid, cerebral MRI, or nerve conduction studies. Bell’s palsy may be diagnosed after exclusion of all secondary causes, but causes of secondary FNP and Bell’s palsy may coexist. Treatment of secondary FNP is based on the therapy of the underlying disorder. Treatment of Bell’s palsy is controversial due to the lack of large, randomized, controlled, prospective studies. There are indications that steroids or antiviral agents are beneficial but also studies, which show no beneficial effect. Additional measures include eye protection, physiotherapy, acupuncture, botulinum toxin, or possibly surgery. Prognosis of Bell’s palsy is fair with complete recovery in about 80% of the cases, 15% experience some kind of permanent nerve damage and 5% remain with severe sequelae

Accroissement de la population et migrations intérieures dans les régions péri-urbaines et extra-urbaines des Pays-Bas.

Population growth and internal migration in the peri-urban and extra-urban areas of the Netherlands The differences in regional growth in the Netherlands are increasingly linked with internal migrations. Since the seventies, a slackening of counter-urbanization is observed while flows of young migrants are increasing towards the urban areas. A result of this change is the ageing of the non-urban population.Les différences de croissance régionale aux Pays-Bas sont de plus en plus influencées par les migrations intérieures. Depuis les années soixante-dix on observe un ralentissement de la rurbanisation au profit des flux de jeunes migrants vers les villes. Un processus de vieillissement de la population non-urbaine est ainsi en train de s'amorcer.Atzema O. A. L .C, Bargeman C. A. Accroissement de la population et migrations intérieures dans les régions péri-urbaines et extra-urbaines des Pays-Bas.. In: Espace, populations, sociétés, 1986-3. Populations rurales et populations agricoles - Rural populations and agricultural populations. pp. 47-53