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Vicc · 10-15-2007, 01:24 AM

Tayla,

I am wondering why then did this lady exhibit sings of improvement for some time following nerve blocks if there wasn't a neurological element to the disease? Interesting thoughts, but we know that blocks do provide temporary relief; the problem is that no one knows why. I don't have an answer either. At any rate, I don't deny that nerve damage is present in ischemia-reperfusion injury (IRI), I argue is is caused by ischemia.

The fact that she relapsed may well have been due to ineffectual care from her doctor rather than the wrong care. From what I understand, blocks provide temporary relief and just about everyone relapses. Perhaps when looked at objectively, blocks are ineffectual except to provide temporary relief.

I am wondering if you could address how this could be an IRI when the face and neck is such a very odd place to have ever experienced an ischaemic event? IRI is actually an ischemia-reperfusion-ischemia injury, with the 2nd ischemia different from the initiating ischemia. At the acute stage, ischemia is caused by inflammation, so it hasn't yet become the reperfusion ischemia of IRI. In this light, she is not yet experiencing the direct ischemia, but still in the inflammatory stage of the disease.

In my opinion the photos show very clearly the flush of vasomotor changes due to a sympathetic/autonomic nerve supply disorder. Is it your opinion that this redness can only be caused by a sympathetic/autonomic nerve supply disorder, and not by inflammation?

There are not too many disorders that present with such delineation but a sympathetic disorder is one. Does the disorder you talk about have a name? Can you provide some documentation describing this disorder?

Finally, IRI is, among other things, a nerve supply disorder, but that doesn't begin until later, after the 2nd ischemia begins. It isn't part of the acute stage...Vic