Muni RH, Pitkethly M, et al. The authors used meta-analysis to compare several treatment regimens and a variety of outcomes. Basura GJ,
2015 Jul 1;(7):CD001869.
de Almeida JR, Al Khabori M, Guyatt GH, Witterick IJ, Lin VY, Nedzelski JM, et al. Complete recovery rates of facial nerve function in patients with Bell palsy were improved by treatment with corticosteroids plus antivirals vs. corticosteroids alone at six months (relative risk [RR] = 0.61; 95% confidence interval [CI], 0.39 to 0.97; NNT = 15 [95% CI, 10 to 200]; n = 1,315). 2009 Oct 7;(4):CD001869. Jeste SS, et al. Patients with Bell's palsy were treated with either oral prednisolone alone or oral prednisolone plus an oral antiviral agent, and the therapeutic outcomes of the two treatment regimens were compared. In our series of 3385 patients with acute facial paralysis over the past 30 years, Bell's palsy accounted for 2097 cases (62%). Antiviral treatment for Bell's palsy (idiopathic facial paralysis). doi: 10.1002/14651858.CD001869.pub9.Gagyor I, Madhok VB, Daly F, Somasundara D, Sullivan M, Gammie F, Sullivan F.Cochrane Database Syst Rev. 2015 Jul-Aug;133(4):383. doi: 10.1590/1516-3180.20151334T1.Ann Emerg Med.
A subgroup analysis of patients with severe Bell palsy (i.e., House-Brackmann index of 5 or 6 out of 6) found that more patients achieved complete recovery when the combination of antivirals and corticosteroids was used vs. corticosteroids alone (RR = 0.64; 95% CI, 0.41 to 0.99; n = 478).The combination of corticosteroids and antivirals also improved long-term motor synkinesis and excessive tear production (so-called “crocodile tears”) over corticosteroids alone (RR = 0.56; 95% CI, 0.36 to 0.87; NNT = 12 [95% CI, 8 to 40]; n = 469]).
To see the full article, log in or purchase access. This site needs JavaScript to work properly. Unable to load your collection due to an error 2015 May 4;(5):CD001869. doi: 10.1002/14651858.CD001869.pub3.J Korean Med Sci. . It is the most common acute facial paralysis, with an incidence of 20–30 per 100 000 people annually. (Strength of Recommendation [SOR]: B, based on inconsistent or limited-quality patient-oriented evidence.) Combined corticosteroid and antiviral treatment for Bell palsy: a systematic review and meta-analysis. Acute unilateral facial palsy of probable viral aetiology. Gronseth GS, High-dose corticosteroids should be administered in all patients in the absence of significant contraindications. Cape AV, Khedr EM(1), Badry R(1), Ali AM(1), Abo El-Fetoh N(1), El-Hammady DH(2), Ghandour AM(2), Abdel-Haleem A(1). Eleven people need to be treated for one extra complete recovery at six months. Wiley
2019 Oct;39(5):316-321. doi: 10.14639/0392-100X-2415.Cochrane Database Syst Rev.
2019 Mar 1;11(3):296. doi: 10.3390/cancers11030296. Antiviral Treatment for Bell's Palsy (Idiopathic Facial Paralysis) Low-quality evidence from randomised controlled trials showed a benefit from the combination of antivirals with corticosteroids compared to corticosteroids alone for the treatment of Bell's palsy of various degrees of severity. Gagyor I, 2019 Dec 16;12:319-333. doi: 10.2147/JIR.S227279. 2019 Sep 5;9(9):CD001869. BMJ. Steroid/Antiviral for the treatment of Bell's palsy: Double blind randomized clinical trial. Peleg AY. Left untreated, 70–75% of patients make a full recovery. Epub 2016 Jun 25.JAMA.
Alvarez G, Unable to load your delegates due to an error eCollection 2019.Mancini P, Bottaro V, Capitani F, De Soccio G, Prosperini L, Restaino P, De Vincentiis M, Greco A, Bertoli GA, De Seta D.Acta Otorhinolaryngol Ital. Sullivan F. Evidence-based guideline update: steroids and antivirals for Bell palsy: report of the Guideline Development Subcommittee of the American Academy of Neurology.
There may be benefit in adding an antiviral drug to prednisolone in some cases. doi: 10.3346/jkms.2020.35.e245.J Inflamm Res. doi: 10.1002/14651858.CD001869.pub8. 2015 Jul 1;(7):CD001869. Antivirals should not be used alone to treat Bell palsy. doi: 10.1002/14651858.CD001869.pub6.Gagyor I, Madhok VB, Daly F, Somasundara D, Sullivan M, Gammie F, Sullivan F.Cochrane Database Syst Rev. Author information: (1)Department of Neuropsychiatry, Assiut University Hospital, Assiut, Egypt. Treatment with antivirals alone was associated with higher rates of residual symptoms vs. treatment with corticosteroids alone (RR = 1.52; 95% CI, 1.08 to 2.12; n = 472).
2009 Sep 7. Wiley Early treatment with prednisolone increases the chance of complete recovery of facial function to 82%. doi: 10.1002/14651858.CD001869.pub5.Lockhart P, Daly F, Pitkethly M, Comerford N, Sullivan F.Cochrane Database Syst Rev. doi: 10.1002/14651858.CD001869.pub8. The natural history of Bell's palsy.
Paduga R. Daly F, This information sheet is provided to help you understand the role of steroids and antiviral drugs for treating Bell’s palsy.
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