Treatment of Bell’s Palsy
The PFP is more than two thirds of cases of viral origin, and therefore has been suggested that the early use of prednisone (steroid) and acyclovir (antiviral) would have some utility in the treatment of early-stage, marked by facial nerve inflammation.
On October 18, 2007 was published in the New England Journal of Medicine a double-blind study compared the effects of prednisone and acyclovir in Bell’s palsy or facial nerve palsy (PFP).
The study was conducted in Scotland led by Dr. Frank M. Sullivan, of the Scottish School of Primary Care at the University of Dundee, Scotland.
A 94.4% of patients receiving prednisone within 72 hours of the start of the PFP, had an excellent performance in following up to 9 months. 85.4% of those who received acyclovir had an excellent performance.
The group of patients who received placebo, was in 85.2% of the total recovery, almost the same percentage as the group with acyclovir.
It is clear from this study that only the Prednisone would be useful in early treatment of the PFP, and that Aciclovir alone or with prednisone, it would be useless.
Currently, the Cochrane Database, found no compelling evidence to support the use of either acyclovir or prednisone in patients with PFP.
Be at the discretion of the treating neurologist then, that drug (I) use in patients who consult within the first 72 hours after the start of the PFP.