CHAPTER 50 STEROIDS AND ANTIVIRALS IN BELL’S PALSY

Early Treatment With Prednisolone or Acyclovir in Bell’s Palsy

Sullivan F, Swan IR, Donnan P, et al. N Engl J Med. 2007;357(16):1598–1607

BACKGROUND

Idiopathic unilateral facial nerve paralysis (Bell’s palsy) affects approximately 40,000 Americans per year. Although most patients recover well, as many as 30% are left with a facial disfigurement and ongoing pain. Treatment choices varied and prior to this study, two Cochrane reviews independently concluded that there was insufficient data to support the use of prednisolone, acyclovir, or both in the treatment of Bell’s palsy due to lack of evidence.

OBJECTIVES

To determine the efficacy of prednisolone and acyclovir, individually and in combination, in the early treatment of Bell’s palsy.

METHODS

Double-blind, placebo-controlled randomized trial conducted across 17 hospitals in Scotland.

Patients

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