Steroid plus antiviral treatment for Bell's palsy

• Published in: Journal of internal medicine Vol. 277; no. 5; pp. 532 - 539
• Main Authors: Kang, H. M., Jung, S. Y., Byun, J. Y., Park, M. S., Yeo, S. G.
• Format: Journal Article
• Language: English
• Published: England 01.05.2015
• Subjects: Administration, Oral; Adolescent; Adult; age; Aged; Antiviral Agents - administration & dosage; antivirals; Bell Palsy - drug therapy; Bell's palsy; Child; Child, Preschool; Drug Administration Schedule; Drug Therapy, Combination; electroneurography; Female; Glucocorticoids - administration & dosage; Humans; Male; Middle Aged; Prednisolone - administration & dosage; severity; steroid; Treatment Outcome; Young Adult; severity; antivirals; electroneurography; age; Bell's palsy; steroid
• ISSN: 0954-6820; 1365-2796; 1365-2796
• DOI: 10.1111/joim.12288

Objectives The effectiveness of antiviral agents for the treatment of Bell's palsy is uncertain. We evaluated whether a steroid with an antiviral agent (S + A group) provided better recovery outcomes than a steroid alone (S group) in patients with Bell's palsy. Subjects and design A total of 1342 patients diagnosed with Bell's palsy who visited the Kyung Hee Medical Center in Seoul, Korea, from 2002 to 2012 were included in this study. Patients in the S + A group were treated with prednisolone and antiviral agents (n = 569) and those in the S group with prednisolone alone (n = 773). Outcomes were measured using the House–Brackmann (HB) scale according to age, initial disease severity, electroneurography (ENoG) findings and underlying comorbidities. Results The rate of recovery (HB grades I and II) with initially severe Bell's palsy (HB grades V and VI) was higher in the S + A than in the S group (P = 0.001). However, the rates of recovery were similar with initially moderate palsy (HB grades II–IV) (P = 0.502). In patients classified according to age and ENoG‐determined severity of palsy, the overall recovery rate was higher in the S + A than in the S group, but the differences were not statistically significant (P > 0.05 for both). The recovery rate without diabetes mellitus (DM) and hypertension (HTN) was higher in the S + A group than in the S group (P = 0.031). But in the patients with HTN and DM, the difference in recovery rates between the S + A and S groups was not statistically significant (P = 0.805). Conclusions Treatment with a steroid plus antiviral agent resulted in significantly higher recovery rates than steroid therapy alone in patients with initially severe Bell's palsy and without either HTN or DM, and a nonsignificant trend towards higher recovery rates in all patients with Bell's palsy in this study. Antiviral agents may therefore help in the treatment of Bell's palsy.