Corticosteroids for Bell's palsy (idiopathic facial paralysis). Comerford N, Acute unilateral facial palsy of probable viral aetiology.
Jeste SS, (Strength of Recommendation [SOR]: B, based on inconsistent or limited-quality patient-oriented evidence.) The benefits of steroids versus steroids plus antivirals for treatment of Bell's palsy: a meta-analysis. et al. Guidelines on Bell palsy from the American Academy of Otolaryngology–Head and Neck Surgery Foundation currently recommend prescribing oral corticosteroids … Basura GJ, 2009 Oct 7;(4):CD001869. Peitersen E. doi: 10.1002/14651858.CD001869.pub8. Data from two studies (98 participants) showed that in people with severe Bell's palsy (complete or almost complete facial paralysis), combined antivirals and corticosteroids had no clear effect on recovery compared with corticosteroid treatment alone.
Antivirals should not be used alone to treat Bell palsy.
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).
Ishii LE, doi: 10.3346/jkms.2020.35.e245.J Inflamm Res. Cape AV, All rights Reserved. doi: 10.1002/14651858.CD001869.pub9.Gagyor I, Madhok VB, Daly F, Somasundara D, Sullivan M, Gammie F, Sullivan F.Cochrane Database Syst Rev. 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.
High-dose corticosteroids should be administered in all patients in the absence of significant contraindications. Author information: (1)Department of Neuropsychiatry, Assiut University Hospital, Assiut, Egypt. There may be benefit in adding an antiviral drug to prednisolone in some cases. Quant EC, Copyright © 2016 by the American Academy of Family Physicians.Copyright © 2020 American Academy of Family Physicians. Antiviral treatment for Bell's palsy (idiopathic facial paralysis).
339:b3354. 2015 Jul-Aug;133(4):383. doi: 10.1590/1516-3180.20151334T1.Ann Emerg Med. Pitkethly M, 2019 Oct;39(5):316-321. doi: 10.14639/0392-100X-2415.Cochrane Database Syst Rev. doi: 10.1002/14651858.CD001869.pub5.Lockhart P, Daly F, Pitkethly M, Comerford N, Sullivan F.Cochrane Database Syst Rev. . Combined corticosteroid and antiviral treatment for Bell palsy: a systematic review and meta-analysis.
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. Evidence-based guideline update: steroids and antivirals for Bell palsy: report of the Guideline Development Subcommittee of the American Academy of Neurology. The rate of adverse effects was similar among all of the treatments compared.The results of this review differ slightly from another meta-analysis that found that the routine addition of antivirals to corticosteroid therapy did not improve at least partial recovery.Guidelines on Bell palsy from the American Academy of Otolaryngology–Head and Neck Surgery Foundation currently recommend prescribing oral corticosteroids within 72 hours of symptom onset (grade A) and recommend against the use of antiviral monotherapy (grade A).Author disclosure: No relevant financial affiliations.The practice recommendations in this activity are available at The views expressed in this article are those of the authors and do not reflect the official policy or position of the U.S. government, the Department of the Army, or the Department of Defense.These are summaries of reviews from the Cochrane Library.This series is coordinated by Corey D. Fogleman, MD, Assistant Medical Editor.A collection of Cochrane for Clinicians published in
2019 Sep 5;9(9):CD001869. 2016 Aug 23-30;316(8):874-5. doi: 10.1001/jama.2016.10160.Cochrane Database Syst Rev. The natural history of Bell's palsy. 2015 Jul 1;(7):CD001869. Sullivan F. Please enable it to take advantage of the complete set of features! 2015 Jul 1;(7):CD001869.