Objectives: To evaluate the efficacy of prednisolone and/or acyclovir in the treatment of
Bell's palsy in relation to severity at the first visit.
Design: A prospective, randomised, placebo-controlled study.
Setting: Four public outpatient ENT clinics.
Patients: 603 patients aged 18-70 years were treated within 72 h of palsy onset. Patients were
assigned to three groups; group 1 treated with prednisolone plusplacebo (n = 198), group 2 treated with
acyclovir plus placebo (n 203), and group 3 treated with prednisolone plus acyclovir in = 202). Each
group was divided into three subgroups according to severity of palsy at presentation using the Sunnybrook
score; severe; moderate and mild. Point of assessment was at the end of the 12th month.
Main outcome measures: Facial function and synldnesis were evaluated for correlation to severity of
palsy at baseline.
Results: In patients with severe palsy, complete recovery at 12 months was 56% with prednisolone,
41.6% with acyclovir and 55.5% in prednisolone plus acyclovir group. In patients with moderate palsy,
recovery was 64.5%, 56.6% and 70.2% in groups 1,2 and 3 respectively. In patients with mild palsy,
recovery was 92%, 62.6% and 91.5% in groups 1,2 and 3, respectively. Complete recovery and absence
of slinkiness results were correlated to the baseline severity. Group 3 had significant higher results in
moderate palsy cases.
Conclusion: Prednisolone treatment resulted in higher complete recovery rates, regardless of severity
at presentation. Prednisolone treatment should be considered in all patients irrespective of degree of
palsy.
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Allied Sciences. |
