Corticosteroids for Bell's palsy (idiopathic facial paralysis)

Salinas, Rodrigo; Álvarez, Gonzalo; Ferreira, Joaquim J.

doi:10.1002/14651858.cd001942.pub2

Cited by 105 publications

(107 citation statements)

References 19 publications

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“…9 For Bell's palsy, both corticosteroids and antivirals have been suggested as possible treatments although insufficient evidence had existed to conclusively demonstrate the efficacy of either therapy. 33,34 A recent randomized placebo-controlled, multifactorial trial compared both prednisone and acyclovir to placebo for the treatment of adults with Bell's palsy who presented within 72 hours of symptom onset. 10 Of note, the study was conducted in Scotland where B burgorferi is not endemic and, therefore, no patients with Lyme disease were included (F.M.…”

Section: Discussionmentioning

confidence: 99%

Clinical Predictors of Lyme Disease Among Children With a Peripheral Facial Palsy at an Emergency Department in a Lyme Disease–Endemic Area

et al. 2008

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Section: Discussionmentioning

confidence: 99%

Clinical Predictors of Lyme Disease Among Children With a Peripheral Facial Palsy at an Emergency Department in a Lyme Disease–Endemic Area

et al. 2008

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“…In the absence of skin lesions, the etiologic role of VZV or HSV reactivation is not clinically obvious and must be determined by use of laboratory methods [48][49][50]. It has been suggested that, because of the involvement of VZV or HSV, moderate or severe Bell palsy in adults should be treated with antiviral therapy as well as adjunctive administration of corticosteroids; results of controlled trials, however, have been conflicting [51][52][53][54][55]. Reactivation in the geniculate ganglion can produce skin lesions in the mucocutaneous distribution of its peripheral nerves, including the ear and the side of the tongue.…”

Section: Clinical Aspects Of Hzmentioning

confidence: 99%

Recommendations for the Management of Herpes Zoster

Dworkin

Johnson

Breuer

et al. 2007

Clinical Infectious Diseases

712

581

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The objective of this article is to provide evidence-based recommendations for the management of patients with herpes zoster (HZ) that take into account clinical efficacy, adverse effects, impact on quality of life, and costs of treatment. Systematic literature reviews, published randomized clinical trials, existing guidelines, and the authors' clinical and research experience relevant to the management of patients with HZ were reviewed at a consensus meeting. The results of controlled trials and the clinical experience of the authors support the use of acyclovir, brivudin (where available), famciclovir, and valacyclovir as first-line antiviral therapy for the treatment of patients with HZ. Specific recommendations for the use of these medications are provided. In addition, suggestions are made for treatments that, when used in combination with antiviral therapy, may further reduce pain and other complications of HZ.

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“…Interestingly, the same holds true for the use of steroids although most national and international guidelines recommend steroids for management of BP [9,17]. Famciclovir, the most recent aciclovir analogue, offers important advantages in virostatic therapy with excellent oral bioavailability and longer intracellular half-life of its active metabolite than aciclovir in VZVinfected cells.…”

Section: Introductionmentioning

confidence: 99%

Bell’s palsy

et al. 2008

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There is insufficient evidence concerning the efficacy of antiviral treatment of Bell's palsy (BP). We therefore compared the efficacy of prednisone and famciclovir to prednisone treatment alone in BP. A total of 167 consecutive patients with untreated acute BP were included. Severity of BP was evaluated using the House-Brackmann scale (HBS) and virus antibody tests (herpes simplex virus, varicella zoster virus) were performed. Patients admitted on even dates were treated with prednisone ("P group") and patients admitted on odd dates were treated with prednisone and famciclovir ("P+F group"). 117 patients completed the follow-up after 3 months or later (67 P/51 P+F). While most patients showed at least partial recovery with both treatment types, improvement of at least 4 grades in the HBS was more common in the "P+F group" (29.4 % vs. 11.9 %), whereas smaller changes of less than 3 grades were more common in the "P group" (29.9 % vs. 17.6 %; Chi-square test, p = 0.02). Patients with complete BP (HBS grade of 5 or 6) had significantly better chances of reaching normal function if treated with famciclovir additionally instead with prednisone alone (73.7 % vs. 47.1 %; Cochran-Armitage trend test, p = 0.03). These results suggest that the combined treatment of famciclovir and prednisolone should be considered (at least) in patients with severe BP.

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Corticosteroids for Bell's palsy (idiopathic facial paralysis)

Cited by 105 publications

References 19 publications

Clinical Predictors of Lyme Disease Among Children With a Peripheral Facial Palsy at an Emergency Department in a Lyme Disease–Endemic Area

Clinical Predictors of Lyme Disease Among Children With a Peripheral Facial Palsy at an Emergency Department in a Lyme Disease–Endemic Area

Recommendations for the Management of Herpes Zoster

Bell’s palsy

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