Steroid-antiviral Treatment Improves the Recovery Rate in Patients with Severe Bell's Palsy

Lee, Ho Yun; Byun, Jae Yong; Park, Moon Suh; Yeo, Seung Geun

doi:10.1016/j.amjmed.2012.08.020

Cited by 73 publications

(60 citation statements)

References 27 publications

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“…Therefore, antiviral treatment is likely to benefit patients, providing that treatment is started early and that the severe cases are given a high enough dose to cover an infection with varicella as well. 19,24,43,63,[68][69][70][71] Table II shows that the pooled odds ratio for patients with initial severe palsy recovering to at least House-Brackmann grade II is 1.985 (95 per cent CI = 1.334-2.952). If the data from the paper by Quant et al 67 are updated, the results of combination therapy in prospective trials are likely to be significantly better than those for monotherapy, with an odds ratio of 1.712 (95 per cent confidence interval (CI) = 1.172-2.501) (Table I).…”

Section: Antiviral Medicationmentioning

confidence: 99%

Antiviral agents convey added benefit over steroids alone in Bell's palsy; decompression should be considered in patients who are not recovering

Brennan

Martens

2015

J. Laryngol. Otol.

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Section: Antiviral Medicationmentioning

confidence: 99%

Antiviral agents convey added benefit over steroids alone in Bell's palsy; decompression should be considered in patients who are not recovering

Brennan

Martens

2015

J. Laryngol. Otol.

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“…23 Antiviral ajanlar, sinir yaralanmasının etyolojisinde bir faktör olan endonöral ödemi azaltmaya yardım ederler. 25 Hiperbarik oksijen (HBO) ise, akut travmatik yaralanmalarda yardımcı tedavidir, endo-nöral ödem ve kapiller damarlardaki basınç riskini azalttığı bildirilmiştir. 26 Toros ve ark.…”

Section: Sġnġr Tamġrġ Medikal Tedaviunclassified

Di̇ş Heki̇mli̇ği̇nde Peri̇feri̇k Si̇ni̇r Yaralanmalari Ve Tedavi̇si̇

Er¹,

Duygu²,

Çanakçi³

et al. 2015

Atatürk Üniversitesi Diş Hekimliği Fakültesi Dergisi

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ÖZDiş hekimliğinde periferik sinir yaralanmaları, rutin işlemler sırasında, cerrahi uygulamalarda veya travma sonucunda sıklıkla karşılaşılan olgulardır. Sinirin yapısı ve sinir hasarı mekanizmaları konusunda bilgi sahibi olmak, doğru teşhis ve tedavi için oldukça önemlidir. Sinir yaralanmalarının tedavisi, temel olarak medikal tedavi ve cerrahi tedavi olarak ikiye ayrılır. Medikal tedavinin sonuç vermediği hastalarda, muhtemel cerrahi tedavi için seçenek ve sonuçlarını bilmek, bu kritik komplikasyonda, doğru zamanlama ve uygulama açısından büyük önem arz etmektedir. Bu derlemenin amacı; diş hekimliği klinik uygulamalarında karşılaşıla-bilecek periferik sinir yaralanmaları sebeplerini hatırlamak ve mevcut kitap bilgileri ile güncel literatür bilgilerini harmanlayarak bu önemli komplikasyon hakkında bilgi sahibi olmaktır. Anahtar kelimeler: diş hekimliği; medikal tedavi; periferik sinir yaralanması; sinir cerrahisi GĠRĠġSinir sistemi iç ve dış ortamda oluşan değişik-liklere ani yanıtın oluşturulduğu sistemdir. İç ortamda oluşan değişiklikleri düz kas, kalp kası ve salgı bezlerine gönderdiği emirlerle düzenleyip kontrol ederken; dış ortamda oluşan değişikliklere iskelet kaslarına emir göndererek yanıt verir. 1 İnsan vücudunda, sinir sistemi; merkezi sinir sistemi (MSS) ve periferik (çevresel) sinir sistemi (PSS) olarak iki kısımda incelenir.PSS'yi oluşturan sinirler horizontal kesitte içten dışa doğru incelendiğinde en dışta arter, ven ve lenfa- ABSTRACTPeripheral nerve injuries are frequently seen during routine procedures, surgical operations or after traumas in dentistry. Knowledge about the structure of the nerve tissue and nerve damage mechanisms is important for accurate diagnosis and treatment. Management of nerve injury is basically divided in two as medical and surgical treatment. It has a great importance to be aware of surgical treatment options and their possible results for correct timing and treatment in patients who do not respond to medical therapy. The purpose of this review is to to have information about peripheral nerve injuries and recent treatment approaches in clinical dental practice combining the book information and current literature. Key words: dentistry; peripheral nerve injury; medical treatment; surgical treatment tiklerin bulunduğu gevşek yapısı ile siniri dış etkenlere karşı koruyan epinöriyum tabakası görülür. Hemen altındaki perinöriyum, fasikül adı verilen akson demetlerini saran kuvvetli bir bağ dokusu olup, travma ve iskemiye karşı çok dayanıklıdır ve bu bariyerin bozulması halinde sinir iletimi önemli ölçüde etkilenir. Endonöriyum ise sinir liflerini çevreleyen gevşek bağ dokusu olup, içerisinde aksonlar, Schwann hücreleri, kollajen lifler, fibroblastlar, kapiller damarlar ve az sayıda mast hücresi ile makrofajlar vardır. Fasikül ise periferik sinirin en küçük anatomik birimi olup, cerrahi olarak diseke edilebilir ve görülebilir. 2

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“…However, since the findings did not reach statistical significance, the authors concluded that prednisone remains the single best evidence-based treatment for Bell’s palsy [61]. A 2013 study in Korea found a statistically significant improvement in patients with severe facial palsy when given famciclovir plus steroids within 1 week of presentation vs. steroids alone [67]. These results are promising, but it is unlikely that additional studies will significantly change current clinical practice due to the modest benefit of adding antivirals [68].…”

Section: Management Of Bell’s Palsymentioning

confidence: 99%

The neurologist’s dilemma: A comprehensive clinical review of Bell’s palsy, with emphasis on current management trends

Loukas

2014

Med Sci Monit

110

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BackgroundRecent advances in Bell’s palsy (BP) were reviewed to assess the current trends in its management and prognosis.Material/MethodsWe retrieved the literature on BP using the Cochrane Database of Systematic Reviews, PubMed, and Google Scholar. Key words and phrases used during the search included ‘Bell’s palsy’, ‘Bell’s phenomenon’, ‘facial palsy’, and ‘idiopathic facial paralysis’. Emphasis was placed on articles and randomized controlled trails (RCTs) published within the last 5 years.ResultsBP is currently considered the leading disorder affecting the facial nerve. The literature is replete with theories of its etiology, but the reactivation of herpes simplex virus isoform 1 (HSV-1) and/or herpes zoster virus (HZV) from the geniculate ganglia is now the most strongly suspected cause. Despite the advancements in neuroimaging techniques, the diagnosis of BP remains one of exclusion. In addition, most patients with BP recover spontaneously within 3 weeks.ConclusionsCorticosteroids are currently the drug of choice when medical therapy is needed. Antivirals, in contrast, are not superior to placebo according to most reliable studies. At the time of publication, there is no consensus as to the benefit of acupuncture or surgical decompression of the facial nerve. Long-term therapeutic agents and adjuvant medications for BP are necessary due to recurrence and intractable cases. In the future, large RCTs will be required to determine whether BP is associated with an increased risk of stroke.

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Steroid-antiviral Treatment Improves the Recovery Rate in Patients with Severe Bell's Palsy

Cited by 73 publications

References 27 publications

Antiviral agents convey added benefit over steroids alone in Bell's palsy; decompression should be considered in patients who are not recovering

Antiviral agents convey added benefit over steroids alone in Bell's palsy; decompression should be considered in patients who are not recovering

Di̇ş Heki̇mli̇ği̇nde Peri̇feri̇k Si̇ni̇r Yaralanmalari Ve Tedavi̇si̇

The neurologist’s dilemma: A comprehensive clinical review of Bell’s palsy, with emphasis on current management trends

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