title: Bell's palsy treatment with acyclovir and prednisone compared with prednisone alone: a double-blind, randomized, controlled trial.
abstract: In a double-blind study, we compared the final outcome of 99 Bell's palsy patients treated with either acyclovir-prednisone (53 patients) or placebo-prednisone (46 patients). For patients receiving acyclovir, the dosage was 2,000 mg (400 mg 5 times daily) for 10 days. Electrical tests included electroneurography and the maximal stimulation test. Univariate comparisons of outcome and electrical tests between the two groups were made with chi 2 analysis, Fisher's exact test, and t-tests. The outcome in acyclovir-prednisone-treated patients was superior to that in placebo-prednisone-treated patients. Treatment with acyclovir-prednisone was statistically more effective in returning volitional muscle motion (recovery profile of 10; p = .02) and in preventing partial nerve degeneration (p = .05) than placebo-prednisone treatment. The t-tests indicated that the recovery profile and index means were significantly better for the acyclovir-treated group (recovery profile t = 1.99, p = .051; recovery index t = 2.10, p = .040). We conclude that acyclovir-prednisone is superior to prednisone alone in treating Bell's palsy patients and suggest that herpes simplex is the probable cause of Bell's palsy.
authors.affiliation: Department of Head and Neck Surgery, Kaiser Permanente Medical Center, Oakland, CA 94611-5693, USA.
authors.forename: K K
authors.initials: KK
authors.lastname: Adour
authors.forename: J M
authors.initials: JM
authors.lastname: Ruboyianes
authors.forename: P G
authors.initials: PG
authors.lastname: Von Doersten
authors.forename: F M
authors.initials: FM
authors.lastname: Byl
authors.forename: C S
authors.initials: CS
authors.lastname: Trent
authors.forename: C P
authors.initials: CP
authors.lastname: Quesenberry
authors.forename: T
authors.initials: T
authors.lastname: Hitchcock
mesh_terms: D000212:Acyclovir / Q000008:administration & dosage / Q000627:therapeutic use*; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005158:Facial Paralysis / Q000188:drug therapy* / Q000209:etiology / Q000821:virology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011241:Prednisone / Q000008:administration & dosage / Q000627:therapeutic use*; D018139:Simplexvirus / Q000472:pathogenicity
chemical_list: D000893:Anti-Inflammatory Agents; D011241:Prednisone; D000212:Acyclovir