[Arguments favouring the pharmacotherapy of Bells' palsy].
Some clinicians claim a spontaneous complete recovery of facial nerve function after Bell's palsy in more than 80% of patients. However, for elderly patients and patients with a severe paresis/paralysis this is not the case. The main cause of Bell's palsy is probably reactivation of latent herpes viruses. Recent literature supports treatment with corticosteroids and antiviral medication, inhibiting viral replication and reducing oedema in the bony canal of the facial nerve. Using this medication in the first days of the disease provides a further 15% of patients with a good outcome in addition to the ones that improve spontaneously. Therefore, prednisone and valacyclovir are recommended for all patients with Bell's palsy and severe dysfunction, i.e. House-Brackmann facial grading scale IV, V and VI.
de Ru
J A
JA
Universitair Medisch Centrum Utrecht, afd. Keel-, Neus- en Oorheelkunde, Postbus 85.500, 3508 GA Utrecht.
van Benthem
P P G
PP
Hordijk
G J
GJ
D000212:Acyclovir / Q000031:analogs & derivatives / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D000998:Antiviral Agents / Q000627:therapeutic use*; D020330:Bell Palsy / Q000188:drug therapy* / Q000209:etiology; D006566:Herpesviridae Infections / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D011241:Prednisone / Q000627:therapeutic use; D016896:Treatment Outcome; D000077483:Valacyclovir; D014633:Valine / Q000031:analogs & derivatives / Q000627:therapeutic use; D014775:Virus Activation / Q000187:drug effects
D000893:Anti-Inflammatory Agents; D000998:Antiviral Agents; D014633:Valine; D000077483:Valacyclovir; D011241:Prednisone; D000212:Acyclovir