Acyclovir plus steroid vs steroid alone in the treatment of Bell's palsy.
OBJECTIVE
The pathogenetic mechanism of Bell's palsy is thought to involve herpes simplex virus reactivation within the geniculate ganglion, followed by inflammation and entrapment of the nerve at the meatal foramen. We therefore compared the therapeutic effect of acyclovir plus steroid vs steroid alone, in combination with physical therapy, in patients with Bell's palsy.


METHODS
In a double-blind, randomized, prospective trial, 91 patients were randomized to treatment with acyclovir and prednisone (44 patients) or prednisone alone (47 patients). All patients underwent physical therapy. The follow-up period was greater than 6 months or encompassed the period of complete recovery from paralysis. House-Brackmann grade was evaluated 2 and 6 months after onset, with complete and satisfactory recovery defined as House-Brackmann grades I and II, respectively.


RESULTS
The overall recovery rate of patients treated with steroid and acyclovir (93.1%) was greater than that of patients treated with steroid alone (85.1%), but the difference was not statistically significant.


CONCLUSIONS
The benefit of acyclovir in Bell's palsy has not been definitively established.
Yeo
Seung Geun
SG
Department of Otolaryngology, College of Medicine, Kyung Hee University, Seoul, South Korea. yeo2park@yahoo.co.kr
Lee
Young Chan
YC
Park
Dong Choon
DC
Cha
Chang Il
CI
D000212:Acyclovir / Q000627:therapeutic use*; D000284:Administration, Oral; D000328:Adult; D000998:Antiviral Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D020330:Bell Palsy / Q000188:drug therapy* / Q000503:physiopathology; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D017060:Patient Satisfaction; D011241:Prednisone / Q000008:administration & dosage / Q000627:therapeutic use*; D011446:Prospective Studies; D020127:Recovery of Function; D016896:Treatment Outcome
D000998:Antiviral Agents; D005938:Glucocorticoids; D011241:Prednisone; D000212:Acyclovir