[Medicinal treatment of Bell's palsy: effect of prednisolone not sufficiently demonstrated].
Bell's palsy is an acute idiopathic paralysis of the facial nerve. Antiviral drugs and corticosteroids have been suggested as treatment. Due to a lack of consistent, significant treatment effects in various studies, controversy has remained. Recently, a large randomised placebo-controlled, Scottish study concluded that corticosteroids significantly improve outcome in all patients with Bell's palsy. In our opinion the study had several considerable drawbacks. For instance, the results were not in accordance with the expected natural course. Also an analysis of the effect of treatment between patients with complete or incomplete Bell's palsy could not be made. A meta-analysis shows a significant effect of corticosteroids due to domination by the Scottish study. Therefore, we consider it inappropriate to treat all Bell's palsy patients with corticosteroids and patients with incomplete palsy should not be treated at all. More research is needed to clarify the role of corticosteroids in patients with complete Bell's palsy.
Romijn
M
M
Academisch Medisch Centrum/Universiteit van Amsterdam, afd. Neurologie, H2-222, Postbus 22.660, 1100 DD Amsterdam.
de Gans
K
K
Vermeulen
M
M
D020330:Bell Palsy / Q000188:drug therapy*; D019317:Evidence-Based Medicine; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D011239:Prednisolone / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
D005938:Glucocorticoids; D011239:Prednisolone