Steroid/Antiviral for the treatment of Bell's palsy: Double blind randomized clinical trial.
A large number of patients with Bell's palsy fail to recover facial function completely after steroid therapy. Only a few small trials have been conducted to test whether outcomes can be improved by the addition of antiviral therapy.



To evaluate the efficacy of treatment with steroid alone versus steroid + antiviral in a group of patients with moderately severe to severe acute Bell's palsy.



Fifty eligible patients out of a total of 65 with acute onset Bell's palsy were randomized to receive the two treatments. Evaluation was performed before starting treatment, after 2 weeks of treatment and 3 months after onset, using the House and Brackmann facial nerve grading system (HB) and the Sunnybrook grading system.This study was registered with ClinicalTrials.gov, number NCT02328079.



Both treatments had comparable demographics and clinical scores at baseline. There was greater improvement in the mean HB and Sunnybrook scores of the steroid + antiviral group in comparison to steroid group at 3 months. At the end of the 3rd month, 17 patients (68%) had good recovery and 8 patients (32%) had poor recovery in the steroid group compared with 23 patients (92%) and 2 (8%) respectively in the steroid and antiviral group (p = 0.034).



The combination of steroid and antiviral treatment increases the possibility of recovery in moderately severe to complete acute Bell's palsy.
Department of Neuropsychiatry, Assiut University Hospital, Assiut, Egypt.
Eman Mohamed
EM
Khedr
Department of Neuropsychiatry, Assiut University Hospital, Assiut, Egypt.
Reda
R
Badry
Department of Neuropsychiatry, Assiut University Hospital, Assiut, Egypt.
Anwer Mohamed
AM
Ali
Department of Neuropsychiatry, Assiut University Hospital, Assiut, Egypt.
Noha
N
Abo El-Fetoh
Department of Rheumatology and Rehabilitation, Assiut University Hospital, Assiut, Egypt.
Dina Hatem
DH
El-Hammady
Department of Rheumatology and Rehabilitation, Assiut University Hospital, Assiut, Egypt.
Abeer Mohamed
AM
Ghandour
Department of Neuropsychiatry, Assiut University Hospital, Assiut, Egypt.
Ahmed
A
Abdel-Haleem
D000212:Acyclovir / Q000627:therapeutic use*; D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D020330:Bell Palsy / Q000188:drug therapy*; D004311:Double-Blind Method; D004576:Electromyography; D019054:Evoked Potentials, Motor / Q000187:drug effects / Q000502:physiology; D005154:Facial Nerve / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009431:Neural Conduction / Q000187:drug effects; D012720:Severity of Illness Index; D013256:Steroids / Q000627:therapeutic use*; D016896:Treatment Outcome; D055815:Young Adult
D000998:Antiviral Agents; D013256:Steroids; D000212:Acyclovir
Bell’s palsy; electroneurography; prognosis; steroid/antiviral