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Bell’s palsy is a weakness of facial muscle from inflammation of the facial nerve. Sometimes this is caused by an infection, but many times the cause is unknown. The paralysis is usually temporary. Treating this illness with steroids has been debated for many years because there has been no good evidence. A study published in the New England Journal of Medicine offers new hope for quick recovery from Bell’s palsy with the steroid medication called prednisolone.

About the Study

Researchers compared prednisolone to a placebo in 496 patients over 16 years old (patients with herpes zoster were excluded). There were four different groups in the study. Two of the groups were given acyclovir, a medication used to treat some viral infections. There was no benefit shown with this medication. The patients who were treated with prednisolone, were given 25 mg twice daily for 10 days starting within 72 hours of symptoms.

Patients taking prednisolone (with or without acyclovir) had better recovery than those taking the placebo. At three months, 83% of the prednisolone group were symptom-free compared to only 63% of the placebo group. At nine months, 94% of the prednisolone group had no symptoms compared to 81% of the placebo group. While at the end of nine months many in the placebo group did experience full recovery, the treatment group recovered sooner. There were very few bad reactions to the medication. Common side effects to any steroid include dizziness, insomnia , and night sweats.

How Does This Affect You?

Bell’s palsy occurs annually at a rate of 25 per 100,000. As seen by this study, most patients will recover completely without any treatment. A long recovery can be uncomfortable and unpleasant. If you have any symptoms of facial muscle weakness, call your physician immediately so you can receive prompt treatment.

  • American Academy of Otolaryngology—Head and Neck Surgery

    http://www.entnet.org/healthinfo/topics/bells.cfm

  • National Institute of Neurological Disorders and Stroke

    http://www.ninds.nih.gov/disorders/bells/bells.htm

  • Sullivan FM, Swan IR, Donnan PT, Morrison JM, Smith BH, McKinstry B, et al. Early treatment with prednisolone or acyclovir in Bell's palsy. N Engl J Med . 2007 Oct 18;357(16):1598-607.