Bells Palsy Info

Treatment of Bells palsy is a matter of controversy. Two Cochrane reviews from 2004 underlined the need for larger, properly designed clinical trials to evaluate antiviral drugs[17] or corticosteroids[18] for Bell's palsy. The effect of treatment is difficult to evaluate experimentally because spontaneous recovery (without any treatment) is common.

In patients presenting with incomplete facial palsy, where the prognosis for recovery is very good, treatment may be unnecessary. Patients presenting with complete paralysis, marked by an inability to close the eyes and mouth on the involved side, are usually treated. Early treatment (within 3 days after the onset) seems to be necessary for therapy to be effective.

Prednisolone, a corticosteroid, if used early in treatment of Bell's palsy, significantly improves the chances of complete recovery at 3 and 9 months when compared to treatment with the anti-viral drug acyclovir or no treatment at all.[20]

The possible link between Bell's palsy and the herpes simplex and varicella zoster virus has led to the prescription of anti-viral medications (such as acyclovir or valaciclovir) to patients with unexplained facial palsy. Recently (2007), a large randomized clinical trial reported no additional benefit from acyclovir beyond that from prednisolone alone.[20]

The efficacy of acupuncture remains unknown because the available studies are of low quality (poor primary study design or inadequate reporting practices).[21] Surgical procedures to decompress the facial nerve have been attempted, but have not been proven beneficial.

A 2005 practice parameter from the American Academy of Neurology states that "corticosteroids are safe and probably effective, and that acyclovir is safe and possibly effective".[22]

Physiotherapy is also a vital part of Bell's palsy since it is a nerologic condition. Facial kabat techniques and criostimulation along with exercises based on facial mimicry have shown good results in clinical practice.

Source: Wikipedia