Study examines effect of prednisolone in patients with Bell palsy

CHICAGO – Treatment for Bell palsy (a condition involving the facial nerve and characterized by facial paralysis) with the corticosteroid prednisolone within 72 hours appeared to significantly reduce the number of patients with mild to moderate palsy severity at 12 months, according to a report in the May issue of Archives of Otolaryngology – Head & Neck Surgery, a JAMA Network publication.

The cause of Bell palsy is unknown but one theory is that a reactivation of latent herpes simplex virus may cause injury to the facial nerve. Most people fully recover from Bell palsy within six months without treatment, but some have varying degrees of sequelae (lasting effects) with functional, psychosocial and esthetic consequences, the authors write in the study background.

Thomas Berg, M.D., Ph.D., of Oslo University Hospital Rikshospitalet, Norway, and colleagues report data from a large Swedish and Finnish Scandinavian Bell's Palsy Study, a randomized placebo-controlled trial. Patients were divided into one of four treatment groups: placebo plus placebo, prednisolone plus placebo, the antiviral valacyclovir plus placebo or prednisolone plus valacyclovir.

The study included 829 patients ages 18 to 75 years. The investigators evaluated facial function at 12 months using the Sunnybrook and House-Brackmann grading systems.

"To conclude, treatment with prednisolone significantly reduced mild and moderate sequelae in Bell's palsy at 12 months. Prednisolone did not reduce the number of patients with severe sequelae. Valacyclovir alone did not affect the severity of sequelae. The combination of prednisolone plus valacyclovir did not reduce the number of patients with sequelae compared with prednisolone alone," the authors write.

(Arch Otolaryngol Head Neck Surg. 2012;138[5]:445-449. Available pre-embargo to the media at http://media.jamanetwork.com.)

Editor's Note: The study was supported by Uppsala University and Acta Otolaryngologica Foundation. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

To contact Thomas Berg, M.D., Ph.D., email thomas.berg@lycos.com.