Advertisement

Bell’s Palsy

  • Mark Syms
  • Mitchell Ramsey

Abstract

A computerized Ovid search of MEDLINE 1966–2005 was performed. The terms “facial paralysis” and “Bell’s palsy” were exploded, resulting in 1043 articles. These results were limited to English language and therapy-related subheadings yielding 293 trials, which were reviewed. Trials evaluating steroid treatment were reviewed to identify those that met inclusion criteria consisting of: 1) patients with Bell’s palsy (idiopathic facial nerve paralysis), 2) intervention with systemic steroids, 3) treatment within 10 days of onset, 4) outcome measures consisting of normal motor facial recovery [House-Brackmann (HB) or similar scale]. Exclusion criteria included: 1) trials including multiple, etiologies of facial paralysis, 2) multiple interventions, 3) treatment initiated after 10 days of onset. The references of these articles were then reviewed and manually cross-checked to ensure all applicable literature was reviewed. This search yielded five randomized controlled trials (RCTs) [1, 2, 3, 4, 5] and four systematic reviews [6, 7, 8, 9] that met inclusion criteria.

Keywords

Facial Nerve Herpes Zoster Steroid Treatment Surgical Decompression Facial Paralysis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Taverner D. Cortisone treatment of Bell’s palsy. Lancet 1954;2:1052–1054.CrossRefGoogle Scholar
  2. 2.
    May M, Wette R, Hardin WB Jr, Sullivan J. The use of steroids in Bell’s palsy: a prospective controlled study. Laryngoscope 1976;86(8):1111–1122.CrossRefPubMedGoogle Scholar
  3. 3.
    Wolf SM, Wagner JH, et al. Treatment of Bell palsy with prednisone: a prospective, randomized study. Neurology 1978;28(2):158–161.PubMedGoogle Scholar
  4. 4.
    Unuvar E, Oguz F, et al. Corticosteroid treatment of childhood Bell’s palsy. Pediatr Neurol 1999;21(5):814–816.CrossRefPubMedGoogle Scholar
  5. 5.
    Lagalla G, Logullo F, et al. Influence of early high-dose steroid treatment on Bell’s palsy evolution. Neurol Sci 2002;23(3):107–112.CrossRefPubMedGoogle Scholar
  6. 6.
    Williamson IG, Whelan TR. The clinical problem of Bell’s palsy: is treatment with steroids effective? Br J Gen Pract 1996;46(413):743–747.PubMedGoogle Scholar
  7. 7.
    Ramsey MJ, DerSimonian R, et al. Corticosteroid treatment for idiopathic facial nerve paralysis: a meta-analysis. Laryngoscope 2000;110(3 Pt 1):335–341.CrossRefPubMedGoogle Scholar
  8. 8.
    Grogan PM, Gronseth GS. Practice parameter: steroids, acyclovir, and surgery for Bell’s palsy (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology 2001;56(7):830–836.PubMedGoogle Scholar
  9. 9.
    Salinas R, Alvarez G, et al. Corticosteroids for Bell’s palsy (idiopathic facial paralysis). Cochrane Database Syst Rev 2004;(4):CD001942.Google Scholar
  10. 10.
    House JW, Brackmann DE. Facial nerve grading system. Otolaryngol Head Neck Surg 1985;93(2):146–147.PubMedGoogle Scholar
  11. 11.
    Peitersen E. Bell’s palsy: the spontaneous course of 2,500 peripheral facial nerve palsies of different etiologies. Acta Otolaryngol Suppl 2002;(549):4–30.Google Scholar
  12. 12.
    Brown JS. Bell’s palsy: a 5 year review of 174 consecutive cases—an attempted double blind study. Laryngoscope 1982;92(12):1369–1373.CrossRefPubMedGoogle Scholar
  13. 13.
    Austin JR, Peskind SP, et al. Idiopathic facial nerve paralysis: a randomized double blind controlled study of placebo versus prednisone. Laryngoscope 1993;103(12):1326–1333.CrossRefPubMedGoogle Scholar
  14. 14.
    Shafshak TS, Essa AY, et al. The possible contributing factors for the success of steroid therapy in Bell’s palsy: a clinical and electrophysiological study. J Laryngol Otol 1994;108(11):940–943.CrossRefPubMedGoogle Scholar

References

  1. 1.
    Adour KK, Ruboyianes JM, Von Doersten PG, Byl FM, Trent CS, Quesenberry CP Jr, Hitchcock T. Bell’s palsy treatment with acyclovir and prednisone compared with prednisone alone: a double-blind, randomized, controlled trial. Ann Otol Rhinol Laryngol 1996;105(5):371–378.PubMedGoogle Scholar
  2. 2.
    De Diego JI, Prim M P, et al. Idiopathic facial paralysis: a randomized, prospective, and controlled study using singledose prednisone versus acyclovir three times daily. Laryngoscope 1998;108(4 Pt 1):573–575.CrossRefPubMedGoogle Scholar
  3. 3.
    Hato N, Matsumoto S, et al. Efficacy of early treatment of Bell’s palsy with oral acyclovir and prednisolone. Otol Neurotol 2003;24(6):948–951.CrossRefPubMedGoogle Scholar
  4. 4.
    House JW, Brackmann DE. Facial nerve grading system. Otolaryngol Head Neck Surg 1985;93(2):146–147.PubMedGoogle Scholar
  5. 5.
    Adour KK, Wingerd J, et al. Prednisone treatment for idiopathic facial paralysis (Bell’s palsy). N Engl J Med 1972;287(25):1268–1272.PubMedCrossRefGoogle Scholar

Reference

  1. 1.
    Gantz BJ, Rubinstein JT, Gidley P, Woodworth GG. Surgical management of Bell’s palsy. Laryngoscope 1999;109(8):1177–1188.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • Mark Syms
    • 1
  • Mitchell Ramsey
    • 2
  1. 1.Division of Neurotology, Department of NeurosurgeryBarrow Neurological InstitutePhoenixUSA
  2. 2.Tripler Army Medical CenterHonoluluUSA

Personalised recommendations