Acyclovir Versus Steroids in the Treatment of Bell’s Palsy

  • M. L. Navarrete
  • P. Quesada
  • V. Gimeno
  • A. Garcia
  • M. Garcia
Conference paper

Abstract

Bell’s palsy is the most common form of all facial paralyses with a peripheral cause [1]. In spite of this, at present we do not have any specific treatment at our disposal, since the etiopathogenesis of the disease has not been sufficiently proven. Most authors support its immunovirological origin, which implies the reactivation of a latent virus as a leading agent of cross-immunological chain reactions between the facial nerve and the viral antigens [5]. Until now, a number of empirical treatments have been implemented. Findings which demonstrated an inflammatory reaction on a local and systemic level, immunity changes at a peripheral level, and the phenomena of nervous demyelination gave rise to steroidal therapy [6, 7]. Nevertheless, these results have been much disputed. That is why, based on the rising protagonism of the herpes simplex-1 virus in this pathology, serological studies carried out by various authors, the isolation of this virus in specimens of the epineural tissue in a patient with Bell’s palsy, and our own experience in this field, we decided to start a treatment with acyclovir for this type of patient beginning in November 1988 [10, 11].

Keywords

Peri Prednisone Clarification Acyclovir 

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References

  1. 1.
    Adour KK, Bell DN, Hilsinger RL (1975) Herpes simplex virus in idiopathic facial paralysis ( Bell’s palsy ). Jama 233: 527–530Google Scholar
  2. 2.
    Al Husain A, Jamal GA, Hilmi AM (1986) Steroids therapy in Bell’s palsy. Int J Clin Pharmacol Ther Toxicol 24 /8: 430–432Google Scholar
  3. 3.
    Dickins JR, Smith JT, Graham SS (1988) Herpes zoster oticus: treatment with intravenous acyclovir. Laryngoscope 98 /7: 776–779PubMedCrossRefGoogle Scholar
  4. 4.
    Hase K, Shiraishi M, Hasumi K, Kamiyama Y, Sugita R (1986) The effect of acyclovir on fresh Bell’s palsy. Facial N Res Jpn 6: 31–34Google Scholar
  5. 5.
    Hughes GB, Barna BP, Kinney SE, Goren H, Sweeney PJ, Valenzuela R, Calabrese LH, Tucker HM (1986) Immune reactivity in Bell’s palsy. Otolaryngol Head Neck Ther 95: 586–588Google Scholar
  6. 6.
    Liston SL, Kleid MS (1989) Histopathology of Bell’s palsy. Laryngoscope 99: 23–26PubMedGoogle Scholar
  7. 7.
    Matsumoto Y, Petterson MJ, Pulec JL, Yanagihara N (1988) Facial nerve biopsy for etiologic clarification of Bell’s palsy. Ann Otol Rhinol Laryngol 97 [Suppl 13]: 22–27Google Scholar
  8. 8.
    May M, Klein SR, Taylor PH (1985) Idiopathic (Bell’s) facial palsy: natural history defies steroid or surgical treatment. Laryngoscope 95: 406–409PubMedCrossRefGoogle Scholar
  9. 9.
    Mckendrick MW, McGill J, White JE, Wood MJ (1986) Oral acyclovir in acute herpes zoster. BMJ 293: 1529–1532PubMedCrossRefGoogle Scholar
  10. 10.
    Mulkens PS (1980) Acute facial paralysis: a virological study. Clin Otolaryngol Engl 5: 303–310CrossRefGoogle Scholar
  11. 11.
    Nakamura K, Yanagihara N (1988) Neutralization antibody to herpes simplex virus type I in Bell’s palsy. Ann Otol Rhinol Laryngol 97 [Suppl 137]: 18–21Google Scholar
  12. 12.
    Peterslund NA. Esmann V, Ipsen J, Christensen KD, Petersen CM (1984) Oral and intravenous acyclovir are equally effective in herpes zoster. Antimicrob Chemother 14: 185–189CrossRefGoogle Scholar
  13. 13.
    Prescott CAJ (1988) Idiopathic facial nerve palsy (the effect of treatment with steroids). Laryngol Otol 102: 403–407Google Scholar
  14. 14.
    Shiraishi M, Hase R, Kamiyama Y (1987) The effect of acyclovir on Bell’s palsy. Facial N Res Jpn 7: 199–202Google Scholar
  15. 15.
    Stankiewicz JA (1983) Steroids and idiopathic facial paralysis. Otolaryngol Head Neck Surg 991: 672–677Google Scholar

Copyright information

© Springer-Verlag 1994

Authors and Affiliations

  • M. L. Navarrete
    • 1
  • P. Quesada
    • 1
  • V. Gimeno
    • 1
  • A. Garcia
    • 1
  • M. Garcia
    • 1
  1. 1.Department of OtorhinolaryngologyAutonomous University of BarcelonaSpain

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