Bell’s Palsy Treatment: Steroids vs. Steroids and Antivirals

This article pertained to my H&P on a patient diagnosed with Bell’s Palsy. I was interested in the efficacy of dual steroid and antiviral treatment that was prescribed for the patient I saw in the ED, wondering if steroids alone would not provide the same benefit as the patient did not have any viral illness in the few years preceding her Bell’s Palsy diagnosis. The article is meta-analysis from 2009 comparing the benefit of steroids vs steroids and antivirals in treatment of Bell’s Palsy. The meta-analysis included six randomized control trials that analyzed 1145 patients. The primary outcome was at least partial facial muscle recovery defined by the House-Brackmann grade of at least 2 or an equivalent score on an alternative recognized scoring system. The patients were followed for at least one month. The study found that no difference was seen between patients receiving steroids alone vs. steroids and antivirals in terms of the primary outcome of partial facial muscle recovery. The study concluded that antivirals may provide no benefit in Bell’s Palsy, but also stated that more research with newer antivirals and improved herpes virus diagnostics was necessary.

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