For people experiencing first-time symptoms of Bell's palsy, steroid pills very likely are the most effective known treatment for recovering full strength in the facial muscles, according to a guideline published in the November 7, 2012, online issue of Neurology®, the medical journal of the American Academy of Neurology. Bell's palsy is a nerve disorder that affects muscle movement in the face and usually leaves half of the face temporarily paralyzed.
"Although most cases of Bell's palsy resolve without treatment, about 15 percent of those affected never fully recover muscle strength. There are now several well-designed studies that show these treatments can increase the chances of a good recovery in such cases," said study author Gary Gronseth, MD, with the University of Kansas Medical Center in Kansas City and a Fellow of the American Academy of Neurology.
Short-term use of steroids was safe and tolerable in the research. People who are obese, have uncontrolled diabetes, or cannot tolerate steroids might be at higher risk for complications with steroid use.
According to the guideline, antiviral therapy alone was not shown to increase the chance of recovering full muscle strength in the face. In addition, the guideline suggests that adding antiviral medications to steroid treatment does not strongly increase the chance of a full facial recovery from paralysis in people experiencing Bell's palsy, but that there is a slight chance it may have a marginal effect on symptoms.
"Because of the possibility of modest recovery with combination treatment, people might be offered both steroid pills and antiviral medications," said Gronseth. "However, they should be aware that the benefit of adding antivirals to steroid treatment is likely slight."
- Gary S. Gronseth and Remia Paduga. Evidence-based guideline update: Steroids and antivirals for Bell palsy Report of the Guideline Development Subcommittee of the American Academy of Neurology. Neurology, 2012 DOI: 10.1212/WNL.0b013e318275978c
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