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🚵 Bell's Palsy - #MEDSHED
👀 Oral steroids for Bell’s Palsy when given within 72 hours decreases recovery time and improves facial nerve function.
Bell’s Palsy presents with a rapid onset of unilateral facial weakness or paralysis. It has been attributed to Herpes Simplex, but there are no confirmatory diagnostics.
Symptoms are a result of compression of the facial nerve from inflammation and edema. Corticosteroids are highly effective in recovering of facial nerve function.
Antivirals should not be given as monotherapy as theres no clear benefit compared to placebo for these patients. They can be offered in addition to steroids within 72 hours of symptom onset.
We’ll start all patients with Bell’s Palsy on prednisone 40 to 60 mg po qday with a 10-day tapering course. Caution in diabetics with steroid-induced hyperglycemia.
For antivirals, acyclovir 400 mg five times daily or valacyclovir 1gm TID x 7 days and up to 10 for immunocompromised. Dose adjust antivirals in those with renal impairment as they can be nephrotoxic.
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References
Baugh RF, Basura GJ, Ishii LE, et al. Otolaryngol Head Neck Surg. 2013 Nov;149(3 Suppl):S1-27.
Singh, A & Deshmukh, P. Cureus. 2022 Oct; 14(10): e30186.
Tiemstra, JD & Khatkhate N. Am Fam Physician. 2007;76(7):997-1002
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