Bell's Palsy: Difference between revisions
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==Etiology/cause== | |||
Most cases of Bell's Palsy are caused by [[Herpes simplex virus]] type 1<ref name="pmid7503474">{{cite journal |author=Murakami S, Mizobuchi M, Nakashiro Y, Doi T, Hato N, Yanagihara N |title=Bell palsy and herpes simplex virus: identification of viral DNA in endoneurial fluid and muscle |journal=Ann. Intern. Med. |volume=124 |issue=1 Pt 1 |pages=27–30 |year=1996 |pmid=7503474 |doi= |issn=}}</ref> Some cases are caused by [[Herpes zoster]] virus.<ref name="pmid12482166">{{cite journal |author=Peitersen E |title=Bell's palsy: the spontaneous course of 2,500 peripheral facial nerve palsies of different etiologies |journal=Acta oto-laryngologica. Supplementum |volume= |issue=549 |pages=4–30 |year=2002 |pmid=12482166 |doi= |issn=}}</ref> | |||
==Treatment== | ==Treatment== | ||
A [[randomized controlled trial]] 496 patients within 3 days after the onset of symptoms using 25 mg of prednisolone twice a day for 10 days improved facial function at 3 months from 64% to 83.0%.<ref name="pmid17942873">{{cite journal |author=Sullivan FM, Swan IR, Donnan PT, ''et al'' |title=Early treatment with prednisolone or acyclovir in Bell's palsy |journal=N. Engl. J. Med. |volume=357 |issue=16 |pages=1598–607 |year=2007 |pmid=17942873 |doi=10.1056/NEJMoa072006 |issn=}}</ref> This means that the drug benefits one out of every five patients treated ([[number needed to treat]] is 5). Acyclovir was also studied in this trial but showed no benefit. | A [[randomized controlled trial]] 496 patients within 3 days after the onset of symptoms using 25 mg of prednisolone twice a day for 10 days improved facial function at 3 months from 64% to 83.0%.<ref name="pmid17942873">{{cite journal |author=Sullivan FM, Swan IR, Donnan PT, ''et al'' |title=Early treatment with prednisolone or acyclovir in Bell's palsy |journal=N. Engl. J. Med. |volume=357 |issue=16 |pages=1598–607 |year=2007 |pmid=17942873 |doi=10.1056/NEJMoa072006 |issn=}}</ref> This means that the drug benefits one out of every five patients treated ([[number needed to treat]] is 5). Acyclovir was also studied in this trial but showed no benefit. | ||
Revision as of 13:11, 20 November 2007
Etiology/cause
Most cases of Bell's Palsy are caused by Herpes simplex virus type 1[1] Some cases are caused by Herpes zoster virus.[2]
Treatment
A randomized controlled trial 496 patients within 3 days after the onset of symptoms using 25 mg of prednisolone twice a day for 10 days improved facial function at 3 months from 64% to 83.0%.[3] This means that the drug benefits one out of every five patients treated (number needed to treat is 5). Acyclovir was also studied in this trial but showed no benefit.
This results contradicts a previous randomized controlled trial of 99 patients in which acyclovir was better than prednisone at improving electroneurography evidence of volitional muscle motion and in preventing partial nerve degeneration.[4]
References
- ↑ Murakami S, Mizobuchi M, Nakashiro Y, Doi T, Hato N, Yanagihara N (1996). "Bell palsy and herpes simplex virus: identification of viral DNA in endoneurial fluid and muscle". Ann. Intern. Med. 124 (1 Pt 1): 27–30. PMID 7503474. [e]
- ↑ Peitersen E (2002). "Bell's palsy: the spontaneous course of 2,500 peripheral facial nerve palsies of different etiologies". Acta oto-laryngologica. Supplementum (549): 4–30. PMID 12482166. [e]
- ↑ Sullivan FM, Swan IR, Donnan PT, et al (2007). "Early treatment with prednisolone or acyclovir in Bell's palsy". N. Engl. J. Med. 357 (16): 1598–607. DOI:10.1056/NEJMoa072006. PMID 17942873. Research Blogging.
- ↑ Adour KK, Ruboyianes JM, Von Doersten PG, et al (1996). "Bell's palsy treatment with acyclovir and prednisone compared with prednisone alone: a double-blind, randomized, controlled trial". Ann. Otol. Rhinol. Laryngol. 105 (5): 371–8. PMID 8651631. [e]