488 Limited benefits from antivirals in Bell’s palsy

August 28, 2016

written by Brian R McAvoy.

Clinical Question
How effective are antiviral treatments alone, or in combination with other therapy, for Bell’s palsy?

Bottom Line
Moderate-quality evidence from randomised controlled trials showed no additional benefit from the combination of antivirals with corticosteroids, compared to corticosteroids alone, for the treatment of Bell's palsy of various degrees of severity. There was a small but just significant benefit of combination therapy, compared with corticosteroids alone, in severe Bell’s palsy. Corticosteroids alone were more effective than antivirals alone and antivirals plus corticosteroids were more effective than placebo or no treatment. There was no benefit from antivirals alone over placebo. The combination of antivirals and corticosteroids reduced sequelae of Bell's palsy (excessive tear production and synkinesis) compared with corticosteroids alone. There was no significant increase in adverse events from the use of antivirals compared with either placebo or corticosteroids.

There were insufficient data to examine any of the other variables reported in the studies, such as pain, quality of life, and variation in response due to time to treatment and severity at onset.

Corticosteroids are widely used in the treatment of Bell’s palsy, but the effectiveness of additional treatment with an antiviral agent is uncertain.

Cochrane Systematic Review
Gagyor I et al. Antiviral treatment for Bell’s palsy (idiopathic facial palsy). Cochrane Reviews, 2015, Issue 7. Art. No.: CD001869.DOI: 10.1002/14651858. CD001869.pub6. This review contains 11 studies involving 2,883 participants.

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