Guidelines recommend steroids for new-onset disease; addition of antivirals offers modest benefit
THURSDAY, Nov. 8 (HealthDay News) -- Updated guidelines recommend steroids for patients with new-onset Bell's palsy, which increases the probability of recovery of facial nerve function, while the addition of antivirals is associated with a modest benefit, according to evidence-based guidelines published online Nov. 7 in Neurology.
Gary S. Gronseth, M.D., and Remia Paduga, M.D., from the University of Kansas Medical Center in Kansas City, and colleagues reviewed the evidence published since the American Academy of Neurology practice parameter for 2001, regarding the effectiveness, safety, and tolerability of steroids and antiviral agents for Bell's palsy.
The researchers identified nine studies, two of which were rated Class I due to high methodologic quality. Steroids were found highly likely to be effective in patients with new-onset Bell's palsy and should be offered to increase the probability of facial nerve functional recovery. Antivirals in combination with steroids do not increase the probability of facial nerve recovery by more than 7 percent in those with new-onset Bell's palsy; however, because of a possible modest increase in recovery, antivirals may be offered to patients in addition to steroids. Patients who are offered antivirals should be advised that the potential benefit is modest at best.
"It is unlikely that additional research regarding the efficacy of steroids will change the current estimate of its effect," the authors write. "Further future research efforts should be directed toward finding the optimal dose and timing of steroids, the effect of other therapeutic modalities, and the identification of the effect of steroids in specific populations, such as in children."
One author disclosed financial ties to Boehringer Ingelheim.