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[Facial paralysis: treatment with an acyclovir-methylprednisolone combination, preliminary results]
V Darrouzet1, S Lacher-Fougère, J Y Duclos
1C.H.U. Pellegrin, Clinique Universitaire O.R.L., Bordeaux, France.
Rationale:
Many actual data suspect a viral etiology to Bell's palsy. Herpes viridae are more and more incriminated. On these basis, we have studied the efficacity of parenteral association of 30 mg/Kg/j of Aciclovir and 1 mg/Kg/j of Methylprednisolone in the treatment of Bell's palsy with less than 12 days of evolution.
Method:
The evaluation concern 53 patients. We also evaluated the functional motor result (using House and Brackmann staging) and search prognostic factors in clinic and paraclinic data. A viral investigation have been made in most of the cases.
Results:
Only one of our patients treated with Aciclovir keeps some sequeles (stage III of House and Brackmann classification). We didn't found any deleterious effect. Statistically, the electromyography is the only one test with a prognostic value. But we feel that delay between the starting and the treatment of the palsy is important. Viral tests show sometime abnormal Ig against the Herpes viridae group.
Conclusions:
These promising results are lightened with a review of the literature. A multicentric investigation is already in place for a stronger statistic effect.
Insights
This study suggests that combining Aciclovir and Methylprednisolone effectively treats Bell
Area of Science:
- Virology
- Neurology
- Pharmacology
Context:
- Bell's palsy is a neurological condition with suspected viral origins, often implicating Herpesviridae.
- Current treatment strategies for Bell's palsy require further investigation for optimal efficacy.
- Early intervention is crucial for managing Bell's palsy outcomes.
Purpose:
- To evaluate the efficacy of parenteral Aciclovir and Methylprednisolone in treating Bell's palsy.
- To assess functional motor recovery using the House and Brackmann staging.
- To identify prognostic factors influencing Bell's palsy recovery.
Summary:
- A study involving 53 Bell's palsy patients demonstrated that combined parenteral Aciclovir and Methylprednisolone treatment resulted in minimal sequelae (only one patient at House and Brackmann stage III).
- No adverse effects were observed with this treatment regimen.
- Electromyography was identified as the sole statistically significant prognostic test, although treatment delay was also considered important.
Impact:
- The findings suggest a promising therapeutic approach for Bell's palsy, potentially reducing long-term disability.
- The study highlights the importance of early treatment initiation and the role of viral diagnostics.
- Further multicenter investigations are warranted to strengthen the statistical significance and confirm these promising results.