Medical management of idiopathic (Bell's) palsy

Experience with treating more than 400 cases of Antoni's palsy, the findings of autoimmune reaction, and recent gadolinium-enhanced magnetic resonance imaging reports in "idiopathic" Bell's palsy verify the hypothesis that the disease results from a viral geniculate ganglionitis. The diagnosis no longer needs to be one of exclusion. We now are capable of establishing a positive diagnosis, permitting the clinician to initiate treatment with corticosteroids and acyclovir confidently. Facial nerve compression and electrotherapy are not advised. It is suggested that the term idiopathic Bell's palsy be replaced with Antoni's palsy as the first step in changing erroneous concepts of the past.