Adding antiviral agents to steroids to treat facial paralysis is not linked to improved recovery

Jun 15, 2009

Adding an antiviral agent to corticosteroids for treatment of Bell's palsy (a condition characterized by partial facial paralysis) is not associated with improved recovery of facial movement function, according to a meta-analysis of previously published studies in the June issue of Archives of Otolaryngology-Head & Neck Surgery, one of the JAMA/Archives journals.

Bell's palsy is the most common cause of sudden facial paralysis, affecting an estimated 20 to 45 per 100,000 individuals per year, according to background information in the article. "The main clinical symptom of Bell's palsy is facial motor dysfunction, the degree of which varies from minor weakness to complete paralysis depending on the amount of neural injury," the authors write. "Genetic factors, vascular ischemia [blocked blood flow] and inflammation owing to viral infection or autoimmune disorders have been proposed as the possible underlying cause, but the etiology remains unknown."

Current treatment choices for Bell's palsy include corticosteroids, antiviral therapy or a combination of the two. John K. Goudakos, M.D., M.Sc., and Konstantinos D. Markou, M.D., Ph.D., of the University of Thessaloniki, Greece, identified randomized controlled trials comparing corticosteroids to combination therapy in patients with this condition published between 1996 and 2007.

A total of five eligible studies involving 738 patients were identified, four of which (involving 709 patients, including 358 taking corticosteroids and 351 taking combination therapy) were included in the meta-analysis. "The complete recovery rate of facial motor function at three months after the initiation of therapy was not significantly different between the corticosteroids group and the combined therapy group," the authors write. Adverse effects also were not significantly different between the two treatment groups.

"Treatment decisions regarding patients with Bell's palsy are doubtful and remain a common problem in medical practice. Corticosteroids have been established as the therapy of choice, despite the fact that the available evidence from randomized controlled trials does not exhibit a clear benefit. However, the largest available randomized controlled trial published recently suggested a benefit from the use of corticosteroids in patients with idiopathic [of unknown cause] acute facial paralysis," the authors conclude.

"Additional well-designed randomized controlled trials are needed to assess the potential value of antiviral addition to the recovery of facial palsy with more confidence. However, based on the currently available evidence, the addition of an antiviral agent to for the treatment of patients with Bell's palsy is not justified."

Source: JAMA and Archives Journals (news : web)

Explore further: Research gives new insights into rare disease of the inner ear

add to favorites email to friend print save as pdf

Related Stories

Evidence lacking to guide treatment for sudden hearing loss

Jun 18, 2007

Although steroids are the most widely used treatment for sudden hearing loss, little scientific evidence supports their use or that of any other therapies for this condition, according to a systematic review and meta-analysis ...

Surgical technique helps to reanimate paralyzed faces

Jul 16, 2007

A surgical technique known as temporalis tendon transfer, in conjunction with intense physical therapy before and after surgery, may help reanimate the features of those with facial paralysis, according to a report in the ...

Recommended for you

Thyroid disease risk varies among blacks, Asians, and whites

14 hours ago

An analysis that included active military personnel finds that the rate of the thyroid disorder Graves disease is more common among blacks and Asian/Pacific Islanders compared with whites, according to a study in the April ...

The key to easy asthma diagnosis is in the blood

17 hours ago

Using just a single drop of blood, a team of University of Wisconsin-Madison researchers has developed a faster, cheaper and more accurate tool for diagnosing even mild cases of asthma.

Younger adults hit hardest this flu season

19 hours ago

(HealthDay)—The H1N1 flu was the predominant influenza strain in the United States this year, but it packed a lot less punch than in 2009 when it caused a worldwide pandemic, health officials report.

User comments : 0

More news stories

ESO image: A study in scarlet

This new image from ESO's La Silla Observatory in Chile reveals a cloud of hydrogen called Gum 41. In the middle of this little-known nebula, brilliant hot young stars are giving off energetic radiation that ...

First direct observations of excitons in motion achieved

A quasiparticle called an exciton—responsible for the transfer of energy within devices such as solar cells, LEDs, and semiconductor circuits—has been understood theoretically for decades. But exciton movement within ...

Warm US West, cold East: A 4,000-year pattern

Last winter's curvy jet stream pattern brought mild temperatures to western North America and harsh cold to the East. A University of Utah-led study shows that pattern became more pronounced 4,000 years ago, ...

Patent talk: Google sharpens contact lens vision

(Phys.org) —A report from Patent Bolt brings us one step closer to what Google may have in mind in developing smart contact lenses. According to the discussion Google is interested in the concept of contact ...