Bell's Palsy - Medical Treatment and Influence of Prognostic Factors
type: CreativeWork
description: Bell’s palsy is an acute onset of peripheral facial nerve dysfunction. Despite extensive research the aetiology is unclear. The most prevailing theory is that reactivation of viruses such as Herpes simplex type-1 or Varicella zoster may cause Bell’s palsy. The natural course is favourable but at least 30% of patients will suffer sequelae such as residual paresis, synkinesis and/or contracture. The most commonly used medical treatment to reduce sequelae has been corticosteroids and/or antiviral agents, the usefulness of which has been debated since earlier studies have shown diverging results. The aim of this thesis was to evaluate the effect of treatment with prednisolone and/or valaciclovir in a large number of Bell’s palsy patients and study how prognostic factors such as age, severity of palsy at baseline, and time to treatment start may influence outcome. Data from the Scandinavian Bell’s Palsy Study (SBPS), a prospective, randomised, double-blind, placebo-controlled multicentre study with 12-month follow-up, were evaluated. In total, 829 patients, aged 18−75, were included in the intention to treat (ITT) analysis: 210 patients received prednisolone plus placebo, 207 valaciclovir plus placebo, 206 prednisolone plus valaciclovir and 206 placebo plus placebo. Outcome was measured using the Sunnybrook facial grading system (SFGS) and House-Brackmann scale (HBS) at baseline and each follow-up. Follow-ups were scheduled for day 11–17 and 1, 2, 3, 6 and 12 months after palsy onset. Significantly better outcome was seen in patients treated with prednisolone (72%) compared with patients who did not receive prednisolone (57%) (P<0.0001). Time to complete recovery was also significantly shorter in patients treated with prednisolone compared with patients not treated with prednisolone (P<0.0001). Synkinesis at 12 months was less frequent in patients treated with prednisolone (14%) compared with patients not receiving prednisolone (29%) (P<0.0001). Where treatment started w…
abstract: Bell’s palsy is an acute onset of peripheral facial nerve dysfunction. Despite extensive research the aetiology is unclear. The most prevailing theory is that reactivation of viruses such as Herpes simplex type-1 or Varicella zoster may cause Bell’s palsy. The natural course is favourable but at least 30% of patients will suffer sequelae such as residual paresis, synkinesis and/or contracture. The most commonly used medical treatment to reduce sequelae has been corticosteroids and/or antiviral agents, the usefulness of which has been debated since earlier studies have shown diverging results. The aim of this thesis was to evaluate the effect of treatment with prednisolone and/or valaciclovir in a large number of Bell’s palsy patients and study how prognostic factors such as age, severity of palsy at baseline, and time to treatment start may influence outcome. Data from the Scandinavian Bell’s Palsy Study (SBPS), a prospective, randomised, double-blind, placebo-controlled multicentre study with 12-month follow-up, were evaluated. In total, 829 patients, aged 18−75, were included in the intention to treat (ITT) analysis: 210 patients received prednisolone plus placebo, 207 valaciclovir plus placebo, 206 prednisolone plus valaciclovir and 206 placebo plus placebo. Outcome was measured using the Sunnybrook facial grading system (SFGS) and House-Brackmann scale (HBS) at baseline and each follow-up. Follow-ups were scheduled for day 11–17 and 1, 2, 3, 6 and 12 months after palsy onset. Significantly better outcome was seen in patients treated with prednisolone (72%) compared with patients who did not receive prednisolone (57%) (P<0.0001). Time to complete recovery was also significantly shorter in patients treated with prednisolone compared with patients not treated with prednisolone (P<0.0001). Synkinesis at 12 months was less frequent in patients treated with prednisolone (14%) compared with patients not receiving prednisolone (29%) (P<0.0001). Where treatment started w…
author: Axelsson, Sara
language: eng
keywords: Oto-rhino-laryngology, Bell’s palsy, Treatment, Recovery, Prognostic factors, Prednisolone, Valaciclovir, Facial grading, Sunnybrook
date published: 2013
date modified: 2026-07-24T02:59:49Z
provider: University of Lund
publisher: Networked Digital Library of Theses and Dissertations
type: WebPage
source organization: Department of Otorhinolaryngology, Lund University