Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology · 2003
Efficacy of early treatment of Bell's palsy with oral acyclovir and prednisolone.
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Hato Naohito, Matsumoto Shuichi, Kisaki Hisanobu, Takahashi Hirotaka, Wakisaka Hiroyuki, Honda Nobumitsu, Gyo Kiyofumi, Murakami Shingo, Yanagihara Naoaki
Аннотация
OBJECTIVE: To investigate the therapeutic effects of acyclovir and prednisolone in relation to the timing of treatment in Bell's palsy.
STUDY DESIGN: This was a retrospective study of 480 Bell's palsy patients who were treated with oral acyclovir and prednisolone (94 cases) or prednisolone alone (386 cases).
PATIENTS: Patients met the after criteria: (1) severe or complete Bell's palsy with a score lower than 20 on the 40-point Yanagihara facial score and (2) treatment started within 7 days after onset. The patients were treated with oral prednisolone (60-40 mg/day) with or without oral acyclovir (2,000 mg/day).
MAIN OUTCOME MEASURE: Rate of recovery, which was defined as a facial score of 36 or more, and the absence of contracture with synkinesis.
RESULTS: The overall recovery rate of patients treated with acyclovir and prednisolone was 95.7 percent, which was better than that of patients treated with prednisolone alone (88.6%). The recovery rate in patients who began the combined therapy within 3 days of the onset of palsy was 100 percent and early treatment resulted in early remission. In contrast, the recovery rate in patients who started the combined therapy more than 4 days after onset was 86.2 percent.
CONCLUSION: These results suggest that early diagnosis and treatment within 3 days of the onset of paralysis are necessary for maximal efficacy of combined acyclovir and prednisolone therapy for Bell's palsy.
STUDY DESIGN: This was a retrospective study of 480 Bell's palsy patients who were treated with oral acyclovir and prednisolone (94 cases) or prednisolone alone (386 cases).
PATIENTS: Patients met the after criteria: (1) severe or complete Bell's palsy with a score lower than 20 on the 40-point Yanagihara facial score and (2) treatment started within 7 days after onset. The patients were treated with oral prednisolone (60-40 mg/day) with or without oral acyclovir (2,000 mg/day).
MAIN OUTCOME MEASURE: Rate of recovery, which was defined as a facial score of 36 or more, and the absence of contracture with synkinesis.
RESULTS: The overall recovery rate of patients treated with acyclovir and prednisolone was 95.7 percent, which was better than that of patients treated with prednisolone alone (88.6%). The recovery rate in patients who began the combined therapy within 3 days of the onset of palsy was 100 percent and early treatment resulted in early remission. In contrast, the recovery rate in patients who started the combined therapy more than 4 days after onset was 86.2 percent.
CONCLUSION: These results suggest that early diagnosis and treatment within 3 days of the onset of paralysis are necessary for maximal efficacy of combined acyclovir and prednisolone therapy for Bell's palsy.