Bell's palsy: a 5 year review of 174 consecutive cases: an attempted double blind study.

The etiology of Bell's palsy is unknown and present treatment is empirical and, at best, controversial. Between 1973 and 1976, 174 consecutive cases were seen and clinically divided into a group with incomplete facial palsy and a group with complete facial palsy. The incomplete group consisted of 82 patients who were matched and treated alternatively with steroids or supportive treatment only. The return of function in each patient was tabulated and results in the two groups compared. Patients in this group have an excellent prognosis regardless of treatment. The complete facial palsy group consisted of 92 cases, who were matched according to age, sex, race and clinical picture and most importantly to the results of a series of tests designed to test the function of the affected facial nerve and its musculature. In this group 10 patients elected to have supportive treatment only, while 41 cases received cortisone and 41 matching patients underwent well planned decompression of the facial nerve.