Electric Stimulation Therapy for Bell's Palsy in the Acute Stage: A Systematic Review and Meta-Analysis.

INTRODUCTION

Bell's palsy, an idiopathic peripheral facial palsy, often resolves naturally but can benefit from electric stimulation therapy. However, efficacy and safety during the acute stage remain controversial and understudied.

OBJECTIVE

To measure the effectiveness of electrical stimulation therapy as an add-on treatment for patients in the acute stage of Bell's palsy, as measured by incomplete recovery rates.

METHODS

We searched nine databases for randomized controlled trials comparing add-on electric stimulation therapy with usual care or placebo in patients within 7 days of Bell's palsy onset. The primary outcome was incomplete recovery. Risk of bias was assessed using Cochrane RoB 2 tool, with results synthesized via random-effects meta-analysis and evidence certainty evaluated using GRADE.

RESULTS

Fourteen studies encompassing 1,311 participants were included. Electric stimulation therapy plus usual care reduced incomplete recovery rates compared with usual care alone (risk ratio 0.65, 95% CI: 0.48-0.88; 13 trials, n = 1,191; moderate certainty). The effect persisted after excluding six studies with a high risk of bias.

CONCLUSION

Add-on electric stimulation therapy during acute Bell's palsy may reduce incomplete recovery risk. However, results had moderate certainty with limitations including risk of bias and short follow-up durations.