Madhok VB, Gagyor I, Daly F et al. (2016) Corticosteroids for bell’s palsy (idiopathic facial paralysis). Cochrane Database Syst Rev 18:CD001942.
Bell’s palsy is a relatively common presentation to emergency departments (incidence of 25/100 000/year). Though the prognosis is generally good, adverse sequelae can have a serious social impact for patients. Theuse of corticosteroids in the treatment of Bell’s palsy is very controversial.
Should I prescribe corticosteroids to patients with Bell’s palsy?
Corticosteroids should be prescribed in Bell’s palsy. They significantly reduced incomplete recovery of facial motor function at 6 months without adverse effects (high quality evidence). The number of people who need to be treated with corticosteroids to avoid one incomplete recovery was 10. Corticosteroids also reduced the development of motor synkinesis and crocodile tears syndrome (moderate quality evidence).
The administration of corticosteroids (dosage, route and administration time since the beginning of the symptoms) differed between included studies.
All authors did not use a standardized scale to evaluate recovery of motor facial function.
Hospices Civils de Lyon, CHU Lyon-Sud,
Dalhousie University – Halifax Infirmary
Nova Scotia, Canada