Bell's palsy
Vibhor Jain
How to treat Bell's palsy?Give Steroid or not? If yes then how much and for how long?
Unlike · · Unfollow Post · February 17 at 3:52pm near Muzaffarnagar, Uttar Pradesh
You, DrRajeev Adhana and Khalid Mahida like this.
Ravi Meher will always give steroids. Almost 90% will improve without any treatment. And a we can not be told at the start of treatment that he kids in 90% or 10% group.
February 20 at 9:14pm via mobile · Like · 1
Rakesh Srivastava I remember an OCNA published in 1994, stated no role of steroids in bell's palsy. I do not know the present status, but in practice I think most of ENT surgeons prescribe steroids. Dr Ravi Meher is right.
February 21 at 5:52am · Like
Vibhor Jain sir have a young male patient, have tried everything but not showing response, have been treating for past one week..
February 21 at 12:01pm · Like
Chandrashekhar Tengli it takes two to three weeks time and some times even more ...
February 21 at 3:30pm via mobile · Like
Amit Keshri http://www.ncbi.nlm.nih.gov/pubmed/21099725 : a wonderful article it will explain,when to give and what to expect
Prednisolone in Bell's palsy related to treatm... [Otol Neurotol. 2011] - PubMed - NCBI
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February 21 at 9:43pm · Like · 4 ·
Surya Prakash the scottish trial says prednisolone 1mg perkg per day, untapered, for total of ten days. this works better than all other protocols of giving steroids if the facial palsy is idiopathic.
February 21 at 10:18pm · Like
Ninad S Narkar Bell's palsy is a diagnosis of exclusion. If it does not respond to two weeks of treatment, then reconsider the diagnosis. We find good results when Acyclovir is given in addition to steroids.
February 22 at 7:27am · Like · 5
Naeem Prasla What's usual dose of acyclovir
February 22 at 2:27pm via mobile · Like
Amit Keshri no role of acyclovir on recovery the article http://www.ncbi.nlm.nih.gov/pubmed/18849193
Prednisolone and valaciclovir in Bell's palsy:... [Lancet Neurol. 2008] - PubMed - NCBI
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February 22 at 11:13pm · Unlike · 2 ·
Ninad S Narkar @ Amit ... No offence intended. But we treat patients not articles. If patients benefit with acyclovir, the matter ends there. If we go by all the above articles we are left with no pharmocological treatment. Only reassurance. Will the patient come back to you if you just reassure and do not give any medicines?
February 23 at 12:13am · Like
Amit Keshri sir the article says prednisolone is the treatment,but the article is a large multicentre trial,and we also not now prescribe acyclovir which i did in residency days and patients improved without it...i think today is era of evidence based medicine....but at same time opinions in medicine differ...everyone is free to choose what drugs he use..........and in bells palsy we treat nerve edema..which responds well to steroids..
February 23 at 12:38am · Like
Kuldeep Thakur prednisolone 1mg/kg/day for 5days then taper for next 10days and acyclovir 200mg tds day for 10 days orally
February 23 at 12:45am · Like
Ninad S Narkar Amit Keshri So how do you treat a patient with Bell's palsy who comes to your clinic.
February 23 at 6:34am · Like
Amit Keshri prednisolone 1 mg/kg/day for 10 days,will assess recovery and then think of tapering, along with the eye care and physiotherapy,sir no offence to acyclovir i read this article and after that i stopped giving it.
February 23 at 8:39pm · Like · 2
Ninad S Narkar What if the patueny comes to you after 48 hours? Going by the article I guess you will not gjve him prednisolone.
February 23 at 10:21pm · Like
Ravi Meher i will give steroids even if the patient has come after 48 hours and will supplement acyclovir only if there is clear signs of viral etiology(vesicles over pinna)
February 24 at 6:24pm · Like · 2
