Effectiveness of combination of physiotherapy and steroids in the treatment of Bell's palsy, Benghazi experience

ABSTRACT

The present study was conducted with dual objectives to compare the initiation of an early recovery and final out come [full recovery], among patients with Bell's palsy treated by a combination of physiotherapy with steroid and physiotherapy alone. Effectiveness clinical trial included 46 patients with Bell's palsy who attended neuroclinic at Al Fateh childrens Hospital Benghazi [2000-2001]. From patients accompanier data on; demographic characteristics, history of trauma and an attack of respiratory infection [10 days prior to the development of symptoms] was obtained, blood pressure of each patient was measured, otoscopic examination was carried out, clinical evaluation was done for evidence of Herpes simplex, also peripheral blood smear and monospot test were performed for IMN and CMV, respectively. The patients alternately assigned to group A to receive a combination of prednisolone and physiotherapy and B group to receive physiotherapy alone. Objective outcomes were measured in terms of mean time required for initiation of improvement in signs [clenching teeth, blowing of mouth, movement of eyebrows, closure of eyelids] and complete recovery. The inferences on statistical significance of observed differences in the outcomes between the groups, were based on the result of unpaired t-test. Of the 46 patients, analysis was inclusive of 42 patients as four patients [two from each group] didn't recover up to 6 months. There was a female predominance [73.8%]. Despite, the female patients were administered interventions significantly earlier, because of early, seeking medical advice, as compared to male patients it didn't hasten the recovery process [initial improvement in signs or complete recovery] in female patients. The mean time in days required for initiation of improvement of signs was comparable for group A [9.15] and B group [10.2]. Complete recovery was significantly ahead for the patients who received physiotherapy alone. It was deduced from the trial that physiotherapy alone was effective in complete recovery studied patients. Instead of treating all patients with prednisolone [present practice at neuroclinic], etiology may be identified and patients without an evidence of inflammation may be managed by only physiotherapy. However further research is necessary and if present evidence is supported, this will help in better management of patients and also in logical use of our resources