Study on Efficacy of Steroids and Acyclovir Treatment in Bells Palsy

ABSTRACT

Bells palsy is an idiopathic disease of the seventh cranial nerve. This is the most frequent cranial mononeuropathy with an annual incidence of 10 to 40 cases per 100,000 population with geographical variations. Aim: To assess the efficacy of Steroids and Acyclovir in the management of Bell’spalsy. Methods: All the patients with Bell's palsy, without clinical evidence of other cranial nerve damage or central nervous system diseases were included. Patients were divided into 4 groups, control, steroid alone, steroid with acyclovir and acyclovir alone. The study groups of patients were clinically tested in a periodic manner within twelve months at various intervals. The severity of the facial nerve involvement is assessed with House- Brackmann grading (HB) system. Results: In 101 patients, Majority of patients come under grade IV (43.6%) and next comes to grade V (31.7%). 86% of the percentage of patients improved in grade IV, and 68.8% of patients improved in grade V. None of the patients from grade VI showed improvement. Combination of Steroids and acyclovir is definitely useful when compared to the control group. The combination scores over the control group by 1.37 times which is statistically significant (P value= 0.031668). Conclusion: Steroids are safe and are probably effective in the management of bells palsy which improves the rate ofrecovery. Acyclovir in combination with prednisolone is safe and has a definite role in improving facial functional outcomes in patients with Bell’s palsy than using the drugalone.