Therapeutic Management of Bell’s Palsy: A Comparative Study

Abstract

Background: Bell's palsy is a form of facial paralysis resulting from a dysfunction of the cranial nerve VII (the facial nerve) causing temporary weakness of the muscles on one side of the face. They may include muscle twitching, weakness, or total loss of the ability to move one or rarely both sides of the face. Material and methods: The study was an open labeled, randomized controlled trial conducted in the Department of pharmacology, Anugrah Narayan Magadh Medical College and Hospital, Gaya, India from one year 100 patients were divided into two groups, according to apre-generated computerized randomization table. Patients in group 1 received a single dose of 500 mg of IV infusion of methyl prednisolone while those in group 2 received oral prednisolone in a tapering dosage schedule (60 mg daily for initial 5 days, tapered by 10 mg daily over next 5 days). All patients were followed for a minimum of 3 months after inclusion, and the outcome analysis was done at 1-month and at 3months.  Results: After 1-month of treatment, 26 (52%) patients from group 1 and 20 (40%) from group 2 recovered completely; a total of 46 (46%) patients thus recovered completely. The patients treated with IV methylprednisolone and oral prednisolone, both, showed improvement in the symptoms. The results were however statistically non-significant when compared between the two groups. After 3 months of treatment, 41 (82%) patients from group 1 and 40 (80%) from group 2 recovered completely; a total of 81 (81%) patients recovered completely. No statistically significant differences were observed between the two treatment group. All patients of Grade 2 and 3 recovered completely while only 45.46% and 40% patients in Grade 4 and Grade 5, respectively, showed complete recovery. No meaningful recovery was observed in patients with Grade 6 Bell’s palsy.  Conclusion:None of the patients in either treatment groups reported any adverse event during the study period. Single dose of 500 mg of IV methylprednisolone may be an equally efficacious alternative to a 10 days course of oral prednisolone. Early institution of treatment should be attempted for optimum results.