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Effectively treating Bell palsy

September 1, 2009 3:16:01 PM PDT
Lifetime odds of getting Bell palsy are about 1 in 60, and while this facial paralysis is most likely caused by a virus, new medical research shows that antiviral agents don't help much - unless used with another treatment. Doctors usually have to reassure patients that the facial paralyis that suddenly appeared will very likely be resolved. Diana D'Uva is okay now, but one morning, she woke to a face dropping down and half frozen.

"I woke up and I thought I was having some sort of allergic reaction because my face was very numb," she said.

"Bell palsy is perhaps one of the commonest forms of facial paralysis," said Dr. Joseph Chen, of the University of Toronto and Sunnybrook Health Sciences Center. "We believe it's probably due to a viral infection of the facial nerve itself."

"What happens is one side of their face gets very droopy, which of course is extremely disconcerting," said Dr. Gordon Guyatt, of McMaster University.

Diane was given a steroid by her doctor.

Another possibility would have been to receive a drug known as an antiviral, which are drugs that treat viral infections.

Does one work better than the other? Dr. Guyatt was part of a research team that looked into it.

"We looked at all the randomized trials that looked at either of those two treatments, steroids or antiviral agents for Bell palsy, to try and get the best estimate of the effects of those treatments," he said.

They studied the records of more than 2,700 patients and published their report in the Journal of the American Medical Association.

They found that treatment with steroids alone improved patient outcomes, while use of anti-viral agents by themselves did not. However, it was when the two medications were used in combination that they appeared to be most effective.

"There was no hint of any effect of antivirals when given by themselves, but when given with steroids, they appeared to augment the effect of steroids," Dr. Guyatt said.

They are findings that Diane finds hopeful, along with her own experience.

"You can get to the point where you can talk to people and not worry that your eye might shut on you or you might look a little silly," she said.

The researchers note that further studies are needed to definitively establish the benefit of the combined drug treatments.

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WEB PRODUCED BY: Bill King


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