Efficacy of antivirals in Bell's palsy

INTRODUCTION: Bell's palsy is a common condition. Incomplete recovery occurs in 15% of cases. In recent years evidence of a possible role of herpes simplex virus type 1 in its etiology has accumulated. OBJECTIVES: To compare the efficacy of valacyclovir and prednisone versus prednisone placebo in Bell's palsy. MATERIAL AND METHODS: We conducted a prospective, randomized and placebo controlled study. Of 41 patients enrolled, 21 were treated with 2 g valacyclovir qd for seven days and prednisone (PV) and 19 with prednisone plus placebo (PP) administered orally. Clinical controls were carried out at 2, 4, 8 and 12 weeks, patients with incomplete recovery were followed for six months. Recovery was defined as satisfactory with a score higher than 90 on a composite score of facial paralysis (FGS). RESULTS: There were no significant differences between groups in the score of facial paralysis. Recovery at six months was 86.4% in the PV group and 89.5% in the PP group (p = 0.86). The average recovery was 70.2 and 71.1 days, respectively (p = 0.88). CONCLUSIONS: Our results do not show an additional benefit of valacyclovir in the treatment of Bell's palsy. According to current evidence, there is no consensus regarding the routine use of antivirals in all cases of Bell's palsy