Randomized clinical trial of acyclovir plus prednisone versus prednisone alone in Bell's Palsy

OBJECTIVE: To determine the effect of treatment with combination of prednisone plus acyclovir versus prednisone alone in time to recovery and outcome in Bell's palsy. METHODS: Between 1995 and 1996 we carried out a randomized, double-blind, placebo-controlled trial on 46 patients with Bell's palsy that developed less than 4 days before study enrolment. Acyclovir or a matched placebo was administered orally, 800mg five times daily for 7 days. Prednisone was administered to both groups of patients orally at 60 mg/d for the first 5 days, 50mg, 40mg, 30mg, 20mg, 10mg, daily for other 5 days. Bell's palsy was graded by House-Brackmann facial nerve dysfunction grading system. Facial nerve function evaluation was done monthly for 6 months. RESULTS: Demographic characteristics were similar for each group. Patients receiving acyclovir plus prednisone had accelerated time to recovery of Bell's palsy, and significantly improved outcome compared with patients receiving prednisone alone (t=4.15, p<0.05, x2=B.54, p<0.01 respectively). CONCLUSIONS: In patients with Bell's palsy combined acyclovir and prednisone therapy can shorten time to recovery, and improve outcome.