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Bell palsy is a peripheral facial weakness of unknown etiology. Most patients recover completely, but 20% to 30% have permanent disfiguring facial weakness or paralysis (Acta Otolaryngol Suppl 2002; 549:4). Early treatment is focused on this substantial minority of patients. Treatments have included corticosteroids and antiviral agents, but the evidence for their effectiveness — either alone or in combination — has been mixed.
Now, a new meta-analysis updates the state of the evidence. The authors identified 18 trials that met the predefined criteria; these included two recent large, randomized controlled trials (N Engl J Med 2007; 357:1598 and Lancet Neurol 2008; 7:993).
Overall, short-term corticosteroid use significantly improved recovery …