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Bell palsy (BP) resolves in most cases, but up to 30% of sufferers have prolonged facial paralysis and pain. Although steroids and antivirals — alone or in combination — are commonly used for treatment, their effectiveness remains unclear. Investigators in Scotland now report results from a double-blind trial examining the efficacy of steroids and acyclovir in the early treatment of BP. Adults presenting during the first 72 hours of symptoms were randomized to receive prednisolone (50 mg/day), acyclovir (2 g/day), both, or placebo, for 10 days. The primary outcome measure was recovery of facial-nerve function at 3 and 9 months, as determined using the House–Brackmann scale.
Of the 551 patients randomized, 496 had outcome measures assessed. A…