The Efficacy of Acyclovir in Childhood Bell’s Palsy

Abstract

Objective: Bell’s palsy is an acute onset, unilateral, self-limiting paresis or paralysis of the facial nerve. The objective in treatment is to increase facial functions and to accelerate recovery by suppressing this inflammatory process. Steroids and acyclovir (singly or in combination) are used in medical treatment. The objective of this study was to determine the clinical profile of Bell’s palsy in childhood and to compare the efficacy of combined acyclovir-prednisolone therapy with that of prednisolone therapy alone.

Materials and Methods: Eighty-six patients diagnosed as having Bell’s palsy were enrolled in the study. All patients were assessed in terms of facial nerve dysfunction and recovery time using the House-Brackman Facial Nerve Grading scale (HBFNGS) at initial presentation and at the 15th day, and the first, third, and sixth months. Grade 4 and above was assessed as severe, and lower grades were regarded as mild.

Results: The mean age of the patients was 9.5 (±2.4) years. Forty-six (57.6%) patients received prednisolone therapy only, and 34 (42.4%) were started on a combination of oral acyclovir and prednisolone therapy, 29 of whom were in the severe category. Analysis of HBFNGS at one month revealed that the addition of acyclovir to treatment had no effect on the recovery period. However, combination therapy seems more beneficial in severe cases.

Conclusion: Bell’s palsy frequently resolves entirely in childhood, and an acyclovir plus prednisolone combination is not superior to prednisolone alone except in severe cases.