Tratamiento precoz con corticoides en la paralisis facial idiopatica (Bell)

Idiopathic facial palsy (IFP) (Bell's palsy) is the commonest cause of acute facial paralysis. Perhaps because of its unknown origin, a wide range of treatments are used. Controversy exists as to whether the disorder should be left to run its natural course or treated with steroids. The effect of early steroid treatment on the evolution of IFP was evaluated in the Ear, Nose, and Throat Service of the University Hospital of Alicante (Spain) with a prospective protocol from September 1991 to January 1992. The therapeutic protocol for all patients (47 patients) was an intramuscular injection of 60 mg prednisone in the Emergency Room followed by a course of oral steroids (deflazacort) that was gradually tape-red-off. The average duration of IFP before presentation in the Emergency Department was 1.30.9 days. Clinical improvement was observed on day 149 and a complete cure by day 3026. Full recovery of facial motor function without sequelae occurred in 95.6% of patients. Age, the intensity of paralysis, and a history of hypertension and diabetes had a negative influence on the course of IFP. These results support early steroid treatment for IFP.