What is the efficacy of prednisone and prednisolone for the treatment of Bell palsy (idiopathic facial paralysis) (IFP)?

Updated: Jun 14, 2019
  • Author: Danette C Taylor, DO, MS, FACN; Chief Editor: Selim R Benbadis, MD  more...
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Answer

Many trials have been carried out to study the efficacy of prednisone in Bell palsy. In 1972, for example, Adour et al conducted a large, controlled clinical trial that found that 89% of patients treated with prednisone had full recovery, compared with 64% of patients treated with placebo. [50]

This trial and other early studies, however, showed conflicting results for steroid use in treating Bell palsy, [51] and they were limited in their size.

However, 3 subsequent randomized, controlled trials showed significant improvement in outcomes when prednisolone was started within 72 hours of symptom onset. [12, 13, 52] Based on these 3 studies, steroids should be strongly considered to optimize outcomes. Once the decision to use steroids is made, the consensus is that this treatment should be started immediately.


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