Prednisone Treatment for Idiopathic Facial Paralysis (Bell's Palsy)

The effects of prednisone administered orally to 194 patients with idiopathic facial paralysis (Bell's palsy) were compared with the outcome in 110 untreated patients. The treated group experienced fuller recovery and less severe complications. Of the patients with clinically complete paralysis, 24 per cent of the untreated group and none of the treated group had complete denervation. Differences in mean Recovery Profile and Recovery Index were also significant. Complications of prednisone treatment occurred in fewer than 4 per cent of patients. Facial-nerve edema is found in the acute stage of idiopathic facial paralysis, and may be the first step in the events leading to the neuropathy. Treatment with prednisone may reduce this edema along the entire facial nerve, and may be preferable to surgical decompression.