practice parameter attempts to synthesize what evidence is available
for the treatment of Bellís palsy.1
There are no RCTs with enough power to make clear, evidence-based
recommendations for the use of steroids in the treatment of Bellís
Although not part of this clinical question, this article discusses
other management options for Bellís palsy, including acyclovir and
were not routinely included in the studies.1
Two of the Class IV studies (not included in the final recommendations)
included children > 4 years old.
One Class I study included patients > 12 years old, but was not limited
One Class II study did not include patientsí ages.
Remainder of studies used adult patients only.
from multiple experts were not included in this practice parameter.1
from patients were not included in this practice parameter.1
questions remain unanswered:
How early in the course of disease should steroids be started?
What impact do co-morbid conditions (DM and HTN) have on treatment
and recovery in Bellís palsy?
How is the treatment of kids different from adults?
PM, Gronseth GS. Practice parameter: Steroids, acyclovir, and
surgery for Bellís palsy (an evidence-based review). Neurology
2001: 56: 830-36.
E et al. Corticosteroid treatment of childhood Bellís Palsy. Pediatric
Neurology 1999; 21: 814-16.
IG, Whelan TR. The clinical problem of Bellís Palsy: Is treatment with
steroids effective? British Journal of General Practice 1996;
M. Investigation and treatment of facial paralysis. Arch Dis Child
CAJ. Idiopathic Facial Nerve Palsy in Children and the Effect of Treatment
With Steroids. Int Jour Ped Otorhinolaryngology 1987; 13: