Limited benefits from antivirals in Bell’s palsy

Moderate-quality evidence from randomised controlled trials showed no additional benefit from the combination of antivirals with corticosteroids, compared to corticosteroids alone, for the treatment of Bell's palsy of various degrees of severity. There was a small but just significant benefit of combination therapy, compared with corticosteroids alone, in severe Bell’s palsy. Corticosteroids alone were more effective than antivirals alone and antivirals plus corticosteroids were more effective than placebo or no treatment. There was no benefit from antivirals alone over placebo. The combination of antivirals and corticosteroids reduced sequelae of Bell's palsy (excessive tear production and synkinesis) compared with corticosteroids alone. There was no significant increase in adverse events from the use of antivirals compared with either placebo or corticosteroids.