Corticosteroids effective for Bell’s palsy

Tuesday 10 October 2017

Brian McAvoy

PEARLS No.

537

Clinical question

How effective and safe are corticosteroids for people with Bell’s palsy?

Bottom line

Compared with placebo, corticosteroids reduced the number of people left with facial weakness after Bell's palsy (NNT* 10). The reduction in the proportion of participants with cosmetically disabling sequelae 6 months after randomisation was very similar in the corticosteroid and placebo groups. However, there was a significant reduction in motor synkinesis during follow-up in participants receiving corticosteroids. There was no significant difference in adverse effect rates between people receiving corticosteroids and people receiving placebo.

*NNT = number needed to treat to benefit 1 individual.

Caveat

Risk of bias in the older, smaller studies included some unclear or high-risk assessments, whereas the larger studies had low risk of bias. The duration of the studies for adults and children ranged from 157 days to 12 months.

Context

Bell's palsy is a paralysis or weakness of muscles in the face, usually on one side, with no certain cause. Symptoms usually recover, although not always. Reducing inflammation of the facial nerve using corticosteroids is thought to limit nerve damage.

Cochrane Systematic Review

Madhok VB et al. Corticosteroids effective for Bell’s palsy. Cochrane Reviews, 2016, Issue 7. Art. No.: CD001942.DOI: 10.1002/14651858. CD001942.pub5. This review contains 7 studies involving 895 participants.

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