Bell’s Palsy is a sudden loss of function in half of the facial muscles. It is believed to be secondary to inflammation, which causes swelling in the facial nerve. Approximately 70% of patients diagnosed will have a complete recovery.
The chance of a full recovery is improved with prompt treatment within 72 hours. Patients that do not completely recover have issues that range from mild to severe. Patients with more severe issues may have complete paralysis of the hemi-face (that half of the face) or significant synkinesis. Synkinesis is loss of the ability to independently make coordinated movements of the muscles of the face. The face has 43 muscles that work in harmony to eat, blink, smile, talk, and show emotions. Patients with synkinesis have difficulty with many of these functions.
Traditionally, patients with Bell’s Palsy that have been treated with high doses of steroids and antivirals soon after their appearance of symptoms had improved outcomes or chances of a complete recovery. A new study revealed that patients treated with only the high dose of steroids improved their recovery and the antivirals had no effect. This is an important study because it may give insight on the best treatment for patients with new onset of facial paralysis.
For my patients with Bell’s Palsy in Charlotte, I will still prescribe them high doses of steroids and antivirals regardless of the results of this study. There are other studies that have shown that antivirals can be helpful in the recovery of the facial nerve, and they have a low side effect profile. If there is a small chance that antivirals will be helpful for my patients with Bell’s Palsy, I will continue to use them.
This highlights the fact that while new studies and their results are important in the progression of best practices for taking care of patients, studies must be viewed in light of previous research and knowledge. This is why patients cannot read an advertisement or news story that makes a claim about a new study and assume that it is the new standard of care.
I hope this raises awareness about the importance of seeing a doctor immediately after developing Bell’s Palsy in Charlotte to ensure the best chance of a complete recovery.