Template:Bell's palsy Treatment: Difference between revisions
(Strip translate tags to enable SMW subobject creation) |
(Fix cite errors: add content to empty bells guidelines ref, fix Gronseth ref reuse to self-closing tag) |
||
| Line 1: | Line 1: | ||
===Eye Protection=== | ===Eye Protection=== | ||
*Cornea eye protection ([[EBQ:Evidence Levels|Level X]])<ref name="bells guidelines"></ref> | *Cornea eye protection ([[EBQ:Evidence Levels|Level X]])<ref name="bells guidelines">Baugh RF, Basura GJ, Ishii LE, et al. Clinical practice guideline: Bell's palsy. Otolaryngol Head Neck Surg. 2013;149(3 Suppl):S1-S27. doi:10.1177/0194599813505967</ref> | ||
**Artificial tears qhr while patient is awake | **Artificial tears qhr while patient is awake | ||
**Ophthalmic ointment at night | **Ophthalmic ointment at night | ||
| Line 11: | Line 11: | ||
===Antivirals=== | ===Antivirals=== | ||
''Most likely no added benefit when combined with steroids.''<ref>Lockhart et al. Cochrane Database Syst Rev. 2009 Oct 7;(4):CD001869.</ref> However also little harm associated with antivirals especially in patients with normal renal function<ref name="Gronseth" | ''Most likely no added benefit when combined with steroids.''<ref>Lockhart et al. Cochrane Database Syst Rev. 2009 Oct 7;(4):CD001869.</ref> However also little harm associated with antivirals especially in patients with normal renal function<ref name="Gronseth"/> | ||
*{{AntibioticDose|disease=Bell's palsy|drug=Valacyclovir|dose=1000mg TID x1 week|context=Antiviral}} '''OR''' | *{{AntibioticDose|disease=Bell's palsy|drug=Valacyclovir|dose=1000mg TID x1 week|context=Antiviral}} '''OR''' | ||
*{{AntibioticDose|disease=Bell's palsy|drug=Acyclovir|dose=400mg 5x per day x1 week|context=Antiviral}} | *{{AntibioticDose|disease=Bell's palsy|drug=Acyclovir|dose=400mg 5x per day x1 week|context=Antiviral}} | ||
Revision as of 01:00, 21 March 2026
Eye Protection
- Cornea eye protection (Level X)[1]
- Artificial tears qhr while patient is awake
- Ophthalmic ointment at night
- Eye should be taped shut at night
- Protective glasses or goggles
Steroids
Should be started within 72hrs of symptom onset[2]
- Prednisone 60-80mg qday x1wk[3] (Level B Evidence)[4]
Antivirals
Most likely no added benefit when combined with steroids.[5] However also little harm associated with antivirals especially in patients with normal renal function[4]
- Valacyclovir 1000mg TID x1 week OR
- Acyclovir 400mg 5x per day x1 week
Antibiotics
- Consider empiric empiric dosing if high index of suspicion for Lyme based on clinical presentation or lab data
- ↑ Baugh RF, Basura GJ, Ishii LE, et al. Clinical practice guideline: Bell's palsy. Otolaryngol Head Neck Surg. 2013;149(3 Suppl):S1-S27. doi:10.1177/0194599813505967
- ↑ Vargish L. For Bell's palsy, start steroids early; no need for an antiviral. J Fam Pract. Jan 2008; 57(1): 22–25http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3183838/pdf/JFP-57-22.pdf
- ↑ UpToDate. Bell's Palsy Prognosis and Treatment. March, 2014
- ↑ 4.0 4.1 Gronseth GS, Paduga R. Evidence-based guideline update: Steroids and antivirals for Bell palsy: Report of the Guideline Development Subcommittee of the American Academy of Neurology. Neurology. 2012Full Text
- ↑ Lockhart et al. Cochrane Database Syst Rev. 2009 Oct 7;(4):CD001869.