How Long Does It Take For Steroids To Work For Bell’s Palsy?

Bell’s palsy is named after Scottish surgeon Charles Bell (1774–1842), who first described the connection of the facial nerve to the condition (1).

Epidemiological studies show that males and females are affected equally. (1)

How Long Does It Take For Steroids To Work For Bell’s Palsy?

Bell’s palsy also known as acute facial paralysis/idiopathic facial palsy is commonly encountered in the age group between 20 to 50 years. The symptoms of this condition range widely and can present within a few hours to months. The condition is mostly related to the pathology of the seventh cranial nerve that is facial nerve and when the cause is unknown then it is known as Bell’s palsy. Although it has also been speculated that it is commonly associated with acute viral illnesses in many cases but it has to be predicated based on the presentation of the case.

The most common and most accepted form of treatment is oral corticosteroids. In many of the studies conducted on the effects of corticosteroids on Bell’s palsy, it has been found that these are beneficial in many of the cases. Although it has also been seen that about 80 % of the cases suffering from idiopathic Bell’s palsy gets cured automatically without any treatment within a period of 3 to 9 months. In another 20 %, there was seen some kind of sequelae left behind of the condition of which the 5 % was permanent, severe and incurable.

According to various studies, the Role of corticosteroids is more prominent in acute presentation especially within the period of 48 to 72 hours. It is known to reverse the pathology that can compress the facial nerve like nerve edema due to inflammation etc. In a study conducted in 1972 on the cases of acute facial paralysis, it was seen that patients who were given corticosteroids recovered completely in 89 % cases as compared to 64 % patients who were given a placebo (2).

In a study published in the US, it was shown that corticosteroids if started within 48 to 72 hours then the recovery from the condition was seen considerably within a period of three weeks and gets cured in an average period of 3 to 6 months with earliest at 1 month. Corticosteroid of choice is usually prednisolone with a dosage of 1 mg/kg and the median dose is 60 mg. But in many cases, high dose corticosteroid therapy has also been practiced and has shown good results at a dosage of 2 mg per kg or 120 mg.

The treatment of Bell’s palsy also consisted of antiviral drugs such as acyclovir, valganciclovir, etc. if there is a strong suspicion of viral etiology. It can be started along with oral corticosteroids but its response is not quite up to the mark. In a Scottish study, the effect of antiviral therapy was comprehended and it did not show a major change in the treatment of this condition.

Conclusion

The usual period taken by corticosteroids for the effective cure of this condition is about 3 to 6 months with a dosage of 60 mg. But it has to be kept in mind that for the maximum output, it must be started within the period of 48 to 72 hours after the presentation as after this period permanent damage of the nerve starts.

Corticosteroids such as Prednisone are very effective in reducing nerve edema and can prevent permanent damage to the facial nerve occurring due to compression.

However, it is also evident that in many cases this treatment therapy may not work. It can be due to natural factors or delayed diagnosis/presentation, so it is equally important to consult the doctor as soon as the symptoms are encountered.

References:

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