efficacy of early treatment of bell’s palsy with oral acyclovir and prednisolone
DESCRIPTION
Efficacy of Early Treatment of Bell’s Palsy With Oral Acyclovir and Prednisolone. Otology & Neurotology 24:948-951, 2003, Nov Naohito Hato, Shuichi Matsumoto, Hisanobu Kisaki, etc. - PowerPoint PPT PresentationTRANSCRIPT
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Efficacy of Early Treatment of Bell’s Palsy With Oral Acyclovir and Prednisolone
Otology & Neurotology
24:948-951, 2003, NovNaohito Hato, Shuichi Matsumoto, Hisanobu Kisaki, etc
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To investigate the therapeutic effects of acyclovir and prednisolone in relation to the timing of treatment in Bell’s palsy.
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Bell’s Palsy Idiopathic Peripheral facial palsy Sudden onset
HSV Reactivation VZV Reactivation
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Bell’s Palsy > 10 % patients are unable to
recover normal facial movement after conventional treatment
Acyclovir therapy has been evaluated in some trials
Correlation between the timing of treatment and the recovery function
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Patients
Oct 1986 ~ Dec 2000 Bell’s palsy: without CNS disorders,
neoplasms, otits media, trauma or herpes zoster oticus
1023 patients
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Patient selection Severe, with Yanagihara score < 20 Begin treatment within 7 days, no initial Tx > 6 months F/U, or complete recovery No systemic disease, no contraindication of
steroid use Only medication, no surgical intervention
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Yanagihara score
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Drug Dosage
Adult: Acyclovir 2000mg/d x 7days
Prednisolone 1 mg/kg per day Pediatric patients:
Acyclovir 80mg/kg per day x 5days
Prednisolone 1 mg/kg per day
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Table1
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Table2
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Table3
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Table4
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Acyclovir is less effective later after onset Acyclovir affects only replicating viruses Acyclovir is unable to destroy viruses that h
ave already relpicated
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Conclusion
Early diagnosis and treatment within 3 days of the onset of paralysis are necessary for maximal efficacy of combined acyclovir and prednisolone therapy for Bell's palsy.