Results of Conservative Therapy on Peripheral Facial Palsy

Abstract

Thirty six cases of peripheral facial palsy (Bell's palsy; 20 cases, Hunt's syndrome; 16 cases) were treated conservatively at our clinic from January,1988 through September,1990, and the outcome of the therapy was analyzed. Combined therapy of high-dose steroid and low-molecular dextran with or without stellate ganglion block (SGB) and administration of antiviral agents was performed within two weeks after onset of the palsy. The steroid (bethamethasone, initial dose; 8 to 12 mg/day) was drip-infused intravenously for 12 to 15 days (maximum total dose; 120 mg), and then all patients were followed up for 6 months. Facial movements were evaluated on a 40-point scoring system ( Japanese Society for Facial Nerve Research), and electrophysiological examinations such as impedance audiometry (stapedial reflex; SR) and electroneurography (ENoG).
These findings showed that high-dose (initial dose; 10 to 12 mg/day) intravenous administration of a steroid (bethamethasone) would be of benefit to obtain satisfactory( 12/13; 92%)return of facial movement in adults.