Study on Prognostic Value of Electrophysiological Tests and Efficacy of Steroids and Acyclovir in Bell's Palsy.

Kingsly Jebasingh, Y (2007) Study on Prognostic Value of Electrophysiological Tests and Efficacy of Steroids and Acyclovir in Bell's Palsy. Masters thesis, Madras Medical College, Chennai.


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Bell's palsy is the most frequent disease of the seventh cranial nerve, with a good prognosis. More than 70% patients attain complete clinical recovery, with no noticeable residua. Persistent sequellaes are usually noted in cases with profound axonal loss only. Electrophysiological tests may offer valuable information in defining the severity of nerve injury and a possible residual dysfunction. Treatment of Bell’s palsy is still controversial. Therapy is difficult to evaluate, because as many as two thirds of patients with Bell’s palsy spontaneously recover and achieve near-normal function. Many patients begin to improve as early as 10 days after the onset, even without treatment . Drug therapy mainly consists of corticosteroids with or without an antiviral (acyclovir). These drugs hasten the recovery and lessen the ultimate degree of dysfunction. One hundred and one patients with clinical signs of Bell's palsy were included in this study. Clinical signs were recorded (the degree of facial muscle palsy) and treated with steroids and acyclovir in combination or separately. Electrophysiological tests (amplitude and latency of compound muscle action potential CMAP) were done on first week and fourteenth day of the onset of palsy. The results were analysed in regard to the usefulness of electrophysiological studies in prognostication and which combination of drugs is most useful in management of Bells palsy. The most reliable prognostic data is obtained after the fourteenth day from the onset of palsy. • Electrophysiological studies can predict duration of the clinical recovery and the outcome of the illness. • Amplitude ratio of CMAP is the most reliable parameter in assessing the prognosis • Latency measurement as an independent factor is not much helpful in assessing the prognosis, however when combined with the amplitude ratio predicts the prognosis. • Simultaneous subclinical facial nerve involvement does occur on the contralateral side in 16% of the cases. • Bell’s palsy patients with incomplete facial paralysis have excellent outcomes • Steroids are safe and are probably effective in management of bells palsy which improves the rate of recovery. • Acyclovir in combination with prednisolone is safe and has a definite role in improving facial functional outcomes in patients with Bell’s palsy than using the drug alone • Early treatment in cases with incomplete paralysis hastens the recovery and it has no effect on cases with severe deficit.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Prognostic Value; Electrophysiological Tests; Efficacy of Steroids; Acyclovir; Bell's Palsy.
Subjects: MEDICAL > Neurology
Depositing User: Kambaraman B
Date Deposited: 28 Jun 2017 10:06
Last Modified: 28 Jun 2017 10:06

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