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Medical Therapies for Facial Paralysis

Reactivation of herpes simplex virus (HSV) is thought to be the likely underlying cause of Bell’s palsy. Bell’s palsy can be triggered by stress, fatigue, infection with another virus, and any condition leading to immune compromise. Pregnancy is also associated with Bell’s palsy, most often occurring during the third trimester.

              While 70% of patients with Bell’s palsy make a full recovery, 30% of patients will have chronic sequelae from the condition such as facial tightness and synkinesis. However, there are medications which can maximize patients’ chances of making a complete recovery. The mainstay of treatment is corticosteroids to decrease inflammation and swelling of the facial nerve. Prednisone should be started as soon as possible once the diagnosis of Bell’s palsy is made. At the Facial Nerve Center, we prescribe 60 mg Prednisone daily for 5 days and then taper off over the ensuing 5 days. There is also some evidence to suggest that combining antiviral medications with steroids can improve recovery from Bell’s palsy. Hence, at the Facial Nerve Center we prescribe Valacyclovir (Valtrex) in addition to Prednisone.

              It is never too early to visit the Facial Nerve Center when one has been diagnosed with acute facial palsy. At the Facial Nerve Center, we will work with patients to assure the right tests have been performed, the correct medications have been started, and the necessary follow up is scheduled to maximize the probability of a complete recovery. If patients do not make a complete recovery, we have many options to treat chronic facial palsy.

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