Steroids with and Without Antivirals in the Treatment of Bell’s Palsy: Does It Make any Difference in Recovery? A Study at a Tertiary Care Center, Karachi, Pakistan

IF 0.4 Q4 NEUROSCIENCES

Archives of Neuroscience Pub Date : 2021-07-31 DOI:10.5812/ans.115645

A. Talib, Gohar Baloch, I. Naqvi, M. Ubaid

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Abstract

Objectives: To compare the pharmacological effects of steroids in comparison to steroids with antiviral drugs for the treatment of Bell’s Palsy. Methods: A total 60 patients were enrolled and segregated equally into two groups, where patients on prednisolone were labeled as group A (Control group), whereas patients on prednisolone + acyclovir were labeled as group B (study group). All patients had House Brackmann score. The control group started oral prednisolone 1 mg/kg for 10 days, whereas the study group started acyclovir 400 mg 4 times a day for 10 days along with prednisolone tablets. Patients were regularly observed till the study was completed. Primary outcome measure was facial nerve recovery. Health-related quality of life and facial appearance were considered secondary outcomes. Results: The primary outcomes assessed as complete recovery from Bell’s Palsy by Brackmann score at week 4 were found in 17/30 (57%) patients and 23/30 (77%) patients at week 8 in the control group. Complete recovery from Bell’s Palsy was also shown in the experimental group (Prednisolone + acyclovir) where 25/30 (83%) patients completed recovery at week 4, while 27/30 (90%) patients at week 8. Comparison of the two groups showed a significant improvement in the study group (prednisolone + acyclovir) (P = 0.047) at week 4 and (P = 0.02) at week 8. The secondary outcomes were assessed as improvement in the quality of life and facial appearance from Bell’s Palsy. Health utility score was 0.84 ± 0.01 in the control group (On prednisolone) with facial appearance score of (Derriford appearance scale 59) 61 ± 28. At week 4, the study group (on prednisolone+ acyclovir) showed 0.88 ± 0.12 score on Health utility index scale-3 and 46 ± 26 score on Derriford appearance scale. Comparison of the quality of life (Health quality index scale-3) and facial appearance among both control and study groups showed a significant improvement in the study group (P = 0.001 and P = 0.005, respectively). Moreover, when health utility score and Derriford appearance were compared among both groups, it showed a significant improvement in the study group (P = 0.001 and 0.016, respectively). Conclusions: The combination of prednisolone with acyclovir is found superior to prednisolone alone, and this combination treatment results in improvement in both recovery and quality of life.

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类固醇加与不加抗病毒药物治疗贝尔氏麻痹:对康复有影响吗?巴基斯坦卡拉奇某三级保健中心的研究

目的:比较类固醇与类固醇联合抗病毒药物治疗贝尔麻痹的药理作用。方法:共入组60例患者，随机分为两组，强的松龙治疗组为A组(对照组)，强的松龙+阿昔洛韦治疗组为B组(研究组)。所有患者都有House Brackmann评分。对照组开始口服强的松龙1 mg/kg，持续10天，而研究组开始阿昔洛韦400 mg，每天4次，持续10天，同时服用强的松龙片。定期观察患者直至研究完成。主要观察指标为面神经恢复。与健康相关的生活质量和面部外观被认为是次要结局。结果:在第4周，17/30(57%)的患者和23/30(77%)的对照组患者在第8周被Brackmann评分评估为完全从贝尔麻痹中恢复。实验组(强的松龙+阿昔洛韦)也显示贝尔麻痹完全康复，其中25/30(83%)患者在第4周完成康复，而27/30(90%)患者在第8周完成康复。两组比较，实验组(强的松龙+阿昔洛韦)在第4周显著改善(P = 0.047)，第8周显著改善(P = 0.02)。次要结果评估为贝尔麻痹患者的生活质量和面部外观的改善。对照组(强的松龙组)健康效用评分为0.84±0.01，面部外观评分为(Derriford外貌量表59)61±28。第4周，泼尼松龙+阿昔洛韦治疗组健康效用指数-3评分为0.88±0.12分，Derriford外观评分为46±26分。对照组和研究组的生活质量(健康质量指数量表-3)和面部外观的比较显示，研究组有显著改善(P = 0.001和P = 0.005)。此外，当两组比较健康效用评分和Derriford外观时，实验组显着改善(P分别= 0.001和0.016)。结论:强的松龙联合阿昔洛韦优于单用强的松龙，且在康复和生活质量方面均有改善。

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Archives of Neuroscience NEUROSCIENCES-

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期刊介绍： Archives of neuroscience is a clinical and basic journal which is informative to all practitioners like Neurosurgeons, Neurologists, Psychiatrists, Neuroscientists. It is the official journal of Brain and Spinal Injury Research Center. The Major theme of this journal is to follow the path of scientific collaboration, spontaneity, and goodwill for the future, by providing up-to-date knowledge for the readers. The journal aims at covering different fields, as the name implies, ranging from research in basic and clinical sciences to core topics such as patient care, education, procuring and correct utilization of resources and bringing to limelight the cherished goals of the institute in providing a standard care for the physically disabled patients. This quarterly journal offers a venue for our researchers and scientists to vent their innovative and constructive research works. The scope of the journal is as far wide as the universe as being declared by the name of the journal, but our aim is to pursue our sacred goals in providing a panacea for the intractable ailments, which leave a psychological element in the daily life of such patients. This authoritative clinical and basic journal was founded by Professor Madjid Samii in 2012.