ITEMS IN AFP WITH KEYWORD:
Short-term systemic corticosteroids are frequently prescribed for adults by primary care physicians; however, short courses of the steroids are associated with adverse effects, including hyperglycemia, elevated blood pressure, mood disturbance, sepsis, and fracture. There is evidence against corticosteroid use in patients with acute bronchitis, acute sinusitis, carpal tunnel, and allergic rhinitis and for its use in patients with Bell palsy and acute gout. There is insufficient evidence supporting its use for patients with pharyngitis, lumbar radiculopathy, and herpes zoster.
The combination of antiviral agents and corticosteroids is more effective than corticosteroids alone for the complete recovery of patients with Bell palsy (number needed to treat [NNT] = 15) and for the resolution of motor synkinesis and excessive tear production (NNT = 12). Antivirals should not be used alone to treat Bell palsy.
Anxiety and fear surrounding a clinical diagnosis like Bell palsy can lead to requests for increased testing or frequent patient encounters.
Photo Quiz presents readers with a clinical challenge based on a photograph or other image.
Bell palsy is an acute affliction of the facial nerve, resulting in sudden paralysis or weakness of the muscles on one side of the face. Testing patients with unilateral facial paralysis for diabetes mellitus or Lyme disease is not routinely recommended. Patients with Lyme disease typically present ...
Mar 15, 2009 Issue
Acyclovir or Steroids as Pharmacologic Treatment of Bell Palsy [AFP Journal Club]
Does acyclovir or steroids speed recovery in adults with Bell palsy? This study suggests that it is reasonable to start prednisolone in some cases, but physicians should not forget about practical considerations, such as lubricant eye drops, pain management, and chewing instruction. Acyclovir was of no benefit
Bell's palsy is a peripheral palsy of the facial nerve that results in muscle weakness on one side of the face. Affected patients develop unilateral facial paralysis over one to three days with forehead involvement and no other neurologic abnormalities. Symptoms typically peak in the first week and ...