The Course of Pain in Bell's Palsy: Treatment With Prednisolone and Valacyclovir.

Thomas Berg, Sara Axelsson, Mats Engström, Anna Stjernquist-Desatnik, Anne Pitkäranta, Mervi Kanerva, Lars Jonsson

Research output: Contribution to journalArticlepeer-review

13 Citations (SciVal)

Abstract

OBJECTIVE:: To evaluate the effect of prednisolone and valacyclovir on ipsilateral pain around the ear and in the face or neck in Bell's palsy. The incidence and intensity of pain during the first 2 months of palsy and its prognostic value were also assessed. STUDY DESIGN:: Prospective, randomized, double-blind, placebo-controlled, multicenter trial. SETTING:: Sixteen tertiary referral centers in Sweden and 1 in Finland. PATIENTS:: Data are part of the Scandinavian Bell's palsy study; 829 patients aged 18 to 75 years with onset of palsy within 72 hours were included. Follow-up time was 12 months. INTERVENTION:: Patients were assigned to 1 of 4 treatment arms in a factorial fashion: placebo plus placebo; prednisolone 60 mg daily for 5 days, then tapering for 5 days, plus placebo; valacyclovir 1,000 mg 3 times daily for 7 days plus placebo; or prednisolone plus valacyclovir. MAIN OUTCOME MEASURES:: Pain was registered on a visual analog scale within 72 hours, at Days 11 to 17, 1 month, and 2 months. Facial function was assessed with the Sunnybrook and House-Brackmann systems. RESULTS:: Prednisolone and/or valacyclovir did not significantly affect the incidence or intensity of pain during the first 2 months. Pain was registered in 542 (65%) of 829 patients. At 2 months, 53 (8%) of 637 patients still reported pain. Subjects with pain at Days 11 to 17 had lower facial recovery rates at 12 months than those with no pain (p < 0.0001). CONCLUSION:: Prednisolone and/or valacyclovir did not affect the incidence or intensity of ipsilateral pain in Bell's palsy. The incidence of pain was similar during the first 2 weeks and then decreased. Presence of pain at Days 11 to 17 indicated a worse prognosis for facial recovery.
Original languageEnglish
Pages (from-to)842-846
JournalOtology & Neurotology
Volume30
DOIs
Publication statusPublished - 2009

Subject classification (UKÄ)

  • Otorhinolaryngology

Fingerprint

Dive into the research topics of 'The Course of Pain in Bell's Palsy: Treatment With Prednisolone and Valacyclovir.'. Together they form a unique fingerprint.

Cite this