The neurologist’s dilemma: A comprehensive clinical review of Bell’s palsy, with emphasis on current management trends
| Autor: | Shane R. Tubbs, Stephen Osiro, Petru Matusz, Ryan Hudson, Anthony Zandian, Marios Loukas, Irfan M. Ali |
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| Rok vydání: | 2014 |
| Předmět: |
Male
Herpesvirus 3 Human medicine.medical_specialty Hydroxycorticosteroids Herpesvirus 1 Human Bell's palsy Bell Palsy medicine Humans Disease management (health) Review Articles Randomized Controlled Trials as Topic Palsy business.industry Disease Management Herpes Simplex Virus Protein Vmw65 General Medicine Prognosis medicine.disease Dilemma stomatognathic diseases Current management Family medicine Immunology Female business |
| Zdroj: | Medical Science Monitor : International Medical Journal of Experimental and Clinical Research |
| ISSN: | 1643-3750 |
| DOI: | 10.12659/msm.889876 |
| Popis: | Background Recent advances in Bell’s palsy (BP) were reviewed to assess the current trends in its management and prognosis. Material/Methods We retrieved the literature on BP using the Cochrane Database of Systematic Reviews, PubMed, and Google Scholar. Key words and phrases used during the search included ‘Bell’s palsy’, ‘Bell’s phenomenon’, ‘facial palsy’, and ‘idiopathic facial paralysis’. Emphasis was placed on articles and randomized controlled trails (RCTs) published within the last 5 years. Results BP is currently considered the leading disorder affecting the facial nerve. The literature is replete with theories of its etiology, but the reactivation of herpes simplex virus isoform 1 (HSV-1) and/or herpes zoster virus (HZV) from the geniculate ganglia is now the most strongly suspected cause. Despite the advancements in neuroimaging techniques, the diagnosis of BP remains one of exclusion. In addition, most patients with BP recover spontaneously within 3 weeks. Conclusions Corticosteroids are currently the drug of choice when medical therapy is needed. Antivirals, in contrast, are not superior to placebo according to most reliable studies. At the time of publication, there is no consensus as to the benefit of acupuncture or surgical decompression of the facial nerve. Long-term therapeutic agents and adjuvant medications for BP are necessary due to recurrence and intractable cases. In the future, large RCTs will be required to determine whether BP is associated with an increased risk of stroke. |
| Databáze: | OpenAIRE |
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