High-Dose Corticosteroid Therapy in Facial Nerve Palsy: A Retrospective Study

TL;DR

This study compares high-dose and reduced-dose corticosteroid treatments for facial nerve palsy, finding no significant difference in effectiveness.

Contribution

The study provides evidence that higher initial corticosteroid doses do not improve outcomes in facial nerve palsy.

Findings

Standard and reduced high-dose corticosteroid therapy showed similar efficacy in Bell’s palsy and Ramsay Hunt syndrome.

More than 80% of patients had no significant improvement regardless of initial dose.

Higher initial doses of prednisolone did not lead to better recovery outcomes.

Abstract

Objectives

The difference in therapeutic efficacy between an initial dosage of 200 mg and 100 mg prednisolone (PSL) with a taper for Bell’s palsy and Ramsay Hunt syndrome was retrospectively investigated.

Methods

A total of 259 patients (172 with Bell’s palsy and 87 with Ramsay Hunt syndrome) were treated with high-dose corticosteroid therapy (HDCT) with PSL (the standard HDCT: 200 mg/day for three days with a seven-day taper, or the reduced HDCT: 100 mg/day for three days with a seven-day taper) and evaluated once a month by the Yanagihara facial nerve grading system until facial nerve paralysis was cured or six months after the onset.

Results

The therapeutic efficacy of the standard HDCT was not significantly improved, compared to the reduced HDCT, in Bell’s palsy and Ramsay Hunt syndrome, and even in less than 20.0% of electroneuronography in Bell’s palsy and Ramsay Hunt syndrome.

Conclusion

HDCT with more than an initial dosage of 100 mg/day PSL with a taper for Bell’s palsy and Ramsay Hunt syndrome does not increase the therapeutic efficacy.

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