# Steroid administration facilitates recovery in severe refractory Bell’s palsy patients who did not receive steroids in the acute stage: a retrospective study

**Authors:** Sha-Sha Ding, Kai-Hua Song, Ying-Ying Zhang, Fu Xu, Li-Hua Xuan, Shou-Hai Hong

PMC · DOI: 10.3389/fneur.2026.1760155 · Frontiers in Neurology · 2026-02-11

## TL;DR

Steroid treatment helps severe Bell’s palsy patients recover better when given during the recovery stage, even if they missed steroids earlier.

## Contribution

Shows that late steroid treatment improves recovery in severe Bell’s palsy patients who missed acute-stage steroids.

## Key findings

- Steroid group had better facial nerve recovery than the control group (p < 0.05).
- Steroids improved outcomes when administered in the recovery stage of severe refractory Bell’s palsy.

## Abstract

In the present study, we aimed to evaluate the efficacy of steroid treatment on patients with severe refractory Bell’s palsy in the recovery stage who had not been treated with steroids in the acute stage.

We performed a retrospective analysis of 122 patients with severe refractory Bell’s palsy. These patients had a clinical course of 15–30 days, House-Brackmann (HB) grade ≥ IV, and no history of steroid therapy. Of those, 65 patients who received steroid therapy after hospitalization were assigned to the steroid group and 57 patients who did not receive steroid therapy were assigned to the control group. Both groups received folic acid and mecobalamin, acupuncture, and mirror exercises as basic treatments. The primary outcome was the rate of grade I on the HB Grading Scale. The secondary outcome was the Sunnybrook Facial Grading system. All outcomes were assessed before treatment (baseline), at 2 weeks of steroids treatment (2 weeks), and at 8 weeks after steroids treatment (10 weeks).

The steroid group had a better recovery rate of facial-nerve function than the control group (p < 0.05).

The use of steroids facilitate the recovery of severe refractory Bell’s palsy in the recovery stage, who did not receive steroids in the acute stage.

## Linked entities

- **Diseases:** Bell’s palsy (MONDO:0005665)

## Full-text entities

- **Genes:** TNF (tumor necrosis factor) [NCBI Gene 7124] {aka DIF, IMD127, TNF-alpha, TNFA, TNFSF2, TNLG1F}, IL1A (interleukin 1 alpha) [NCBI Gene 3552] {aka IL-1 alpha, IL-1A, IL1, IL1-ALPHA, IL1F1}, IL6 (interleukin 6) [NCBI Gene 3569] {aka BSF-2, BSF2, CDF, HGF, HSF, IFN-beta-2}
- **Diseases:** HB (MESH:D018877), vascular ischaemia (MESH:D057772), edematous swelling of (MESH:D004487), insomnia (MESH:D007319), mental illness (MESH:D001523), liver and kidney dysfunction (MESH:D051437), tumors (MESH:D009369), weakness (MESH:D018908), diabetes mellitus (MESH:D003920), hypertension (MESH:D006973), Viral infection (MESH:D014777), muscles (MESH:D019042), autoimmune inflammatory disorders (MESH:D007249), spasms (MESH:D013035), facial nerve swelling (MESH:D005155), gastric ulcer (MESH:D013276), trauma (MESH:D014947), hematomas (MESH:D006406), facial palsy (MESH:D005158), systemic diseases (MESH:D034721), autonomic dysfunction (MESH:D001342), Bell's palsy (MESH:D020330), contracture (MESH:D003286), vascular ischemia (MESH:D007511), nerve (MESH:C537568), synkinesis (MESH:D046608), hepatitis (MESH:D056486), palsy (MESH:D010243), tuberculosis (MESH:D014376), gastric discomfort (MESH:D013272), depression (MESH:D003866), facial asymmetry (MESH:D005146)
- **Chemicals:** dexamethasone (MESH:D003907), neurotrophic drugs (-), folic acid (MESH:D005492), blood glucose (MESH:D001786), mecobalamin (MESH:C019476), gado-linium (MESH:D005682), Steroid (MESH:D013256), prednisone (MESH:D011241)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Full text

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## Figures

2 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12932197/full.md

## References

24 references — full list in the complete paper: https://tomesphere.com/paper/PMC12932197/full.md

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Source: https://tomesphere.com/paper/PMC12932197