Template:Bell's palsy Treatment

Eye Protection

  • Cornea eye protection (Level X)[1]
    • Artificial tears qhr while patient is awake
    • Ophthalmic ointment at night
    • Eye should be taped shut at night
    • Protective glasses or goggles

Steroids

Should be started within 72hrs of symptom onset[2]

Antivirals

Most likely no added benefit when combined with steroids.[5] However also little harm associated with antivirals especially in patients with normal renal function[4]

Antibiotics

  • Consider empiric doxycycline if high index of suspicion for Lyme based on clinical presentation or lab data
  • Cite error: Invalid <ref> tag; no text was provided for refs named bells guidelines
  • Vargish L. For Bell’s palsy, start steroids early; no need for an antiviral. J Fam Pract. Jan 2008; 57(1): 22–25http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3183838/pdf/JFP-57-22.pdf
  • 3.0 3.1 UpToDate. Bell's Palsy Prognosis and Treatment. March, 2014
  • 4.0 4.1 Gronseth GS, Paduga R. Evidence-based guideline update: Steroids and antivirals for Bell palsy: Report of the Guideline Development Subcommittee of the American Academy of Neurology. Neurology. 2012Full Text
  • Lockhart et al. Cochrane Database Syst Rev. 2009 Oct 7;(4):CD001869.