Analysis of Clinical Outcome and Effectiveness of Steroid and Antiviral Treatment in Patients with Bell's Palsy in the Emergency Department.
- Author:
Sung Jae LEE
1
;
Hyung Ju KIM
;
Dong Woo SEO
;
Chang Hwan SOHN
;
Jae Ho LEE
;
Byum Jin OH
;
Kyung Soo LIM
;
Won Young KIM
Author Information
1. Department of Emergency Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea. wonpia@yahoo.co.kr
- Publication Type:Original Article
- Keywords:
Bell's palsy;
facial nerve;
Prognosis;
Emergency department
- MeSH:
Acyclovir;
Antiviral Agents;
Bell Palsy;
Electronic Health Records;
Emergencies;
Facial Nerve;
Facial Paralysis;
Humans;
Paralysis;
Prognosis;
Retrospective Studies;
Valine
- From:Journal of the Korean Society of Emergency Medicine
2012;23(4):531-536
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: This study was conducted for investigation of the recovery rate and prognostic factors of Bell's palsy treated with steroid and antiviral agents in the emergency department (ED). METHODS: A retrospective review of electronic medical records of patients with acute, unilateral Bell's palsy within 72 hrs of onset who were admitted from the ED between March 2008 and February 2010 was conducted. All patients were treated uniformly with high-dose steroid and valaciclovir. The House-Brackmann (HB) grading system was used for evaluation of the severity of facial palsy. Satisfactory recovery was defined as facial palsy that recovered to Grade I on the HB grading scale. RESULTS: During the three-year period, 231 patients (age, 51+/-15) with confirmed Bell's palsy were included in this study. Initial grade of paralysis was as follows: 43 patients (18.6%) were HB grade II, 107 patients (46.3%) were grade III, 72 patients (31.2%) were grade IV, and nine patients (3.9%) were grade V. The satisfactory recovery rate was 77.9% at three months, and 88.3% at 12 months from diagnosis. Satisfactory recovery rate was significantly lower in patients with initial HB grade III/IV (85.2% vs. 92.7%, p<0.01), and age over 40 years (85.72% vs. 95.2%, p=0.04). CONCLUSION: The satisfactory recovery rate of patients with Bell's palsy treated with steroid and antiviral agents was 77.9% at three months, and 88.3% at 12 months, and initial severity was found to be an important factor in predicting the long term prognosis of Bell's palsy.
