Acyclovir in the Treatment of Bell's Palsy

Abstract

Objective: To examine the role of acyclovir in the treatment of Bell's palsy. Data Sources: A search was performed using MEDLINE (1966–September 2002) and the Cochrane Database of Systematic Reviews with the search terms acyclovir, antiviral, idiopathic facial paralysis, Bell's palsy, herpes simplex virus, and corticosteroids. Data Synthesis: Treatment of Bell's palsy is controversial. Recent research has indicated that herpes simplex virus type 1 may be the likely causative agent. Clinical trials and review articles focusing on the use of acyclovir in the treatment of Bell's palsy were reviewed and evaluated. Conclusions: More solid evidence is necessary to validate whether herpes simplex virus type 1 causes Bell's palsy. Limited published clinical studies exist that have used acyclovir for the treatment of Bell's palsy. The results of available trials are contradictory. The American Academy of Neurology's practice parameter states that acyclovir, in combination with steroids, is safe and possibly effective for Bell's palsy treatment. Further information is needed from larger prospective, randomized, placebo-controlled trials to clarify the ultimate therapeutic role of acyclovir for Bell's palsy.