Abstract
Is there a rational basis for treating facial nerve palsy (FNP) patients—or a definable subgroup—with antiviral agents? There is substantial evidence that infections—including with herpesviruses1—can play an important etiologic role in FNP, although there are no systematic data to indicate the proportion in which this is the case. Paradoxically, the role of anti-infectious therapy is much less clear. An upcoming American Academy of Neurology Guideline2 concludes, much like the original 2001 one, “Because of the possibility of a modest increase in recovery, patients may be offered antivirals (in addition to steroids).” Despite similarly cautious wording, the original guideline was followed by widespread use of antivirals in FNP—use that has decreased substantially in light of more recent data.
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