Bell's Palsy

A large randomized, controlled, double-blinded trial published in the NEJM has concluded that Acyclovir and prednisolone dual therapy does not offer benefit over prednisolone alone. The jury is still out regarding the addition of valacyclovir. Severe cases respond best to valacyclovir and prednisolone dual therapy according to the published papers on the subject. For now prednisolone is certainly indicated for cases of Bell's palsy. Valacyclovir therapy may or may not add benefit. Not prescribing Valacyclovir would certainly be reasonable practice.

NEJM 2007;357:598-607