About 70% of patients with Bell’s palsy recover completely within 6 months without treatment.

Bell’s palsy presents as unilateral weakness or paralysis of the face due to acute dysfunction of the peripheral facial nerve with no readily identifi able cause.1

Bell’s palsy accounts for 70% of peripheral facial palsies and the yearly incidence is about 30 per 100 000.2,3

About 70% of patients with Bell’s palsy recover completely within 6 months without treatment.

facial palsy

Patients aged 18 to 75 years with onset of palsy within 72 h were considered for inclusion.

Exclusion criteria were systemic antiherpetic medication within the past 2 weeks, ongoing systemic steroid medication, allergy to aciclovir, valaciclovir, famciclovir, or ganciclovir, pregnancy, breastfeeding, being a woman of childbearing age who was unwilling to use contraceptives
during the medication period, other neurological diseases, diabetes, badly controlled hypertension, current or a history of serious heart disease, history of renal or hepatic disease, gastric or duodenal ulcer, history of glaucoma, acute otitis or history of ipsilateral chronic otitis, history of tuberculosis, history of immunodeficiency syndromes, recent head injury, psychiatric disease, or any other condition that was at risk of being influenced by the study medication or that might have affected completion of the study.


Pain around the ear, in the face, or in the neck was registered on a visual analogue scale that ranged from 0 to 10 points, where 0 was no pain and 10 very severe pain.

Facial function was assessed at all visits with two grading systems. The Sunnybrook system is regionally weighted and assesses resting symmetry, the degree of voluntary movements, and synkinesis, to produce a composite score that ranges from 0 to 100 points, where 0 is complete paralysis and 100 normal function.20 The House-Brackmann scale is based on a six-grade score, where I is normal function and VI is complete paralysis,
for gross assessment of facial motor function and sequelae.21 In this multicentre study, in vivo grading of facial function was done by many investigators, which might lead to between-assessor differences in facial gradings (ie, inter-rater variability). Another risk is that gradings done by the same assessor at diff erent time points might vary. Therefore, variability in the assessment process was expected, and to reduce such problems two validated grading scales were used.21