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KMID : 0385920120230040531
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Journal of the Korean Society of Emergency Medicine
2012 Volume.23 No. 4 p.531 ~ p.536
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Analysis of Clinical Outcome and Effectiveness of Steroid and Antiviral Treatment in Patients with Bell’s Palsy in the Emergency Department
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Lee Sung-Jae
Kim Hyung-Ju
Seo Dong-Woo
Sohn Chang-Hwan
Lee Jae-Ho
Oh Byum-Jin
Lim Kyung-Soo
Kim Won-Young
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Abstract
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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.
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KEYWORD
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Bell’s palsy, facial nerve, Prognosis, Emergency department
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