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Randomised controlled trial
Combination therapy of steroids and antivirals improves the recovery rate in patients with severe Bell's palsy
  1. J Alexander De Ru1,
  2. Peter Paul G Van Benthem2
  1. 1 Central Military Hospital, Utrecht, The Netherlands;
  2. 2 Department of Otolaryngology, Head Neck Surgery, Gelre Ziekenhuizen Apeldoorn, Apeldoorn, The Netherlands
  1. Correspondence to: Dr J Alexander De Ru, Central Military Hospital, Lundlaan 1, Utrecht 3584 CX, The Netherlands; j.a.deru{at}umcutrecht.nl

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Context

Bell's palsy is an acute, peripheral facial paresis of unknown cause. Fortunately, many patients with Bell's palsy recover completely. However, about 15% end up with sequelae. The more severe the initial paresis, the poorer the patient's prognosis. Age is also an influencing factor, with less than 50% of patients aged over 60 achieving complete recovery.1

The existing literature suggests that Bell's palsy is caused by a reactivation of herpes simplex virus type 1 and in some cases of varicella zoster virus (sine herpete). The inflammatory reaction against the virus causes swelling of the nerve, which consequently …

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