Steroids in facial palsy due to herpes zoster

BMJ 1998; 316 doi: https://doi.org/10.1136/bmj.316.7126.233a (Published 17 January 1998) Cite this as: BMJ 1998;316:233

Steroids are indicated if paralysis is complete and no contraindications exist

  1. C P Fielder, Consultanta,
  2. S A Raza, Specialist registrarb
  1. ahilncol@clara.net
  2. bDepartment of Otolaryngology-Head and Neck Surgery, Singleton Hospital, Swansea SA2 8QA
  3. cAcademic Department of Otorhinolaryngology-Head and Neck Surgery, Hull Royal Infirmary, Hull HU3 2JZ

    Editor-Devine's letter about treatment of facial nerve paralysis, which commented on the case that we reported in Minerva, was inaccurate and misleading.1 Steroids are not contraindicated in the management of herpes zoster. Wood et al and Whitley et al showed in double blind controlled trials that prednisolone significantly reduced pain in the acute phase of the disease at days 7 and 14 and resulted in significantly faster healing of vesicles.2 3 The use of steroids in any facial palsy (Bell's or Ramsay Hunt) is controversial. Most otologists, however, would support their use when the palsy is complete. This is our policy. We treat facial palsy due to herpes zoster with aciclovir, with or without steroids. In this case the patient had …

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