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Acupuncture for Bell's palsy

Bell's palsy or idiopathic facial palsy is the most common disorder affecting the facial nerves and results in weakness or paralysis on one side of the face. The paralysis causes distortion of the face and interferes with normal functions, such as closing the eye and eating. It is thought to be caused by inflammation of the facial nerve.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2010

Corticosteroids for Bell's palsy

Bell's palsy is a paralysis or weakness of muscles in the face, usually on one side, with no certain cause. Symptoms usually recover, although not always. Reducing inflammation of the facial nerve using corticosteroid medicines (steroids) is thought to limit nerve damage. This is an update of a review first published in 2002 and last updated in 2010.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2016

Antiviral treatment for Bell's palsy

We reviewed the evidence about the effect of antiviral therapy alone or in combination with any other therapy, on Bell's palsy.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Surgical operation for Bell's palsy (idiopathic facial paralysis)

Bell’s palsy is a paralysis of the muscles of the face, usually on one side, that has no known underlying cause. The symptoms probably occur when a nerve in the face is trapped and swollen. People with Bell's palsy generally recover but there is a small group who do not. Some surgeons have thought that an operation to free the nerve could improve recovery. We did this review to assess the effects of surgery for Bell's palsy compared with no treatment, other types of surgery, sham (fake) treatment or treatment with medicines.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

High pressure (hyperbaric) oxygen therapy for Bell's palsy

Bell's palsy is a weakness of one side of the face that is diagnosed after other causes of facial weakness have been ruled out. It is a 'diagnosis of exclusion'. Bell's palsy may be caused by a virus affecting the facial nerve. Standard treatment includes steroids to help settle swelling of the facial nerve, whereas antiviral treatment does not appear to help. In hyperbaric oxygen therapy, the person undergoing treatment breathes 100% oxygen in a pressurised chamber for about one hour (called a 'dive'). This may produce more dissolved oxygen in the facial nerve and might reduce nerve damage in Bell's palsy. We searched for evidence from randomised controlled trials on hyperbaric oxygen therapy in adults with moderate to severe Bell's palsy. Our searches revealed no trials that met the inclusion criteria for the review. We found very low quality evidence from one trial to suggest that hyperbaric oxygen therapy might be beneficial for moderate to severe Bell's palsy. The trial involved 79 participants and compared hyperbaric oxygen therapy to prednisone, a corticosteroid, which is a proven active treatment. The participants did not know which treatment they were being given. Those treated with hyperbaric oxygen recovered more quickly and recovered normal facial movement more often (95% versus 76%). All participants tolerated the treatment well, and there were no major complications. The quality of evidence from this trial was very low because the assessors of facial function were aware of which treatment each participant had been given, which introduces a high risk of bias. There is therefore no high quality evidence on which to base conclusions about the efficacy of hyperbaric oxygen therapy in Bell's palsy.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2016

Physical treatments for idiopathic facial paralysis

Bell's palsy is an acute disorder of the facial nerve, which produces full or partial loss of movement on one side of the face. The facial palsy gets completely better without treatment in most, but not all, people. Physical therapies, such as exercise, biofeedback, laser treatment, electrotherapy, massage and thermotherapy, are used to hasten recovery, improve facial function and minimise sequelae. For this updated review we found a total of 12 studies with 872 participants, most with high risk of bias. Four trials studied the efficacy of electrical stimulation (313 participants), three trials studied exercises (199 participants), and five studies combined some form of physical therapy and compared with acupuncture (360 participants). There is evidence from a single study of moderate quality that exercises are beneficial to people with chronic facial palsy when compared with controls and from another low quality study that it is possible that facial exercises could help to reduce synkinesis (a complication of Bell's palsy), and the time to recover. There is insufficient evidence to decide whether electrical stimulation works, to identify risks of these treatments or to assess whether the addition of acupuncture to facial exercises or other physical therapy could produce improvement. In conclusion, tailored facial exercises can help to improve facial function, mainly for people with moderate paralysis and chronic cases, and early facial exercise may reduce recovery time and long term paralysis in acute cases, but the evidence for this is of poor quality. More trials are needed to assess the effects of facial exercises and any risks.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

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