de Ru J A, van Benthem P P G, Hordijk G J
Universitair Medisch Centrum Utrecht, afd. Keel-, Neus- en Oorheelkunde, Postbus 85.500, 3508 GA Utrecht.
Ned Tijdschr Geneeskd. 2005 Jun 25;149(26):1454.
Some clinicians claim a spontaneous complete recovery of facial nerve function after Bell's palsy in more than 80% of patients. However, for elderly patients and patients with a severe paresis/paralysis this is not the case. The main cause of Bell's palsy is probably reactivation of latent herpes viruses. Recent literature supports treatment with corticosteroids and antiviral medication, inhibiting viral replication and reducing oedema in the bony canal of the facial nerve. Using this medication in the first days of the disease provides a further 15% of patients with a good outcome in addition to the ones that improve spontaneously. Therefore, prednisone and valacyclovir are recommended for all patients with Bell's palsy and severe dysfunction, i.e. House-Brackmann facial grading scale IV, V and VI.
一些临床医生称，超过80%的贝尔面瘫患者面神经功能可自发完全恢复。然而，老年患者以及重度轻瘫/瘫痪患者并非如此。贝尔面瘫的主要病因可能是潜伏性疱疹病毒的再激活。近期文献支持使用皮质类固醇和抗病毒药物进行治疗，这些药物可抑制病毒复制并减轻面神经骨管内的水肿。在疾病发作的头几天使用这种药物，除了自发改善的患者外，还能使另外15%的患者获得良好预后。因此，对于所有贝尔面瘫且功能严重障碍（即House-Brackmann面神经分级量表IV级、V级和VI级）的患者，推荐使用泼尼松和伐昔洛韦。
