Hyakusoku Hiroshi, Katsumata Noriyuki, Nakayama Meijin
Otorhinolaryngology, Yokosuka Kyosai Hospital, Yokosuka, JPN.
Cureus. 2025 Apr 9;17(4):e81949. doi: 10.7759/cureus.81949. eCollection 2025 Apr.
Objectives The difference in therapeutic efficacy between an initial dosage of 200 mg and 100 mg prednisolone (PSL) with a taper for Bell's palsy and Ramsay Hunt syndrome was retrospectively investigated. Methods A total of 259 patients (172 with Bell's palsy and 87 with Ramsay Hunt syndrome) were treated with high-dose corticosteroid therapy (HDCT) with PSL (the standard HDCT: 200 mg/day for three days with a seven-day taper, or the reduced HDCT: 100 mg/day for three days with a seven-day taper) and evaluated once a month by the Yanagihara facial nerve grading system until facial nerve paralysis was cured or six months after the onset. Results The therapeutic efficacy of the standard HDCT was not significantly improved, compared to the reduced HDCT, in Bell's palsy and Ramsay Hunt syndrome, and even in less than 20.0% of electroneuronography in Bell's palsy and Ramsay Hunt syndrome. Conclusion HDCT with more than an initial dosage of 100 mg/day PSL with a taper for Bell's palsy and Ramsay Hunt syndrome does not increase the therapeutic efficacy.
目的 回顾性研究泼尼松龙（PSL）初始剂量200 mg与100 mg减量治疗贝尔面瘫和拉姆齐·亨特综合征的疗效差异。方法 共有259例患者（172例贝尔面瘫患者和87例拉姆齐·亨特综合征患者）接受了PSL大剂量皮质类固醇治疗（HDCT）（标准HDCT：200 mg/天，连用3天，然后7天减量；或减量HDCT：100 mg/天，连用3天，然后7天减量），并每月通过柳原面神经分级系统进行评估，直至面神经麻痹治愈或发病后6个月。结果 在贝尔面瘫和拉姆齐·亨特综合征中，标准HDCT与减量HDCT相比，疗效并未显著提高，在贝尔面瘫和拉姆齐·亨特综合征中，即使在不到20.0%的神经电图检查中也是如此。结论 对于贝尔面瘫和拉姆齐·亨特综合征，初始剂量超过100 mg/天PSL减量的HDCT不会提高治疗效果。
