Corticosteroids are highly effective in recovering of facial nerve function. Antivirals should not be given as monotherapy as theres no clear benefit compared to placebo for these patients. They can be offered in addition to steroids within 72 hours of symptom onset.
We’ll start all patients with Bell’s Palsy on prednisone 40 to 60 mg po qday with a 10-day tapering course. Caution in diabetics with steroid-induced hyperglycemia. For antivirals, acyclovir 400 mg five times daily or valacyclovir 1gm TID x 7 days and up to 10 for immunocompromised.
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