The cause of Bell's palsy is
uncertain: A viral neuritis caused by such agents as herpes simplex or
herpes zoster is a possible mechanism, even in patients who do not have a
skin eruption. This possibility has led to the widespread empiric use of
such antiviral agents as acyclovir or fam-ciclovir (usually in addition to
corticosteroid treatment) in an attempt to improve Bell's palsy recovery
rates. The cost of these agents and the residual uncertainty about the
efficacy of corticosteroids makes it important that an RCT with enough
power to evaluate both cortico-steroid and antiviral therapy in patients
with Bell's palsy be done in the near future.
There are no medications specifically approved to treat Bell's palsy. Underlying medical conditions that lead to facial nerve disorder are treated specifically according to the specific condition that is responsible for the damage to the nerve. Steroid medications ( corticosteroids ) are the best treatment for Bell's palsy, and it is recommended that all patients be treated. The usual amount is one milligram per kilogram body weight of prednisone (or steroid alternative) per day for 7 to 14 days. Recently, antiviral medications like acyclovir ( Zovirax ) given in conjunction with steroids have been demonstrated to increase recovery. Doses of the antiviral agent will vary with the drug chosen.