Bell's Palsy Epidemiology

The annual incidence of Bell palsy is about 20 per 100,000 population, and the incidence increases with age. Bell’s palsy affects about 40,000 people in the United States every year. It affects approximately 1 person in 65 during a lifetime. Familial inheritance has been found in 4–14% of cases. Bell's Palsy is three times more likely to strike pregnant women than non-pregnant women. It is also considered to be four times more likely to occur in diabetics than the general population.

A range of annual incidence rates have been reported in the literature: 15, and 25-53

Treatment of Bell's palsy is a matter of controversy. Two Cochrane reviews from 2004 underlined the need for larger, properly designed clinical trials to evaluate antiviral drugs or corticosteroids for Bell's palsy. The effect of treatment is difficult to evaluate experimentally because spontaneous recovery (without any treatment) is common.

Steroids

Prednisone, a corticosteroid, if used early in treatment of Bell's palsy, significantly improves the chances of complete recovery at 3 and 9 months when compared to treatment with the anti-viral drug aciclovir or no treatment at all.

Antivirals

The possible link between Bell's palsy and the herpes simplex and varicella zoster virus has led to the prescription of anti-viral medications (such as aciclovir or valaciclovir) to patients with unexplained facial palsy. Recently (2007), a large randomized clinical trial reported no additional benefit from acyclovir beyond that from prednisone alone.

Alternative treatments

The efficacy of acupuncture remains unknown because the available studies are of low quality (poor primary study design or inadequate reporting practices). Surgical procedures to decompress the facial nerve have been attempted, but have not been proven beneficial.

Bell's Palsy Epidemiology

Steroids

Antivirals

Alternative treatments

Further Reading