Bell Palsy Treatment

J. M. K. Murthy and Amrit B. Saxena. Bell's

palsy: Treatment guidelines. Ann Indian Acad
Neurol. 2011 July.

CMAJ. Vol. 186, Issue 12. 2 Sep 2014:

Management of Bell palsy: clinical practice
guideline by John R, etc
Corticosteroids
• co: prednisone, prednisolone
• The recommended dose of prednisone for the treatment of Bell palsy
is 1 mg/kg or 60 mg/day for 6 days, followed by a taper, for a total of
10 days. (Medscape)
• 10-day course of oral steroids with at least 5 days at a high dose
(either prednisolone 50 mg (25mg x2) for 10 days or prednisone 60
mg for 5 days with a 5-day taper). (jurnal AAO)
MoA
• inhibisi pelepasan fosfolipase A2 dan inhibisi faktor transkripsi aktifasi gen pro
inflamasi
• decrease inflammation by inhibition of migration of PMN and reversal of
increased capillary permeability.
• supresses immune system by reducing the activity and production of
lymphocytes and eosinophil.
• Kontraindikasi:
• prednisolone: herpes simplex keratitis, infeksi sistemik
• prednisone: infeksi jamur sistemik
• Efek samping:
• prednisolone: allergic reaction, kejang, hipokalemia, sakit kepala, pusing
• prednisone: allergic reaction, mata kabur, hipokalemia, hipertensi
Antiviral
• monotheraphy, tidak dianjurkan
• kombinasi antiviral dan steroid, optional
• valacyclovir: 1000 mg p.o per hari, diberikan 5-7 hari
• acyclovir: 400 mg p.o, 5 kali sehari, diberikan 10 hari
• mekanisme kerja:
Aciclovir triphosphate inhibits DNA synthesis and viral replication by
competing with deoxyguanosine triphosphate for viral DNA polymerase
and being incorporated into viral DNA
Eye protective
• Use of sunglasses
• Frequent administration of lubricating ophthalmic drops
• Frequent administration of ophthalmic ointments
• Use of a moisture chamber using a polyethylene cover
• Eye patching or taping
• Combination of the above treatment

Clinical Practice Guideline: Bell’s Palsy. Journal American

Academy of Otolaryngology—Head and Neck Surgery. 2013
Referensi
• http://www.cmaj.ca/content/186/12/917#F1
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3152161/
• https://www.entnet.org/content/clinical-practice-guideline-bells-
palsy
• MIMS