Therapy target
- Improvement of the symptomatology
Therapy recommendations
- Therapy depends on the cause of the disease (borrelia e.g. antibiotics).
- Virostatics (agents that inhibit viral replication) are indicated only when varicella zoster virus (VZV) is the cause of facial paresis.
- In idiopathic peripheral facial nerve palsy, a so-called steroid shock therapy (prednisiolone/glucocorticoids) is given for 10 days
- Symptomatic measures:
- Artificial tears (liposomal eye spray).
- Dexpanthenol eye ointment
- Watch glass bandage (at night) for incomplete eyelid closure.
- Adjuvant measure: injections of botulinum toxin to treatimprove synkinesia, such as involuntary eyelid closure during speech, or to restore symmetry.
- See also under “Other therapy.”
Further notes
- Glucocorticoids resulted in significant improvement compared with placebos.
- Patients with severe Bell’s palsy benefited from a combination of glucocorticoids and antivirals in idiopathic facial palsy. Note: Fatal interaction: brivudine and 5-fluoropyrimidines.
- In facial nerve palsy due to Borrelia, glucocorticoids may delay healing of facial nerve palsy. Note: Often in these cases, facial nerve palsy is bilateral (on both sides).
