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Prednisolone in Bell's Palsy Related to Treatment Start and Age.

Axelsson, Sara LU ; Berg, Thomas; Jonsson, Lars; Engström, Mats; Kanerva, Mervi; Pitkäranta, Anne and Stjernquist-Desatnik, Anna LU (2011) In Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology Dec. p.141-146
Abstract
OBJECTIVE:: To evaluate if treatment start and age are related to the outcome in Bell's palsy patients treated with prednisolone. STUDY DESIGN:: Prospective, randomized, double-blind, placebo-controlled, multicenter trial. SETTING:: Sixteen otorhinolaryngologic centers in Sweden and 1 in Finland. PATIENTS:: Data were collected from the Scandinavian Bell's palsy study. A total of 829 patients were treated within 72 hours of onset of palsy. Follow-up was 12 months. INTERVENTION:: Patients were randomly assigned to treatment with placebo plus placebo (n = 206), prednisolone plus placebo (n = 210), valacyclovir plus placebo (n = 207), or prednisolone plus valacyclovir (n = 206). MAIN OUTCOME MEASURES:: Facial function was assessed with the... (More)
OBJECTIVE:: To evaluate if treatment start and age are related to the outcome in Bell's palsy patients treated with prednisolone. STUDY DESIGN:: Prospective, randomized, double-blind, placebo-controlled, multicenter trial. SETTING:: Sixteen otorhinolaryngologic centers in Sweden and 1 in Finland. PATIENTS:: Data were collected from the Scandinavian Bell's palsy study. A total of 829 patients were treated within 72 hours of onset of palsy. Follow-up was 12 months. INTERVENTION:: Patients were randomly assigned to treatment with placebo plus placebo (n = 206), prednisolone plus placebo (n = 210), valacyclovir plus placebo (n = 207), or prednisolone plus valacyclovir (n = 206). MAIN OUTCOME MEASURES:: Facial function was assessed with the Sunnybrook grading system, and complete recovery was defined as Sunnybrook = 100. Time from onset of palsy to treatment start was registered. RESULTS:: Patients treated with prednisolone within 24 hours and 25 to 48 hours had significantly higher complete recovery rates, 66% (103/156) and 76% (128/168), than patients given no prednisolone, 51% (77/152) and 58% (102/177) (p = 0.008 and p = 0.0003, respectively). For patients treated within 49 to 72 hours of palsy onset, there were no significant differences. Patients aged 40 years or older had significantly higher complete recovery rates if treated with prednisolone, whereas patients aged younger than 40 years did not differ with respect to prednisolone treatment. However, synkinesis was significantly less in patients younger than 40 years given prednisolone (p = 0.002). CONCLUSION:: Treatment with prednisolone within 48 hours of onset of palsy resulted in significantly higher complete recovery rates and less synkinesis compared with no prednisolone. (Less)
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Contribution to journal
publication status
published
subject
in
Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology
volume
Dec
pages
141 - 146
publisher
Lippincott Williams & Wilkins
external identifiers
  • WOS:000285334400029
  • PMID:21099725
  • Scopus:78650725199
ISSN
1537-4505
DOI
10.1097/MAO.0b013e3182009f35
language
English
LU publication?
yes
id
25d8fe23-9176-4ee4-9dcb-4a75a1723ba6 (old id 1731617)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/21099725?dopt=Abstract
date added to LUP
2010-12-01 13:32:52
date last changed
2017-01-01 07:44:35
@article{25d8fe23-9176-4ee4-9dcb-4a75a1723ba6,
  abstract     = {OBJECTIVE:: To evaluate if treatment start and age are related to the outcome in Bell's palsy patients treated with prednisolone. STUDY DESIGN:: Prospective, randomized, double-blind, placebo-controlled, multicenter trial. SETTING:: Sixteen otorhinolaryngologic centers in Sweden and 1 in Finland. PATIENTS:: Data were collected from the Scandinavian Bell's palsy study. A total of 829 patients were treated within 72 hours of onset of palsy. Follow-up was 12 months. INTERVENTION:: Patients were randomly assigned to treatment with placebo plus placebo (n = 206), prednisolone plus placebo (n = 210), valacyclovir plus placebo (n = 207), or prednisolone plus valacyclovir (n = 206). MAIN OUTCOME MEASURES:: Facial function was assessed with the Sunnybrook grading system, and complete recovery was defined as Sunnybrook = 100. Time from onset of palsy to treatment start was registered. RESULTS:: Patients treated with prednisolone within 24 hours and 25 to 48 hours had significantly higher complete recovery rates, 66% (103/156) and 76% (128/168), than patients given no prednisolone, 51% (77/152) and 58% (102/177) (p = 0.008 and p = 0.0003, respectively). For patients treated within 49 to 72 hours of palsy onset, there were no significant differences. Patients aged 40 years or older had significantly higher complete recovery rates if treated with prednisolone, whereas patients aged younger than 40 years did not differ with respect to prednisolone treatment. However, synkinesis was significantly less in patients younger than 40 years given prednisolone (p = 0.002). CONCLUSION:: Treatment with prednisolone within 48 hours of onset of palsy resulted in significantly higher complete recovery rates and less synkinesis compared with no prednisolone.},
  author       = {Axelsson, Sara and Berg, Thomas and Jonsson, Lars and Engström, Mats and Kanerva, Mervi and Pitkäranta, Anne and Stjernquist-Desatnik, Anna},
  issn         = {1537-4505},
  language     = {eng},
  pages        = {141--146},
  publisher    = {Lippincott Williams & Wilkins},
  series       = {Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology},
  title        = {Prednisolone in Bell's Palsy Related to Treatment Start and Age.},
  url          = {http://dx.doi.org/10.1097/MAO.0b013e3182009f35},
  volume       = {Dec},
  year         = {2011},
}