• Kazuhiro Kawaguchi, Hiroo Inamura, Yasuhiro Abe, Hidehiro Koshu, Emi Takashita, Yasushi Muraki, Yoko Matsuzaki, Hidekazu Nishimura, Hitoshi Ishikawa, Akira Fukao, Seiji Hongo, and Masaru Aoyagi.
• Department of Otolaryngology, Yamagata University School of Medicine, Yamagata, Japan. kazukawa@med.id.yamagata-u.ac.jp
• Laryngoscope. 2007 Jan 1;117(1):147-56.

ObjectivesTo determine whether reactivation of herpes simplex virus (HSV) type 1 or varicella-zoster virus (VZV) is the main cause of Bell's palsy and whether antiviral drugs bring about recovery from Bell's palsy.Study DesignRandomized, multicenter, controlled study.MethodsOne hundred fifty patients with Bell's palsy were enrolled in this study. The patients were randomly assigned to a prednisolone group or a prednisolone-valacyclovir group, in whom virologic examinations for HSV-1 and VZV were performed by simple randomization scheme in sealed envelopes. The recovery rates among various groups were analyzed using the Kaplan-Meier method and the Cox proportional hazards model.ResultsReactivation of HSV-1, VZV, and both viruses was detected in 15.3%, 14.7%, and 4.0% of patients, respectively. There was no significant difference in recovery rates between the prednisolone group and the prednisolone-valacyclovir group, although recovery in the patients with HSV-1 reactivation tended to be higher in the prednisolone-valacyclovir group than in the prednisolone group. There was a significant difference in recovery among age groups and between individuals with complete and incomplete paralysis.ConclusionsReactivation of HSV-1 or VZV was observed in 34% of the patients with Bell's palsy. The effect of combination therapy with prednisolone and valacyclovir on recovery was not significantly higher than that with prednisolone alone.

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