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. 2025 Apr 9;17(4):e81949.
doi: 10.7759/cureus.81949. eCollection 2025 Apr.

High-Dose Corticosteroid Therapy in Facial Nerve Palsy: A Retrospective Study

Hiroshi Hyakusoku  1 , Noriyuki Katsumata  1 , Meijin Nakayama  1
Affiliations

High-Dose Corticosteroid Therapy in Facial Nerve Palsy: A Retrospective Study

Hiroshi Hyakusoku et al. Cureus. .

Abstract

Objectives The difference in therapeutic efficacy between an initial dosage of 200 mg and 100 mg prednisolone (PSL) with a taper for Bell's palsy and Ramsay Hunt syndrome was retrospectively investigated. Methods A total of 259 patients (172 with Bell's palsy and 87 with Ramsay Hunt syndrome) were treated with high-dose corticosteroid therapy (HDCT) with PSL (the standard HDCT: 200 mg/day for three days with a seven-day taper, or the reduced HDCT: 100 mg/day for three days with a seven-day taper) and evaluated once a month by the Yanagihara facial nerve grading system until facial nerve paralysis was cured or six months after the onset. Results The therapeutic efficacy of the standard HDCT was not significantly improved, compared to the reduced HDCT, in Bell's palsy and Ramsay Hunt syndrome, and even in less than 20.0% of electroneuronography in Bell's palsy and Ramsay Hunt syndrome. Conclusion HDCT with more than an initial dosage of 100 mg/day PSL with a taper for Bell's palsy and Ramsay Hunt syndrome does not increase the therapeutic efficacy.

Keywords: bell’s palsy; facial nerve paralysis; high-dose corticosteroid therapy; prednisolone; ramsay hunt syndrome.

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Conflict of interest statement

Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. The Ethics Committee of Yokosuka Kyosai Hospital, Yokosuka, Japan issued approval 24-1. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Comparison of therapeutic efficacy for Bell’s palsy patients between the 100 mg and 200 mg PSL dosage groups
A) YFGS, B) Recovery rates Both YFGS and recovery rates were not significantly different at any time point between the 100 mg and 200 mg PSL dosage groups; bars denote SD YFGS, Yanagihara facial nerve grading system; PSL, Prednisolone
Figure 2
Figure 2. Comparison of therapeutic efficacy for Ramsay Hunt syndrome patients between the 100 mg and 200 mg PSL dosage groups.
A) YFGS, B) Recovery rates Both YFGS and recovery rates were not significantly different at any time point between the 100 mg and 200 mg PSL dosage groups; bars denote SD YFGS, Yanagihara facial nerve grading system; PSL, Prednisolone
Figure 3
Figure 3. Comparison of therapeutic efficacy for patients with less than 20.0% ENoG between the 100 mg and 200 mg PSL dosage groups.
A) YFGS, B) Recovery rates Both YFGS and recovery rates were not significantly different at any time point between the 100 mg and 200 mg PSL dosage groups; bars denote SD YFGS, Yanagihara facial nerve grading system; PSL, Prednisolone; ENoG, Electroneuronography
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References

    1. Bell palsy and herpes simplex virus: identification of viral DNA in endoneurial fluid and muscle. Murakami S, Mizobuchi M, Nakashiro Y, Doi T, Hato N, Yanagihara N. Ann Intern Med. 1996;124:27–30. - PubMed
    1. The etiology of Bell's palsy: a review. Zhang W, Xu L, Luo T, Wu F, Zhao B, Li X. J Neurol. 2020;267:1896–1905. - PMC - PubMed
    1. Sencen L. Ramsay Hunt syndrome. [ Apr; 2025 ]. 2024. https://rarediseases.org/rare-diseases/ramsay-hunt-syndrome/ https://rarediseases.org/rare-diseases/ramsay-hunt-syndrome/
    1. Bell's palsy: the spontaneous course of 2,500 peripheral facial nerve palsies of different etiologies. Peitersen E. Acta Otolaryngol Suppl. 2002;4:30. - PubMed
    1. Yanagihara facial nerve grading system as a prognostic tool in Bell's palsy. Hato N, Fujiwara T, Gyo K, Yanagihara N. Otol Neurotol. 2014;35:1669–1672. - PubMed

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