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Reactivation of Herpes Simplex Virus Type 1 and Varicella‐Zoster Virus and Therapeutic Effects of Combination Therapy With Prednisolone and Valacyclovir in Patients With Bell's Palsy
Author(s) -
Kawaguchi Kazuhiro,
Inamura Hiroo,
Abe Yasuhiro,
Koshu Hidehiro,
Takashita Emi,
Muraki Yasushi,
Matsuzaki Yoko,
Nishimura Hidekazu,
Ishikawa Hitoshi,
Fukao Akira,
Hongo Seiji,
Aoyagi Masaru
Publication year - 2007
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1097/01.mlg.0000248737.65607.9e
Subject(s) - prednisolone , medicine , varicella zoster virus , valaciclovir , herpes simplex virus , palsy , bell's palsy , methylprednisolone , gastroenterology , herpesviridae , virus , virology , viral disease , pathology , alternative medicine
Objectives: To 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 Design: Randomized, multicenter, controlled study. Methods: One 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. Results: Reactivation 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. Conclusions: Reactivation 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.