Underlying medical conditions which lead to facial nerve disorder are treated specifically according to the condition detected. Cortisone medications (corticosteroids) are the best treatment for Bell's palsy, and it is recommended that all patients be treated. The usually amount is one milligram per kilogram body weight of prednisone (or steroid alternative) per day. Recently, antiviral medications like acyclovir (Zovirax) given in a dose of 200 to 400 milligrams five times per day for five days have been demonstrated to increase recovery. After five days of treatment, if the paralysis improves, the acyclovir is stopped and the steroids can be tapered (gradually discontinued) over the next five days. If the paralysis is still complete after five days, then the same dose of both medications are continued for another five days, then the steroids are tapered over the next five days.
Physical therapy and electrotherapy probably have no significant benefit. Surgical facial nerve decompression is controversial in Bell's palsy. Some physicians recommend surgical decompression during the first two weeks in patients showing the most severe nerve degeneration.
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