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Translating Uncertainty Into Practice

John F. Steiner, MD, MPH

JAMA. 2009;302(9):1003-1004.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Bell palsy is an inflammatory condition of the facial nerve that is associated with herpes simplex or varicella virus infections and can result in temporary or permanent facial disfigurement and pain. With an annual incidence of 13 to 43 per 100 000 population, more than 60 000 cases are diagnosed each year in the United States.^1-2 Approximately 15% of patients with Bell palsy will have persistent facial nerve dysfunction and related impairments in quality of life.³

Evidence about the efficacy of medications for improving the resolution of Bell palsy has accumulated rapidly in recent years. Both corticosteroids and antiviral agents such as acyclovir and valacyclovir have been extensively studied in randomized controlled trials. In 2004, a systematic review of 4 trials suggested that corticosteroids were not superior to placebo.⁴ However, 2 large randomized controlled trials published in 2007 and 2008 showed that short-term corticosteroid use significantly improved . . . [Full Text of this Article]

Author Affiliation: Institute for Health Research, Kaiser Permanente Colorado, Denver, Colorado.

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