Based on the pathophysiology of
Bell's palsy that
edema as well as
ischemia lead to both compression and
hypoxia, Stennert employed high doses of
cortisone and
dextran and reported a high recovery rate. In the past 5 years, we have been treating patients with
Bell's palsy and Hunt syndrome with a high dose of
steroids or low-molecular
dextran (SD
therapy). SD
therapy was administrated in 71 cases of Hunt syndrome, and the results were compared with those of a group of 36 patients who had been treated with orally administrated low-dose
steroids. All patients with incomplete
palsies recovered completely, regardless of the mode of treatment. In cases of complete
palsy, 62% of patients recovered completely when treated with SD
therapy. In contrast, 29% of the patients treated with orally administrated
steroids recovered completely. These results indicate that for patients with complete
palsy SD
therapy is more effective than oral
steroid therapy, while patients with incomplete
palsy recover completely with oral
steroids. On the basis of this study, oral
steroids are best used in cases of incomplete
palsy unless complete
palsy develops. In these latter cases, we now believe that SD
therapy should be started immediately.