JOURNAL READING

Comparison of acyclovir and famciclovir for the treatment of Bell’s palsy

Pembimbing :
dr. Untung Gunarto, Sp.S

Disusun Oleh:
Khusnul Khotimah
1620221217

RSUD PROF. DR. MARGONO SOEKARJO

SMF ILMU PENYAKIT SYARAF
UNIVERSITAS PEMBANGUNAN NASIONAL “VETERAN”
FAKULTAS KEDOKTERAN
PURWOKERTO
@017
 Introduction
HSV (Herpes S. Virus) Infection Mechanism
Bells Palsy most common has been reported as led to
cranial nerve Lesion etiology in most case cytotoxic edema 
20/100000 indv neuronal edema
Found in endoneural fluid of
Geniculate ganglions
Ischemia neuropathy
Unknown Etiology

3 Kind of antivrus

Acyclovir

Corticosteroid
Recently, Combination
Corticosteroids as an corticosteroid w/
Valacyclovir
effective initial treatment antivirus agent 
more effective
Famcilovir

Less is known about comparative effectiveness

 Materials and Method
Patient Bells Palsy Exclusion Review Demographic
+ Medical Data
Kyung Hee Medical Center >7d after onset symptoms
Otolaryngology Dept Lack of prev. Medication
Jan 2006- Jan 2014 Traumatic palsy Hypertension
Post surgical palsy
Presence other neurologic disease Diabetes Mellitus
Cerebellopontine lesion (MRI/CTs)

Function Categorizing Grade >2  Incomplete Recovery

House-Brackmann (HB) scale
Initial and Final treatment
6 grade Grade <2  Complete Recovery

Electronneurography (ENoG) Max. Amplitude Affected Side

5-14 days after onset symp. X 100%
Healthy vs. Affected side Max Amplitude Healthy Side
 Statistical Analysis
Group Famciclovir Group Acyclovir

Compared

Chi Square Metaanalysis

P<0.05  Estimate Success Rate
SIGNIFICANCE Odds Ratio (OR)
 Results
Comparison of recovery rates in patients with Bell’s palsy according to initial
severity

Comparison of recovery rates in patients with Bell’s palsy according to

electroneurography
 Results
Comparison of recovery rates in patients with Bell’s palsy
according to underlying disease
 Conclusion
Combined treatment with prednisolone and
famciclovir may be superior to prednisolone and
acyclovir in patients with severe Bell’s palsy