Oral steroids for bell's palsy

As a glucocorticoid , the lipophilic structure of prednisolone allows for easy passage through the cell membrane where it then binds to its respective glucocorticoid receptor (GCR) located in the cytoplasm. Upon binding, formation of the GC/GCR complex causes dissociation of chaperone proteins from the glucocorticoid receptor enabling the GC/GCR complex to translocate inside the nucleus. This process occurs within 20 minutes of binding. Once inside the nucleus, the homodimer GC/GCR complex binds to specific DNA binding-sites known as glucocorticoid response elements (GREs) resulting in gene expression or inhibition. Complex binding to positive GREs leads to synthesis of anti-inflammatory proteins while binding to negative GREs block the transcription of inflammatory genes. [28]

Oral corticosteroids have traditionally been prescribed to reduce facial nerve inflammation in patients with Bell's palsy. Prednisone is typically prescribed in a 10-day tapering course starting at 60 mg per day. A 2004 Cochrane review and meta-analysis of three randomized controlled trials comparing corticosteroids with placebo found small and statistically nonsignificant reductions in the percentage of patients with incomplete recovery after six months (relative risk [RR] = ; 95% confidence interval [CI], to ) and the percentage of patients with cosmetic complications (RR = ; 95% CI, to ). 14 However, these trials included only 117 patients; larger prospective trials are needed to establish the benefit of corticosteroids.

Oral steroids for bell's palsy

oral steroids for bell's palsy

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