In Bell Palsy, which therapy is most beneficial when started within 72 hours of onset?

• A. Prednisone started within 72 hours of onset
• B. Antibiotics
• C. Acyclovir
• D. No treatment

Answer: (A)

Early corticosteroid therapy is the most beneficial approach for Bell palsy when started within 72 hours of onset. The facial nerve runs through a very narrow bony canal, so inflammation and swelling can compress the nerve and worsen damage. Prednisone helps reduce this inflammation, improving the likelihood of nerve preservation and faster recovery. The benefit is time-sensitive; after about 3 days, swelling may cause more irreversible injury, and steroids are less effective. Antibiotics aren’t indicated unless there’s a bacterial infection, and antivirals like acyclovir haven’t shown consistent benefit for typical Bell palsy, so they’re not as helpful as timely corticosteroid treatment.