A 28-year-old woman presents within 72 hours of onset of complete unilateral Bell's palsy. She has no contraindication to corticosteroids and has normal blood glucose. According to current evidence-based practice, the recommended treatment is:

• A Observation with eye protection only, since 85% recover spontaneously regardless
• B Oral acyclovir alone for 7 days
• C Intravenous methylprednisolone pulse therapy followed by physiotherapy alone
• D Oral prednisolone 1 mg/kg/day for 5 days, then tapered over the next 5 days ✓

Explanation

High-dose oral steroids started within 72 hours improve complete recovery rates in Bell's palsy; the accepted regimen is prednisolone 1 mg/kg/day (typically 60 to 80 mg) for 5 days followed by taper over 5 more days. Acyclovir alone is inferior and is added to steroids only when a viral cause is strongly suspected, killing option B. Observation alone underuses proven benefit in this complete palsy, and IV pulses have no advantage over oral dosing.

Reference: Katzung's Basic and Clinical Pharmacology, 15th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.