Recent developments in Bell's palsy: Summary of responses

EDITOR—Holland and Weiner's clinical review on recent developments in Bell's palsy prompted 24 responses, 10 of them critical of the views on treatment.1 The authors were wrong to recommend early treatment with steroids or antiviral agents, or both, because the supporting evidence they offered was inconclusive and flawed; they ignored the best evidence (two systematic reviews) and selected other trials to support their own opinion; neither treatment is harmless, and antiviral agents are expensive; and they glossed other potentially useful treatments.

A physiotherapist thought the review a bit light on facial retraining for people with residual paralysis, and a surgeon from Seattle wanted more on the potential benefits of decompression surgery. A patient said that speech therapy …