Wyselone dose in bell's palsy
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"Bell's palsy" AND prednisolone AND corticosteroid
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Wyselone (Prednisolone) in Bell's Palsy
Wyselone is a brand name for prednisolone. Here is the evidence-based dosing:
Recommended Dose
| Regimen | Details |
|---|---|
| Prednisolone 50 mg/day x 10 days | Most widely used; preferred in guidelines |
| Prednisone 60 mg/day x 5 days, then taper over 5 days | Equivalent alternative |
Guidelines recommend a 10-day course of oral corticosteroids with at least 5 days of high dose (prednisolone 50 mg for 10 days, or prednisone 60 mg for 5 days with a 5-day taper).
- Rosen's Emergency Medicine, p. 1498
Adams and Victor's Neurology states: prednisone 40-60 mg/day (or equivalent glucocorticoid) during the first week to 10 days after onset.
- Adams and Victor's Principles of Neurology, 12th Ed., p. 1371
Key Points
- Start within 72 hours of symptom onset - early treatment significantly improves outcomes
- Corticosteroids reduce the risk of residual facial weakness (NNT = 10 to prevent one case of permanent weakness)
- Antivirals alone are less effective than steroids alone; combination therapy adds little benefit for most patients
- Eye protection is mandatory - use artificial tears, lubricating ointment at night, and protective glasses due to incomplete eyelid closure
Antivirals (if added)
For Bell's palsy with complete facial palsy, some evidence (Hato et al.) suggests valacyclovir + prednisolone may offer additive benefit over steroids alone, though this is not universally recommended.
For Ramsay Hunt syndrome (not Bell's palsy), antivirals (acyclovir 400 mg 5x/day or valacyclovir 1000 mg TID x 7-10 days) are recommended alongside steroids.
Recent evidence (2024): A systematic review and meta-analysis (PMID 37940744) compared oral vs. IV steroids in Bell's palsy - oral prednisolone remains the standard route with no proven advantage of IV dosing.
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