Bell Palsy – Prednisolone — SCE Neurology MCQ

Correct answer: C — Start oral prednisolone now and protect the exposed eye

The best answer is “Start oral prednisolone now and protect the exposed eye”. For Bell palsy, corticosteroids started within 72 hours improve facial recovery; incomplete closure also requires lubrication, taping or other eye-protection measures to prevent exposure keratopathy. “Use aciclovir alone without corticosteroid or eye care” is less appropriate because antiviral monotherapy has not shown the recovery benefit of prompt corticosteroids and does not address corneal exposure “defer the planned intervention for two weeks to confirm persistent weakness” is less appropriate because the evidence-supported treatment window would be lost “Patch both eyes continuously without lubricating the affected eye” is less appropriate because the unaffected eye need not be occluded and the exposed cornea requires lubrication and closure support “Begin long-term levodopa for facial bradykinesia” is less appropriate because a peripheral facial neuropathy is not dopamine-responsive bradykinesia

Reference: Bell’s palsy: treatment and prognosis. https://pmc.ncbi.nlm.nih.gov/articles/PMC3980711/