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Acupuncture for Bell's palsy

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Abstract

Background

Bell's palsy or idiopathic facial palsy is an acute facial paralysis due to inflammation of the facial nerve. A number of studies published in China have suggested acupuncture is beneficial for facial palsy.

Objectives

The objective of this review was to examine the efficacy of acupuncture in hastening recovery and reducing long‐term morbidity from Bell's palsy.

Search methods

We searched the Cochrane Neuromuscular Disease Group Register, MEDLINE (January 1966 to December 2002), EMBASE (January 1980 to December 2002), LILACS (from January 1982 to December 2002) and the Chinese Biomedical Retrieval System (January 1978 to December 2002) for randomised controlled trials using 'Bell's palsy' and its synonyms, 'idiopathic facial paralysis' or 'facial palsy' as well as search terms including 'acupuncture'. Chinese journals in which we thought we might find randomised controlled trials or controlled clinical trials relevant to our study were handsearched. We reviewed the bibliographies of the randomised trials and contacted the authors and known experts in the field to identify additional published or unpublished data.

Selection criteria

We included all randomised or quasi‐randomised controlled trials involving acupuncture in the treatment of Bell's palsy irrespective of any language restrictions.

Data collection and analysis

Two reviewers identified potential articles from the literature search and extracted data independently using a data extraction form. The assessment of methodological quality included allocation concealment, patient blinding, differences at baseline of the experimental groups and completeness of follow‐up. Two reviewers assessed quality independently. All disagreements were resolved by discussion between the reviewers.

Main results

Three studies including a total of 288 patients met the inclusion criteria. Two of them used acupuncture while the third used acupuncture combined with drugs. No trials reported on the outcomes specified for this review.

Three included studies showed that the therapeutic effect of acupuncture alone was superior to that of medication or that acupuncture combined with medication was better than medication alone. Harmful side‐effects were not reported in any of the trials. Flaws in study design or reporting (particularly uncertain allocation concealment and substantial loss to follow‐up) and clinical differences between trials prevented a meta‐analysis.

Authors' conclusions

The quality of the included trials was inadequate to allow any conclusion about the efficacy of acupuncture. More research with high quality trials is needed.

Plain language summary

More evidence is needed to show whether acupuncture is beneficial for Bell's palsy

Bell's palsy is a disease in which one side of the face is paralysed. The theoretical basis of Traditional Chinese Medicine predicts that acupuncture would promote recovery from Bell's palsy. This review found insufficient evidence from randomised trials to decide whether acupuncture is helpful. More research is needed.